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These letters are selected from rapid responses posted bmj.com To submit a rapid on bmj.com. Selection is usually made 12 days after print publication of the article to which they respond. response go to any article LETTERS on bmj.com and click “respond to this article” Robert T Mathie research development adviser, Competing interests: Most signatories of this letter are British Homeopathic Association, Luton LU1 3BE health professionals who incorporate homoeopathy and Y [email protected] other forms of complementary medicine into their practice. alam Peter Fisher clinical director, Royal London Homoeopathic Y/ 1 Colquhoun D. Secret remedies: 100 years on. BMJ Hospital, London WC1N 3HR 2009;339:b5432. (15 December.) Competing interests: None declared. 2 Science and Technology Subcommittee. Evidence check: homeopathy. Witnesses. 30 Nov 2009. www. 1 O’Dowd A. Government says public backs homoeopathy parliamentlive.tv/Main/Player.aspx?meetingId=5257. photograph despite lack of evidence. BMJ 2009;339:b5234. Y Y Cite this as: BMJ 2010;340:c594 GA (2 December.) Y Y 2 O’Dowd A. Giving homoeopathy on the NHS is unethical and unreliable, MPs are told. BMJ 2009;339:b5080. GARR (27 November.) UNCOMPLEMENTARY DEBATE 3 Science and Technology Committee. Evidence check Herbal medicine and acupuncture: 2: homeopathy. 30 Nov 2009. www.parliament.uk/ parliamentary_committees/science_technology/s_t_ protecting patients What parliamentary witnesses homeopathy_inquiry.cfm. also said about homoeopathy Cite this as: BMJ 2010;340:c592 David Colquhoun’s editorial makes unfounded assertions about the Department of Health Adrian O’Dowd’s two articles about the steering group and its recommendations.1 Science and Technology Committee’s Editorial ignores evidence Given that a public consultation has only evidence check on homoeopathy failed to The BMJ’s coverage of homoeopathy is biased recently closed, his views should not be seen mention several key responses made by and systematically ignores the evidence. We are as representative. witnesses at the parliamentary hearings1‑3— astonished that the BMJ commissioned David He states, as before,2 that decisions for example: Colquhoun’s polemical rant as an editorial.1 are needed on whether disciplines being • There are 24 condition based systematic He attacks the minister, the Department of considered for statutory regulation are reviews of randomised controlled trials Health’s chief scientist, the chief executive “nonsense” or sufficiently grounded in (RCTs) of homoeopathy, of which nine are of the Medicines and Healthcare Products science and evidence based practice to positive, five negative, and 10 inconclusive Regulatory Agency, and others who do not share justify regulation. If acupuncture and herbal (question 112 in transcript). his opinions, insulting them by describing their medicine are nonsense, he thinks that • Of 87 placebo controlled RCTs (efficacy considered replies at the recent Commons regulation may officially endorse treatments trials) in peer reviewed literature, Science and Technology Committee hearings on with no proper evidence base. Colquhoun 37 provide positive evidence for homoeopathy as “pure comedy gold.” wrongly asserts that the steering group and homoeopathy; the remainder are mostly A recording of the entire proceedings is the Department of Health lost this important non‑conclusive (Q145). available online to those who prefer to make point. The report states clearly that NHS • Not all homoeopathic medicines are up their own minds, but we don’t recommend it funding should be available to complementary diluted beyond the point where no for a laugh.2 Colquhoun’s glossary is no doubt medicine only if there is evidence of efficacy, molecules of original substance are left in intended to be humorous, but the definitions safety, and quality assurance,3 and it reviewed solution (Q123). he gives of acupuncture, herbal medicine, how best to implement meaningful research. • The minister for health services, Mike and homoeopathy bear no relation to the true Statutory regulation and the quest for O’Brien, considered homoeopathy worth definitions and belie any pretence that this is a evidence should proceed together, and in further clinical research (Q199), and he serious contribution. the interests of patient safety, the second stated that government should not stop Despite the subtitle calling for a look at point should not be an absolute prerequisite NHS funding for homoeopathy (Q245‑246). efficacy there is not a word about evidence. for the first.4 Many conventional treatments • On medical practitioners of homoeopathy, All attempts to inject evidence into this prove ineffective as research proceeds, Mr O’Brien stated, “There is a significant debate have come from those who believe but to protect patients, practitioners are lobby of clinicians who are quite capable homoeopathy deserves proper investigation regulated while they practise according to of looking at data and who take the view (previous letter). current evidence. Lastly, as many as 10.6% that [homoeopathy] works . There is an The only independent and contemporary of adults in England have accessed the more illiberality in saying that personal choice in citation Colquhoun offers in support of his established therapies, so regulation to protect an area of significant medical controversy views is from the Sun. It would be lamentable the public is a priority. should be completely denied” (Q248). if the BMJ’s level of discourse emulated that Robert M Pittilo university vice-chancellor and principal, • And on patient choice he said, “We should publication. Robert Gordon University, Aberdeen AB10 1FR not take the view that patients should not [email protected] Peter A Fisher clinical director, Royal London Homoeopathic be able to have homoeopathic medicine Hospital, London WC1N 3HR [email protected] Competing interests: RMP was chair of the Department when they want it” (Q248). on behalf of Robert T Mathie, David Owen, Anita E Davies, of Health steering group on the statutory regulation of acupuncture, herbal medicine, traditional Chinese medicine, It is important to reflect on these facts when Jeremy Swayne, Tom Whitmarsh, Gary J Smyth, Noel Thomas, Boris Morrice, George Lewith, Saul Berkovitz, and other traditional medicine systems practised in the UK. forming a balanced judgment of contributions Sosie Kassab, David Peters, Joyce Frye, Mike Cummings, He has also served as a trustee of the Prince’s Foundation for made at the committee hearings. Menachem Oberbaum, and seven others Integrated Health. BMJ | 6 FEBRUARY 2010 | VOLume 340 277 LETTERS 1 Colquhoun D. Secret remedies: 100 years on. BMJ surrounding the subject. That is why the 2009;339:b5432. (15 December 2009.) 2 Colquhoun D. Complementary medicine. A very bad Department of Health’s policy towards Author’s reply to report on regulating complementary medicine. BMJ complementary and alternative medicines is the minister 2008;337:a591. neutral. 3 Department of Health Steering Group on the Statutory Regulation of Acupuncture, Herbal Medicine, Whether I personally think homoeopathy I think the minister (fifth letter) is wrong in two Traditional Chinese Medicine and Other Traditional is nonsense or not is beside the point. As a ways, one relatively trivial but one very important. Medicine Systems Practised in the UK. Report to minister, I do not decide the correct treatment Firstly, he is wrong to refer to homoeopathy ministers. 2008. http://hdl.handle.net/10059/176. 4 Pittilo RM. Complementary medicine. Regulating for patients. Doctors do that. I do not propose as controversial. It is not. It is quite the daftest herbal medicine and acupuncture: Author’s reply. BMJ on this occasion to interfere in the doctor‑ of the common forms of magic medicine and 2008;337:a590. patient relationship. essentially no informed person believes a word Cite this as: BMJ 2010;340:c595 Mike O’Brien minister of state for health services, of it. Of course, as minister, he is free to ignore 410 Richmond House, 79 Whitehall, Westminster, London scientific advice. But he should admit that that SW1A 2NS [email protected] is what he is doing, and not hide behind the Protecting patients? Competing interests: None declared. (imagined) controversy. 1 Colquhoun D. Secret remedies: 100 years on. BMJ In his letter (previous page) Pittilo states that 2009;339:b5432. (15 December 2009.) Secondly, and far more importantly, he is in conventional medicine, many treatments Cite this as: BMJ 2010;340:c617 wrong to say I was mistaken to claim that “you prove ineffective as research proceeds. cannot start to think about a sensible form of True! Sorting out the wheat from the chaff regulation unless you first decide whether or not is precisely what evidence based medicine Lead, follow, or get out of the way the thing you are trying to regulate is nonsense.” aims to achieve. All statutory regulations If it were irrelevant that the subject you are trying of UK healthcare professions include an In the previous letter Mike O’Brien, minister to regulate was nonsense then why not have obligation to practise evidence based of state for health services, made a statement statutory regulation of voodoo and astrology? The medicine. But the proposed regulation of that cannot be allowed to stand without Pittilo proposals would involve giving honours herbal, traditional Chinese medicine, and exposing its fallacies and cynicism: degrees in nonsense1 if one took the minister’s acupuncture practitioners does not include Further research into the efficacy of view that it doesn’t matter whether the subjects such an obligation. Why? Making sure that therapies such as homoeopathy is unlikely are nonsense or not. Surely he isn’t advocating NHS funding is available to complementary to settle the debate, such is the controversy that? medicine only where evidence exists is not surrounding the subject. That is why the The minister is also wrong to suppose that the same as obliging practitioners to practise Department of Health’s policy towards regulation, in the form proposed by Pittilo, would evidence based medicine.
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