UK medical students spend 25% of their curricular time on elective “Student Selected Components” (SSCs). We report one in homeopathic medicine run jointly by the University of Bristol and the Bristol Homeopathic Hospital.

The SSC was an intensive four week course using a variety of learning methods, grounded in the Faculty of Homeopathy’s Primary Health Care Examination (PHCE) Certificate syllabus.

Students were exposed to specialist clinics and the prescribing methods used in them. They received tuition from a veterinarian, a psychiatrist, a medical historian, a professional homeopath and an expert in the evidence base of complementary medicine.

Educational methods included interactive lectures, out-patient clinics, recorded video cases, live cases via video link, a “dream proving” and a reflective diary.

At the end of the course students sat and passed the Faculty’s PHC examination. Assessment also included an in-depth case report in which most students revealed understanding of the course.

Though students were uncertain about the nature of the healing stimulus, many were affected by the healing responses they witnessed and the intellectual challenge of remedy selection.

Some professed interest in further training and all wished to see the Bristol Homeopathic Hospital (BHH) develop as a centre for holistic care. For some the experience was “transformative learning”. We conclude that this approach to a foundation training in homeopathy is feasible and effective.

Numerous surveys over the past 150 plus years have confirmed that people who seek homeopathic treatment tend to be considerably more educated than those who don’t (1). What is not as well known is the fact that homeopathic medicine is the leading “alternative” treatment used by physicians in Europe… and growing numbers of the citizenry.

And despite homeopathy’s impressive popularity in Europe, it is actually even more popular in India where over 100 million people depend solely on this form of medical care (2).

Read about more scientific research into homeopathy

Further, according to an A.C. Neilsen survey in India, 62 percent of current homeopathy users have never tried conventional medicines and 82 percent of homeopathy users would not switch to conventional treatments (3).

Skeptics of homeopathy insist that homeopathic medicines do not work, but have difficulty explaining how so many people use and rely upon this system of medicine to treat themselves for so many acute and chronic diseases; and a very large number of these people do not have to use anything else.

A previous article that I wrote at this site presented a strong case for the scientific and historical evidence for homeopathy. Further, other articles here have provided additional scientific evidence for the use of homeopathic medicines in respiratory allergies and in pediatrics.

Although a small and vocal group of skeptics of homeopathy continue to deny its viability, homeopathy’s growing popularity throughout the world amongst physicians, other health professionals, and educated populations continue to prove that skeptics are really simply medical fundamentalists.

The entire field of “alternative and complementary medicine” was so hot in the 1980s that, according to a respected market survey, the field of alternative and complementary medicine in Europe was second only to the computer industry for growth during this decade (4). This explosion of interest in natural medicine has continued in the 21st century.

In 1998, homeopathy was the most frequently used CAM therapy in five out of 14 surveyed countries in Europe and among the three most frequently used CAM therapies in 11 out of 14 surveyed countries (5). Three out of the four Europeans know about homeopathy and of these people 29 percent use it for their own health care. In other words, approximately 100 million Europeans use homeopathic medicines (6).

The sales of homeopathic and anthroposophical medicines grew by 60 percent between 1995 and 2005, from 590 million Euros in 1995 to 775 million Euros in 2001 and to $930 million Euros in 2005 (7).

Because of homeopathy’s impressive and growing popularity in Europe, this alternative treatment poses a significant threat to conventional medicine, which may explain why there are ongoing efforts to attack it (and homeopaths) using devious and questionably ethical means.

France
Homeopathy is particularly popular in France, where it is the leading alternative therapy. In 1982, 16 percent of the population used homeopathic medicine, rising to 29 percent in 1987, and to 36 percent in 1992 (8). In 2004, 62 percent of French mothers used homeopathic medicines in the previous 12 months (9).

A survey of French pharmacists was conducted in 2004 and found that an astounding 94.5 percent reported advising pregnant women to use homeopathic medicines (10).

Homeopathy is popular not only among the French public but also among the French medical community. As many as 70 percent of physicians are receptive to homeopathy and consider it effective, at least 25,000 physicians prescribe homeopathic medicines for their patients.

Homeopathy is taught in at least seven medical schools: Besancon, Bordeaux, Lille, Limoges, Marseille, Paris-Nord, and Poitiers, and there are numerous postgraduate training programs. Courses in homeopathy are taught in 21 of France’s 24 schools of pharmacy, and also taught in two dental schools, two veterinary medical schools, and three schools of midwivery.

United Kingdom
England’s Royal Family has been homeopathy’s strongest advocates, thereby confirming that this system of natural medicine is not some “new age” therapy. There are five homeopathic hospitals working within the National Health Service, some of them with a two-year waiting list for non-emergency visits to a homeopath.

According to a House of Lords report (2000), 17 percent of the British population use homeopathic medicines (11). The respect accorded homeopathy and homeopathic practice by British physicians is evidenced by a 1986 survey in the British Medical Journal that showed that 42 percent of physicians referred patients to homeopathic doctors (12).

Other evidence of support from health professionals was a 1990 survey of British pharmacists that found 55 percent considered homeopathic medicines “useful,” while only 14 percent considered them “useless” (13). The normally conservative British Pharmaceutical Association held a debate in 1992 to decide whether pharmacists should promote homeopathic medicines (14). They concluded by a large majority that they should.

The field of complementary medicine has gained much support in the 1990s. In 1993 the British Medical Association published a book entitled, Complementary Medicine: New Approaches to Good Practice (15).

Britain’s health minister (in 1994), Dr. Brian Mawhinney, stated, “Complementary medicine has generally proved popular with patients, and a recent survey found that 81 percent of patients are satisfied with the treatment they received” (16). Another health minister stated that 80 percent of general practitioners want training in complementary therapies; 75 percent now refer patients to complementary therapists.

Despite the use and acceptance of homeopathy throughout the UK, there is a very active group of skeptics, with significant Big Pharma funding, who work vigorously to attack this system of natural medicine.

Even though there is a wide variety of serious and significant pressing issues in British medicine and science today, an active group of skeptics of homeopathy successfully resurrected in October, 2009, a House of Commons committee, called the Science and Technology Committee, with the intent to issue a report on homeopathy.

A leading skeptics organization, Sense about Science, that has been pushing for the re-creation of this Committee is led by a former public relations professional who worked for a PR company that represents many Big Pharma companies.

Of additional interest is the fact that other Directors of the Sense about Science organization are a mixture of former or present libertarians, Marxists, and Trotskyists who also, strangely enough, seem to advocate for the GMO industry (ironically, libertarians normally advocate for a “live and let live” philosophy, but in this instance, it seems that they prefer to take choice in medical treatment away from British consumers).

Sense about Science is a registered UK charity despite being a political pressure group. As such they have to divulge their sources of income which they do on their website. Not surprisingly, much of this comes from named pharmaceutical manufacturers.

One of the investigators for the House of Commons Science Committee is a Liberal Democrat MP, Evan Harris. He has collaborated with Sense about Science on various projects, and he was also one of the skeptic demonstrators against the national pharmacy chain, Boots, which sells homeopathic medicines. This advocacy role does not make him an unprejudiced observer as is required for this type of investigation.

A report from this kangaroo court was issued recommending that the National Health Service stop funding for homeopathy and homeopathic doctors, despite the support for homeopathy and for consumer choice from Mike O’Brien, the country’s present Health Minister.

This report is only of an advisory nature, and because the Health Minister has already expressed his support for consumers’ right to choose their own health care, it is uncertain what, if anything, will result of this report.

What was most surprising about this report was that it verified that when people repeat a lie frequently enough, such as “there is no research on homeopathy,” many people actually believe it, despite its transparent falsity.

Any rational person should and must be very suspicious of this “report.” The MPs (Members of Parliament) who were a part of the Science and Technology Committee which voted for this anti-homeopathy report comprised of five members, with three members barely eking out their victory.

