MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

A recent article in the LIVERPOOL ECHO caught my eye. It is about the possibility that the NHS in Liverpool might stop funding their homeopathy service . Maybe I should read the LIVERPOOL ECHO more often, because the short article is most revealing.

It first cites the chairman of the local NHS Clinical Commissioning Group, Dr Nadim Fazlani saying that “There is little evidence that homeopathy has a clinical benefit so, as a governing body, our preferred option would be to stop commissioning this service. However, it is important that the people have an opportunity to provide their views before a decision is made.”

Fair enough!

I would like to mention, however, that health care is not a beauty contest or a supermarket shelve. We don’t have popular votes for bone marrow transplants or bypass surgery either. Why? Not because we don’t believe in democracy but because the general public cannot possibly understand medicine well enough. This is why we send some of our kids to medical school and other institutions to help us comprehend and eventually take responsible decisions for us. It is, I think, an ethical imperative to base important health care decisions of this nature on the best evidence and expertise, and it seems foolish to expect the public to have either.

Then the article in the LIVERPOOL ECHO quotes a statement of the Liverpool homeopathy service which is run by GPs Dr Hugh Nielsen and Dr Sue de Lacy: “The patients we see generally have long-standing, complex conditions that are often difficult to treat with conventional medicine. Yet regular audits of our clinic show a very high level of patient satisfaction, with patients consistently reporting an improvement in their health. As experienced doctors trained in homeopathy we see it working every day and that is why we believe Liverpool CCG – and more importantly the patients the CCG serves – is getting excellent value for the relatively small amount of funding the service receives.”

I find this interesting, not least because the arguments used by these two GPs are, in my view, miles better than those we have seen on this blog recently by Christian Boiron, Dana Ullman, Dr Michael Dixon or the Queen’s homeopath Dr Fisher all put together. At least they do not contain blatant lies!

This does not mean, however, that the arguments of the two homeopaths from Liverpool are convincing. They are not – for the following 4 reasons:

  1. True, long-standing, complex conditions are often difficult to treat with conventional medicine. But if they are difficult to treat with real medicine, they surely are even more difficult to treat with fake medicine.
  2. I have no problem believing that their audits show high level of patient satisfaction, with patients consistently reporting an improvement in their health. But we need to be quite clear that these effects are not brought about by the homeopathic remedies which contain zero active ingredients. They are due to the compassion shown by these homeopath. If they prescribed real medicine in addition to providing compassion, their results would in all likelihood be even better.
  3. It is also true that an experienced doctor trained in homeopathy will see it working every day. But the ‘it’ refers not to the remedy, it relates to the compassion – and to convey compassion, we do not need bogus treatments.
  4. It is a little misleading to claim that homeopathy is ‘excellent value’. The remedies contain nothing but lactose, and £ 5-10 for a gram or two of lactose is jolly expensive! So, the remedies are over-priced placebos, and the consultations might be good value.

Despite these counter-arguments, I must congratulate these two GPs from Liverpool: they seem to be so much more honest and intelligent than the defenders of homeopathy mentioned above.

15 Responses to Homeopathy in Liverpool: finally two homeopaths who don’t tell overt untruths

  • It is a little misleading to claim that homeopathy is ‘excellent value’. The remedies contain nothing but lactose, and £ 5-10 for a gram or two of lactose is jolly expensive! So, the remedies are over-priced placebos…

    Isn’t there evidence that expensive placebos work better than cheaper ones? If this is the case, then overpricing placebos is a good idea. Presumably if homoeopathy was removed from the NHS so that the customers had to pay the full price the placebos would be more effective.

    • Expensive placebos are more effective, but only if the patient is paying for them.

