Treat with extreme caution

Homoeopathic medicine is founded on a bogus philosophy. Its continued use is a drain on NHS resource

Two years ago, a loose coalition of like-minded scientists wrote an open letter to chief executives of the National Health Service Trusts. The signatories simply stated that homoeopathy and other alternative therapies were unproven, and that the NHS should reserve its funds for treatments that had been shown to work. The letter marked an extraordinary downturn in the fortunes of homoeopathy in the UK over the following year, because the overwhelming majority of trusts either stopped sending patients to the four homoeopathic hospitals, or introduced measures to strictly limit referrals.

Consequently, the future of these hospitals is now in doubt. The Tunbridge Wells Homoeopathic Hospital is set to close next year and the Royal London Homoeopathic Hospital is likely to follow in its wake. Homoeo paths are now so worried about the collapse of their flagship hospitals that they are organising a march to deliver a petition to Downing Street on 22 June. Local campaign groups are being formed and patients are being urged to sign the petition.

Homoeopaths believe that the medical Establishment is crushing a valuable healing tradition that dates back more than two centuries and that still has much to offer patients. Homoeopaths are certainly passionate about the benefits of their treatment, but are their claims valid, or are they misguidedly promoting a bogus philosophy?

This is a question that I have been considering for the past two years, ever since I began co-authoring a book on the subject of alternative medicine with Professor Edzard Ernst. He was one of the signatories of the letter to the NHS trusts and is the world's first professor of complementary medicine. Before I present our conclusion, it is worth remembering why homoeo pathy has always existed beyond the borders of mainstream medicine.

Homoeopathy relies on two key principles, namely that like cures like, and that smaller doses deliver more powerful effects. In other words, if onions cause our eyes to stream, then a homoeopathic pill made from onion juice might be a potential cure for the eye irritation caused by hay fever. Crucially, the onion juice would need to be diluted repeatedly to produce the pill that can be administered to the patient, as homoeopaths believe that less is more.

Initially, this sounds attractive, and not dissimilar to the principle of vaccination, whereby a small amount of virus can be used to protect patients from viral infection. However, doctors use the principle of like cures like very selectively, whereas homoeopaths use it universally. Moreover, a vaccination always contains a measurable amount of active ingredient, whereas homoeopathic remedies are usually so dilute that they contain no active ingredient whatsoever.

A pill that contains no medicine is unlikely to be effective, but millions of patients swear by this treatment. From a scientific point of view, the obvious explanation is that any perceived benefit is purely a result of the placebo effect, because it is well established that any patient who believes in a remedy is likely to experience some improvement in their condition due to the psychological impact. Homoeopaths disagree, and claim that a "memory" of the homoeopathic ingredient has a profound physiological effect on the patient. So the key question is straightforward: is homoeopathy more than just a placebo treatment?

Fortunately, medical researchers have conducted more than 200 clinical trials to investigate the impact of homoeopathy on a whole range of conditions. Typically, one group of patients is given homoeopathic remedies and another group is given a known placebo, such as a sugar pill. Researchers then examine whether or not the homoeopathic group improves on average more than the placebo group. The overall conclusion from all this research is that homoeopathic remedies are indeed mere placebos.

In other words, their benefit is based on nothing more than wishful thinking. The latest and most definitive overview of the evidence was published in the Lancet in 2005 and was accompanied by an editorial entitled "The end of homoeopathy". It argued that ". . . doctors need to be bold and honest with their patients about homoeopathy's lack of benefit".

An unsound investment

However, even if homoeopathy is a placebo treatment, anybody working in health care will readily admit that the placebo effect can be a very powerful force for good. Therefore, it could be argued that homoeopaths should be allowed to flourish as they administer placebos that clearly appeal to patients. Despite the undoubted benefits of the placebo effect, however, there are numerous reasons why it is unjustifiable for the NHS to invest in homoeopathy.

