MD, PhD, FMedSci, FSB, FRCP, FRCPEd

A short report about a Scottish legal case is worth a mention, I think.

Honor Watt, 73 had sued Lothian Health Board after the authority stopped in June 2013 to provide homeopathic treatments to patients. Ms Watt, an arthritis sufferer, had previously received homeopathic medicine for this condition. There is, of course, no good evidence that homeopathic remedies are better than placebos for this (or any other) disease.

Ms Watt’s lawyers decided to challenge the board’s decision in the Court of Session claiming the health board acted illegally. There is reason to believe that Ms Watt was assisted by a professional organisation of homeopathy ( the judgement mentions that the Board’s submission stated that ‘the real force behind the petition was a charity, not the petitioner’).

In any case, Watt’s legal team claimed the Equality Act 2010 placed an obligation on the health board to ask their patients for their views on whether homeopathy should be continued to be funded. The legislation states that public sector organisations have an obligation to consider their decisions on the terms of what is called a public sector equality duty.

The case went to court and the judge, Lord Uist, recently ruled that the health board had acted legally. He therefore refused to overturn the board’s original decision. In a written judgement issued on Friday, Lord Uist confirmed that the health board acted correctly: “It is clear to me from an examination of the relevant documents that the board was from the outset consciously focusing on its PSED.”

The judgement explains that Ms Watt was first referred to the homeopathic service in 2003 when she was suffering from anxiety. Later, she was given a homeopathic medicine for her arthritis after telling her doctor that conventional medicine wasn’t controlling her problems with this condition. In January 2014, she had a final appointment with the homeopathic service and told that she was no longer entitled to homeopathic treatment. However, the judgement states that Ms Watt still receives a prescription of homeopathic medicine.

Lothian Health Board decided to end homeopathic provision after concluding the money would be better spent on conventional treatments. The board made the decision after holding a consultation exercise and concluding that only few NHS users would be affected by their decision. In a report, the reasons for why the board should stop spending money on homeopthy were set out.

Judge Uist confirmed that this report “stated that the withdrawal of funding for homeopathic services would have a limited negative impact on patients and staff, the majority of patients were from more affluent areas and it was felt that they could perhaps afford to self fund alternative provision.”

Ms Watt’s lawyers claimed that the board didn’t do enough to seek the views of those who used the service. They argued that the board broke the terms of the 2010 Equality Act. After examining the evidence, Judge Uist  concluded, however, that the health board had done everything in its power and had made the correct decision: “I am satisfied that reduction of the board’s decision of June 26 2013 would result only in a waste of time and public funds as it would inevitably result in exactly the same decision being taken by the board.”

From my perspective, this is an important decision. As a physician, I naturally dislike not giving patients what they want. However, I dislike it even more when there is not enough money for other patients to have essential treatments. Thus it is obvious that harsh decisions have to be made in order to spend the available funds as rationally as possible – and that, of course, means that treatments for which there is no good evidence must not be funded from public money. Homeopathy clearly falls in that category.

As I am not a lawyer, I see this case with the eyes of a medic and researcher. For me, it is about the age-old question: should patients get the treatment they want or the treatment they need? For me, health care is not a supermarket where people can their trolleys with everything they happen to fancy. For me, health care is not about satisfying the ‘wants’; it is about coping with the needs of people. For me, this is a question of medical ethics. For me, the Scottish judgement is spot on.

20 Responses to Homeopathy: another day in court + another defeat

  • Giving people what they want instead of what they need is utterly irresponsible, and a waste of scarce public resources the tax payer is coughing up with great difficulty. Just look at smokers, alcoholics and drug addicts. This judge made a responsible decision, the only one anyone with some reasoning powers could possibly take.

  • ‘Homeopathy’ and ‘homeopathic services’ should be recast as ‘A system for counselling patients according to the homeopathic tradition’ (inquiry, analysis, diagnosis of ‘constitution’). As Homeopathically prepared (HP) remedies are placebos, placebos could be prescribed (and would be much cheaper than going to the unecessary expese of HP). But surely some patients would content enough with the empathic consultation and not bother with the pillules (which in any case have no effect on any specific condition).

    If my views are disputed, please provide the placebo controlled evidence from randomised patients that HP pillules have an effect that placebos do not (all patients receiving consultation and prescription {not all of which are filled}).

    I am unclear about one thing: “However, the judgement states that Ms Watt still receives a prescription of homeopathic medicine.”
    Who is paying for these remedies?
    Did the judge understand that ‘homeopathic medicine’ is an oxymoron?
    What evidence is there that Ms Watt has benefit from any HP remedy and noy simply the placebo effect of a non-HP pillule (placebo)?

