The publication of the report of the House of Commons Science and Technology Committee Evidence Check into Homeopathy has resulted in a lot of misinformation about how much public money is spent on homeopathy. The report states that there are four homeopathic hospitals in the UK, based in London, Bristol, Liverpool and Glasgow.
How much do these hospitals cost and what exactly is going on within these institutions?
Various figures abound. The Society of Homeopaths, misleading as ever, chose to highlight the lowest figure they can find and state in a recent press release that the NHS spends £152,000 on homeopathic medicines. The irony of this is that homeopaths claim that the benefit of homeopathy comes from the ‘whole package of care’ and not just the pills. What this complete package costs is more difficult to discover. The Guardian has reported that a Freedom of Information request suggested that the NHS spent about £4 million per year on homeopathy.
What is widely unreported is that the MPs, in their report, state quite clearly that it is not known how much is really spent. These figures are almost certain to be inaccurate and underestimates as they do not take into account all costs. For example, the Royal London Homeopathic Hospital has recently undergone a £20 million refurbishment and such figures do not reflect such expenditure on maintenance and running costs. The report requests that the government investigates and publishes what the true costs have been over the past ten years including purchasing of the sugar pills, referral and running costs.
However, it is also worth investigating what the true nature of the services are in these homeopathic hospitals. The four remaining hospitals are used to legitimise the nature of homeopathy both here and abroad. If the NHS provides public NHS hospitals then it must be a valid treatment option.
The truth is though that these four hospitals are not really hospitals at all. They are the sad vestigial remnants of what were once proud and well funded homeopathic hospitals reduced to rooms and annexes of real hospitals. The UK once boasted many homeopathic clinics and hospitals, mainly founded in the Victorian age by rich and aristocratic benefactors. Many small hospitals existed in the rich spa towns and South coast resorts where the wealthy and aristocratic could indulge in their exclusive magic medicine. At the beginning of the 20th Century, the support of the aristocracy waned and it was left to industrialists, such as the tobacco magnate Wills, in Bristol, and the sugar family of Tate in Liverpool to fund the philanthropic city homeopathic hospitals. Come the foundation of the NHS, the few remaining homeopathic hospitals were nationalised as part of the wide ranging negotiations between doctors and the government in the creation of welfare state.
Since then, the homeopathic hospitals have been in continuous decline with the complete closure of the remains of Tunbridge Wells Homeopathic Hospital almost two years ago. So, what is the status of the remaining four? None can really call themselves hospitals anymore. Gone are the full range of services you would expect from a hospital with in-patient facilities, dedicated buildings, independent management and budgets. Instead, we find mainly simple out-patient facilities annexed to bigger institutions.
Bristol Homeopathic Hospital was built in 1921 at Cotham House. It is now reduced to a new annexe of this building where it was moved to in 1994. The main building is now used by the University of Bristol as a home for its Primary Health Care research unit. Some inpatients may attend Bristol Eye hospital and a few ‘satellite clinics’ exists provided by GPs who support homeopathy, such as Dr Michael Dixon OBE who is a director of the Foundation for Integrated Health – the charity set up by Prince Charles to promote quackery in the NHS. The remaining annexe is used to treat chronic illnesses and for complementary cancer care. Their web site states that
Homeopathy is useful in the management of:
- Allergic conditions
- Eczema and other dermatology conditions
- Menstrual and Menopausal problems
- Digestive and Bowel Problems
- Stress and Mood disorders
We are not given any references to evidence for this. It is ironic that the ASA has found lay homeopaths in breach of their rules for making similar claims.
Liverpool Homeopathic Hospital is now perhaps the saddest of all the old hospitals. It now occupies space in the Old Swan Health Centre and no longer calls itself a ‘hospital’ – just a department.
It gives a similar list of complaints to Bristol. However, it does have a very peculiar speciality in that it offers mistletoe treatment for cancer. This is a hocus-pocus treatment based on the mystical musings of Rudolf Steiner who believed mistletoe was a cancer on trees – and given the homeopathic mantra of like-cures-like, mistletoe can cure cancer in humans. The Liverpool departments makes all sorts of wild claims for mistletoe including,
- It can induce cell death in cancer cells, so helping to stop or reverse tumour growth
- It allows immune cell populations affected by cancer to regenerate
- It protects the DNA of healthy cells from the harmful effects of cell toxins. It makes the effects of chemotherapy or radiation treatment more tolerable and lessens the damage caused by these treatments to healthy cells.
