Health policy statements are boring to read. Navigating through qualifiers such as ‘notwithstanding’ and ‘not limited to’ can feel like solving a logic puzzle. Often the statements are designed to be clear enough to identify a stance, but vague enough to avoid offence.
But the language in the Royal Australian College of General Practitioners’ (RACGP) latest policy position on homeopathy marks a serious shift in tone. In four plain sentences, the college draws sharp lines: GPs should not practice homeopathy. Pharmacists should stop selling the remedies. Homeopathic vaccines shouldn’t be used. Private rebates should not apply to homeopathy.
How much more direct could they be? But with complete inaction against homeopathy despite scientific consensus against it, there is a more relevant question: what more will it take?
Clearly, scientific fact isn’t enough. In January 2016 the NHMRC published a report which assessed the effectiveness of Homeopathy as medical treatment. The result was damning. They found zero evidence that homeopathy is effective for any medical condition.
This echoed reviews by the Cochrane Collaboration, and a British Parliament House of Commons report which both found no evidence that homeopathy is more effective than a placebo.
But this was not enough. Not for the government of Australia. Not for the Pharmaceutical Board of Australia. And it certainly wasn’t enough for the Australian Homeopathic Association. Ironically, the dilution of evidence for homeopathy seems to have fortified their belief in it.
This shouldn’t surprise us; they did not arrive at their views through rigorous science, rigorous science was unlikely to rescue them from it.
What is surprising is the weak, indefensible posture of the government. The ill are being given a false cure and the government, far from restricting the practice, is funding it. This is irrefutable fact; private health rebates for debunked homeopathy are tax funded.
So how can the government justify this absurdity? They don’t, mainly because evading the issue is far safer than defending their position. It is particularly difficult to defend this practice, as the NHMRC review of homeopathy was commissioned by the Australian Government itself (albeit the current opposition).
Very simply, the government asked the NHMRC to investigate if funding homeopathy through tax payer rebates was justifiable. Our peak research institution said no. And the government is now sticking it’s fingers in it’s ears.
Discussing homeopathy in the context of private health rebates is, of course, to side step the obvious question of broader ethics. There are many problems that result from promoting a false practice, such as misdiagnosis and mistreatment. These are rather obvious ethical issues that our politicians are aware of. To suggest that their inaction is due to ignorance is simplistic.
Politicians’ inaction on the matter is pragmatic. The facts is that 6% of Australians have used homeopathy. And banning, regulating, restricting or even defunding it, not only limits people’s choice, it also tells them their choices are wrong.
This is what it’s come to. The symbology of alternative medicine has insidiously embedded itself so deeply into our culture that restricting a false, dangerous practice is a huge political risk. It’s a risk that requires the kind of political bravery that is in short supply.
And then there is the pharmacy industry, straddling the line between their commercial interests and health advocacy. Their evasion of the issue has been telling. Both the Pharmaceutical Guild of Australia and the Pharmaceutical Society of Australia concede the evidence, but refrain from any meaningful policy. They stress they are not regulatory bodies and that selling homeopathic treatments is an individual decision for pharmacists.
But it goes further — the stance of the national regulatory body, Pharmaceutical Board of Australia is extraordinary. Far from advising against sale of homeopathic treatments, in its current 2011 guidelines the board advises pharmacists precisely how they can practice homeopathy in their pharmacy. Suggestions include conducting homeopathy consults in a separate room.
Homeopathy presents a unique public health challenge. But to appreciate its complexity requires not just close inspection, but a step back to capture the madness of the vast scene: Homeopaths peddle medicine that doesn’t work. Pharmacists admit the medicine doesn’t work, yet sell it. The government also admits the medicine doesn’t work, but offers discounts on it.
In the background the scientists run madly in circles, waving reams of research papers, screaming that the medicine does not, in fact, work.
The patients meanwhile, awfully confused, are either subsidising the medicine with their taxes, or are swallowing it. But they are certainly not getting much better from it.
And for the climax of this sitcom, the RACGP has entered the fray and announced first the madness, and then requested it stop. And indeed, with the bold words of the college of general practitioners, that’s where the saga should end. But if it does not end now, what more will it take?