First, it is important to recognise that money spent on homoeopathy means a lack of investment elsewhere in the NHS. It is estimated that the NHS spends £500m annually on alternative therapies, but instead of spending this money on unproven or disproven therapies it could be used to pay for 20,000 more nurses. Another way to appreciate the sum of money involved is to consider the recent refurbishment of the Royal Homoeopathic Hospital in London, which was completed in 2005 and cost £20m. The hospital is part of the University College London Hospitals NHS Foundation Trust, which contributed £10m to the refurbishment, even though it had to admit a deficit of £17.4m at the end of 2005. In other words, most of the overspend could have been avoided if the Trust had not spent so much money on refurbishing the spiritual home of homoeopathy.

Second, the placebo effect is real, but it can lull patients into a false sense of security by improving their sense of well-being without actually treating the underlying conditions. This might be all right for patients suffering from a cold or flu, which should clear up given time, but for more severe illnesses, homoeopathic treatment could lead to severe long-term problems. Because those who administer homoeopathic treatment are outside of conventional medicine and therefore largely unmonitored, it is impos sible to prove the damage caused by placebo. Never theless, there is plenty of anecdotal evidence to support this claim.

For example, in 2003 Professor Ernst was working with homoeopaths who were taking part in a study to see if they could treat asthma. Unknown to the professor or any of the other researchers, one of the homoeopaths had a brown spot on her arm, which was growing in size and changing in colour. Convinced that homoeopathy was genuinely effective, the homoeopath decided to treat it herself using her own remedies. Buoyed by the placebo effect, she continued her treatment for months, but the spot turned out to be a malignant melanoma. While she was still in the middle of treating asthma patients, the homoeopath died. Had she sought conventional treatment at an early stage, there would have been a 90 per cent chance that she would have survived for five years or more. By relying on homoeopathy, she had condemned herself to an inevitably early death.

The third problem is that anybody who is aware of the vast body of research and who still advises homoeopathy is misleading patients. In order to evoke the placebo effect, the patient has to be fooled into believing that homoeopathy is effective. In fact, bigger lies encourage bigger patient expectations and trigger bigger placebo effects, so exploiting the benefits of homoeopathy to the full would require homoeopaths to deliver the most fantastical justifications imaginable.

Over the past half-century, the trend has been towards a more open and honest relationship between doctor and patient, so homoeopaths who mislead patients flagrantly disregard ethical standards. Of course, many homoeopaths may be unaware of or may choose to disregard the vast body of scientific evidence against homoeo pathy, but arrogance and ignorance in health care are also unforgivable sins.

If it is justifiable for the manufacturers of homoeopathic remedies in effect to lie about the efficacy of their useless products in order to evoke a placebo benefit, then maybe the pharmaceutical companies could fairly argue that they ought to be allowed to sell sugar pills at high prices on the basis of the placebo effect as well. This would undermine the requirement for rigorous testing of drugs before they go on sale.

A fourth reason for spurning placebo-based medicines is that patients who use them for relatively mild conditions can later be led into dangerously inappropriate use of the same treatments. Imagine a patient with back pain who is referred to a homoeopath and who receives a moderate, short-term placebo effect. This might impress the patient, who then returns to the homoeopath for other advice. For example, it is known that homoeopaths offer alternatives to conventional vaccination - a 2002 survey of homoeopaths showed that only 3 per cent of them advised parents to give their baby the MMR vaccine. Hence, directing patients towards homoeo paths for back pain could encourage those patients not to have their children vaccinated against potentially dangerous diseases.

Killer cures

Such advice and treatment is irresponsible and dangerous. When I asked a young student to approach homoeopaths for advice on malaria prevention in 2006, ten out of ten homoeopaths were willing to sell their own remedies instead of telling the student to seek out expert advice and take the necessary drugs.

The student had explained that she would be spending ten weeks in West Africa; we had decided on this backstory because this region has the deadliest strain of malaria, which can kill within three days. Nevertheless, homoeopaths were willing to sell remedies that contained no active ingredient. Apparently, it was the memory of the ingredient that would protect the student, or, as one homoeopath put it: "The remedies should lower your susceptibility; because what they do is they make it so your energy - your living energy - doesn't have a kind of malaria-shaped hole in it. The malarial mosquitoes won't come along and fill that in. The remedies sort it out."