Of the three votes, two members did not attend any of the investigational meetings, one of whom was such a new member of the committee that he wasn’t even a member of the committee during the hearings, and the remaining “yes” vote was from Evan Harris, a medical doctor and devout antagonist to homeopathy.

This report was not exactly a vote of and for the people.

In Scotland, 12 percent of general practitioners use homeopathic medicines and 49 percent of all general practitioner practices prescribe them (at least one medical doctor in a group practice)(17).

The use of homeopathic medicines is not simply popular in the treatment of humans but also animals. Although there is little data presently available on this subject, one survey discovered that 20 percent of Irish milk producers have tried homeopathic medicines to treat mastitis or high cell count cows, and 43 percent believe that they work.

In the herds surveyed, 50 percent added homeopathic medicines to the cow’s drinking water, 27 percent administered medicines via injection, six percent orally doses the cows, and six percent of herds placed the medicines in the cow’s vagina (18).

Ireland
A survey in Ireland was conducted at 13 pediatric settings over a 4-month period (19). They found that 57 percent of parents reported using CAM for their child. Use was significantly higher in the two to four years age group.

The most common medicinal CAMs used were vitamins (88 percent), fish oils (27 percent) and Echinacea (26 percent). The most common non-medicinal CAMs used were homeopathy (16 percent) and craniosacral therapy (14 percent). Only 13 percent of parents had informed their pediatrician of their child’s CAM use.

Germany
The German people are so supportive of natural medicine that the German government mandated that all medical school curricula include information about natural medicines.

Approximately 10 percent of German doctors specialize in homeopathy, with approximately 10 percent more prescribing homeopathic remedies on occasion. In 1993, there were 1,993 medical doctors who had formally qualified in homeopathy, while in 2006, this number jumped over 100 percent to 6,073 (20).

In Germany there are 9,000 natural health practitioners called heilpraktikers in 1993 and over 20,000 in 2007. Approximately 20-30 of heilpraktikers specialize in homeopathy.

A cross-sectional survey was conducted in a large random sample of 516 German outpatient care physicians with qualifications in 13 medical fields representative of a basic population of 118,085 statutory health insurance physicians in November and December 2005 as part of a national healthcare survey (21).

In this survey, 51 percent were in favor of CAM use (26 percent were very much in favor, 25 percent were in favor). This survey found that 38 percent of the medical doctors prescribed homeopathic medicines.

A survey of departments of obstetrics in hospitals in the state of North Rhine-Westphalia, Germany, found that acupuncture and homeopathic medicine were the two most commonly used CAM practices (22). A total of 187 department of obstetrics were identified, and 138 (73.4 percent) responded to a questionnaire. Almost 96 percent of the obstetrical departments offered homeopathic medicines for obstetrical care.

The 2003-2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS) found a higher than expected use of homeopathic medicine amongst German children (23). The survey found that pediatric homeopathy is quite popular in Germany, particularly among children from families with a higher socioeconomic status.

Nearly half of the homeopathic preparations were obtained by prescriptions from medical doctors or Heilpraktiker (non-medical practitioners) and used most often to treat certain self-limiting conditions. About 60 percent of homeopathy users concomitantly received conventional medicines.

Homeopathy use was closely related to socioeconomic factors, with a significantly higher prevalence rate found in the zero to six year age group, among children residing in the former West Germany or the south of Germany, among children with a poor health status, with no immigration background , who received breast-feeding greater than 6 months, were from upper social-class families, and whose children’s mothers were college educated.

In 2002, the British Medical Journal (BMJ) reported that 75 percent of Germans have used complementary or natural medicine (24). They also reported that 5,700 doctors received specialized training in natural medicine, with this number doubling to 10,800 by 2000.

Homeopathic medicine is practiced by 4,500 medical doctors in Germany, almost twice as many as did so in 1994. The German government conducted this survey, and it also discovered that there was a 33 percent reduction in sick days if people used natural therapies, especially homeopathy or acupuncture.

It was also reported that women used natural therapies more than men did, but when men used them, they benefited more than women did.

In 2009 a survey of Germans who used homeopathy or acupuncture was published (25). This survey found that seven percent of the population used homeopathy and 10 percent used acupuncture. Individuals who had a high education level used homeopathy (68 percent), as compared with 53 percent who used acupuncture.

A survey of patients in Germany with chronic lymphocytic leukemia found that 44 percent had used alternative treatments. No correlation was seen with educational level, gender, or previous or current chemotherapy. The most common alternative or complementary treatment modality was vitamin supplementation (26 percent), followed by mineral (18 percent), homeopathic (14 percent), and mistletoe therapy (9.2 percent) (26).

A 2008 survey of German children with cancer was conducted and which found that 35 percent of the responders had used CAM (27). The most frequently used methods were homeopathy, dietary supplements and anthroposophic medicine including mistletoe therapy.

Factors which increased the probability of using CAM were the previous use of CAM, higher social status and poor prognosis of the child’s disease. An impressively high percentage of parents of patients (89 percent) reported that they would recommend CAM to other parents.

The use of homeopathy and CAM in Germany by people with other chronic disease is also high, as was observed in a survey of German’s with multiple sclerosis (28). A 53-item survey was mailed to the members of the German Multiple Sclerosis Society, chapter of Baden-Wuerttemberg.

Surveys of 1,573 patients were analyzed. In comparison with conventional medicine, more patients displayed a positive attitude toward complementary and alternative medicine (44 percent vs 38 percent, P less than 0.05), with 70 percent reporting lifetime use of at least one method. Among a wide variety of complementary and alternative medicine, diet modification (41 percent), Omega-three fatty acids (37 percent), vitamins E (28 percent), B (36 percent), and C (28 percent), homeopathy (26 percent), and selenium (24 percent) were cited most frequently.

Most respondents (69 percent) were satisfied with the effects of complementary and alternative medicine. Use of complementary and alternative medicine was associated with religiosity, functional independence, female sex, white-collar job, and higher education (P less than 0.05). Compared with conventional therapies, complementary and alternative medicine rarely showed unwanted side effects (9 percent vs 59 percent, P less than 0.00001).

Sales of homeopathic medicines in Germany were approximately $428 million in 1991, growing at a rate of about 10 percent per year. Evidence of the significant support from the German medical community is the fact that 85 percent of these sales are prescriptions from physicians.

Surveys indicate that 98 percent of pharmacies sell homeopathic medicines.

Switzerland
A government-sponsored survey was conducted in Switzerland that evaluated patient satisfaction and side effects in primary care and that compared homeopathic treatment and conventional medical treatment (29).

A total of 3,126 adult patients responded to a questionnaire, 1,363 of whom received conventional medical treatment and 1,702 who received homeopathic treatment.

This survey found that a higher percentage of homeopathic patients had chronic and severe conditions than the conventional medical patients, that homeopathic patients were more often “completely satisfied” with their treatment (53 percent vs. 43 percent), that homeopathic patients experienced significantly fewer side effects (7.3 percent vs. 16.1 percent), that the proportion of patients reporting complete resolution of symptoms was non-significantly higher in the conventional medical patients (28 percent vs. 21 percent).

What is particularly important about this survey is the observation that homeopathic patients had a higher percentage of seriously ill patients but they expressed a much higher amount of satisfaction with their treatment than the patients who received conventional medical treatment.

This survey also confirmed a common observation about people who seek homeopathic treatment and that is they were much more educated than those who didn’t (32.4 percent vs. 24.7 percent received “higher education”).

The Swiss Federal Office for Public Health issued a report to the government of Switzerland which concluded that “the effectiveness of homeopathy can be supported by clinical evidence, and professional and adequate application be regarded as safe” (30).