    • You miss the point here, you pay also for time spent diagnosing and dispensing. Furthermore you propagate the myth that there is nothing in these remedies. As a vet of 30 years experience I tell you that animals do not show the placebo effect, but very clearly do respond to homoeopathy- sometimes dramatically. Look up Geoff johnson and his treatment of three dogs with “incurable” tumours (at least according to the referral oncologists who treated them allopathic ally)
      At least keep an open mind and do not be swayed by the critical dogma of the established medical ‘experts’. Just because we do not understand the physics behind how this system of medicine works does NOT mean it is not effective

      • oh dear! where do you get your facts from?
        1) beyond C12, the likelihood of a single ‘active’ molecule present is zero.
        2) animals do respond to placebo. it’s called ‘conditioning’ and was discovered some 100 years ago by Pavlov.
        3) there is no good evidence that homeopathy works in animals. [http://edzardernst.com/2014/10/homeopathy-works-for-animals-so-it-cant-be-a-placebo/]
        4) even 30 years of experience can mislead you. [http://edzardernst.com/2012/11/what-is-and-what-isnt-clinical-evidence-and-why-is-the-distinction-important/]
        SUCH A SHORT COMMENT AND SO MANY ERRORS!!!

      • @Nicki Miller
        I googled “Geoff Johnson cancer dogs” since you weren’t kind enough to provide any links. The first hit was clearly the information you are referring to. It begins as follows: “The cases below were chosen because the prescriptions were successful, and all had been to a specialist oncologist before coming to homeopathy.” Why no mention of cases that were unsuccessful?! No chance of author bias here, for sure!
         
        Just how much skull bludgeoning does it take to get through the message that the plural of ‘anecdote’ is not ‘data’? As for the old trope about ‘it must be true because it works in animals’, just see the other, earlier responses to your post.

      • As a vet of 30 years experience I tell you that animals do not show the placebo effect…

        No, but neither can they report that they feel better. And there are other factors, such as observer bias, that come Ito play instead.

        And see, for example, this paper, noting the “discrepancies between single-blind and double-blind methods”.

        • “No, but neither can they report that they feel better.”
          If you can’t tell if you pet is feeling better, you shouldn’t have pets.

          “And there are other factors, such as observer bias, that come Ito play instead.”
          If you haven’t cultivated a reasonable objectivity in assessing you’re pets’ comfort level, you shouldn’t have pets.

          • There was an interesting study done on whether dogs feel guilt or not. One of the outcomes of this was that when trying to work out what a pet is feeling, people project. I would be very surprised if any pet owner is entirely objective in assessing how their pet feels at any given time, and the chances of people looking for (and thus finding) signs the pet is better after administering either a real treatment or a fake one like homeopathy, is pretty high.

          • “No, but neither can they report that they feel better.”
            If you can’t tell if you pet is feeling better, you shouldn’t have pets.

            If you think that you feeling better about your pet’s condition is more important that whether the treatment it has received has actually benefited the poor animal, then…

            Remember, people are very good at seeing connections. Even when those connections don’t actually exist. And they are particularly bad at being objective about their nearest and dearest.

      • Nicki

        It worries me greatly that you do not seem to appreciate how we can mistakenly infer the existence of therapeutic effects from the evidence we have in clinical practice. This is true of conventional medicines as well, so I am not directing special criticism at homeopathy on that account. My special criticism of homeopathy and its practitioners rests on a lot of other factors.

        I am aware of the claims Geoff has made about some cancer cases he has treated.

        The striking thing about homeopathy is how the supposedly dramatic clinical effects disappear into the statistical noise once all the sources of biased and erroneous observation are eliminated.

        This is why our authorities should long ago have declared that the use of homeopathy in animals is unethical.

  • I will write to those doctors and ask for a copy of the consent form that they use when obtaining consent to treat patients with homeopathically prepared (HP) remedies which have no plausible reproducible means of having any effect and which contain no active ingredient whatsoever.

    I am sure both doctors explain this to their patients, as otherwise they would have failed to obtain fully informed consent – and that would be unethical.

    And the CCG will certianly not wish to engage with unethical practices.

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