Junkfood Science: Truth in advertising

January 09, 2008

Truth in advertising

I just had to share one of the most reputable product companies online. Every page of the company’s website is informative and offers helpful health advice. And every word is true... and you can’t say that very often anymore!

FairDeal Homeopathy says it’s a company that provides effective homeopathic remedies at a fair price. Its remedies are guaranteed as effective as all other homeopathic remedies. It gives a list of conditions their remedies can treat (which, they note, in no way implies "cure"), explains how they work and honestly describes what you are buying and how to administer their remedies. Best of all, they will prescribe a specially prepared, individually tailored remedy just for you based on your symptoms.

What do you have to lose? If you’re feeling run down, old or fat, see what they can do to help you feel better.

The company is based in England and the significance of this website and the point it’s trying to make might not be immediately clear to readers outside the UK. It’s fun but not all in fun. What’s behind it exploded this month, after building for years.

First some background. For years, there has been growing documentation of NHS (National Health Service) patients being denied care and suffering, even dying, as a result. The elderly, smokers and fat people were increasingly the targets of rationing. Back in 1999, the BBC reported that 20% of doctors questioned had known patients who had died as a result of being denied care on the NHS.

Over recent years, for instance, fat people have been denied transplants to joint replacements, under the reasoning: “NHS resources are finite, and, unpopular though the idea is, some degree of rationing is a fiscal necessity.” In the Scotland on Sunday, Dani Garavelli wrote an editorial critical of the NHS policies and the political correctness behind them. Fat people are wrongly perceived as “greedy pariahs who refuse to exercise any self control,” Garavelli wrote, and as a result they’ve become a repressed group that “accepts the abuse they suffer in silence.” They already fare worse in receiving healthcare and are marginalized when it comes to their health. Ruling them out of fairly routine operations on the grounds of weight stigmatizes them further, Garavelli said, concluding:

When making these difficult judgments, it is important for primary care trusts to remember that fat people pay taxes too. After all, it is one thing to insist everyone should be required to give a portion of their income to fund services they may not use (such as education or improved transport networks), it is quite another to demand people pay for a service they will be denied when they need it.

And if we decide the best way to cut costs is to punish people for “self-inflicted" conditions, where is the blame game going to stop? Could we see health authorities refusing to treat people who are sexually promiscuous for STDs or those who use sunbeds for skin cancer? Perhaps those in the throes of a heart attack should be interrogated on their diet before an ambulance is dispatched and anyone who fails to do pelvic floor exercises after childbirth should surely have to thole that self-inflicted prolapse. Indeed, if fat people are refused treatment for fat-related conditions, why shouldn't sports fanatics be denied treatment for sports-related injuries?

The point is, we are all fallible: we all make choices every day that impact on our health, from eating junk food to having children. And unless we are willing to sacrifice our own right to NHS treatment when the time comes, we should not be so hasty in judging other people's lifestyles, and finding them wanting.

Fast forward to 2008, the 60th anniversary of the NHS. January 1st brought headlining stories that smokers, drinkers and fat people would be banned from NHS treatment under a new government proposal. Free care for all would end, according to the Express. Prime Minister Gordon Brown announced plans for a Health Service constitution outlining “rights and responsibilities” for patients to be entitled to care. He said that withholding treatment from people believed to have ‘unhealthy lives’ could potentially save the NHS billions of pounds a year. Some hospitals already deny nonemergency care for smokers, drinkers and fat people, but until now it hasn’t a national policy.

A few days later, an Op-Ed on “ethical rationing” appeared in the Times. Mike Hume wrote:

Gordon Brown resolves that we will all live healthier lives — stop smoking, drink less, exercise more. As a reward, the health service will still treat us should our personal regime inexplicably fail and we fall sick. This generous offer is to be made in a patient's contract spelling out “the rights and responsibilities associated with entitlement to NHS care.”... Mr Brown's plans for a more “personal and preventative service” involve a bigger risk to us all... to make it a role of the NHS to send people to the Naughty Habits Step.