The homoeopathic industry likes to present itself as a caring, patient-centred alternative to conventional medicine, but in truth it offers disproven remedies and often makes scandalous and reckless claims. On World Aids Day 2007, the Society of Homoeopaths, which represents professional homoeopaths in the UK, organised an HIV/Aids symposium that promoted the outlandish ambitions of several speakers. For example, describing Harry van der Zee, editor of the International Journal for Classical Homoeo pathy, the society wrote: "Harry believes that, using the PC1 remedy, the Aids epidemic can be called to a halt, and that homoeopaths are the ones to do it."

There is one final reason for rejecting placebo-based medicines, perhaps the most important of all, which is that we do not actually need placebos to benefit from the placebo effect. A patient receiving proven treatments already receives the placebo effect, so to offer homoeopathy instead - which delivers only the placebo effect - would simply short-change the patient.

I do not expect that practising homoeopaths will accept any of my arguments above, because they are based on scientific evidence showing that homoeopathy is nothing more than a placebo. Even though this evidence is now indisputable, homoeopaths have, understandably, not shown any enthusiasm to acknowledge it.

For now, their campaign continues. Although it has not been updated for a while, the campaign website currently states that its petition has received only 382 signatures on paper, which means that there's a long way to go to reach the target of 250,000. But, of course, one of the central principles of homoeopathy is that less is more. Hence, in this case, a very small number of signatures may prove to be very effective. In fact, perhaps the Society of Homoeopaths should urge people to withdraw their names from the list, so that nobody at all signs the petition. Surely this would make it incredibly powerful and guaranteed to be effective.

"Trick or Treatment? Alternative Medicine on Trial" (Bantam Press, £16.99) by Simon Singh and Edzard Ernst is published on 21 April

Homoeopathy by numbers

3,000 registered homoeopaths in the UK

1 in 3 British people use alternative therapies such as homoeopathy

42% of GPs refer patients to homoeopaths

0 molecules of an active ingredient in a typical "30c" homoeopathic solution

$1m reward offered by James Randi for proof that homoeopathy works

This article first appeared in the 21 April 2008 issue of the New Statesman, Food crisis

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Leader: Denis Healey 1917-2015

The late Denis Healey’s first appearance in the New Statesman came in 1951, with a letter on Soviet ambitions in which he observed, “This argument has certainly stirred up some of the mud which lay beneath the cool limpidity of your correspondents’ first letters.” It was a typically elegant turn of phrase from a politician who excelled at bons mots. His first article for the NS followed eight years later, again on the Soviet threat, in which he warned that the “megaton missile and its terrifying progeny” made ending the cold war arms race an urgent priority.

Mr Healey had the authority to talk about the horrors of conflict: he was the beach master at Anzio in the Second World War and made his speech to the Labour party conference in 1945 dressed in military uniform. In later life, he became sceptical of the effectiveness of a nuclear deterrent, arguing in 2006: “The only case is really a political one. I think the military case now for nuclear weapons has gone.”

His death on 3 October, at the age of 98, reminds us of the heterodox traditions that make up the Labour Party. 

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The day the earth stopped

Ed Miliband’s confidant and former speechwriter recalls the terrible shock of election night and tries to make sense of what has happened since.

Conference season 2015 wasn’t meant to be like this, for any of us. The Conservatives were meant to be plunged into turmoil, having lost office. The Liberal Democrats were meant to be reimagining themselves as partners in a progressive alliance. The leading lights of a young Labour generation – Chuka Umunna, Tristram Hunt, Rachel Reeves and Liz Kendall – were meant to be getting used to their ministerial boxes. And I was meant to be writing a victory speech for a newly elected Labour prime minister.

Painful though it is to recall, it wasn’t that long ago that this alternative future disappeared. It was the night when the hope of 7 May turned to the despair of 8 May. Good news had trickled in to Labour’s HQ at One Brewer’s Green, London, throughout the ­afternoon. Rumours spread. Turnout was up, it was said. Young people seemed enthused, we heard. There were more people voting Labour making the journey to the polling station than people voting Tory. And how did we know? Well, the party had had over five million conversations with voters. Or was it six million? Even that number continued to rise as the day went on. As party staff came in for the evening shift at Brewer’s Green, the challenge was to control expectations.

