Category Archives: Biochemistry

As regular readers will know I have been covering the funding of homeopathic AIDS trials by the Homeopathic Action Trust (HAT), the charitable arm of the Society of Homeopaths (SoH), for some time.  HAT have been aware of my coverage and even invited a reader of my blog, Angus Wood, to give a presentation to them about the issues raised by their activity.  The World Health Organisation (WHO) have even criticised these kind of activities.

This did not change anything.  Their latest accounts are now available at the Charity Commission website and it is clear that they are still funding homeopaths who believe that sugar pills can successfully treat AIDS and malaria and are now expanding into India.

Health in Africa project
The charity has been fundraising to meet the requirements of what is now the Tanzanian project. With an annual volume of 12,000 patients in the Natural Therapies Centre, Dar Es Salaam, consultant Mr. Sigsbert Rwegasira, experienced in treating patients with homeopathy, is working closely with the team.

Africa Project
The projects are now undertaking a new series of research initiatives in Africa and India and are also putting in place a low cost clinic education and support structure for Africa, which involves special remedy kits, training manuals and clinical support. We have assured funding for this for the next year and we are also applying to the Gates Foundation for more funding and also the EU.

The Swaziland Homeopathy Project is one of HAT’s initiatives.  In their objectives they very clearly state their intent to perform medical trials on people with an incurable disease who do not have access to appropriate healthcare:

carry out a scientifically verifiable study on the effect of Homeopathy as a treatment for the side effects of the ART

This study, like previous HAT projects, appears to be in breach of the ethical requirements for human trials, not least The Declaration of Helsinki.

The homeopaths at HAT and the SoH are medical fantasists and cargo cult researchers, anybody who thinks they have a role to play in healthcare is very, very wrong.

Last week I mentioned that David Tredinnick, Conservative MP for Bosworth, was being a bit silly in the lead up to his adjournment debate on integrated healthcare.  At the time I boldly suggested that if Tredinnick was the best ally alternative health had in the Houses of Parliament then it was in a great deal of trouble.  Sadly I may have been too confident.  The transcript of the debate is now available and Tredinnick’s contributions are as fanciful as you would expect.  However, it is not these that cause me concern, the man is not a credible figure and his voice carries little wait in tilting the healthcare debate one way or another, it is Anne Milton, the Under Secretary of State for Public Health, whose replies are troubling in many respects.  Readers may be interested in her pronouncements about ‘service providers’, and changes to the structure of NHS healthcare, which suggest some hard questions about their commitment public healthcare need to be asked of the new government.  My focus though, as usual, will be on those replies more pertinent to quackery and its regulation.  While Milton is clear and sensible on the need to defer to NICE and the evidence base, especially in these uncertain economic times where finite NHS resources are already strained and further threatened by the enthusiastic swishing scalpels in the Treasury, there are nevertheless some arguments that offer succour to alternative practitioners.

From her second paragraph:

My hon. Friend may be interested to know that although I trained as a nurse and worked in the NHS for 25 years in conventional medicine, my grandmother trained at the homeopathic hospital in London, and was herself a homeopathic nurse. Later, she became a Christian Scientist. I am therefore not without my own roots in alternative therapies. My hon. Friend may also be interested to know that my grandmother never, until her death at the age of 89, took any conventional medicine.

While this may be an opening gambit of flattery, designed to lessen the rejection of Tredinnick’s ideas, the claim about her grandmother does not seem particularly appropriate.  While good health, of the sort that lets you live until 89, may not require conventional medicine so much as luck, in both genes and environment, it is undeniable that many lives are saved by its use.  To imply by anecdote, not the most reliable of measures, that homeopathy may allow one to live long in the absence of accepted healthcare is unbecoming of a health minister upon whose decisions the health of millions rests. Worryingly the following paragraph suggests the the Minister may indeed have some mistaken opinions about the benefits of an agitated sugar pill.

My hon. Friend raised the issue of homeopathic hospitals and his concern about them. I understand that there are five such hospitals in the United Kingdom, based in London, Bristol, Tunbridge Wells, Liverpool and Glasgow. However, the Tunbridge Wells homeopathic hospital stopped providing services in March 2009 owing to the primary care trust’s decision to end funding. All the hospitals have experienced a reduction in the number of referrals over the past three years, and it has been claimed that all of them are now in a precarious position as a result of such significant funding losses. That is a matter of concern, given that they have clearly offered valuable treatments to patients.