Other European countries in which homeopathy has a relatively strong presence include Switzerland, where different surveys have suggested that somewhere between 11 percent and 27 percent of general practitioners and internists prescribe homeopathic medicines; Italy where nine percent of the medical doctors prescribe homeopathic remedies sometimes; and the Netherlands where 45 percent of physicians consider homeopathic medicines effective and 47 percent of medical doctors use one or more complementary therapies, with homeopathy (40 percent of these select doctors) being the most popular (31).

The prevalence of CAM use in a sample of Swiss patients undergoing kidney transplant was 11.8 percent. The most frequently used alternative therapy used among these was homeopathy (42.9 percent) (32).

Italy
In 2004 a total of 7.5 million Italians use homeopathic medicines, 2.5 million more than a survey showed in 2000 (33). Approximately 14 percent of Italian women and 10 percent of men prefer homeopathic medicine to conventional medicine. A total of 9.6 percent of children between three and five years of age are treated with homeopathic medicines.

Almost 90 percent of Italians who have used such medicines say these treatments helped by them, with 30 percent saying that they used homeopathic medicines for pain syndromes and 24 percent for severe or chronic diseases.

A 2005 survey on the use of complementary and alternative medicines (CAM) among cancer patients in Europe reported that 73 percent of the Italian cancer patients had used CAM, a number well above the European average of 36 percent (34).

The most popular treatment modalities used by cancer patients in Italy were high use of homeopathy, herbal medicine, and spiritual therapies. A 2008 survey in Tuscany, Italy found that the incidence of CAM use after cancer diagnosis was 17 per cent, with the most widely used forms being herbal medicine (52 percent), homeopathy (30 percent) and acupuncture (13 percent) (35). Use was higher in the urban area and among women, breast cancer patients, and persons with a higher education.

A survey of Italian children with cancer who were being treated at a conventional pediatric oncology unit found that 12.4 percent of the children used at least one type of CAM, with homeopathy being the most popular (36).

Eighty-three percent of the parents of these children reported benefits, ranging from improved immune defenses, regression of diplopia, or improved blood values. This study confirmed the observation of many other surveys which found that users of CAM tended to be more educated than those who did not use CAM (37)(38)(39).

Five hundred and fifty-two patients who had inflammatory bowel disease and who were under treatment at an Italian tertiary medical referral center completed the questionnaire (40); 156 (28 percent) reported using alternative and complementary therapies, of which mainly involved homeopathy (43.6 percent), followed by controlled diets or dietary supplements (35.5 percent), herbs (28.2 percent), exercise (25.6 percent) and prayer (14.7 percent).

An improvement in well-being (45.5 percent) and inflammatory bowel disease symptoms (40.3 percent) were the most commonly reported benefits. A higher education (P equal to 0.027), a more frequently relapsing disease (P equal to 0.001) and dissatisfaction with the doctor’s communication (P equal to 0.001) correlated with alternative and complementary therapy use.

Non-compliance with conventional drugs, disease severity and curiosity regarding novel therapies were predictors of alternative and complementary therapy use.

Spain
In Spain, homeopathy has gotten so popular that INE, the country’s statistic institute, added expenditures on homeopathic medicines to their calculations for monthly inflation rates (41).

Sales of homeopathic medicines in Spain are growing at 10-15 percent annually, with approximately 15 percent of the population saying that they have used a homeopathic medicine and 25 percent said that they would be happy to try one (42).

Eastern Europe
When the Iron Curtain was up, Hungary, Czechoslovakia, and East Germany banned homeopathy, but this medical iron curtain fell with communism.

Homeopathy holds a unique place in Russia, where it has been widely accepted, but is not sanctioned by the state medical bureaucracy. Thus, homeopathic care is not free and has been a part of the new Russian economy where fees are paid for health services. Demand for homeopathic care is so great that Russians prefer to pay for homeopathic care than to receive free conventional medical care.

Some skeptics have asserted that homeopathy and natural medicines are becoming increasingly popular in Russia because “real medicine” is either unavailable or too expensive (43).

However, this assumption has been disproven, because the trend toward homeopathic and natural medicine is particularly popular among those Russians who are more educated and are in higher economic classes.

Journalists and skeptics tend to assume that homeopathic medicines simply do not work, and thus they create fanciful theories about why the use of homeopathy is increasing.

A survey of Russian physicians in three academic hospitals in St. Petersburg was published in 2008 (44). This survey found that 100 percent of the respondents had practice CAM and/or referred patients to at least two CAM therapies. On average, each physician had practiced or referred patients to 12.7 different CAM treatments.

Homeopathic medicine was the 8th most popular, with 58 percent using or referring for homeopathic treatment, 31 percent using on themselves, 29 percent using it on their own patients, and 38 percent referring for homeopathic care.

In Hungary, homeopathic literature was banned for 40 years until 1990. Homeopathy has now been accepted and integrated into regular medical education and is taught in two medical schools. The Hungarian Homeopathic Medical Association started with 11 members in 1990, grew to 75 after 18 months, and grew further to 302 members in 1994.

After the fall of communism in Czecholslovakia, a homeopathic organization in the Czech Republic was established in November, 1990, and it was immediately accepted and integrated within the larger conventional medical society. Within a year, the Ministry of Health officially recognized homeopathy as a medical specialty.

Homeopathy is extremely popular in South America, Mexico, and in Cuba. Homeopathy is spreading fast throughout Africa, Egypt (the Foreign Minister has used homeopathy for over 20 years), and in Iran, it has now spread to Iceland,

REFERENCES:

(1) Rothstein, W. Physicians in the Nineteenth Century. Baltimore: Johns Hopkins University Press, 1972.
(2) Prasad R. Homoeopathy booming in India. Lancet, 370:November 17, 2007,1679-80. (Additional note: Even though the overall mortality rate in India is quite poor compared with most modern First World countries, this is primarily due to the large number of exceedingly poor people. The mortality rate of urban middle and upper class people in India is comparable, if not better, than similar populations in the USA.)
(3) A C Neilsen survey backs homeopathy benefits. Business Standard. September 4, 2007. http://www.business-standard.com/india/news/a-c-nielsen-survey-backs-homeopathy-benefits/295891/
(4) “Alternative Medicine/Alternative Medical Market,” Frost and Sullivan Ltd. Report #E874, London, 1986.
(5) Norges offentlige utredninger, NOU 1998:21 Alternativ medisin. (Official report published by the Norwegian Department of Health. Available at: http://www.regjeringen.no/en/ministries/hod/Documents/NOUer/1998/NOU-1998-21.html?id=141407
(6) di Sarsina PR, Iseppato I. Looking for a person-centered medicine:non convent8onal medicine in the conventional European and Italian setting. eCAM, 2009; doi:10.1093/ecam/nep048.
(7) ECHAMP, Facts and Figures, Second edition, 2007. www.echamp.eu
(8) L’Homeopathie en 1993. Lyons: Syndicat National de la Pharmacie Homeopathique, 1993 (Quoting COFREMCA and IFOP public opinion surveys).
(9) Transactions, Nutrition Business Journal, July 7 2004.
(10) Damase-Michel, C., Vie, C., Lacroix, I., Lapeyre-Mestre, M., Montastruc, J.L. Drug Counselling in Pregnancy: An Opinion Survey of French Community Pharmacists, Pharmacoepidemiol Drug Saf. 2004 March, 18;13(10):711.
(11) House of Lords Science and Technology Report, November, 2000

