tl;dr - a bleat about confusing tube-station signage, with everyone walking in the wrong direction.
Everyone who uses the underground learns, probably quite quickly, that you walk on the left and stand on the right (on an escalator). However there are a handful of tube stations on the system where parts of the passenger route ask you 'keep to the right' when walking - the upper level section of Baker Street and all of Cannon Street tube station come to mind.
I have no idea why Cannon Street tube station wants people to walk on the right and none of the staff I've spoken to seem to know either. Presumably someone deliberately made this decision after doing some test or other. I'm afraid it isn't working.
All the signs say 'keep right' but plenty of people ignore this.
The signs fail to take account of where people's eyes are looking, and fail to make it clear that something is different about this station. If you use are a user of a sytem in which almost every other station is 'keep left' then you can be forgiven for thinking you're meant to walk on the left. Signs on the left hand side will probably be seen, but ignored (other than one word being different the signs look identical so people probably don't even clock them) because people expecgt them to say 'Keep Left', and no-one's looking on the right hand side - why would they, they're walking on the left. Given that you're asking people to walk down the 'wrong' stairs the signs need to be positioned more obviously, on the ground with those shoe sole things indicating which direction to travel in, or a hanging sign above the staircase saying 'this way' or 'no entry'.
If you want users (passengers) to follow your instructions then you need to design the system to accommodate their prior expectations and make it very clear that something is different at this station.
My advice is simple and effective - and it would save a lot of confusion for the passengers who do see and obey the signs and find themselves facing lots of oncoming commuters. Remove the damn signs completely. Everyone already knows to keep left and the lack of signs means that people will simply default to that (in fact that is what they are already doing now, because they're certainly not seeing or paying attention to the signs). Those that don't know* will fall in with everyone else walking left and won't be confused by signs telling them something different. This will also be a lot cheaper than re-signing the station.
It would be interesting to know if there's a particularly good reason why someone thought everyone should move on the right. If it's absolutely essential for people to keep right (have to assume it isn't given that almost no-one does) then (a) make the signs look really, really different fromt the Keep Left ones and (b) think about where people's eyes are actually pointing as they move around the station, and put the signs there.
*The current system is confused as regulars walk on the left and visitors / tourists (often with large bags) look for the signs and obey them, with the result that everyone has to walk around each other on busy stairs.
Thursday, 17 August 2017
Wednesday, 9 August 2017
A lovely time at Wilderness Festival 2017, or 'camping while slightly unfit' ;)
I've not been to an on-site camping-based music festival in about 20 years, and I've not been camping for 10 years (after a handful of brilliant bushcraft weekends with Woodsmoke in the Lake District) so I was pretty thoughtful about spending five days and four nights away in a tent. Knowing that I could bail at any moment and get a taxi back to a train station (or to London if it came to it!) or a hotel might have offered an additional reassurance of course. But in the end I had a great time and didn't freeze or get too soaked, bit of sunburn but nothing awful.
And I met Tom Hollander, which was a lovely surprise.
Table of contents
All the Letters Live people (minus Russell Brand who's not in shot)
On-site help
They have a general store in the main arena that sells soft drinks, sun lotion, lighters, stoves, sleeping bags, ground sheets, tent pegs, toothpaste - pretty much anything you've forgotten. They also sell spring onions, presumably for the campers determined to cook - though I kept a fascinated eye on them and don't think they sold (m)any. There's an Information Tent which is very helpful, also each campsite has its own welfare tent if you get into difficulties. They also have lockers where you can charge your phone (!) though I brought chargers and lasted five days. There are also cash machines. Are all festivals like this now? I might have gone to a few more if I'd known!
I recommend actively checking in with the Information Tent to hear if there are any changes to the programme or exciting additions. Physical programmes are compact thick booklets full of info for £10.
If you're leaving on the last day of the festival note that the arena and stalls will be closed so pick up your breakfast provisions (in my case a Snickers bar and can of diet coke) on the day before.