But then the exit poll came. And then ­Nuneaton. And then Douglas Alexander. And then Ed Balls. And lose we did. This was supposed to be a country, as I had written in speech after speech, “yearning for change”. But it turned out it wasn’t, or at least not in the way we thought. It was happily settling for more of the same. Just without the Liberal Democrats.

Yet, somehow, here we are, at the end of the summer, with Jeremy Corbyn – a serial backbench rebel who had spent 32 years on the furthest reaches of the back benches and the margins of Labour politics – about to give the leader’s speech at conference in Ed Miliband’s place.

Surreal though this story sounds in the abstract, the rough outline of what has happened and why is bizarrely familiar. In May, the British public rejected Labour for seeming to offer too much of an economic risk in exchange for too little of an economic promise. And then, four months later, Labour members and supporters empowered by reforms most people had long forgotten about seized their chance. They flocked to an unlikely candidate who celebrated his own unbending authenticity. Someone who not only put principle before pragmatism in theory, but who was prepared to say things that party members believed but that their leaders had resisted saying for decades. And then to do so again and again. So it turned out that the consequence of an election in which the British public opted for continuity was a landslide Labour leadership election victory for a candidate who promised to bring even bigger change.

Put this way, it is no wonder that there are many who genuinely care about Labour’s election prospects who are in despair. Within four months, we have had the public heading one way, followed by the party heading almost exactly in the opposite direction. It is not what any of my political scientist colleagues would describe as “orthodox vote-seeking behaviour”.

For those seeking a more optimistic reading, however, there is at least one place where the party’s voters and the broader voting public may find common ground. Jeremy Corbyn’s triumph, along with the utter failure of the other leadership candidates, is not only a shift to the ideological left. It is a rejection of a whole way of doing politics. It marks the end of the spadocracy, the strangulated prose of political slogans derived solely from focus groups, the ever-declining levels of trust, the apparent refusal to take the braver course of action, the collapse of respect for grass-roots party activism, the widespread sense that the elite “never listens to us”. When Owen Jones and Yanis Varoufakis are the go-to advisers for Her Majesty’s Opposition, we know we are a long way from Peter Mandelson and David Axelrod.

Now, pundits talk too often about a “new politics” but in this, at least, the election of Jeremy Corbyn is a new political reality. As the political scientist Peter Mair so presciently put it a few years ago, we have witnessed “the hollowing out of western democracy” in recent years, as elites have drifted ever further away from the people, and now almost everyone has had enough. The widespread revulsion at a “political class” separated off from the rest of society has shaken the old order.

People far beyond the membership of the Labour Party have grown tired of politicians of all parties who live in continual dread that someone will discover precisely how little they know or care for what most people call their everyday. People know that underneath those gotcha questions about the price of a pint of milk or a loaf of bread there lurks a terrible truth: most top-level politicians of all parties can’t really know what it feels like to have no formal power, no significant influence, to be worried about how things will pan out in their daily lives.


To those already persuaded, the rawness of Corbyn’s political style seems perfectly suited to a time when people have become turned off by the slick, the polished and the professional. There is a freshness to a party leader who seems not to care what he wears, who takes the night bus and who just doesn’t know when the newspapers go to press. A leader whose acceptance speech contained not one soundbite, not even a memorable phrase, but that laid out a philosophy nonetheless, indicates that we are indeed in a new era. Ironically, it all follows from one of Axelrod’s most compelling pieces of advice to Ed Miliband. Conventional politics where the candidate seems to care more about power than anything else, he always told Miliband, just can’t win for the left in an age like ours.

So, in this respect at least, the public and the party may seem to be at one. Surely that is a reason to be optimistic about what Jeremy Corbyn has to offer?

Sadly, this apparent confluence between the public and the party’s disdain for politics as usual is not quite as simple as it seems to the converted. And that is not because, as the gnarly old sceptics claim, the only way to do politics properly is the Campbell, Mandelson or Crosby way. Of course, Corbyn’s team needs to avoid near-terminal presentational errors, but it faces a bigger challenge than just getting its act together. Instead, there is something important about the public’s turn against professionalised politics that risks being lost in all the frenzy and the excitement of Labour’s political takeover. And that is the precise nature of what the public thinks about politics and politicians. Because it is not just that the public is bored by soundbites and focus groups and strangulated slogans. Millions of members of the public think that our politicians have a deep disdain for the everyday life of millions of people in this country. They believe that politicians lead entirely separate lives, shaped by their own, entirely idiosyncratic ideas, and that they spend a good deal of their time looking down on the rest of us. And no amount of soundbite-free politics is going to change that on its own.