http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12303.htm

(12) Richard Wharton and George Lewith, “Complementary Medicine and the General Practitioner,” British Medical Journal, 292 (June 7, 1986): 1498-1500.
(13) Nelson, op. cit.
(14) Steven Kayne, “Homeopathic Pharmacy: Education, Research and Optimism,” British Homoeopathic Journal, October, 1993: 225.
(15) British Medical Association, Complementary Medicine: New Approaches to Good Practice, Oxford: Oxford University, 1993.
(16) Universal News Services, June 16, 1994.
(17) Ross, S, Simpson, CR, McLay, JS. British Homoeopathic and herbal prescribing in general practice in Scotland. Journal of Clinical Pharmacology, 62,6: December 2006, 647-652.
(18) Buss, Jessica. Irish Turn to Homoeopathy. Farmers Weekly, October 16, 1998.
(19) Low E, Murray DM, O’Mahony O, O’B Hourihane J. Complementary and alternative medicine use in Irish paediatric patients. Ir J Med Sci. 2008 Apr 22.
(20) Joos S, Musselmann B, Miksch A, Rosemann T, and Szecsenyi J. The role of complementary and alternative medicine (CAM) in Germany – a focus group study of GPs.
BMC Health Services Research 2008, 8:127. doi:10.1186/1472-6963-8-127
(21) Stange R, Amhof R, Moebus S. Complementary and alternative medicine: attitudes and patterns of use by German physicians in a national survey. J Altern Complement Med. 2008 Dec;14(10):1255-61.
(22) Munstedt K, et al. Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: A questionnaire study. Eur J Obstet Gynecol (2009), doi:10.1016/j.ejogrb.2009.05.013
(23) Du Y, Knopf H. Paediatric homoeopathy in Germany: results of the German health interview and examination survey for children and adolescents (KiGGS). Pharmacoepidemiol Drug Saf. 2009 Feb 23.
(24) Tuffs, Annette, Three out of Four Germans Have Used Complementary or Natural Remedies, BMJ, November 2 2002;325:990.
(25) Bussing A, Matthiessen PF, Ostermann T. Differential usage of homeopathy and acpunture in German individuals. 2009 North American Research Conference on Complementary and Integrative Medicine, May 2009, Minneapolis, MN. Published in Alternative Therapies. May/June 2009, 15,3:S141.
(26) Hensel M, Zoz M, Ho AD. Complementary and alternative medicine in patients with chronic lymphocytic leukemia. Support Care Cancer. 2008 May 6.
(27) Laengler A, Spix C, Seifert G, Gottschling S, Graf N, Kaatsch P. Complementary and alternative treatment methods in children with cancer: A population-based retrospective survey on the prevalence of use in Germany. Eur J Cancer. 2008 Oct;44(15):2233-40.
(28) Schwarz S, Knorr C, Geiger H, Flachenecker P. Complementary and alternative medicine for multiple sclerosis. Mult Scler. 2008 Sep;14(8):1113-9.
(29) Marian F, Joost K, Saini KD, et al Patient satisfaction and side effects in primary care: an observational study comparing homeopathy and conventional medicine. BMC Comp Alt Med 2008, 8:52. doi:10.1186/1472-6882-8-52.
(30) Bornhoft, G, Wolf, U., von Ammon, et al, Effectiveness, Safety, and Cost-Effectiveness of Homeopathy in General Practice–Summarized Health Technology Assessment, Forschende Komplementarmedizin, 2006;13(suppl 2):19-29.
(31) Fisher, Peter and Ward, Adam. “Complementary Medicine in Europe,” British Medical Journal, 309, July 9, 1994: 107-10.
(32) Hess S, De Geest S, Halter K, Dickenmann M, Denhaerynck K. Prevalence and correlates of selected alternative and complementary medicine in adult renal transplant patients. Clin Transplant. 2008 Sep 11. Clin Transplant. 2008 Sep 11.
(33) ANSA English Corporate Service, 7.5 Million Italians Use Homeopathic Drugs, May 20, 2004.
(34) Molassiotis A, Fernadez-Ortega P, Pud D, et al, Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol, 16: 655-663, 2005.
(35) Johannessen H, von Bornemann Hjelmborg J, Pasquarelli E, Fiorentini G, Di Costanzos F, Miccinesi G., Prevalence in the use of complementary medicine among cancer patients in Tuscany, Italy. Tumori. 2008 May-Jun;94(3):406-10.
(36) Clerici CA, Veneroni L, Giacon B, et al., Complementary and alternative medical therapies used by children with cancer treated at an Italian pediatric oncology unit. Pediatric Blood Cancer. June 2009. doi 10.1002/pbc.22093.
(37) Gomez-Martinez R, Tlacuilo-Parra A, Garibaldi-Covarrubias R. Use of complementary and alternative medicine in children with cancer in Occidental, Mexico. Pediatr Blood Cancer 2007;49:820-823.
(38) Gozum S, Arikan D, Bu¨yu¨kavci M. Complementary and alternative medicine use in pediatric oncology patients in eastern Turkey. Cancer Nurs 2007;30:38-44.
(39) Nathanson I, Sandler E, Ramı´rez-Garnica G, et al. Factors influencing complementary and alternative medicine use in a multisite pediatric oncology practice. J Pediatr Hematol Oncol 2007;29:705-708.
(40) D’Inca R, Garribba AT, Vettorato MG, Martin A, Martines D, Di Leo V, Buda A, Sturniolo GC, Use of alternative and complementary therapies by inflammatory bowel disease patients in an Italian tertiary referral centre, Dig Liver Dis. 2007 Apr 10.
(41) Reuters (Madrid) Tummy tucks join inflation calculation. February 12, 2007.
(42) Izmirlieva, Milena. Global Insight, March 28, 2007 (found in Homeopathy Today, May/June 2007, p.9).
(43) Clines, F. “With Medicine Itself Sick, Russians Turn to Herbs,” New York Times, December 31, 1990.
(44) Brown, Samuel, Use of Complementary and Alternative Medicine by Physicians in St. Petersburg, Russia. The Journal of Alternative and Complementary Medicine Apr 2008, Vol. 14, No. 3: 315-319.

vonsyhomeopath27.2.10:

Read more about Evan Harris and Phil Willis’s friends in Sense About Science

As predicted the media produced the expected snow – every national paper, every TV channel ran the story along similar lines: “Homeopathy should not be funded on the NHS, say MPs”.

The Mail and Telegraph ran stories on Sunday night, which was interesting since the Science and Technology Committee were adamant that details of the report should not be released to the public until after 11am Monday.

Bloggers had already written detailed posts directly quoting the report and published them at precisely 11am.

Leaked?

Surely not,

Patients’ Voice Purposefully Excluded From Homeopathy Kangaroo Court

The Guardian at least waited till Monday to report: “Stop funding homeopathy, MPs urge”.

And so it went on.  Anyone reading the news might have imagined that there had been an in depth investigation of the matter in parliament.

But who are these MPs doing the urging, and how does the Science and Technology Committee work?

The Science and Technology Committee is a parliamentary Select Committee charged with looking into what informs government policy in a number of areas – it’s a relatively recent enterprise and homeopathy is only their second investigation in this form.

One might ask why – of all the government policy the committee could have chosen to investigate, it chose homeopathy – which uses just 0.004% of the NHS budget and has been part of the NHS since 1948.

We can only surmise.

Phil Willis, Chair of the committee was at pains to put on record that it was NOT to be an investigation into whether homeopathy worked or not – and then he chaired a committee which did exactly that, but restricted the investigation to the narrow remit of RCTs (Random Controlled Trials).

Surely not?

Let’s look at this committee in more detail:
At the first meeting on 25th November 5 MPs were present plus the Chair: Phil Willis: a history teacher and associate of the Pharma lobby group Sense About Science; Tim Boswell, a farmer; Brian Iddon, Professor of Chemistry; Graham Stringer, Analytical Chemist; Evan Harris, medical doctor and associate of Sense About Science and Ian Stewart, chemical plant operator and open mind.

It can be said categorically that NONE of the MPS present at the hearings have any expertise or even understanding of the homeopathic method.  It could be said that those steeped in chemistry might find it particularly challenging.

The committee spent a total of 4 and half hours questioning 12 witnesses – 7 of whom also have NO expertise or understanding of the homeopathic method – 5 of the 9 non-governmental witnesses had previously publicly declared they were vehemently opposed to homeopathy.  Only 1 witness is in clinical practice.

