All homeopathic practitioners can now opt to be vetted by the Professional Standards Authority (PSA), it was announced this week:
Practitioners on the Society of Homeopaths’ register will be able to display the Accredited Voluntary Register (AVR) quality mark, a sign that they belong to a register which meets the Professional Standards Authority’s robust standards.
The PSA is a governmental body with two main duties. The first is to oversee the nine regulators of legally-defined medical practitioners, meaning organisations like the General Dental Coucil, the General Medical Council and the Nursing and Midwifery Council. Its second duty, though, is to assess the bodies which oversee those professions which aren’t considered “real” medicine – like the British Acupuncture Council, or the United Kingdom Council for Psychotherapy – and to make sure that they’re meeting their own standards, in areas such as education, training, management and handling complaints. These are “voluntary registers“, and are essentially a form of industry self-regulation.
This dual role on the part of the PSA is (unsurprisingly) controversial, as its stated goal is to “promote the health, safety and well being of users of health and social care services and the public” – but critics point out that this seems to be contradicted by endorsing medical treatments which have never been proven to be more effective than the placebo effect in a clinical trial.
Homeopaths who are registered with the Society of Homeopaths, and who meet its qualifications, are now allowed to use the Accredited Voluntary Register (AVR) quality mark signifying that they meet the PSA’s “robust standards”. This could mean using the symbol in an advert, or it could mean sticking it on homeopathic producuts. As Stephen Pollard pointed out in the Times this week, this now means the public could be buying something they think is medicine, but which is actually just an expensive bottle of ordinary water with an AVR mark on it.
Evidence shows that homeopathy is an ineffective treatment for all health conditions and is no better than a placebo, and is a pseudoscience. It is classified as a complementary or alternative medicine, which, unlike conventional evidence-based medicine, relies on the premises that “like cures like” – that is, that a substance that causes a specific symptom is also meant to alleviate that symptom – and that “ultra-dilution” of something in water increases its potency. Both of these claims contradict fundamental aspects of modern medical science.
Homeopathic remedies are used as “cures” for wide range of conditions – such as mental health problems, asthma, diabetes and hay fever – but, while many patients reporting that they work, there is no evidence to show that these treatments are effective in any way beyond the established effectiveness of the placebo effect. The Faculty of Homeopathy website shows that up until the end of 2013, out of 188 research studies in homeopathy, nearly 60 per cent were either found to be inconclusive or presented a negative result. The PSA’s decision to give homeopathic practitioners a stamp of approval is, therefore, potentially conveying a dangerous or misleading message.
The PSA’s own stance on the issue is that it doesn’t exist to pass judgement on the effectiveness of any kind of medical treatment, be it dentistry or Freudian psychoanalysis – it’s just there to make sure that, if someone’s practicing in one of these fields, they’re meeting the standards that the body representing that field demands. Its own standards for accreditation states:
The PSA recognises that not all disciplines are underpinned by evidence of proven therapeutic value. Some disciplines are subject to controlled randomised trials, others are based on qualitative evidence. Some rely on anecdotes. Nevertheless, these disciplines are legal and the public choose to use them. The Authority requires organisations to make this clear to the public so that they may make informed decisions.”
This is the problem. The PSA’s job is to make sure that people are making “informed decisions” about what they’re choosing when it comes to medical treatment, but with many of the voluntary register organisations – like the Society of Homeopaths – the thing that gives their work the most legitimacy is the ARV quality mark. Something’s wrong with the system if a medical regulatory body is holding neurosurgeons and homeopaths to the same standard of proof, and telling the public that they’re equally trustworthy.
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