Getting there
I am not one for walking long distances holding tents and camping mats and would rather take a coach that drops me off inside the venue than a train that doesn't and where I can't be certain of the taxis. I had a great journey from Blackheath to Victoria rail, then from the coach station to the venue - two hours, easy peasy. We left at 10am and I was tent-up by 1pm and having a light snooze before exploring. Thank you National Express. The return journey was also good although the traffic was so ridiculously busy we left an hour and a half after the scheduled time.
I enjoyed arriving the day before everything got going and having a chance to check out the lay of the land (and where all the food stalls were) while there were considerably fewer people.
General packing advice
Put everything in a plastic bag before putting into main bag and squeeze the air out of it as much as possible, I used sandwich bags a lot. While I knew where everything was at the start (I am a maker of lists) it all got a bit more muddled as time went on, I might try mentally labelling each bag A, B etc and then each pocket is A1 or B4 - we'll see, it's a work in progress ;)
Tent / camping
For the benefit of my hands carrying stuff I prioritised lightness over all other considerations and ended up with a single-skin pop-up two man tent. There was just about enough room for my luggage, but not enough room to stand up or really sit up in. I need more room. Very easy to put up, not so difficult to put down though I still managed to break it, oops.
I am not one for kneeling or crawling around on grass and would prefer a bit more space for getting into the tent, there were quite a few graceless entrances and exits. When moving from wet outdoors to warm indoors I wanted to create a sort of interstitial space between the two, so this basically meant spare shoes that I could change into and get into / out of the tent with, using a spare ground sheet as the 'ante-room'. Lots of people much braver than me went barefoot, feet being neither absorbent nor having treads and so much easier to dry and keep clean. Flip-flops also good I suppose.
Quiet camping isn't all that quiet, but it turned out that family camping is also pretty disturbed too - people aren't that quiet. The quiet camping is further from the main stage but not from the other parties.
Mistakes I made
There's a LOT of walking and standing around, unless you happen to find a seat (there are plenty, but a great deal of competition) and I'm not 20, or even 30. Over the five days I definitely got better at sitting on the grass and getting up again but I don't find it easy (don't really trust my knees or leg muscles not to give way during descent or ascent) so I kept spare socks and those insole things to hand. The site is large but while not massive you are moving around on different terrains, mostly grassy, with some inclines (I'm more worried about things sloping down than up as that's worse on the knees) so quite tiring to walk over. I moved very slowly, but pretty much constantly so ironically I'm a bit fitter than I was at the start.
Loos
Shout out to Andyloos whose loos were lovely. Clean, fragrant, constantly stocked with loo roll and hand sanitiser. Most of the loos had mirrors too. Absolutely amazing. At no point did I feel nauseous in the festival loos, and though the queues were occasionally long they moved quite quickly. I did pack a pound-shop variation on the Shewee in case of emergencies but didn't need it. Nor could I have used it in my tent as I wouldn't have been able to sustain the kneeling position to use it anyway, especially in the dark.
Showers
Each campsite had its own shower units with a fairly long queue for those. I'm afraid I dispensed with the concept of showering and used only baby wipes to maintain a minimal level of cleanliness. Just the thought of getting changed, then wet, then getting changed again - too much effort. A scent spray from Boots possibly helped a bit - which reminds me of a cartoon of a woman trying different scents in a shop and asking the opinion of the shop staff: "no madam, you're still coming through".
Food
Delicious and varied. There were options to have fancy dining experiences with long-table feasts for £80 but they sell out quite quickly and my friends with kids probably wouldn't have been that into it so I didn't splash out to go by myself. Maybe next year I will, I do quite fancy the idea.
Bunting
The Wilderness Festival is peak bunting. It's everywhere. Lovely stuff.
Phone charging
Can you believe it's taken me over six years of owning an iPhone to fully understand what switching off cellular data means. I thought it meant no internet AND no phone signal but no it only switches off internet - you can text and ring your mates nae bother without it (though can't share pictures through text as that seems to require an internet connection, fair enough). This fact alone guaranteed that my phone charge held for much longer than it might have. Amazing. I had packed several full-charged spare chargers and didn't have to use them all.