Biased?  Surely not?

The procedure called for written submissions – closing date was Nov 6th 2009.  Based on these submissions witnesses would be selected to give oral submissions at the committee’s meetings.

Almost 50 written submissions were received by the closing date and invitations for witnesses were apparently sent out 48 hours later. It would be interesting to know which devoted MPs stayed up all night reading the submissions and selecting witnesses.

Unless of course they had already been pre-selected.

Surely not?

Anyone who has watched the archived meetings on the parliamentary website will know that at least two members of the committee had a clear agenda they were determined to push through.

Evan Harris and Chair of the committee Phil Willis,  Sense About Science associates made no attempt to hide their disdain for the witnesses speaking on behalf of homeopathy.

Denialist bloggers and newspapers like the Guardian had a field day with sound bites and helped set the scene for the foregone conclusions of the report itself.

All claims of bias were ignored by the committee and the draft report was written.

This is where it gets even more interesting….

At the meeting of Feb 8th 2010 the Science and Technology committee met to ratify the report. Present was:  Phil Willis in the Chair,  Evan Harris, Tim Boswell, Ian Cawsey, Doug Naysmith and Ian Stewart.

Ian Stewart put forward an amendment not to ratify the report as it stood but to call upon government to “fund a rigorous research programme into homeopathy”
Voting was:  Ayes: Ian Stewart Noes: Evan Harris, Ian Cawsey, Doug Naysmith.   Presumably Tim Boswell abstained though his vote was not recorded.

A second vote was taken on the specific paragraph relating to research – to retain as written and not insert Ian Stewart’s amendment: paragraph 77. “There has been enough testing of homeopathy and plenty of evidence showing that it is not efficacious. Competition for research funding is fierce and we cannot see how further research on the efficacy of homeopathy is justified in the face of competing priorities.”

Voting was: Ayes: Evan Harris, Ian Cawsey, Doug Naysmith, Noes: Ian Stewart Paragraph was agreed to as was.  Tim Boswell abstained?  Vote not recorded.

The vote to accept the report and its recommendations to stop funding NHS homeopathy on the basis that the evidence did not support government policy was:  Ayes:  Evan Harris, Ian Cawsey, Doug Naysmith, Noes: Ian Stewart. Tim Boswell abstained again?  We’ll never know.

SO this report was ratified by just THREE MPs:

Evan Harris, associate of Sense About Science and it’s fair to say rabid anti-homeopathy campaigner, 1023 participant and ’senior counsel for the prosecution’.

Ian Cawsey – IT expert, who joined the Science and Technology Committee in October 2009, just a month before the meetings and yet chose not to attend the committee’s investigation – in fact was nowhere to be seen until the ratification meeting.

Doug Naysmith – an immunologist – did not join the Science and Technology Committee until January 2010 – so was not even on the committee until after all the hearings – yet was present for the ratification of the report.  And he is standing down at the next election.

Surely not?

A committee would invite a new member to join knowing that in a matter of a few months he would be leaving again?

Surely not?

So let’s get this straight – the report and its recommendations that led to the media snow this week, and the dramatic assertion that the public have been duped since 1948 by NHS placebos masquerading as medicine, is the result of a report ratified by THREE MPs: TWO of whom were NOT EVEN PRESENT AT THE COMMITTEE MEETINGS  – and ONE of the two was NOT EVEN A MEMBER OF THE COMMITTEE when the hearings were held, and is due to stand down at the election in May this year.

This Science and Technology Committee investigation into homeopathy was a set up and a sham from its inception to the final meeting and delivery of the report to the UK press.

And there’s no “surely not” about it.

Piglets of the homeopathic treated group had significantly less E. coli diarrhoea than piglets in the placebo group,

Read about more scientific research into homeopathy

BACKGROUND: The use of antibiotics in the livestock sector is increasing to such an extent that it threatens negative consequences for human health, animal health and the environment.

Homeopathy might be an alternative to antibiotics.

It has therefore been tested in a randomised placebo-controlled trial to prevent Escherichia coli diarrhoea in neonatal piglets.

METHOD: On a commercial pig farm 52 sows of different parities, in their last month of gestation, were treated twice a week with either the homeopathic agent Coli 30K or placebo. The 525 piglets born from these sows were scored for occurrence and duration of diarrhoea.

RESULTS: Piglets of the homeopathic treated group had significantly less E. coli diarrhoea than piglets in the placebo group (P<.0001). Especially piglets from first parity sows gave a good response to treatment with Coli 30K. The diarrhoea seemed to be less severe in the homeopathically treated litters, there was less transmission and duration appeared shorter.

Copyright 2009. Published by Elsevier Ltd.

Forestry experts have called for a census of London’s beleaguered horse chestnut trees to assess damage caused by drought, pest attack and disease.

…the use of a homeopathic spray to combat bleeding canker infection and pest infestation has so far yielded positive results. “The trial that’s been running for two years is showing very good results… You can’t spray any kind of toxic chemicals in these public areas, so homeopathics are perfect for the job”.

Read about more scientific research into homeopathy

As The Independent revealed on Thursday, at least one in 10 horse chestnut trees in Britain is believed to have been affected by an environmental “triple whammy,” which is being compared in impact to the outbreak of Dutch elm disease which swept the country in the 1970s. The trees are being attacked by a combination of cankers killing the bark and leaf-moth larvae destroying foliage.

David Rose, a spokesman for the Forestry Commission, said yesterday: “It is imperative that we have a proper survey of the problem across London as it is the area of Britain worst hit by this. It is something that we would be willing to co-ordinate.”

His calls were backed by the London Assembly’s Liberal Democrat spokesman on the environment, Mike Tuffey. “Once we know the size of the epidemic we can nip it in the bud.”

Calls for a rescue plan for the iconic tree, which has provided generations of children with ammunition for annual autumn conker fights, have become increasingly urgent since The Independent revealed the scale of the problem. Mark Spencer, a tree expert at the Natural History Museum, said yesterday: “Because of conker fights and the incredible impact horse chestnuts have on the way London looks any changes could be dramatic”.

Carrying out a census however, would be a costly process. Mr Rose, said: “Larger-scale work would need additional resources but could yield interesting results.”

Meanwhile it emerged yesterday that a treatment being developed in the Netherlands could hold the key to saving Britain’s horse chestnut. The chestnuts which line the boulevards of The Hague face a similar threat to Britain’s trees. But the use of a homeopathic spray to combat bleeding canker infection and pest infestation has so far yielded positive results.

“The trial that’s been running for two years is showing very good results, and we seem to be the only people actually doing anything” said Glen Atkinson, the inventor of the treatment and founder director of Bdmax, the company which is marketing the spray. “You can’t spray any kind of toxic chemicals in these public areas, so homeopathics are perfect for the job.”

But experts in Britain are pessimistic about the chances of saving those trees which have already succumbed to disease or been infested by the leaf miner moth.

Chris Prior of the Royal Horticultural Society said: “Unfortunately there is nothing that can be done about the leaf miner, and it’s very unlikely there’ll be any action that can be taken against cankers as well.”

One tree officer from a London borough also voiced scepticism over a possible Dutch “miracle cure”. He said: “If something worked we’d be very keen to use it, but I’m not sure how it could tackle both problems at once. It sounds a bit too good to be true.”

ABSTRACT: BACKGROUND: Very little is known about the range of diagnoses, course of treatment and long-term outcome in elderly patients who choose to receive homeopathic medical treatment.

We investigated homeopathic practice in an industrialised country under everyday conditions.

The aim of the study was to determine the spectrum of diagnoses and treatments, as well as to describe the course of illness over time among older patients who chose to receive homeopathic treatment.

