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:

1. The Merseyside Skeptics Society is a volunteer organisation with no commercial vested interests clouding our objectivity.
2. 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
3. The North West Friends of Homeopathy state on their website that their homeopathy supplier is Weleda Ltd
4. Weleda Ltd is a large multi-national corporation operating in 53 countries with an annual turnover of around $300m
5. 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).
6. 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.

From Larry Ericksson:

Why are we even concerned with homeopathy, let them do what they want—why is there a campaign against it??

My response:

Hi Larry

Thanks for your email, and your interest. It’s actually a question we’ve covered here (http://www.1023.org.uk/why-you-cant-trust-homeopathy.php) but in short:
- Homeopathy doesn’t work
- People spend a LOT of money on homeopathy, and a lot of homeopaths make a lot of money out of it, despite it being ineffective
- People take it instead of something that would really help them, with often tragic consequences
- When you let homeopaths do what they want, they claim to treat AIDS, Malaria, Cancer and all manner of serious diseases

Hope that helps, thanks again for your support.
Michael

OK, so that one was a bit lame. But how about this one, from Sagar Uubale:

dear sir ,while reading ur issues against homoeopathy i love it .i also one hom doctor. but sir ur immunisation also an homoeopathy. its stimulating system in medicine. and our problem only for reseach in hompathy not compaingn against it. reply please

Lacking capitals? Random punctuation? Poor grammar? Check check check. And my response:

Dear Sagar,

Thanks for your interest. I’m glad you love homeopathy, but unfortunately homeopathy is not a valid medicine. You may find it very stimulating, but your immune system would prefer something it can get it’s metaphorical teeth into. This is where immunisation (not just ‘my’ immunisation, but in fact all immunisation) is utterly different from homeopathy – there is something in immunisation. Vaccines contain deadened forms of a pathogen which the body creates antibodies to fight, and those antibodies are then on hand to fight the live form of the pathogen, if it comes into contact with them. This, I’m sure you can see, is very different to giving somebody water containing the invented vibrations of onion juice.

I’m more than happy, of course, for you to spend your money and time researching homeopathy. I’d even happily have your findings reviewed for plausibility. I take it you don’t sell your homeopathic treatments, then, until you’ve finished your research into whether they work or not? I’m sure as a ‘hom doctor’ your ethics would rightly prevent you from doing so.

All the best in sympathy and stimulation,
Marsh

Next up, this from the identity-confused Marissa Amarilha/Marie Savignac:

Hello,

I’ve long been skeptical at about homeopathy, believing like many other that the effect was only placebo. I then witnessed the healing of animals treated only with homeopathy, and on several occasions. And there is no placebo effect in animals!

Additionally after researching the subject, I discovered a precursor to Hahnemann: Hippocrates, who called this principle “the law of similars. ” The effectiveness of homeopathy in fact had been proven many times at “proving” in hospital. If the theory of water memory remains unexplained to this day, it does not prove that it is false. What if homeopathy treats people every day, either by placebo effect or not, it does not take away anything of value, unlike allopathy called “law of opposites” by Hippocrates, which claimed thousands of victims through disease called “iatrogenic”.

Sincerely,
Marie Savignac

Ah, it works on animals! Ace…

Dear Marie and/or Marissa

Thanks for your interest in our campaign. I’m glad you once saw that homeopathy was in fact just placebo – that will make it much easier when it comes to correcting your current confusion. Your main point is that animals don’t benefit from the placebo effect, and therefore homeopathy must work. You’ll be pleased to know, then, that animals DO benefit from the placebo effect – just ask a vet. Because our furry friends can’t tell us where it hurts and how much, their feelings are subjectively appraised by their owners, people. People, as we know, are very susceptible to various cognitive traps which convince us things work when they don’t – part of the joy of being human is an awareness of such foibles. So, the placebo effect does work in animals – I take it you withdraw your support for homeopathy and happily join our campaign?

Hippocrates was barely a precursor to Hahnemann, of course – he just happens to have been around first. He’s got nothing at all to do with homeopathy. He also existed at a time when medicine was pretty rudimentary, and not very effective – it’s a good thing we don’t still have to rely on leeches, blood letting and magic pills! As for homeopathic provings, here’s an idea – take 50 people. Give them all the same homeopathic remedy. See what symptoms they develop. If all 50 get the same symptoms, clearly, and with little or no statistical deviance, it works. If all 50 get different groups of symptoms, many of them subjective, then it doesn’t work. Deal?