I would like to know the evidence that showed clear benefit from these relics.  It certainly isn’t in the Science and Technology Committee report on homeopathy, which the Minister claims to be considering:

I note my hon. Friend’s comments on the Lords [sic] Science and Technology Committee report on homeopathy, and I am aware that it caused quite a lot of concern. It was published on 22 February, and we are still considering it and will formally respond in due course. He raised considerable concerns about the report, and highlighted the low cost of many alternative therapies and the important contributions they make. He also made reference to experiences from around the world-he mentioned Australia in particular, and also the USA-and he made an important point about the open-mindedness of some countries to alternative therapies.

In considering outcomes, patient-reported outcome measures must be an important factor. As my hon. Friend rightly said-and as I mentioned-individuals’ own experiences are very important, and if we want to achieve the best outcomes, one step we must take is to ask the patient whether they actually got better.

In conclusion, I wish to thank my hon. Friend for his contribution to the debate and to suggest that perhaps the picture is not as bleak as he fears-I noted a certain weariness in his voice; he feels that he has raised this issue on so many occasions and it has fallen on deaf ears.

I do not expect the government to fundamentally disagree with the reports recommendations, that would be a foolish fight to choose given homeopathy’s many vociferous critics, however the comment about patient-reported outcome measures intrigues.  As mentioned in the previous post on Tredinnick, these are the brain child of Boo Armstrong, ex-writer for an AIDS denialist magazine and former Chief Executive of the Prince’s Foundation for Integrated Health (FIH), and a rather curious thing for the Minister to pick up on.  While an inherently weak form of evidence that NICE would not normally consider, they are amenable to misinterpretation by those seeking to attribute what most would consider human bias to unscientific modalities, or magic if you prefer.  One wonders who briefed Anne Milton before this debate and why she considers that alternative therapies are not as threatened as Tredinnick fears?

Perhaps the answer to this lies in the new government’s views on regulation:

The issue of regulation was raised, and it is a thorny one. When I was a shadow Health Minister, I met on numerous occasions psychologists, psychotherapists and counsellors who were very concerned about the regulation of their professions. Across the professions allied to health care, there are those who are keen on regulation and those who feel regulation would be wrong and would be unable to deal with the intricacies of their work. There is no doubt that vulnerable people are often preyed upon by unskilled and unscrupulous practitioners, and I think that professions wanting to achieve the highest standards will welcome proper regulation. The issue for Government is always whether statutory regulation is the most appropriate way of dealing with that risk, or if a lighter-touch approach would be more appropriate. That is why, as I understand it, last year the Department of Health, along with devolved Departments, consulted on the regulation of practitioners of acupuncture, herbal medicine and traditional Chinese medicine. As my hon. Friend will be aware, the consultation closed in November, and more than 6,000 responses were received. The high response rate is a testament to the strength of feeling about public access to complementary and alternative medicines; I am sure I am not alone in having received a huge number of letters on the subject.

The consultation examined in detail the options for regulation, including alternatives to statutory regulation. Once the Government have considered the consultation responses, we will make clear the next steps in the regulatory process. In acknowledgment of my hon. Friend’s keen interest in the matter, I am very happy to keep in touch with him about it. In the meantime, the Complementary and Natural Healthcare Council [CNHC] provides for voluntary registration for practitioners from nine complementary therapy disciplines. I appreciate that my hon. Friend feels that that is not sufficient, but that is in place for the moment while we consider the consultation that has taken place and make a decision on what the next steps should be.

While there is no firm commitment to any particular position here there are two things the Minister needs to consider.

1) ‘light touch’ regulation does not work.

The CNHC have declared that they will ignore complaints from some members of the public, and have been utterly ineffectual in what little concerns they have considered. Not only that they have had to tolerate some outrageous conspiracy theories and false accusations widely circulated by email.

2) Statutory regulation does not work.

Consider the Chiropractors, The General Chiropractic Council (GCC) are supposed to be the statutory body that regulates Chiropractic.  However, since one of the GCC affiliate associations decided to unsuccessfully sue Simon Singh, the profession has found itself under considerable scrutiny, with many of its members subjected to professional standards complaints.  The GCC have been obstructive, inconsistent, dishonest and completely ineffectual in dealing with these.