Read about more scientific research into homeopathy

METHODS: In this subgroup analysis of a prospective, multicentre cohort study totally including 3981 patients treated by homeopathic physicians in primary care practices in Germany and Switzerland, data was analysed from all patients > 70 years consulting the physician for the first time.

The main outcome measures were: assessment by patient of the severity of complaints (numeric rating scales) and quality of life (SF-36) and by the physician of the severity of diagnoses (numeric rating scales) at baseline, and after 3, 12, and 24 months.

RESULTS: A total of 83 patients were included in the subgroup analysis (41% men, mean age 73.2 +/- (SD) 3.1 years; 59% women, 74.3 +/- 3.8 years). 98.6 percent of all diagnoses were chronic with an average duration of 11.5 +/- 11.5 years. 82 percent of the patients were taking medication at baseline.

The most frequent diagnoses were hypertension (20.5%, 11.1+/-7.5 years) and sleep disturbances (15.7%, 22.1+/-25.8 years).

The severity of complaints decreased significantly between baseline and 24 months in both patients (from 6.3 (95%CI: 5.7-6.8) to 4.6 (4.0-5.1), p<0.001) and physicians’ assessments (from 6.6 (6.0-7.1) to 3.7 (3.2-4.3), p<0.001); quality of life (SF 36) and the number of medicines taken did not significantly change.

CONCLUSION: The severity of disease showed marked and sustained improvements under homeopathic treatment, but this did not lead to an improvement of quality of life.

Our findings might indicate that homeopathic medical therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on comparative effectiveness are needed to evaluate this hypothesis.

Read about more scientific research into homeopathy

“Save NHS homeopathy”, it says. Another poster urges supporters to join a lobby of parliament. Long before MPs from the cross party Commons committee on science and technology gave the thumbs down to homeopathy on Monday, people here knew what was coming. The remedies worked no better than a placebo, the committee said, and the NHS should cease funding.

Read about more scientific research into homeopathy

It was a withering verdict but the Royal London Homeopathic Hospital remains undaunted. There are no placards or demonstrators here. Just the usual crowd of patients ? predominantly middle aged and female ? that you find in any hospital waiting area.

Supporters of homeopathy ? practitioners and patients alike ? are used to controversy and another bout of negative publicity, of which there is never a shortage, is not going to change their minds.

“I was irate,” says Gillian Arneil, waiting for her appointment. “They don’t understand what this hospital does for people. I come out of my GP’s surgery banging my head and I come out of here feeling 10ft tall. This is the main homeopathic hospital and it is the Royal as well. You can’t do better than that.”

Graham McClarty taps me on the shoulder, anxious to tell me what homeopathy has done for him. A former policeman, he used to be off sick with bronchitis for extended periods at least twice a year. He tried a course of homeopathy, the bronchitis cleared up immediately. Today he has brought his wife here. “I just wanted you to know,” he says.

Linda Tricker, fizzing with enthusiasm and anxiety in equal measure, describes the digestive problems that brought her here which orthodox medicine was unable to solve. “I had more investigations and consultations than hot dinners. My file was becoming fatter and fatter ? the doctors said I was neurotic and sent me away with anti-depressants. The NHS did nothing for me,” she said.

For many, this is the place of last resort. She has been coming for two years, referred by her GP, and says the hospital has seen her through the most stressful period of her life. “I know there is a lot of quackery in alternative medicine but for people who have difficult problems these hospitals are a godsend.”

Whether homeopathy has divine origins is for others to judge, but the level of enthusiasm shown by the patients I met during a two-hour visit was untypical of the average NHS district general. As Dr Sarah Eames, director of women’s services, was showing me around the pharmacy, a woman touched her sleeve. “Thank you for what you are doing,” she said, gazing into her eyes.

The patients know they are getting special treatment, not available to most. It is exotic, too, with its “tinctures” and “provings” and “water memory”. The Royal London Homeopathic Hospital is the biggest of the four homeopathic hospitals in the country but it has just 20,000 out-patient visits a year, compared with hundreds of thousands in a conventional NHS hospital.

There are 20 doctors, and although most are part-time they do not give the impression of being under pressure as in much of the NHS. All the staff, including the nurses and pharmacists, are medically qualified. This may be alternative medicine but it is the Rolls Royce model.

In one of the smart consulting rooms, with a poster outside describing “Marigold therapy for bunions,” Dr Sarah Eames, 56, describes how she came to be a leading practitioner of what many of her medical colleagues regard as magic.

“I have been a doctor for over 30 years. I worked as a GP before I stumbled across homeopathy like most people here. What we specialise in is people who are not helped by conventional medicine. Their suffering is long term and we can save money on NHS tests and treatment that has not proved particularly helpful.”

Like many alternative practitioners she is sceptical that figures alone can provide a full picture of what is going on. The Commons science committee argued that randomised controlled trials, medicine’s gold standard, showed homeopathy worked no better than a placebo.

“It depends how you jiggle the statistics,” she says. A 1998 Lancet meta-analysis, cited in the committee report, appeared to show homeopathy was effective and then, when re-analsysed, that it wasn’t. “I rest my case.” Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials Lancet 1997, vol. 350, no9081, pp. 834-843

Her bottom line, like many orthodox doctors, is that regardless of what the trials may show, she knows what works, and she has seen patients get better. “It may be dismissed as anecdote but when you continue to see people respond it does build up. Homeopathy has been going for 200 years and hundreds of thousands of people have been treated. Do you discount them all?”

Many doctors would answer Yes, you should discount the evidence of your own eyes until it has been subtantiated by reliable, scientific trials. Observation is notoriously unreliable in medicine, as in other fields, because people see what they want to see. Doctors, whether alternative practitioners or not, are as vulnerable as the rest of us.

She discounts the argument that homeopathy is “scientifically implausible” on the grounds that while we may lack a scientific model to explain it now we may have one in the future. “We can’t explain everything in terms of molecules ? what about electronics and ultra molecular physics? To say homeopathy is implausible is rather old fashioned.”

I ask how she can defend spending scarce NHS cash on homeopathic remedies of unproven effect while cancer patients are denied effective drugs because they are too expensive.

“I understand the NHS has to look at how it spends its resources. But by treating the patients we see ? with half a dozen conditions and a list of investigations and drugs as long as your arm ? we probably save the NHS money.”

In the pharmacy, Janvika Shah, pharmacist, is sticking a label on a jar of Calendula-Urtica cream. It contains mother tinctures to soothe eczema and other skin conditions. In front of her, rows of brown bottles with white lids carrying labels such as Aconite, and Pulsatilla, each have a coloured sticker to indicate the degree of dilution. Next to them glass tubes of tiny white inert pills, 120 in each, await the addition of seven drops of tincture, the “active ingredient”.

The tube is shaken after additon of the drops and the tincture, in an alcohol and water base, vaporises so it rises through the pills. Patients typically take one or two pills a day, held under the tongue, for five days or until symptoms improve.

“Everyone who works here uses homeopathy as a first line treatment,” says Dr Sarah Eames. Janvika Shah nods in assent. “There’s a good place for this”, she says, preparing a dose for another patient. “It is not a substitute, its complementary.”

Read about more scientific research into homeopathy

This report presents the findings from an evaluation of a pilot project which provided patients with access to a range of Complementary and Alternative Medicine (CAM) through their GP practice.

Overall 713 patients were referred to the project by their GP. Patients presenting to their health centre with musculoskeletal and mental health conditions, were referred for a range of CAM therapies including acupuncture, chiropractic, osteopathy, homeopathy, reflexology, aromatherapy and massage.

The project was commissioned by the Department of Health, Social Services and Public Safety with a view to exploring the potential for CAM within existing primary care services in Northern Ireland.

Homeopathy was an integral part of this CAM Pilot Project

Read more about Scientific Research into homeopathy

The project was implemented by Get Well UK in two primary care centres in Northern Ireland: Shantallow Health Centre in Londonderry and The Arches Centre in Belfast.