There are places on-site where you can charge your phone.
Phone signal
I had excellent 3G and general O2 text / call signal throughout the festival. It struggled a little on the last day (when everyone is packing up and arranging to meet people I suppose) but I didn't really need it then.
Useful information I kept on my phone
Obviously I had my National Express ticket in my emails but I kept a screenshot as well just in case of low signal. I also had a copy of the PDF map and various other files and bits and pieces in a folder on Dropbox. Before I set off I changed the setting on each file so that it was accessible if I had no signal. Dropbox on a phone is great for this.
Family friendly
It's the most ridiculously family-friendly festival I've ever heard of. Not only do they have a big dedicated kids' area with fun stalls full of things for smaller visitors, loads of adults had small trolleys with them for transporting their kids around the site. I'm not sure if they brought them with them or hired them but whoever came up with the idea is a genius.
Torches
It turns out I had four sources of light: my iPhone, headtorch, regular torch and one of the phone chargers also has a light. I kept my headtorch on me at all times so that I never had to go back to my tent at dusk in order to collect it for use later. When in use I kept it on my wrist to avoid blinding people.
Keeping dry / weather
I saw a few people with umbrellas but I find them fiddly to 'manage' so I got by with a pac-a-mac thing and a shower curtain (lighter than a ground sheet / tarp and does the job fine) for sitting on. Alas my legs are too chubby to fit comfortably in most wellies but my footwear is reasonably waterproof and we only had one major downpour.
The weather app on the iPhone was pretty reliable for keeping me informed. Annoyingly you kind of have to pack for rain and sunshine, though I was glad I did.
What I would change
Online information
There was a lot of information about dressing up and themes but I found the website info quite confusing. All I really wanted was a list of timings and answers to FAQs. I did find this information eventually but felt the website was more of a teaser for the event than informative.
Shush people in quiet camping
I'd have liked a bit more policing of the quiet camping area as people walked in having loud conversations and continued them inside the compound. My in-tent shushing was ineffective as they were too far away anyway.
Announce ISS passes
A nice thing on Saturday night, after the special event on the main stage, was seeing the International Space Station going overhead. I was with very good friends and their kids (that I've known since they were born) so it was a lovely communal moment, among many. Lots of people were moving away from the main stage, as the event had ended, and none of them seemed to know about the ISS. I thought that was a tiny bit of a shame as it would have been lovely for everyone there to be able to look up and see it very clearly - on a lovely cloudless sky. It was beautiful. I wish I'd thought to ask them to make a public address system announcement about it.
As the ISS was due to pass over again on Sunday night I tried to suggest it at the Info Tent but they weren't buying it, and in any case it was cloudy anyway. But if you have an outdoor evening event and there's an ISS pass why not tell people about it.
And I met Tom Hollander, which was a lovely surprise.
Tom Hollander reading a letter at Letters Live
Table of contents
- On-site help
- Getting there
- General packing advice
- Tent / camping
- Mistakes I made
- General foot comfort
- Loos
- Showers
- Food
- Bunting
- Phone charging
- Phone signal
- Useful information I kept on my phone
- Family friendly
- Torches
- Keeping dry / weather
- What I would change (more informative website, ISS pass announcements)
All the Letters Live people (minus Russell Brand who's not in shot)
On-site help
They have a general store in the main arena that sells soft drinks, sun lotion, lighters, stoves, sleeping bags, ground sheets, tent pegs, toothpaste - pretty much anything you've forgotten. They also sell spring onions, presumably for the campers determined to cook - though I kept a fascinated eye on them and don't think they sold (m)any. There's an Information Tent which is very helpful, also each campsite has its own welfare tent if you get into difficulties. They also have lockers where you can charge your phone (!) though I brought chargers and lasted five days. There are also cash machines. Are all festivals like this now? I might have gone to a few more if I'd known!