I realised the depth of this problem almost exactly a year ago. At that time, I was working with Ed Miliband on his eventually disappointingly received annual conference speech. Miliband’s goal, with just months to go to the general election, was to share his vision of the future of our country. More ambitiously still, he wanted to describe what Britain could look like after not just one term of a Labour government, but two. Yet he also knew that for this vision to resonate with people it had to start not from him, but from them. It had to begin, that is, with the dreams and the nightmares of the people of this country, not from the abstractions and the ambitions of the professional politician.

The question for me as a speechwriter was how to reach those dreams and nightmares. The answer seemed simple. Listen and talk to people. And that is how Ed and I ended up spending day after day in conversation with people we bumped into in the park. It’s how we ended up, as a close friend joked at the time, “cruising for anecdotes on Hampstead Heath”.

It all seems like a different world now. But at heart, it was an honest attempt to describe the spirit of the country. The stories didn’t just come from the rich or the powerful. They didn’t just come from people who lived in north London. They came from all over. And they were written in and rehearsed, and they provided a texture to his understanding.

But as Ed began to deliver this part of his speech, the reaction was stark. People began to tweet with incredulity and, believe me, that is not what you want as a speechwriter. The first accusation was that the people were invented. They weren’t. The second was that they couldn’t really have said the words that Ed attributed to them. They had. The third was that they hadn’t really been persuaded by Ed’s arguments. They were. The fourth was that it was inappropriate to talk about real people and their petty ­goings-on in a speech of this scale. That it was silly or sentimental, mawkish or mad. And that just reinforced the whole problem with which we began.

Despite the frustration, and now that the dust has settled, I understand the scepticism. It goes far beyond the standard critique of leadership ratings or rhetorical power. Why should anyone who didn’t know Ed Miliband personally believe that he was sincerely trying to do things differently, trying to demonstrate that the words of political leadership should be dictated by the people? Why shouldn’t they just think it was a cheap trick in an otherwise standard party conference speech? Why should anyone think that a Labour government led by Ed would think differently from governments that had gone before?

These are the same questions that remain for Labour’s new leader. The ideology and policy orientation may have changed. The style may have changed even more. But it is going to take much more than either of those things to convince the British public that Labour has an approach to politics that respects them, that takes their lives seriously, that is sincerely concerned with changing the relationship between the governed and those who aspire to govern.

Working out precisely what is required to convince the British public that this is now a party rooted in their concerns and not in its own interests will be the central task of the next few years. It will take us right to the heart of all the hardest debates about policy and ideology. But I believe the essence of what is required is already evident.

Most of all it needs a culture of humility at the top. The new leader, deputy leader and shadow cabinet need to display an inner belief that people matter more than politicians, that government doesn’t possess all the answers. They need to show they know that the trust that is crucial to our politics has snapped and needs to be restored. This means speaking boldly and directly to people’s concerns. It means forgetting the tendency to speak in the arcane abstractions of socialist politics; dropping the references to the International Labour Organisation and the long march of the working class. It also means an end to behaving as if all the conventions of public life apply only to others. It was the haughtiness behind the decision not to sing the national anthem at the Battle of Britain commemoration that was most off-putting of all. Even more importantly, it means turning decisively against the statism and the centralism of Labour’s past, both in terms of the party’s structures and its plans for government. Corbyn must be clear: the future is democracy, not dirigisme, experimental innovation, not narrow ideology. Ours is an age in which people rightly long to direct as much of their own lives as possible, not have their lives directed for them. Labour is a party that has shown such success recently in engaged, local government, from Hackney to Manchester, and now is the time that the party can make that change with confidence. But doing so will require a break with many of the habits of mind and spirit that many around Corbyn have acquired over the decades.

