I’ve had a rather interesting evening. Last week, MSS member and local councillor Darren Dodds alerted me to the fact that Wirral NHS were holding an open meeting to discuss whether to continue funding homeopathy in the region, with the recommendation being very much ‘No, we absolutely shouldn’t’. Needless to say, I agree with this recommendation, and wanted to go along to let them know that I – and by extension the hundred or more local MSS members – applaud their step in the right direction. Interested parties should read the report they came up with, it’s really pretty good. Some highlights:
The paper concludes that the lack of evidence on efficacy and cost-effectiveness of homeopathic therapies means that it should not be a high priority for the PCT at this time. It is recommended that NHS Wirral does not commission homeopathictherapies.
The key risk is that NHS Wirral fails to maintain its reputation as an evidence-based commissioning PCT.
Excellent stuff. Still, it seems we weren’t the only ones made aware of the open meeting – also invited were patients currently or formerly using homeopathy, and the ‘North West Friends of Homeopathy‘. This latter group are most interesting, and I’ll come back to them a little later in more detail, but first it’s worth pointing out that I appeared on local radio with a member of the group on Monday morning, in an exchange that might amuse, and will certainly give a far better impression of who John Cook is than I could ever do justice with words. UK-based readers can listen here, it starts around the 2hour 13minute mark and lasts about 10 minutes. I’ll wait.
For those not able, willing or interested in listening, what we have from John is a charming ability to hog a conversation, and the maniacal insistence that the date of the meeting was aired. Clearly, John wanted his supporters to arrive mob-handed. Fair enough, he probably feels he has a strong case. As it was, when I arrived with a couple of other MSS members there were maybe 40 or so people present, a number which I presume to be in excess of the general norm for these meetings.
John, having lobbied for inclusion, was amongst the speakers, joined by Dr. Hugh Neilsen BA MA BM BCh MRCP FFHom (it’s worth pointing out that his name is actually Hugh Nielsen, and the NWFoH’s own website, while painstaking in it’s detail of Hugh’s many qualifications, mispells the name of their own president), and the panel was completed by two local GPs who were involved in making the recommendation, and who spent the evening ranging between bemused, compassionate and at times startled. Startled, not least, by the quite spectacular opening by John, the homeopath’s friend (which I imagine is rather like a Fisherman’s Friend, but lacking in clout), in which he directed a quite flattering string of insults at me directly, and at the Merseyside Skeptics Society. A typo on our website (proclaiming the meeting to be on the 6th not the 9th) drew from John the hilarious gag:
Perhaps you’re the Merseyside Dyslexics Society, although you’ve somehow managed to make it here on the right night so perhaps you can get by. (*from memory, not verbatim*)
Clearly the friends of homeopathy are no friends of dyslexics, I suppose. Either that or he had a range of tinctures in his impressively boxy briefcase, and was merely touting for business. Who knows. Still, it was a harmless enough jape (unless you are actually dyslexic, in which case I’m sure it was infuriatingly insulting), but I assume not the standard practice for such meetings as the Chair looked quite surprised. John’s epic 10-minute rant (he moved to stand behind the Chair so everybody could see him in full), whilst including a few more rib-ticklers at my expense (I was merely an audience member at this point, bear in mind), also included a number of utterly wonderful assertions, which he’d taken the time to print for us (with such adherence to spelling and grammar as to paint his dyslexic wisecrack in immensely ironic light) and which I can reproduce here verbatim from the copy I took away with me.
North West Friends – Small Registered Charity supporting Patients.
This is interesting to me, given that the Charities Comission has NWFoH listed as being for:
THE RELIEF OF SICKNESS BY HOMOEOPATHIC MEDICINE. THE EDUCATION OF THE GENERAL PUBLIC IN THE BRANCH OF MEDICINE KNOWN AS HOMOEOPATHIC MEDICINE AND TO ASSIST IN RESEARCH OF HOMOEOPATHIC MEDICINE, THE RESULTS OF SUCH RESEARCH BEING DISSEMINATED TO THE PUBLIC AT LARGE.
Am I splitting hairs there? I think not – the NWFoH are very much designed to support homeopathy as a system, to further its usage and to promote homeopathy wherever possible. Clearly this is not the same thing as supporting patients – it’s supporting homeopathy. They’re not the North West Friends of Patients, after all, and were the interests of homeopathy to be in conflict with those of patients (like, say, when over 200 trials show homeopathy to be ineffective for patient use and a local PCT recommend, for increased patient care, the cessation of homeopathy funding), it’s easy to see where John and the rest of the NWFoH’s chips would fall.
10% each year of the UK population use homeopathy
This struck me as grossly exaggerated, but as one of John’s ill-judged and smug barbs pointed out ‘this includes the many skeptics who were seen debauchedly gulping entire bottles of homeopathy outside of Boots’. On this point, I agreed with him (we did), although the 10% still looks over-inflated to me. Small point, though, there’s better to come.
John also went on to claim that the Government rejected the Science and Technology Comittee’s recommendation to cease funding for homeopathy (implying that for a PCT to do so, citing the Evidence Check, would be out of line). This, as I pointed out to John when given the chance to retort from my seat in the audience, was highly disingenuous and misleading – the Government actually said that any decision should be made not by them but by local PCTs after local consulation. And we were sat in that local consultation at that very minute. Bewildering.
In perhaps John’s coup de grace, he stated defiantly:
Despite the Department of Health’s rejection of the conclusion of the Evidence Check Report, Wirral PEC’s recommendation says ‘there is no evidence that homeopathy works beyond the placebo effect; which is another way of saying there is no evidence of efficacy (RTCs) – which is wrong, because there is.