I recommend actively checking in with the Information Tent to hear if there are any changes to the programme or exciting additions. Physical programmes are compact thick booklets full of info for £10.
The bunting outside the Information Tent
If you're leaving on the last day of the festival note that the arena and stalls will be closed so pick up your breakfast provisions (in my case a Snickers bar and can of diet coke) on the day before.
Getting there
I am not one for walking long distances holding tents and camping mats and would rather take a coach that drops me off inside the venue than a train that doesn't and where I can't be certain of the taxis. I had a great journey from Blackheath to Victoria rail, then from the coach station to the venue - two hours, easy peasy. We left at 10am and I was tent-up by 1pm and having a light snooze before exploring. Thank you National Express. The return journey was also good although the traffic was so ridiculously busy we left an hour and a half after the scheduled time.
I enjoyed arriving the day before everything got going and having a chance to check out the lay of the land (and where all the food stalls were) while there were considerably fewer people.
General packing advice
Put everything in a plastic bag before putting into main bag and squeeze the air out of it as much as possible, I used sandwich bags a lot. While I knew where everything was at the start (I am a maker of lists) it all got a bit more muddled as time went on, I might try mentally labelling each bag A, B etc and then each pocket is A1 or B4 - we'll see, it's a work in progress ;)
Tent / camping
For the benefit of my hands carrying stuff I prioritised lightness over all other considerations and ended up with a single-skin pop-up two man tent. There was just about enough room for my luggage, but not enough room to stand up or really sit up in. I need more room. Very easy to put up, not so difficult to put down though I still managed to break it, oops.
I am not one for kneeling or crawling around on grass and would prefer a bit more space for getting into the tent, there were quite a few graceless entrances and exits. When moving from wet outdoors to warm indoors I wanted to create a sort of interstitial space between the two, so this basically meant spare shoes that I could change into and get into / out of the tent with, using a spare ground sheet as the 'ante-room'. Lots of people much braver than me went barefoot, feet being neither absorbent nor having treads and so much easier to dry and keep clean. Flip-flops also good I suppose.
Quiet camping isn't all that quiet, but it turned out that family camping is also pretty disturbed too - people aren't that quiet. The quiet camping is further from the main stage but not from the other parties.
Mistakes I made
- trusting the piddly little tent pegs which bent easily in the tough terrain of Wilderness (fortunately I'd picked up a bag of extra-sturdy pegs from a pound shop)
- not bringing a plastic mallet to hammer them in (borrowed one from a new neighbour, campers being a friendly, helpful bunch)
- adding bunting to my tent - looked lovely but here's what happens when it rains and is windy. The rain that's on the outside of the rain is basically tapped through the single-skin tent as the wind flaps the bunting against the outside of the tent. After the first night I dispensed with the bunting.
- forgot sun lotion, didn't bother to pick up spare though - didn't get too burned fortunately
- packed sunglasses, forgot (every single day) to transfer them into my day bag so squinted
There's a LOT of walking and standing around, unless you happen to find a seat (there are plenty, but a great deal of competition) and I'm not 20, or even 30. Over the five days I definitely got better at sitting on the grass and getting up again but I don't find it easy (don't really trust my knees or leg muscles not to give way during descent or ascent) so I kept spare socks and those insole things to hand. The site is large but while not massive you are moving around on different terrains, mostly grassy, with some inclines (I'm more worried about things sloping down than up as that's worse on the knees) so quite tiring to walk over. I moved very slowly, but pretty much constantly so ironically I'm a bit fitter than I was at the start.
Loos
Shout out to Andyloos whose loos were lovely. Clean, fragrant, constantly stocked with loo roll and hand sanitiser. Most of the loos had mirrors too. Absolutely amazing. At no point did I feel nauseous in the festival loos, and though the queues were occasionally long they moved quite quickly. I did pack a pound-shop variation on the Shewee in case of emergencies but didn't need it. Nor could I have used it in my tent as I wouldn't have been able to sustain the kneeling position to use it anyway, especially in the dark.