Thanks
Michael Marshall/Michael Marshall

And, saving the best to last, here’s this effort from Jeff Cooper:

What a nasty bunch of pseudo-fascists you seem.

There is no way you are putting in all this effort for the good of others. It seems to me that you just have a massive ego-fed desire to exercise control.

Shame on you all.

Jeff

Oooooh! My response:

Hi Jeff

Thanks very much for your interest in our campaign.

I’m glad you agree that we’re not fascists, but I’m a bit confused – are you saying we’re pretending to be fascists, when in fact we’re not? Seems an odd extrapolation from our actions, but in any case I’m happy to put your mind at rest and confirm that, as you say, we’re not fascists. Unless you are only pseudo-saying that, it’s hard to tell. In any case, I’m sorry to hear you find us nasty – was there something in particular that struck you as nasty? I’d be happy to discuss with you, either over email or over the phone.

Still, happy to put another of your misapprehensions to bed – we are indeed doing this for the good of others. Already we’ve seen lots of people are becoming aware of what homeopathy is, and why it’s sheer nonsense, so that’s enough reward for us. As for control, what do you fear we’re controlling? People’s access to information on homeopathy? Technically we’re putting an end to the control of information, allowing people to make a genuine informed choice. As for the massive ego, I’m sure it’s hard to distinguish between ego and charitable desire from atop your pedestal.

Yours in shame
Marsh, and the 10:23 team

Marsh and I have Joe Nickell and Chris French to look forward to.

Even more interest in 10:23 from the delegates, many of whom are keen to join in for 2011 and have lots of good ideas of their own.

I’m writing this whilst listening to a talk about baby bullshit from a mathematician who has mathematically modelled why nonsense treatments are so widespread. He has invented a country called “believia” and an illness called Giant Ear Syndrome!

Joe Nickell’s talk is worth a mention. He’s been personally involved in a huge variety of skeptical investigations and I’m sure his name is well known to many Merseyside Skeptics. One key aspect that he focussed upon was his undercover work. In this capacity he would attend some kind of claimant incognito, and carry out an investigation masquerading as a genuine “case”. However he’s really well known. And to avoid being rumbled he would wear a disuse of some kind. Some of the pictures were very funny.

He recounted a tale of a spiritualist carrying out a “billet reading” technique which he recognized immediately. It reminded me of Marsh’s demonstration of this technique during one of the early MSS social events. I recognized it immediately.

Chris French told some great stories. A couple were in his talk at MSS last year but there was some great new stuff too. In his capacity as editor of Skeptic Magazine, he announced the new issue which has a bit about 10:23 in it, and a new book which is a collection of the “the best of” from the magazine called Why Statues Weep.

This has been a really well organised conference with great speakers from all over Europe and America. From the Turin Shroud to mathematics. It’s been a real eye opener.

We fly back this evening and we’re looking forward to the next MSS social.

Yesterday I got to do a well received talk on 10:23 and I think we’ve been able to recruit a good few countries to participate in 2011. We’ve had dinner with Joe Nickell, Simon Singh and Christopher French as well as meeting luminaries from the Hungarian and German skeptics.

It has also been pretty amazing to meet some Skeptics With a K and InKredulous listeners!  today there’s even a guy wearing a 10:23 t-shirt. He’s from Zurich in Switzerland and is very enthusiastic!

It turns out that there are pockets of skepticism in mainland Europe. Hungary and Germany are particularly well organized but there are also examples where things are just getting going.  Poland, Slovakia, Romania are examples.  Marsh and I just had a nice chat with a couple of guys from Poland who made the point that culturally, people don’t like to speak out in public.

There’s a guy talking now called Istvan Vago.  He is the host of the Hungarian version of Who Wants to be a Millionaire!  He has entitled his talk “why idiotism more popular than clever thoughts?”. All the talks are in English and for most people it’s not their first language.

The interest in 10:23 is two fold.  First of all, people have heard of it and are interested to hear more.  I’m very much realizing that we made a lot more noise in the uk than in mainland Europe.

Secondly, for the countries where “organized” skepticism is in it’s infancy, they see an opportunity to join with other like minded individuals in an international campaign.  The international scale means that they may not feel so exposed by participating.

There are about 130 people here and as usual they are a mixed bag but there’s a good number of younger people.  Lots of scientists, doctors and psychologists.

Simon Singh has spoken this morning was very well received.  He also said some very nice things about the Merseyside Skeptics Society’s work on 10:23. Amardeo Sarma from the German skeptics did the same.

So it’s all systems go over here representing Merseyside Skeptics and 10:23 in Budapest.

More later.