Homeopathic remedies work no better than placebos, and so should no longer be paid for by the UK National Health Service, a committee of British members of parliament has concluded.
The House of Commons Science and Technology Committee, which released its report on homeopathy on Monday, also urges governments in other European countries where homeopathy is popular – notably Germany, France and Austria – to be equally wary of funding homeopathy. "We feel there's a real message, not just in the UK," says committee chairman and Liberal Democrat MP Phil Willis.
In preparing its report, the committee, which scrutinises the evidence behind government policies, took evidence from scientists and homeopaths, and reviewed numerous reports and scientific investigations into homeopathy. It found no evidence that such treatments work beyond providing a placebo effect.
Placebo deception
"We conclude that placebos should not be routinely prescribed on the National Health Service," the report says. It also says homeopathic hospitals should not be funded by the NHS, and NHS doctors should not refer patients to homeopaths. Currently the NHS funds four homeopathic hospitals.
The committee also says that prescribing of placebos, which have an effect because a patient believes they will, involves a "degree of patient deception" and so is "not consistent with informed patient choice".
The committee is also critical of the Medicines and Healthcare Products Regulatory Agency (MHRA) and its practice of licensing homeopathic treatments. This gives the incorrect impression that the evidence of efficacy for homeopathic remedies is as strong as for conventional medicines, the report says.
The committee rejected the MHRA's justification for licensing homeopathic remedies – that there is an "important homeopathic tradition" to uphold. "Witchcraft is traditional, so does that mean the MHRA should endorse that too?" Willis asks.
Sugar pills
Homeopathic medicines are diluted so much that it is extremely unlikely that any active component can possibly be left in the solution. The committee failed to identify any plausible explanation for how such remedies might work.
The MPs' report also criticises the labelling on homeopathic products, which it says fails to inform the public that homeopathic products are "sugar pills containing no active ingredients".
The report draws attention to homeopathic remedies derived from body parts such as hip joints and colons, animals such as iguanas and dragonflies, and even products exposed to different kinds of sunlight. In the case of remedies derived from fragments of archaeological monuments such as the Great Wall of China and Stonehenge, they point out that it is hard to understand how even homeopathy's own principle of "like cures like" could apply.
Unknown costs
The MPs say there seems to be no reliable record of how much the NHS spends on homeopathic treatments. While Mike O'Brien, the minister responsible for the NHS, told the committee that the NHS spends £150,000 a year on homeopathic remedies, the UK-based Society of Homeopaths said that the NHS spends £4 million annually. This does not include the running costs of the homeopathic hospitals and the £20 million spent on refurbishing the Royal London Homoeopathic Hospital between 2002 and 2005.
Edzard Ernst of the Peninsula Medical School in Exeter, Devon, UK, a long-standing critic of homeopathic medicine, says the MPs' report should be noted in other countries where homeopathy is widely practised but not subjected to serious critical scrutiny. "The evidence is negative, and it's internationally negative, because there's no difference between countries in terms of evidence," he says.
In a dig at the Prince of Wales, who is an ardent supporter of homeopathic medicine in the UK, Ernst says: "Either we are governed by evidence and science, or by Prince Charles."
The Prince's Foundation for Integrated Health, which backs complementary therapies, including homeopathy, acknowledges that homeopathy is "scientifically implausible", but defends the use of such remedies nonetheless.
"For patients suffering from long term disease, where no scientific, evidence based medicine can offer effective treatment, it does not matter how it works," says the foundation, in a response to the committee's report. "What matters to them is whether they get better, whether pain and other symptoms are alleviated."
Michael Dixon, medical director of the foundation adds: "Science is a vital tool in healthcare, but so are compassion and caring and treating patients with dignity. It is not clear that the Committee took that into account."