The regulation of quackery requires some fresh thinking and if the government chooses either of the options above then there will only be chaos from quacks and complaints from skeptics.  Whatever their choice it looks like the eternal battle between reason and woo will continue.  With the collapse of the FIH, quackery is in search of new allies and its former employees may already be making contacts.  As the governments ideologically enthusiastic and economically necessary cuts bite, the temptation to favour cheap placebos may lead many astray.  Anne Milton may not yet have chosen her side, but her lack of commitment is telling, the dark mutterings of the deluded are being listened to if not yet obeyed.

David Tredinnick, Conservative MP for Bosworth, fulfils a traditional role, required of those who are outliers to the left of the ability curve, in the Westminster Village.  The idiot.  This has enabled him to have a long undistinguished career, previously he was best known for his role in the ‘cash for questions‘ affair, taking a cheque for £1,000 to ask a question in parliament, now his concerns are quacks and their questions.

In an ePolitix article, to promote his adjournment debate on integrated healthcare, Mr Tredinnick presents all the ability and skills that have kept him out of the 3rd reserves for the Conservative front bench.  An ungracious observation about Evan Harris, the former Liberal Democrat MP for Oxford and Abingdon, one of the previous parliaments most rational and respected members is followed by much crowing about the poor performance from one his challengers in Bosworth, the science writer Dr Michael Brooks.  Mr Tredinnick’s reasoning then goes the way of his charm with the following paragraph:

Surveys show that support for a healthcare model that allows doctors to refer to other therapists such as herbalists, acupuncturists, homeopaths and aromatherapists is increasing. The new coalition government seeking to both give more say to doctors and more choice to patients should embrace integrated health care as its model.

This is presumably referring to the infamous Northern Ireland Trial.  This was carried out by a marketing company, hired by a lobby group fronted by Boo Armstrong, who used to write articles for an AIDS denialist magazine and was latterly Chief Executive of the Prince’s Foundation for Integrated Health (FIH), until it fell victim to fraud.

Tredinnick would like the new government to consider this report.  He would also like them to consider regulating alternative therapists through the Health Professionals Council (HPC), rather than the Complementary and Natural Healthcare Council (CNHC).  This is interesting as the CNHC, an offshoot of the disgraced FIH, has been struggling to recruit enough members to survive, and has already been rejected by herbalists and the Society of Homeopaths (SoH), who have previously collaborated with Tredinnick. Is this a move by these alternative elements and their political proxy reflecting a power grab in the alternative healthcare sector?

And what of Boo Armstrong, now that the FIH are disgraced she must be looking for a new job, is she in league with the legions of the dumb?  Is it coincidence that Tredinnick has cited her report?  Time will tell.  However, such an alliance would be a reflection of the fall of alternative medicine in recent years.  The collapse of the chiropractors, thanks to an ill advised libel claim, as well as the damning Select Committee report on homeopathy has put tremendous pressure on this sector.  Once Boo Armstrong and alternative medicine had the ear of Peter Hain, a former government minister of some considerable standing, now they have the ear of David Tredinnick, a minister only in his imagination.

Sometimes paranoia is rational, sometimes they really are out to get you and sometimes you can prove it.  But in situations like this you should ask yourself what it is you are hiding that you don’t want them to find out?  This seems to be the position homeopaths in the UK now find themselves.  Delusions of big pharma funded conspiracies of doctors ranged against the profession have long been prominent in their thinking, now it seems there may actually be an organised movement against them. The following excerpt is from an email posted to the Minutus mailing list:

Two months ago I accepted a position as research assistant to a London based office.

It has quickly become apparent that their sole remit is to discredit complementary medicine and the current focus is homeopathic education and the London Homeopathic Hospital.

In accordance with a very structured plan a bbc science correspondent has been hired to infiltrate homeopathic education. I am aware that he has been funded to attend a college in east anglia as an apparent homeopathic student. Last month he has been told to find fabricated reasons to move to another college. The college chosen for him to go to next has links to the Royal London Homeopathic hospital and he has been told to gain access to this hospital and to prepare articles to entirely discredit the treatment given there to pave the way for the hospitals closure. The new college chosen to receive this man is the biggest college and therefore when it is discredited and dragged down by this man and his articles the plan is that it will take all homeopathic education down with it.
Incidentally I saw part of his presented report on his present homeopathic college in east anglia and it is scathing of “magic black box sugar pills given to the vulnerable sick and dying”.

My reason for contacting you is that I feel an enormous debt to homeopathy and feel that this is an opportunity for me to give something back to homeopathy itself.

