Homeopathic “remedies” shouldn’t be offered on the NHS for the same reason “intelligent design” shouldn’t be taught in schools.
In 2016, ministers will consider whether or not to blacklist homeopathic treatments. Such treatments are currently offered on the NHS for a range of medical problems, including hay-fever, asthma and depression. Blacklisting these alternative medicines means adding them to Schedule One, a list of substances that GPs are banned from prescribing to patients. The list currently includes things such as heroin, MDMA, peyote and for some reason macaroons. The ban is being put forward primarily as a money saving exercise; the NHS currently spends £4m a year on homeopathic hospitals and prescriptions, and ministers consider this a waste of valuable funds. However, this is not just an issue of funding; it concerns the fundamental relationship between science and the state.
Before wading into any discussion, I ought to explain what homeopathy is. Homeopathy is a form of “alternative” medicine whose practitioners believe that “like cures like”, that diseases are caused by something called a “miasm” and that substances that normally cause harm can acquire curative potential when diluted to a massive degree. In fact, some homeopathic medicines are diluted so much that they almost certainly don’t contain anything apart from water. Homeopaths dismiss this by arguing that the water “remembers” what was originally put into it; such “water memory” has never been detected, and its existence would not fit with our current understanding of basic physics and chemistry.
Other homeopaths take a less extreme stance. They reject the miasm theory, and advocate the use of solutions that are much more concentrated. Nevertheless, there is still no good scientific evidence to suggest that any homeopathic remedy offers anything greater than a placebo effect. This lack of evidence is consistent with the lack of good theory; no homeopath has ever been able to propose a detailed, scientifically accurate mechanism for how the supposed curative agent might actually work. Homeopathy, to put it bluntly, is a load of nonsense. It has the same level of scientific grounding as witchcraft and gay-cure therapies i.e. none.
Should the lack of a scientific basis for these treatments justify banning them? As a libertarian, I support freedom of choice; I believe that your own health is your own responsibility, that your body belongs to you, and that you should be able to mistreat it however you want. In the private sector, this argument holds perfectly well. The proposed blacklisting won’t affect the private sector (it only applies to NHS doctors); if patients want to use their own money on private treatment or over-the-counter homeopathic remedies, they will still be permitted to do so. Prescribing these treatments on the NHS however, is a whole different question.
The NHS is a state institution: government run, government funded and (supposedly) owned by the tax-payers. It is true that when finances are tight (which they tend to be when your government increases the national debt by 50% in a single term), certain major cutbacks are justified, and cutting homeopathy from the NHS budget is an easy enough target. However, money is not the most important consideration here, and I doubt that it’s truly the major consideration for those ministers proposing the ban. The most important point in this case is that the government should not be sanctioning and legitimising pseudoscience.
The NHS is not a market; its purpose is not to provide an environment for customers to make their own economic decisions. The NHS is a system to provide people with state funded healthcare. Taxpayers are paying in order to treat and cure people, in order to give them healthcare. Homeopathy is not healthcare, in the same way that a paper plane is not a means of transport. If people want to pursue homeopathic remedies, they can do so privately with their own money. If people want state funded healthcare via the NHS, they should receive just that: healthcare—not unscientific nonsense.
When the government engages in a certain practice, based on certain ideas, the government is effectively sanctioning that practice and those ideas. There is a legitimisation. If the NHS provides homeopathic treatments, a homeopath is entitled to stand up and say: “Homeopathy, in the eyes of the state authorities, is equal to regular medicine”. It is the same as when fringe religious groups propose teaching ‘intelligent design’ alongside evolution in state schools. The reason this should not be permitted is that it would provide state sanction to creationists, equating religious mythology with near universally accepted scientific fact.
In an ideal world, the government would not be involved with science at all. The problems discussed above would never arise because the state would never have to endorse any particular theory or practice. Sadly, we do not live in an ideal world and probably never will. The state will always have to sanction one practice or another. In view of this, the state should be very careful to only endorse those medical practices that actually have a basis in good science. The future of medicine depends on it.