Crowd enjoying the Wilderness Orchestra at the Atrium on Sunday night
Showers
Each campsite had its own shower units with a fairly long queue for those. I'm afraid I dispensed with the concept of showering and used only baby wipes to maintain a minimal level of cleanliness. Just the thought of getting changed, then wet, then getting changed again - too much effort. A scent spray from Boots possibly helped a bit - which reminds me of a cartoon of a woman trying different scents in a shop and asking the opinion of the shop staff: "no madam, you're still coming through".
Food
Delicious and varied. There were options to have fancy dining experiences with long-table feasts for £80 but they sell out quite quickly and my friends with kids probably wouldn't have been that into it so I didn't splash out to go by myself. Maybe next year I will, I do quite fancy the idea.
Bunting
The Wilderness Festival is peak bunting. It's everywhere. Lovely stuff.
Example of the various bunting, flagging and general garlanding plus moody cloud
Phone charging
Can you believe it's taken me over six years of owning an iPhone to fully understand what switching off cellular data means. I thought it meant no internet AND no phone signal but no it only switches off internet - you can text and ring your mates nae bother without it (though can't share pictures through text as that seems to require an internet connection, fair enough). This fact alone guaranteed that my phone charge held for much longer than it might have. Amazing. I had packed several full-charged spare chargers and didn't have to use them all.
There are places on-site where you can charge your phone.
Phone signal
I had excellent 3G and general O2 text / call signal throughout the festival. It struggled a little on the last day (when everyone is packing up and arranging to meet people I suppose) but I didn't really need it then.
Useful information I kept on my phone
Obviously I had my National Express ticket in my emails but I kept a screenshot as well just in case of low signal. I also had a copy of the PDF map and various other files and bits and pieces in a folder on Dropbox. Before I set off I changed the setting on each file so that it was accessible if I had no signal. Dropbox on a phone is great for this.
Family friendly
It's the most ridiculously family-friendly festival I've ever heard of. Not only do they have a big dedicated kids' area with fun stalls full of things for smaller visitors, loads of adults had small trolleys with them for transporting their kids around the site. I'm not sure if they brought them with them or hired them but whoever came up with the idea is a genius.
Flowers (not real!) at the festival
Torches
It turns out I had four sources of light: my iPhone, headtorch, regular torch and one of the phone chargers also has a light. I kept my headtorch on me at all times so that I never had to go back to my tent at dusk in order to collect it for use later. When in use I kept it on my wrist to avoid blinding people.
Keeping dry / weather
I saw a few people with umbrellas but I find them fiddly to 'manage' so I got by with a pac-a-mac thing and a shower curtain (lighter than a ground sheet / tarp and does the job fine) for sitting on. Alas my legs are too chubby to fit comfortably in most wellies but my footwear is reasonably waterproof and we only had one major downpour.
The weather app on the iPhone was pretty reliable for keeping me informed. Annoyingly you kind of have to pack for rain and sunshine, though I was glad I did.
What I would change
Online information
There was a lot of information about dressing up and themes but I found the website info quite confusing. All I really wanted was a list of timings and answers to FAQs. I did find this information eventually but felt the website was more of a teaser for the event than informative.
Shush people in quiet camping
I'd have liked a bit more policing of the quiet camping area as people walked in having loud conversations and continued them inside the compound. My in-tent shushing was ineffective as they were too far away anyway.
Announce ISS passes
A nice thing on Saturday night, after the special event on the main stage, was seeing the International Space Station going overhead. I was with very good friends and their kids (that I've known since they were born) so it was a lovely communal moment, among many. Lots of people were moving away from the main stage, as the event had ended, and none of them seemed to know about the ISS. I thought that was a tiny bit of a shame as it would have been lovely for everyone there to be able to look up and see it very clearly - on a lovely cloudless sky. It was beautiful. I wish I'd thought to ask them to make a public address system announcement about it.
As the ISS was due to pass over again on Sunday night I tried to suggest it at the Info Tent but they weren't buying it, and in any case it was cloudy anyway. But if you have an outdoor evening event and there's an ISS pass why not tell people about it.
