Leading article: No place for placebos on the NHS

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It cannot be right for the NHS to pay for homeopathic remedies which are no better than placebos while refusing to pay for cancer drugs that are effective, but judged too expensive. Yesterday's withering verdict from the Commons Science and Technology Committee that NHS funding for homeopathic treatment, which has continued uninterrupted for 60 years, should cease, is hard to counter.

Even its supporters admit homeopathy is "scientifically implausible", as the Prince's Foundation for Integrated Health did yesterday. But the Foundation still tried to defend it. What matters, it claimed, is not how homeopathy works but whether patients get better. It would be quite wrong, it said, to abandon patients whom conventional scientific medicine cannot help. Well, up to a point. Compassion is a critical ingredient of care. But that is not an excuse to resort to magic. The problem for homeopathy is not only that there is no plausible explanation for how it works, but also no evidence that it works better than a placebo.

Does this matter? Yes, because it means funds are diverted from efficacious treatments to less efficacious ones, because people may risk their health by rejecting orthodox treatment in favour of homeopathic remedies for a serious illness, and because it undermines the principle that Government investment in health should be evidence-based. The Foundation wants further trials to compare the effectiveness and cost of homeopathy with other solutions for long-term conditions. The committee rejected this option on the grounds that scores of clinical trials have been conducted and failed to show a real effect.

The Government defends homeopathy on the grounds that it is what patients want. But if patients do not know that what they are getting is a placebo then they cannot be said to be exercising meaningful choice. Ministers also acknowledge that the National Institute for Clinical Excellence cannot evaluate homeopathy because of its "somewhat limited evidential base" but insist that does not prevent the NHS spending money on it. There is a mismatch here between policy and evidence. It is time ministers addressed it.

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