Brilliant. Let’s take this point by point:
- The Department of Health did not reject the conclusion of the Evidence Check Report, as covered above. Furthermore they agreed that the evidence was in fact lacking, they merely disagreed that there should be top-down cessation of funding.
- I’ve no idea what an RTC is – a typo is a petty thing to pick up on, admittedly, but given John’s smug gloating over the supposed date error on our own website, I couldn’t resist. An RCT is a Random Controlled Trial – that John can’t get those words in the right order speaks volumes about the NWFoH’s understanding of evidence standards.
- Finally, the best bit – ‘which is wrong, because there is’. Now, you doubtlessly expect the next paragraph to explain this bold assertion. Who am I kidding, no you don’t – you rightly suspect John threw it out there nakedly and expected us to buy it without anything at all to actually back it up, as if merely saying something is enough to make it sound so. Which is right, because he did.
That summed up the thrust of John’s ‘arguments’, aside from another couple of swipes at the very fact that skeptics exist and personal digs at me and the MSS in general, and it was at this point that the Chair, out of keeping with the planned structure of the evening but slightly perplexed by John’s use of his time in attacking a hitherto-silent audience member, allowed me a moment to rebut. Fortunately, I had my rebuttal somewhat planned, and it ran along the lines of these very simple, demonstrable facts:
- The Merseyside Skeptics Society is a volunteer organisation with no commercial vested interests clouding our objectivity.
- The North West Friends of Homeopathy are headed up by John Cook (who appears to have been at one point the Chairman of the British Homeopathic Association, although I’m lacking citation for that and may be mistaken by an identically-named homeopath) and President Hugh Nielsen, who is also Clinical Lead of Old Swan Homeopathic Clinic, Liverpool
- The North West Friends of Homeopathy state on their website that their homeopathy supplier is Weleda Ltd
- Weleda Ltd is a large multi-national corporation operating in 53 countries with an annual turnover of around $300m
- Weleda Ltd produce homeopathic products, and also the non-homeopathic Iscador (made from mistletoe, and often lumped in with homeopathy for reasons too complicated to go into here).
- Welada Ltd currently supply Iscador and homeopathic products to… Old Swan Homeopathic Clinic, where Hugh Nielsen – President of NWFoH is Clinical Lead.
These facts, which I’ve seen nothing to suggest are incorrect, do not of course show any solid financial incentive behind the supposedly-grassroots, ‘supporting the patients’ activities of the NWFoH, however they do make it hard not to wonder that objectivity may be compromised – homeopaths spontaneously campaigning to have preserved a contract that their supplier benefits from financially.
The rest of the evening was genuinely fascinating – clearly many of the people who had turned up (those not part of John’s own group, of which there seemed to be several) had done so out of genuine belief that homeopathy was an effective treatment. Each shared their own tale – terminal cancers held back by homeopathic products, ADHD abated without the need for drugs, breast cancer completely cured by homeopathy. Interestingly, there was an overwhelming preponderance of cancer patients present, and I think this reflects the intentional muddying of the lines between homeopathy, Iscador, and homeopathic Iscador. As the Chair was quick to point out, any case relating to Iscador was fundamentally not one the session was set up to consult on, and still the entirely-sincere and doubtlessly-genuine cancer cases came in. This made me wonder, especially as Monday’s radio phone in seemed curiously skewed towards Iscador stories too, whether there wasn’t an intentional drive to get such patients to come along, with their deeply-emotive – though irrelevant to the subject at hand – cases. If I were an astroturf organisation shilling for an Iscador manufacturer, I’d imagine that’s the kind of situation I’d try and promote.
Still, I felt nothing but empathy for the majority of the cases in the room (by which I mean the ones who weren’t nakedly hostile to the very notion of a skeptic, which formed a minority I imagine). Most of the people there were genuine in their concerns, and really wanted clarity and answers – they were just missing the objectivity that comes with not being in the centre of the storm. It is incredibly hard to accept such counter-intuitive notions as regression to the mean, confirmation bias and spontaneous recovery when you’re the one involved – as human beings we’re built to fit our lives into some kind of understandable narrative and see pattern and structure where there is, sometimes, chaos and randomness, and we’re all susceptible to this. It really did reinforce to me the need to be compassionate and considerate when dealing with people who have been convinced by a particular pseudoscience – even the most vociferous of proponents can themselves be victims, and frequently this is the case.
Amongst the stories told, the recurring theme which became apparent to me was of people who, when desperate, had been convinced to try homeopathy – perhaps by reputation, perhaps by recommendation from a well-meaning or otherwise practitioner. Also recurring, too, were stories of dismissal of the treatments by medical practitioners, and it did make me wonder just how many people would put their faith in homeopathy if explained clearly and gently why those little pills have no clinical effect, and how the placebo effect really works, rather than simply dismissed out of hand (admittedly by doubtlessly busy doctors who have real and pressing issues to deal with – a situation which will only increase now GPs are left holding the purse strings). I wonder if a moment’s pause and patience at the point of first experience might keep many more patients from falling for the weasel-wording of Dr Nielsen (who visibly squirmed when fellow skeptic Tom Williamson pressed him on Nielsen’s own explanation of how homeopathic substances get more effective once the initial substance has been diluted out of them) and the sneering and bullish hyperbole of John Cook.
Ultimately, however, I don’t really believe the discussions this evening will have affected the decision to be made over homeopathic funding, partly because I don’t think it really was – or was even pretending to be – a discussion. ‘Have your say’ invited the website – and plenty of people did. However, there is a significant difference between having your say, and having a vote, and I strongly think in this instance the evidence will outweigh the few passionate-but-sincerely-misguided opinions of the homeopathy users, and the smug point-scoring of the North West Friends of Homeopathy (Manufacturers). I, for one, eagerly await the outcome on March 22nd.