Moon peeking through the clouds
Sunday, 23 July 2017
RadioTimes is stopping its TV Watchlist - recommended alternatives?
RadioTimes had a handy thing for keeping an eye on when favourite films or programmes were going to be broadcast. As long as you had an account you could click a 'Watchlist' button on the page for any programme, then you could look at your watchlist to see what was coming up in the schedules.
I'm not quite sure how I discovered this but I associate it with coming across films that David Arnold had scored and tweeting him that they were on. Gradually I added more of his films and would let him know - whether or not he wanted me to - that a particular film of his was to be screened. Sometimes he'd retweet the info and on occasion people would write back saying how much they loved that score, which was always rather lovely to be included in. It was also fun when he'd live tweet stuff about the making of the film or the score.
But RadioTimes are stopping the Watchlist, and now we have to use some app instead. Alas I can't download any more apps onto my very full phone so I'm looking for a 'web-based solution'. Do you know of any?
I'm not quite sure how I discovered this but I associate it with coming across films that David Arnold had scored and tweeting him that they were on. Gradually I added more of his films and would let him know - whether or not he wanted me to - that a particular film of his was to be screened. Sometimes he'd retweet the info and on occasion people would write back saying how much they loved that score, which was always rather lovely to be included in. It was also fun when he'd live tweet stuff about the making of the film or the score.
More important news RT @JoBrodie: Tomorrow Never Dies is on ITV2 8pm this evening (Friday 19th), and Hot Fuzz is on ITV later at 10.40pm.— DavidGArnold (@DavidGArnold) September 19, 2014
But RadioTimes are stopping the Watchlist, and now we have to use some app instead. Alas I can't download any more apps onto my very full phone so I'm looking for a 'web-based solution'. Do you know of any?
Homeopathy 'banned on the NHS' - nearly, but not quite
NHS England is updating its guidance to Clinical Commissioning Groups (CCGs), recommending that certain items offered in primary care should no longer be prescribed. This includes homeopathy but some herbal remedies are in there too, also glucosamine + chondroitin used (ineffectively as it turns out) for osteoarthritis pain.
The document outlining the recommended changes was published on 21 July 2017 and is called Items which should not routinely be prescribed in primary care: A Consultation on guidance for CCGs. It's out for public consultation until 21 October 2017 (see pg 7 of 48 of the linked docuent on how to respond).
A. Things I want to consider in this post, the short version
1. Has homeopathy been banned from the NHS?
No, not yet
2. Is it likely that homeopathy will be removed from the NHS?
Seems pretty likely
3. Homeopathy costs a fraction of the total NHS costs, why do skeptics want it removed?
The evidence isn't good, also to minimise any unwarranted positive associations with healthcare
4. Are there any reasons to keep homeopathy on the NHS?
Slightly dishonest ones
5. What's been the role of skeptics in removing homeopathy from the NHS?
Probably helped
B. Things I want to consider in this post, the longer version
1. Has homeopathy been banned from the NHS?
Not yet. The document acknowledges that the evidence for homeopathy is poor and that homeopathy should not be prescribed, however this is a consultation document not an edict. Also this will affect England, not the whole UK.
2. Is it likely that homeopathy will be removed from the NHS?
I think so - it's widely acknowledged that it's a waste of money and there is little support for it being on the NHS. To be fair homeopathy has been declining on the NHS for two decades as this bar chart from the Nightingale Collaboration. This is more tidying up loose ends than a big new thing.
3. Homeopathy costs a fraction of the total NHS costs, why do skeptics want it removed?
While it's true that the homeopathy spend is now under £100,000 (a drop in the ocean compared with total NHS costs) it's not just about costs. We don't want money wasted on unevidenced treatments (this includes pharma drugs too), even if it is only a small amount of money. But there's also the 'halo effect': homeopathy benefits by its association with healthcare, the NHS is effectively giving its backing to nonsense. Removing it from the NHS removes this positive association. Annoyingly homeopathy also benefits from the fact that you can buy it in many highstreet pharmacists but that's a different argument.