The evaluation, conducted independently by Social & Market Research (SMR), is based on an analysis of project monitoring data provided by Get Well UK; and focus groups and surveys of patients, CAM practitioners and GPs from the two participating health centres.

Key Findings:

The Patient Experience Using the various data sources, the evaluation has found a significant level of health gain for the vast majority of patients who have received complementary and alternative medicine as part of the pilot project.

This is evidenced by the following:

- Analysis of MYMOP (Measure Yourself Medical Outcome Profile) data, which was generated using a validated health instrument used for measuring patient health gain in general practice, found statistically significant improvements on each of the health outcome indicators measured i.e. the severity of patient symptoms; the level of patient activity associated with their symptoms; and, overall patient wellbeing (source, MYMOP);

- The proportion of patients reporting that the severity of their symptoms were ‘as bad as it could be’, fell from 31% prior to treatment to 5% following treatment (source, MYMOP);

- 80% of patients recorded an improvement in the severity of their main symptom, with 73% recording an improvement in their level of activity associated with their main symptom (source, MYMOP);

- 67% of patients recorded an improvement in their wellbeing (source, MYMOP); 81% of patients said that their general health had improved, with a similarly high proportion of patients 82%) reporting to be less worried about their symptoms following treatment (source, MYMOP);

- 81% of patients reported an improvement in their physical health, with 79% reporting an improvement in their mental health (source, patient survey);

- 84% of patients directly linked the CAM treatments to an improvement in their overall wellbeing (source, patient survey); 62% of patients were suffering less pain, with 60% having more control over pain (source, patient survey);

- There was a 14 percentage point reduction in the proportion of patients using medication between the pre and post-treatment stages (i.e. down from 75% to 61%) (source, project monitoring data);

- 44% of patients who were taking medication prior to their treatment, had reduced their use of medication (source, patient survey);

- Among patients using pain killers prior to treatment, 55% said that they use fewer pain killers following treatment (source, patient survey);

- In the majority of patient cases, CAM practitioners reported an improvement in: patient quality of life; relief of presenting symptoms; relief of chronic conditions; increased mobility; increased emotional stability; and, a reduction in patient worry (source, project monitoring data);

- 24% of patients who used other health services prior to treatment (e.g. other
primary care services, secondary care services and Accident and Emergency), said they now use these services less often (source, patient survey);

- 64% of patients in employment said that following treatment they now take less time off work. Among patients not in employment, 16% said that having the CAM treatments had encouraged them to think about going back into employment (source, patient survey);

- 94% of patients would recommend CAM to other patients with similar health conditions (source, patient survey);

- 89% of patients expressed an interest in continuing with CAM, with just 30% saying they would be able to afford to continue with CAM treatments (source, patient survey);

- Patients were supportive of CAM being integrated into primary health care, with a call for increased public awareness of the potential of CAM for health gain (source, patient focus groups);

- Patients identified a need for CAM to be promoted among GPs in Northern Ireland, and for initiatives to be taken to help reduce the level of scepticism held by some GPs towards CAM (source, patient focus groups);

Key Findings:

The GP Experience

- In 65% of patient cases, GPs documented a health improvement, with a high degree of correlation between GP and patient assessment of health improvement (source, project monitoring data);

- In 65% of patient cases, GPs said they had seen the patient less often following the patient’s referral to CAM (source, project monitoring data); Improving patient health was found to be the main motivation for GPs getting involved in the pilot project (source, GP survey and focus groups);

- Most GPs said that their understanding and knowledge of CAM had improved by participating in the pilot project, with most conceding that their knowledge was limited at the initial stages. Some GPs had experienced difficulty initially in matching their patients with appropriate therapies, with most of the GPs supporting the need for further educational interventions such as seminars, talks with practitioners and having more written information on CAM (source, GP survey and focus groups);

- Half of GPs reported prescribing less medication for chronic or acute patients (source, GP survey);

- Half of GPs reported that the option to refer their patients to CAM had reduced their workload, with two GPs pointing to a financial saving for their practice. All but one of the GPs had seen the project as a positive development for their practice, with all agreeing that it provided them with more referral options (source, GP survey);

- Most GPs reported that their patients were using Allied Health Professionals
less often, with half saying that their patients were using secondary care services less often (source, GP survey);

- Ten out of the 12 GPs surveyed had a more positive view of the potential for CAM within primary care, with all wishing to continue with the option of referring their patients to CAM (source, GP survey);

- In 99% of patient cases, the GP said that they would be willing to refer the same patient, or another patient, to the Get Well UK service. Also in 98% of patient cases, the GP said they would be willing to recommend the service to another GP (source, project monitoring data); Key Findings:

The CAM Practitioner Experience

- CAM practitioners reported a health improvement in 77% of their patients on
average, with health gains including: pain relief; improved quality of life; improved mobility, stress relief and improved emotional wellbeing (source, practitioner survey);

- CAM practitioners identified a need for a series of educational interventions targeted at GPs to improve their understanding of CAM and to better support them with matching health conditions with appropriate therapies (source, practitioner survey and focus groups);

- CAM practitioners called for GPs to supply more information on patient’s medical condition as part of the referral process (source, practitioner survey and focus groups);

- CAM practitioners identified a tendency for GPs to refer patients with chronic medical conditions to the project, with practitioners concerned that the therapies may not be as responsive to this type of patient compared to, for example, patients with acute medical conditions (source, practitioner survey and focus groups);

- Affordability was identified as the main barrier for patients wishing to continue with CAM (source, practitioner survey and focus groups);

- All CAM practitioners supported the integration of CAM within primary health care, with patient health gain cited as the key benefit (source, practitioner
survey and focus groups);

- CAM practitioners reported a more positive attitude to CAM among GPs who
had participated in the project, with ongoing contact and communication between GPs and CAM practitioners identified as a key requisite if CAM is to be rolled out more extensively across Northern Ireland (source, practitioner survey and focus groups);

Recommendations

(i) Given the evidence of health gain documented by patients, GPs and CAM practitioners, it is recommended that DHSSPS and the project partners explore the potential for making CAM more widely available to patients across Northern Ireland. Not only has this project documented significant health gains for patients, but it has also highlighted the potential economic savings likely to accrue from a reduction in patient use of primary and other health care services, a reduction in prescribing levels and reduced absenteeism from work due to ill health.

(ii) This pilot project has clearly demonstrated that CAM fits well within a primary health care context, with patients valuing the support and judgement of their GPs in accessing treatments. It is recommended that DHSSPS and the project partners examine ways of integrating CAM within primary care, taking on board the need for a strategy to promote GP knowledge and understanding of CAM to ensure that health conditions are matched appropriately with CAM therapies. A strategy to promote awareness and understanding of CAM among GPs, as well as the positive health gains for patients, should also go some way to addressing issues around scepticism held by some GPs.

(iii) To further assist the process of integrating CAM with primary health care, it is recommended that consideration be given to exploring the potential for sharing medical records with CAM practitioners. Furthermore, consideration should be given to exploring the potential for CAM practitioners to be involved in clinical meetings and case conferences, which may provide patients, particularly those with chronic health problems, with more treatment options. This may also lead to significant cost savings for the health service.

(iv) The project has highlighted a number of areas where the operation of a CAM service can be further improved. In particular, it is recommended that DHSSPS and the project partners explore ways of ensuring that patients are provided with accurate and up to date information at all points of the referral process, as well as at the point of receiving treatments. In addition, the evaluation has found that patients may benefit from a ‘triage’ system to ensure appropriate matching of health conditions and CAM treatments;

(v) Given that the pilot project has raised expectations among patients, DHSSPS and its partners should consider a mechanism for ensuring that patients who presented with long-term illnesses, and in particular those who experience pain, be offered booster or maintenance sessions beyond the life of the project.

