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Mar08
I am sharing this with a honest and sincere question if UK Science and Technology Committee's findings quote "the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible." unquote is reasonable, just and fair? This is important & urgent since this committee has recommended the UK government to STOP all funding and licensing to Homeopathy Products & research - The Chairman of the Committee, Phil Willis MP, had said: "This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not. "It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.” Is this damning report based on solid evidence? What is the reaction and views of practicing Homeopaths in India? _____________________________________________________ Science and Technology Committee UK Evidence Check 2: Homeopathy The Committee published 'Evidence Check 2: Homeopathy', HC 45, its Fourth Report of Session 2009-10, on Monday 22 February 2010. The report included the oral and written evidence. MPS URGE GOVERNMENT TO WITHDRAW NHS FUNDING AND MHRA LICENSING OF HOMEOPATHY In a report published today, the Science and Technology Committee concludes that the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA. The Committee carried out an evidence check to test if the Government’s policies on homeopathy were based on sound evidence. The Committee found a mismatch between the evidence and policy. While the Government acknowledges there is no evidence that homeopathy works beyond the placebo effect (where a patient gets better because of their belief in the treatment), it does not intend to change or review its policies on NHS funding of homeopathy. The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible. The Committee concluded-given that the existing scientific literature showed no good evidence of efficacy-that further clinical trials of homeopathy could not be justified. In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful. Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS. The report also examines the MHRA licensing regime for homeopathic products. The Committee is particularly concerned over the introduction of the National Rules Scheme (NRS) in 2006, as it allows medical indications on the basis of study reports, literature and homeopathic provings and not on the basis of randomised controlled trials (RCTs) - the normal requirement for medicines that make medical claims. The MHRA’s user-testing of the label for Arnica Montana 30C-the only product currently licensed under the NRS-was poorly designed, with some parts of the test little more than a superficial comprehension test of the label and other parts actively misleading participants to believe that the product contains an active ingredient. The product labelling for homeopathic products under all current licensing schemes fails to inform the public that homeopathic products are sugar pills containing no active ingredients. The licensing regimes and deficient labelling lend a spurious medical legitimacy to homeopathic products. The Chairman of the Committee, Phil Willis MP, said: "This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not. "It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.” Terms of Reference In preparation for the establishment of the Science and Technology Committee on 1 October, the former IUSS Committee commissioned work to assess the Government's use of evidence in policy-making. The Committee wrote to the Government on a number of topics and asked two questions: (1) What is the policy? (2) On what evidence is the policy based? The Government has now replied and having considered the responses the Committee has selected Homeopathy for its second Evidence Check. The Committee invited short submissions on the following issues: - Government policy on licensing of homeopathic products - Government policy on the funding of homeopathy through the NHS - the evidence base on homeopathic products and services. Oral evidence Previous sessions: Monday 30 November 2009 Mr Mike O'Brien QC MP, Minister for Health Services, Department of Health; Professor David Harper CBE, Director General, Health Improvement and Protection, and Chief Scientist, Department of Health; Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency Wednesday 25 November 2009 Professor Jayne Lawrence, Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain; Robert Wilson, Chairman, British Association of Homeopathic Manufacturers; Paul Bennett, Professional Standards Director, Boots; Tracey Brown, Managing Director, Sense About Science; Dr Ben Goldacre, Journalist. Dr Peter Fisher, Director of Research, Royal London Homeopathic Hospital; Professor Edzard Ernst, Director, Complementary Medicine Group, Peninsula Medical School; Dr James Thallon, Medical Director, NHS West Kent; Dr Robert Mathie, Research Development Adviser, British Homeopathic Association. Press notices 20/10/09 Inquiry announced 11/02/10 Report to be published 22/02/10 Report published website: http://www.parliament.uk/parliamentary_committees/science_technology/s_t_homeopathy_inquiry.cfm _____________________________________ MPs deliver their damning verdict: Homeopathy is useless and unethical Homeopaths are evoking grand conspiracies to explain the Science and Technology Committee's brutal report, but in reality they were undone by their own bizarre pronouncements The committee's report criticises homeopaths for their selective approach to evidence. Today the Science and Technology Select Committee delivered its verdict on homeopathy and it was devastating. The committee has called for the complete withdrawal of NHS funding and official licensing of homeopathy. This should come as no surprise to anyone who witnessed the almost farcical nature of the proceedings, with the elite of homeopathy mocked by their own testimony. Peter Fisher, director