More effort needed to crack down on 'secret remedies'

The medical establishment and politicians must do more to crack down on alternative medicine, argues a senior scientist on bmj.com today. In 1909 the BMA, BMJ and politicians tried to end the marketing of secret remedies by uncovering the secret ingredients of popular products like Turlington's Balsam of Life, Mayr's wonderful stomach remedy, and Green Mountain magic pain remover.

Yet, one hundred years on, the response of the medical establishment to the resurgence in magic medicine that started in the 1970s "looks to me like embarrassment," says Professor David Colquhoun from University College London in an editorial in this week's Christmas issue.

Homeopaths regularly talk nonsense about quantum theory, and "nutritional therapists" claim to cure AIDS with vitamin pills, he writes.

In 2007 American adults spent $12bn consulting practitioners of complementary and alternative medicine and $22bn buying their products.

He claims the royal colleges "avoided the hard questions by setting up committees," while the Department of Health refers the hard questions to the Prince of Wales' Foundation for Integrated Health, which was asked to draft "national occupational standards" for make believe subjects like "naturopathy."

Colquhoun cites two recent examples that illustrate the problems. First the Pittilo recommendations for statutory regulation of acupuncture and herbal and traditional Chinese medicine. Colquhoun argues that "you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense."

He also claims the Royal College of Physicians still have "a blind spot about the evidence for acupuncture" in its submission to this report.

The other example concerns the recent "evidence check: homeopathy" conducted by the House of Commons Science and Technology Select Committee, where the health minister Michael O'Brien was "eventually cajoled into admitting that there was no good evidence that homoeopathy worked but defended the idea that the taxpayer should pay for it anyway."

Colquhoun points to the "evasive answers" given by the Department of Health's chief scientific advisor, David Harper, when questioned about the use of homoeopathy in terms of government policy on health.

He also criticises the head of the Medicines and Healthcare products Regulatory Agency (MRHA) for suggesting that homoeopathy cannot be tested by proper randomised controlled trials.

Finally, Colquhoun points to a recent article by the Sun's health journalist Jane Symons. "Imagine going to an NHS hospital for treatment and being sent away with nothing but a bottle of water and some vague promises," it said. "And no, it's not a fruitcake fantasy. This is homeopathy and the NHS currently spends around £10m on it."

It isn't often that a Murdoch tabloid produces a better account of a medical problem than anything the Department of Health's chief scientific advisor can muster, he concludes.

Source: BMJ-British Medical Journal