- In addition Iscador therapy has a direct effect on the patient’s quality of life
- Cancer patients taking iscador feel better and stronger
- Their appetite returns and they start to gain weight
- They sleep better and are more resistant to infection
- Tumour pain is often lessened
- It has been shown in several studies that mistletoe therapy can prolong survival
- Iscador treatment is safe and has very few side effects
Mistletoe has been tested extensively as a treatment for cancer, but the most reliable randomised controlled trials fail to show benefit, and some reports show considerable potential for harm. The costs of regular mistletoe injections are high. I therefore recommend mistletoe as a Christmas decoration and for kissing under but not as an anticancer drug. At the risk of upsetting many proponents of alternative medicine, I also contend that intuition is no substitute for evidence.
So, Liverpool homeopathic hospital has not just shrunk in size, but shrunk into complete mystical delusion and cancer quackery too.
The Royal London Homeopathic Hospital is the flagship institution in the UK. It is undoubtedly known as the most famous homeopathic hospital in the world – but a hospital it is not. Like the other facilities, London now occupies a fraction of its former space. Still housed in its traditional building, with its famous sign outside, the homeopathic facility is now reduced to one floor, and even this space is shared with other complementary therapies. The rest of the building is used by University College London Hospitals and their witchcraft occupant must be something of an embarrassment to them. The RLHH lost is status as an independent hospital in 1974 and has been withering since. It is quite possible it will disappear entirely and the remaining doctors who cling to their homeopathic beliefs know it. They defend their facility by making a virtue out of the fact that that they can offer other forms of quackery too, like acupuncture and nutritional therapy.
They even have a specialist clinic run by Dr M Taufiq Khan for homeopathic treatment of foot problems. The Marigold Clinic uses sugar pills and magic water to treat Verrucae and Athlete’s foot. Dr Khan is also able to offer an ‘authentic range’ of Marigold foot care homeopathic products through his web site at marigoldfootcare.com. Apparently, as was spotted by David Colquhoun, 4.2% of all prescriptions at RLHH are paid to Marigold Footcare Ltd. It’s a rather blatant conflict of interest – the RLHH not only appears to be a remnant of Victorian quackery, but of antiquated medical ethics too.
Perhaps, the best thriving NHS homeopathic clinic is in Glasgow where the ‘Centre for Integrated Care’ has a purpose built clinic in the grounds of Gartnavel General Hospital. The homeopaths boast of their ‘design team’ that created the new building at a cost of £2.8 million with an annual running cost of up to £1.9 million.
What is a pity is that such a building could be using money to offer evidence-based palliative care and support for those with serious chronic illnesses, but unfortunately it is run by homeopaths who really believe their magic sugar pills will do the trick. The Greater Glasgow Health Board had considered closing the clinic down but the Scottish homeopaths appear to be quite good at mobilising support. They use the language of ‘integrative care’ to disguise their homeopathic quackery and turn the issue onto one of ‘freedom of choice’. Of course, this choice ignores those who wish the money to spent on care that does not depend on voodoo thinking and misleading people.
The homeopaths are right about one thing: the amount of money being spent on these tiny facilities is not large within the grand scheme of things. But the millions that is spent on indulging the homeopathic fantasies of these few doctors is still money that could be spent on treatments that have an evidence base, that are based in science and not magic, that could provide effective treatments and even save lives. But what is really wrong about these facilities is that they allow a double standard to exist and fester in an environment where it is important to hold all treatments to the highest levels of scrutiny. Homeopathy cannot demonstrate any cost-effectiveness, it poses serious ethical issues that remain unaddressed by its practitioners and it gives an imprimatur to the non-medically qualified homeopathic quacks who use the same reasoning to inflict their murderous delusions on people with AIDS or malaria in developing regions, such as in Africa or India. If the NHS cannot recognise the blatant nonsense it funds, it does not bode well for the same people fending off the far more sophisticated drug companies when hard decisions need to be made.
The politicians will be spineless here. But the managers in the PCTs who control the budgets can do no worse than follow the example of West Kent PCT and recognise the serious issues funding homeopathy raises – and stop it right now. These vestigial stumps will not be missed. Time to let them go. They are on borrowed time and we need to be concentrating on bigger problems.