Where the “old-fashioned” health service merely treated the sick, today's NHS seeks to beat well people into shape as clean-living citizens through advice and guidance. As Michael Fitzpatrick, an East London GP, observed when such contracts were first proposed, they involve “a major shift of general practice away from the treatment of patients who are ill towards the regulation of the lifestyles of the population”.

Despite this being the age of “evidence-based” medicine, nobody can provide proof that such government drives to alter behaviour improve public health. Yet the authorities press on... These unwieldy plans can only further undermine the efficiency of the health system, the role of doctors as clinical professionals — and most importantly, the autonomy of individuals. They turn the purpose of healthcare on its head... There must be more to life than healthy living. Amid the talk of rights and responsibilities, one that gets ignored is the individual's right to make the “wrong” choices.

As another article in the Sunday Times said such rationing was necessary:

Nearly all of us now know that the NHS — the taxpayer — cannot afford to pay for all the treatments and drugs that are already available, still less for those that will be developed in the future. The demand is going to be almost infinite; tax receipts are not. As more conditions become treatable and patients’ demands become more sophisticated, this problem will soon be a great deal worse.

Everyone knows this and most people admit it, except for politicians. Doctors and think tanks have been pressing the government to recognise it for years... For instance, Saga magazine and Populus have published a survey suggesting that one in six people over 50 had been denied treatment on grounds of cost. More than half the doctors replying to a survey in Doctor magazine said patients were suffering as a result of being denied treatments on grounds of cost. The chairman of NHS Alliance, which represents NHS trusts, commented that “rationing is the great unspoken reality.”

What does any of this have to do with homeopathy, you ask?

While government health officials mandate ‘healthy’ lifestyles and other preventive guidelines with no evidence to support them, and are rationing treatments and medications for poor people and those with undesirable habits — all in the name of saving costs — they have simultaneously okayed NHS coverage for alternative and homeopathic modalities, which are expected to reach $391.28 million (U.S. Dollars).

The Department of Health just funded the creation of a Natural Healthcare Council, which will regulate alternative practitioners. “Among the practices to be covered by the scheme would be aromatherapy, reflexology, massage, nutrition, shiatzu, reiki, naturopathy, yoga, homoeopathy, cranial osteopathy and the Alexander and Bowen techniques,” said the Times this weekend.

Polly Toybee wrote a hard-hitting commentary today in the Guardian, asking: “How does a regulator decide what is good practice and what is charlatanry when none of it has peer-reviewed, scientific evidence that it works?” It might all seem harmless and in fun, she wrote. But it isn’t harmless. As she wrote:

It matters that the NHS spends £50m on alternative treatments, a figure expected to rise soon to £200m. It matters that Newsnight found homeopaths advising patients visiting malaria areas not to take anti-malarial drugs. And that patients are told not to give their children the MMR jab. ..[A]n article in the Lancet suggesting there is no scientific evidence for the efficacy of 46% of conventional NHS treatments...is no reason to encourage more of it.... The serious danger is that lines grow ever more blurred between science that works and popular stuff the government dare not refuse....

Nice makes the hardest, most public decisions on NHS rationing - it was designed to draw the flak. If a drug costs more than £20,000-£30,000 for a quality-adjusted life year, a year of reasonably good life - they scrutinise it thoroughly... The survival of the health service depends on people trusting the science of these decisions.... If enough people refuse to accept the difference between published peer-reviewed evidence in scientific journals and any old "evidence" from some therapist licensed by the official Natural Healthcare Council, the NHS will be lost....

In private realms, fact and fiction are woven together; but in public policy a sharp line has to be drawn between the two. Despite all the knowledge ever known available at the touch of a mouse, people are still dangerously wedded to anecdote over evidence. But governments can't afford to abandon the palisades that protect proven science from the world of superstition.

Proven science matters. Healthcare that’s about health and there when you need it is one reason why.

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