(vi) Given the limited number of CAM practitioners in Northern Ireland, and the difficulties in identifying practitioners to participate in the pilot project, it is recommended that DHSSPS and the project partners consider ways of retaining this resource within a model for wider service delivery.

(vii) Given that the health outcomes for patients have been significant, it is recommended that DHSSPS and the project partners consider the development of a public health information campaign aimed at promoting the potential benefits of CAM. Allied to this point, it is recommended that DHSSPS and its partners examine the role of CAM in supporting health prevention and health promotion strategies, given the evidence that patients are likely to adhere strongly to the advice provided by CAM practitioners.

(viii) The evaluation has documented the positive impact of CAM on patients who are economically active, particularly in the context of helping people back into work following illness. It is recommended that the outcomes from this project be shared with colleagues in other departments (e.g. Department for Employment and Learning), to allow them to examine the potential for CAM within their own operational areas.,

(ix) Given that the evaluation outcomes are based on the perception of the various stakeholder groups (i.e. patients, CAM practitioners and GPs), it is recommended that DHSSPS and the project partners give consideration to integrating other approaches to measuring health impact (e.g. a formal case control study) on an ongoing basis.

Sara Eames, President of the Faculty of Homeopathy says YES.

Homeopathy should be available on the NHS. I am a trained doctor and I have used homeopathy in general practice and in a homeopathic hospital. I am able to help more patients with an appropriate mixture of homeopathy and conventional medicine than with either system alone.

Homeopathy has been practised safely and effectively for more than 200 years. It has been part of the NHS since its inception in 1948.

In general practice it provides a cost-effective way of dealing with common problems. It’s incredibly useful for the treatment of mild, acute conditions such as viral infections, diarrhoea and vomiting, injuries and the management of some long-term symptoms.

Once patients get used to using homeopathic remedies, often they can use simple remedies themselves and consult doctors only if the medicine doesn’t work. This will save the NHS time that otherwise would be taken up by consultations and money that would have been spent on prescriptions.

Furthermore, many patients are delighted to have an alterative to commonly used medications, such as antibiotics, steroids and anti-inflammatories. Second, homeopathy can be very useful in hospitals.

The four NHS homeopathic hospitals in the UK are staffed by conventionally trained doctors and nurses, and all patients are referred by their own doctors, often when they have not responded to conventional medicine.

The argument that a remedy that has a placebo effect has no place in the NHS is flawed. The role of the NHS is to make patients better and I’m very happy to use all treatments that do that. And all treatments can have a placebo effect, not only homeopathy.

Studies from homeopathic hospitals show considerable benefit to patients. A study in Bristol of more than 6,000 patients, published in 2005, showed that 70 per cent experienced improvement not only in their main complaint but also in their overall wellbeing. There have been more than 100 double-blind trials on homeopathy. Far more are positive than negative — and that is after correcting for the placebo effect.

These statistics have been subject to controversy, but they are only part of the picture. Healthcare decisions involve many factors, including patient choice, safety, outcome studies and cost-effectiveness.

We all pay for the NHS and patients should be able to receive the treatment they want.

What will happen to patients who are not helped by conventional medicine if there is no alternative?

The sensible integration of homeopathy and other complementary therapies into healthcare can relieve the financial burden on the NHS while providing a service that patients appreciate.

A cross-party group of MPs this week agreed that homeopathy should not be funded by the NHS: nobody has yet agreed, ­however, the extent to which the health service is funding homeopathy.

The Society of Homeopaths estimates £4m a year; health minister Mike O’Brien put the spend at £152,000 a year.

Is that the whole problem here?

Can homeopaths just not count?

If it really is £4m, this is a problem 10 times smaller than the indigestion blunder, in which ­Gaviscon’s makers allegedly sharp-dealt their way into a huge contract that could have been undercut by almost anybody (I mean “10 times” literally, not as a figure of speech).

If it’s worth £152k, we can file that under “even smaller peanuts”.

There has never been a hotter, yet less substantial potato than the argument about homeopathy. The controversy it generates is fractionally more comprehensible when it concerns endorsement or not by the chief custodians of the nation’s health, but the passion far predates this: when it was just a way for cranks to waste money, homeopathy aroused baffling hostility.

I would never dispute that conventional medics were right, they have an evidence base, they have a peer-review system, they have all this scientific armoury that we believe – maybe rightly – saves us from the tedium of having to argue, but I can never shake the question … what do you care, pointy-heads, what hippies are spending their money on?

Even when the NHS is involved, these issues are still not as large as they’re made out to be. Dr Sara Eames, president of the Faculty of Homeopathy and also a GP, remarks: “Placebo is an effect of every treatment, it’s not the province of homeopathy.”

The epidemiologist Kerr White wrote once to the Lancet: “A 1963 paper in Medical Care reported a two-week survey by 19 GPs in a northern industrial town. They recorded the ‘intent’ of each prescription written. In only 9.3% of the prescriptions for proprietary drugs was the intent specific for the condition for which it was prescribed. Another 22.8% were of ‘probable’ benefit; 27.2% were of ‘possible benefit’; 28.2% were ‘hopeful’, and 8.9% were regarded as a ‘placebo’; 3.6% ‘not stated’.”

Yes, the 1960s are too long ago to be statistically useful. But never mind statistics, how about a sportsman’s bet? I bet you those percentages are still true.

It is reasonable to regulate the claims a homeopathic medicine can make on its packaging, but don’t have kittens. Homeopaths are just as bad in the ­having of unnecessary kittens. What do they care if the medical establishment refuses to believe their unprovable claims? Can’t they just lead us into the light by example, by living incredibly healthy, happy lives?

Personally I’m a hypochondriac, so both conventional and homeopathic medics shun me in unison. The only people who take me seriously are quacks.

From a position of such impartiality, may I observe that this argument has almost nothing to do with medicine? Perhaps the homeopaths are one part medicine, diluted by a million parts of anti-authoritarianism: possibly the doctors would claim to be motivated by pure science, but the energy of their attack makes me smell a rat.

Even if homeopathy has no evidence base at all (and homeopaths dispute this (see Scientific Evidence for homeopathy)– see how rigorously I maintain my ­neutrality), much of conventional ­medicine has none either (a rather mordant BMA statistic puts the figure for conventional medicine with an evidence base at 40%: a qualitative study in Oxford puts it at 82% – but that still leaves nearly 20% of treatments unmoored from demonstrable efficacy, which amounts to a lot more money than has ever been spent on homeopathy).

Yes, an evidence base is a rationalist’s ideal, but things are more complicated than that. There’s very good evidence to show that telling people to eat healthily and exercise more actually makes them put on weight, but when did that ever stop a GP?

I believe this is what sociologists call an “identity builder” – a shorthand for announcing what sort of person you are.

Against homeopathy are those who think of themselves as rationalists – intelligent people who hold a reliable course against the buffeting of fads and fashions, prejudices, fripperies, superstitions and the gamut of human idiocy.

If they really were rational, they would be able to admit there are many corners of conventional medicine that are mainly guess and empathy, but they cannot countenance a world in which a debate might have two answers.

Their very passion for reason undermines their position.

In favour of homeopathy are those who see themselves as anti-authoritarian, maybe a bit subversive, independent thinkers, imaginative, empathetic. They won’t be silenced, either, because crucial to this whole identity is that you won’t let the suits tell you how to think.

What’s interesting is that we’ve chosen this, of all issues, to line up behind. In the US, they have herrings just as red – abortion isn’t really about ­foetuses, the gun debate isn’t really, or not wholly, about guns, and Charles Darwin must be chuckling from his grave at the heat he suddenly generates.

But when Americans are looking for trigger issues, they choose large matters of life, death and the beginning of all things.

We choose homeopathy!

The very humility of this makes me, fleetingly, proud to be British.