Similarly, renewal also requires putting in the hours. Everyone who knows the inner workings of the Labour Party knows about “Labour doorstep” – the time put in by activists all across Britain going door to door, talking to voters, doing voter ID. It is vital. But if that is 90 per cent of the way you meet people, you will never expand the party. The Chicago community organiser Arnie Graf, whose career began with the civil rights movement and who advised Labour during the Miliband years, once put it this way: door-to-door contact is at best a one-minute advertisement, and although that is better than a leaflet, it is not building a relationship. To build a relationship with people, you must know who they are, find out what they care about and begin to show that you can respond. The only way to show you trust someone and care for them, after all, is to show them that you want to spend time with them and that you enjoy it when you do. Labour’s community organising experiment should be at its beginning, not its end. No energy should be wasted on factional fighting in constituencies or in Westminster. All energy should be directed towards turning the increase in membership Corbyn has overseen into a strong connection with Britain’s communities. Put simply, Labour needs to return to the politics of relationship-building, not the politics of reselection.


Yet Labour’s renewal demands more than just humility and hours. It demands honesty, too. That starts with an honesty of campaigning. We need an end to the almost complete domination of politics by negative dividing lines, by minutely tailored messages designed to deceive rather than enlighten. That was the straight talking Corbyn promised during the summer. But it also requires honesty about the scale of the challenges that confront us all in the 21st century and can’t be wished away by grand statements of motivation or intent, as Tristram Hunt’s speech at Policy Network during the leadership campaign acknowledged.

That is why we can’t just have knee-jerk rhetoric about the merits of “investment over cuts” and the evils of austerity, however much the Corbyn victory has reminded us of the need to challenge stale economic orthodoxies. Instead, we have to develop an account of the way we can build an inclusive, egalitarian economy that gives people a sense of security and possibility for the future but also understands that the times we live in are hard and are unlikely to get easier any time soon. The only antidote to destructive populism in such an age is a politics of bracing truth-telling. Labour should lead the way in a conversation where we aim to get beneath the surface of problems, make sense of where we are in order to develop deep and sustainable solutions to them, and do so together. That is why we still can’t duck the challenges of reforming the social security system or of the future funding of the NHS. And it is why we have to remind people relentlessly of the economic, social and cultural imperative of securing our place in the European Union: a task that could define this political generation. Labour’s best hope – no, its only hope – is that the public will respond to clarity and honesty about all of these challenges. It will certainly punish any effort to look the other way, whether motivated by expediency or by passionately held conviction.

As I think about what that future looks like, I am drawn back to 8 May. I probably always will be: the pain of the failure is that intense. But this time I remember something from outside Labour HQ. Just before the exit poll was announced, James Graham’s new play, The Vote, was broadcast on More4 live from the Donmar Warehouse in London. The play was set on polling day at a single polling station in Lewisham, south London. People came in and they talked. There was a middle-aged man who had got drunk over the road and wanted to take his ballot paper to the pub; an elderly man who may, or may not, have voted twice by mistake; a young man, just 18, who had read too much pre-Ed Miliband Russell Brand and ripped up his ballot paper in revolutionary protest; and an elderly woman and her daughter who shared a first name, weren’t sure which one had been registered at their address and thus didn’t know precisely who had the right to cast her vote.

The play was funny and poignant, but most of all it was real. Here were the wonderful people of our country. They disagreed about some things – what should happen to children when parents divorce, whether the one-way system was good for traffic flow, whom to vote for – but shared many others: pride in the place they lived, their lives full of family and work and hope and fear. And a sense that democracy still matters.

It ended with the characters gathering together as the TV election programme began. The last sound the audience heard was the disembodied voice of David Dimbleby announcing the exit poll. It was a moment of pride, because everyone each knew, as so rarely in politics, that their voice had been heard. Then the play stopped. And we all returned sharply to reality. Because what Dimbleby went on to say was that they hadn’t said Labour. That is what Jeremy Corbyn has got to remember. They won’t say Labour again, unless the party sounds and feels like it knows the people we love.

Marc Stears is Professor of Political Theory at University College, Oxford. He was chief speechwriter to Ed Miliband

Marc Stears is fellow in politics, University College, Oxford and visiting fellow at IPPR.

This article first appeared in the 24 September 2015 issue of the New Statesman, Revenge of the Left