of the Royal London Homeopathic Hospital, spewed forth the sort of dialogue that wouldn't look out of place in a Terry Pratchett novel. As the report drily observes: "Dr Fisher stated that the process of 'shaking is important' but was unable to say how much shaking was required. He said 'that has not been fully investigated' but did tell us that 'You have to shake it vigorously [...] if you just stir it gently, it does not work'. Quite. It's hard to say which is more ridiculous: the sight of a grown man speaking this nonsense, or the fact that after 200 years homeopaths apparenly haven't bothered to "fully investigate" how much shaking is required for their remedies to work. And yet, bizarrely, these people expect to be taken seriously. In this they have failed spectacularly. The select committee report has brutally inflicted the 21st, 20th and 19th centuries on this 18th century magic ritual, and under inspection it has fallen apart. As I reported previously in the Guardian, much of the evidence presented by homeopaths simply does not stand up to scrutiny, and the committee agrees, concurring with the government, the scientific community and independent experts in concluding that: "the systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos." Even the claims that more research is needed have been rebutted. Plenty of evidence has accumulated regarding the effectiveness of homeopathy, and a verdict has been reached. It is useless. As the report states: "It is ... unethical to enter patients into trials to answer questions that have been settled already." Even more damning is the MPs' assessment of the competence of homeopaths in handling evidence. In a strongly worded statement clearly directed at the British Homeopathic Association (BHA), the report expresses disappointment at the behaviour of homeopaths submitting evidence to the evidence check: "We regret that advocates of homeopathy, including in their submissions to our inquiry, choose to rely on, and promulgate, selective approaches to the treatment of the evidence base as this risks confusing or misleading the public, the media and policy-makers." The BHA's behaviour throughout the evidence check has been an embarrassment to homeopathy. After my allegation that the BHA had misrepresented evidence to MPs, the author of the association's submission to the committee, homeopath Robert Mathie, in particular should have made a public apology for allowing his standard of scholarship to slip. But the BHA instead chose to attack me in a press statement that contained still further misrepresentations of the evidence. Mathie and the BHA should take the report's criticisms on the chin, accept that they are in error, and reflect on how they present evidence to the public in the future. Sadly, the criticism is likely to fall on deaf ears. Rather than take the opportunity to reassess their approach, homeopaths are filling blogs and tweets with dark imaginings of vast, Big Pharma-controlled conspiracies against their noble art, painting a vivid picture of the fantasy world that they appear to inhabit. Of course, as Peter Fisher's comments reveal, a grand conspiracy is not neccesary to discredit homeopathy. The most effective way to do that is simply to let a homeopath speak. But it's not just homeopaths we should be criticising. The government, and in particular the MHRA (Medicines and Healthcare products Regulatory Agency, which licenses drugs and oversees labelling), also come in for some strong criticism from the committee. Both stand accused of hypocrisy for paying lip-service to the importance of evidence-based medicine while allowing special exemptions for dubious practices. In the words of the committee, the government's position on homeopathy is "confused". It accepts that homeopathy is effectively a placebo, but allows it to be practised within the NHS without considering the ethics of prescribing placebos to patients. Members of the committee were shocked to find that the rigorous rules the MHRA normally applies for licensing medicines were simply abandoned in the case of homeopathy. That the MHRA allows health claims to be made for medicines that cannot be shown to work suggests a failure to live up to its own standards. Even more damning is the committee's verdict on the labels that the MHRA deems acceptable for use on homeopathic Arnica, labels that were tested by the MHRA itself. The report states: "We conclude that the user-testing of the Arnica Montana 30C label was poorly designed with parts of the test actively misleading participants." Clearly, MHRA chief executive Kent Woods has serious questions to answer regarding how his agency came to allow a homeopathic treatment through the net. The report also represents a victory for the blogosphere. Sceptical bloggers such as Andy Lewis and 'Gimpy' have been pursuing homeopaths and leading homeopathic organisations for years, whether exposing the funding of hideously unethical Aids trials in Africa, or doggedly harrying the MHRA over its failure to appropriately regulate labelling. Today, these bloggers are relieved that MPs are finally paying attention. Lewis expressed happiness that the behaviour of those selling homeopathic remedies had come under parliamentary scrutinity, while Gimpy observed that, "this issue is no longer just a concern within the blogosphere but is now a matter for parliament." For homeopaths, the message is clear. Their attempts to defend their position in the face of questioning from MPs have ended in humiliation and embarrassment. It is clear that they have no credible evidence to support their remedies. Time, perhaps, to pick a new profession. Martin Robbins writes for The Lay Scientist http://www.guardian.co.uk/science/blog/2010/feb/22/mps-verdict-homeopathy-useless-unethical


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