[...]I can only tell you to treat this with utmost care – the funding is very large and the people involved determined.

Now I have no knowledge of this investigation, I cannot confirm the veracity of the claims, it may be a spoof for all I know but the response from the homeopaths is telling.  Remember this is a profession whose educational colleges and degree courses have been ruthlessly exposed as presenting a dangerously misinformed understanding of scientific and medical realities by David Colquhoun.

Karin Mont, Chair of the Alliance of Registered Homeopaths, would prefer that the public’s knowledge of homeopathy is carefully managed:

we need to be extra vigilant in all matters relating to how we communicate with the public.

while Fran Sheffield of the Australian Vaccination Network (AVN) is more critical:

Well, if this is true, and if there really is a college that is preparing standard remedies by radionics, it deserves to bite the dust for leaving the whole profession exposed, let alone the standards it is passing on to its students. There is no way responsible and respectful homeopathy can protect itself if associated with this practice.

And if this does result in a great deal of damage to homeopathy it won’t be the fault of the people involved in the sting but with the sloppy standards and behaviours engaged in by those who will do this because ‘it doesn’t matter’. It is like a decay within our profession.

It’s not so much the radionics that is the problem but the covert way they are used and the rationale (is there any rationale for standard remedies) behind a college that would do this with its students and a trusting public using its clinic. It’s about time this sort of thing did come out in the open and was weeded out.

And these comments are coming from someone who has no problem with radionically prepared remedies as a second best option when traditionally prepared ones are not available – just as long as everyone knows what is being done and the limitations involved.

Radionics is based on a belief that ‘energies’ can be tuned by a machine to remotely confer healing properties to an object or person.  It does not have a scientific basis and does not work.  Presumably this is the ‘magic black box’ referred to in the original email.  Ms Sheffield clearly believes that such a process is less efficacious than banging a sequentially diluted solution, to the point at which no molecule of the original solution survives, 50 times against a leather bound board.

Those friends of homeopathy in high places should be concerned by the attitudes revealed in these responses.  Ms Mont, who leads the second largest professional homeopathic body in the UK, is it seems dedicated to a culture of secrecy that is determined to keep the realities of a homeopathic education out of the public domain.  The apparently more considered views of Ms Sheffield should be seen in the context of her belief that ‘responsible and respectful’ homeopathy is defined as telling the public that vaccines cause autism and homeopathy can protect against the lethal diseases of childhood, from diptheria to whooping cough. Ms Sheffield is more concerned with ideological point scoring, there is ongoing debate with radionics vs succussion in the community, than actually examining the perception of homeopathy in public and its related problems.

However, assuming the veracity of the email, it is not just the behaviour of homeopaths themselves that is concerning, it is that their supporters are prepared to leak information to them and are in a position to do so.  One imagines that conspiracies are undertaken with a relative degree of secrecy, so having them leaked is unfortunate.  I am not bothered about the success or failure of any BBC report, rather that supporters of homeopathy seem to be present in organisations combating alternative medicine, whether mysterious London based offices, or the BBC.  My concerns are not those answerable by McCarthyesque interviews, but that despite all the exposes, scandals and reports into homeopathy it still has supporters willing to risk their jobs for the cause.  It seems the concerted efforts of the 10:23 campaign, bloggers, Ben Goldacre and the Science and Technology Committee have failed to quell the passion some feel for a well shaken sugar pill.
This then raises questions about the best ways to deal with a profession whose beliefs are dangerously wrong.  I have a lot of tolerance for people who hold views at odds with the evidence, I am sure facets of my own thinking could be described in this manner, but it is a problem when practiced by those with responsibility over others.  In the case of homeopaths this is primarily their patients so is a matter for the regulators of the profession.  It will be interesting to see if the new government offer any fresh thinking on this issue, the last government recommended regulation by the CNHC, something that split the homeopathic community.  It will also be fascinating to see if any of the new crop of MPs are avid supporters of homeopathy and are prepared to attempt to water down regulatory options, if they are inclined this way then informing them about the response of homeopaths to investigations will be necessary. Perhaps this will occur through a BBC report, I look forward to finding out.

I have not blogged about the election.  I was going to but other things got in the way and I decided not to.  However, if some really stupid MPs are elected then I will be sure to comment from my usual perspective.

If anyone is interested my voting intention is described on my posterous page.

http://gimpyblog.posterous.com/

Any comment should be left there.