    The judge has confused ‘homeopathy’ with ‘consultation + HP remedy’. The two elements must be distinguished. An empathic consultation provides benefit in homeopathy as it does in medicine. Conflation of the two elements is misleading.

  • People should have a choice but the taxpayers and insurance companies should not be required to fund useless treatments. Homeopaths have brought this upon themselves by continuing to push claims (nosodes) which are a danger to the public and discouraging vaccinations. While treating the walking worried who are willing to pay is one thing, putting people with real diseases at risk is getting them noticed. The more notice the better. Homeopathy is a nice sounding term – it is when one learns what it really means that it becomes very ugly.

  • You really are a load of jerks. I’ve been using homoeopathy for over 40 years. I’ve seen my children cured of whooping cough while traditional doctors did nothing, I’ve been cured of acute nephritis whilst my NHS doctor said only rest would do anything, I’ve witnessed rapid healing of bruises, broken bones, twisted ankles – all aided by homoeopathy. I’ve known women whose painful periods have been ended by homoeopathic treatment. I’ve seen rapid improvement of upset stomachs, bilious attacks, headaches and much more. I’ve seen post operative recovery happen so much faster that even the surgeons noticed.
    The real question you have to answer is why has homoeopathy worked to cure up to 75% of people referred to homoeopathic hospitals that so-called modern medicine has abandoned?
    In my view there’s never just one answer to health problems. If I have a broken leg, I need it splinted or in bad cases operated on. I know that the surgeon has skills that only s/he can perform. What really gets my goat is the sheer ignorance of those who oppose homoeopathy without any experience of it and on the basis of nothing in particular (except blind prejudice) want to deny it to people who could benefit from it.

    • I TOO HAVE SEEN MANY SELF-LIMITING CONDITIONS GET BEETER WITH PLACEBOS!
      it would be nice, if you could refrain from calling people ‘JERKS’ who disagree with you. IT DOES NOT HELP YOUR ARGUMENT WHICH IS ALREADY NOT VERY SOUND!

    • Homeopathy was a system of medicine created by a doctor who tried to do better than the conventions of his time. He succeded.
      But times have changed, and his system has been found to not only lack any plausible rationale, but not even to provide any credible evidence that the remedies his system devises have any effects at all – the effects of ‘homeopathy’ being due to a constructive therapeutic relationship with an empathic practitioner.
      Placebo effects with a large dose of faith.

      Personally I do not ‘oppose homeopathy’ any more than I ‘oppose the threapeutic balancing of Hippocratic humours’ but I do not want to have my taxes spent on providing patients with homeopathically prepared (HP) remedies, and would rather any available funds were spent on the counselling which apparently does help some people in need.

      Science is indeed a hard taskmaster, and hard to master.

    • @Mickft
      Leaving aside the issue of the unnecessarily guttersnipe language you use in your first sentence…
       
      “I’ve been using homoeopathy for over 40 years…” Argument from personal anecdote is not evidence.
       
      “why has homoeopathy worked to cure up to 75% of people referred to homoeopathic hospitals that so-called modern medicine has abandoned?” Has it? Please point us to the data so we can all learn which diseases these many people have suffered from and where homeopathy has effected cures. 200 years’ worth of published clinical trials done scientifically show no effect of homeopathy beyond placebo; but perhaps you have access to results the world is ignorant of?
       
      “If I have a broken leg, I need it splinted…” OK, please advise us where the borderline comes between the diseases that are easily treated with homeopathy and those that require medicine. I would hate to see people who need real medicine dangerously refer themselves for homeopathy when it doesn’t work. You mention whooping cough in your post, which is an infection caused by the bacterium Bordetella pertussis. Please explain to us how a ‘medicine’ that contains no active ingredient eliminates a bacterial pathogen from the body.

    • mickft said:

      The real question you have to answer is why has homoeopathy worked to cure up to 75% of people referred to homoeopathic hospitals that so-called modern medicine has abandoned?

      No, in addition to answering FrankO’s question as to the veracity of your claim, the real question you have to answer is, if the cure rate really is 75%, why, when homeopathy is examined critically and independently, it plummets to zero?

      • I am confused.
        ‘Mickft’ (whoever he is) refers to ‘so-called modern medicine’.
        Is not homeopathy called ‘medicine’ (by proponents at least) and is it not ‘modern’?
        Why is he so disparaging of homeopathy when he seems to be an advocate?

    • You honestly think none of us have any experience of homeopathy? Aren’t you just lashing out in blind prejudice here?

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