4. Are there any reasons to keep homeopathy on the NHS?
Not good ones, no. Some doctors have argued that patients who are distressed about perceived ill-health, despite not actually being unwell, might benefit from homeopathy or placebo pills.
The idea would involve doctors knowingly (or perhaps even unwittingly) giving patients inert medication with the aim of making them feel better (placebo effects, being taken seriously etc) without causing any side-effects. Another possible benefit is keeping a link with a patient who might otherwise withdraw from appropriate healthcare and explore unhelpful and costly options from quacks.
To be honest I do have some sympathy with this notion. The dishonesty troubles me - it's basically lying to a patient 'for their own good' but I can see examples of where I might go along with this (which also troubles me!).
Here a GP writes about 'heartsink' patients (where your heart sinks as what's ailing them isn't clear, nor is the solution) in an article on the Faculty of Homeopaths website. The FoH is a society of medical doctors who are also homeopaths.
"Another group of patients for which homeopathy can be helpful is those who frequently appear in GPs’ surgeries presenting with a whole host of “functional disorders”. Despite undergoing the full gamut of blood and hospital tests, no abnormality in the body is found. Nevertheless, these “heart sink” patients are clearly suffering from pain and discomfort, which is blighting their lives. This is understandably frustrating for them, for they know full well something is awry but there is no medical evidence for this.
Sometimes conventional medicines can be useful, but once again they are symptomatic treatments which may also produce unpleasant side-effects, resulting in the patient feeling even worse. Homeopathy affords me another approach in trying to help these patients. It doesn’t work for them all, but I’m frequently surprised at how many it does help."
Source: https://facultyofhomeopathy.org/homeopathy-general-practice-2/
5. What's been the role of skeptics in removing homeopathy from the NHS?
The term 'Skeptics' is generally assumed to mean activist bloggers but obviously includes people who aren't bloggers but who are also skeptical of homeopathy - including scientists, doctors and other healthcare professionals, teachers, people who've tried it but experienced no real benefit from homeopathy, members of the public, anyone.
It's difficult to prove causality. My perception is that online skeptical activism, particularly targeted at homeopathy, really got going in the early-mid 2000s, coalescing around Ben Goldacre's Bad Science colummn and blog. Obviously scientists and doctors have obviously been skeptical of homeopathy pretty much since it was invented. Prof David Colquhoun has been blogging about homeopathy since the very early 2000s and published (in a journal) a re-analysis of some homeopathy data in a paper in 1990 - I'm sure others have too, it's just we happened to have a conversation about this recently!
The focus of skeptic activism can be both narrow and targeted (for example getting something changed, eg getting an advert taken down, getting an event moved from an academic setting etc) or wider (eg contributing to people's awareness of what homeopathy actually is) and I think both feed into each other. I think of the former as 'meat' and the latter as 'marinade' and I think skeptic activism has done both very well. It seems as if articles in the press about homeopathy are much more critical and less credulous than they have been in the past - I don't know if this can be attributed to skeptics but I know that quite a few of us have contacted journalists to point to better information.
In late 2009 the UK Government announced that it was seeking examples of topics in which a science Select Committee could "assess the Government’s use of evidence in policy-making", inviting the public to suggest topics. Homeopathy was one of many, and was chosen to be the second 'evidence check' resulting in a 2010 document recommending that funding be withdrawn.
The fact that homeopathy's been included in the current consultation is also largely due to the efforts of the Good Thinking Society which has mounted legal challenges to Clinical Commissioning Groups to get them to stop funding homeopathy, as well as trying to get it blacklisted from NHS spending.
Further reading
Skeptic successes in homeopathy (originally published 24 August 2015 but regularly updated)
The document outlining the recommended changes was published on 21 July 2017 and is called Items which should not routinely be prescribed in primary care: A Consultation on guidance for CCGs. It's out for public consultation until 21 October 2017 (see pg 7 of 48 of the linked docuent on how to respond).
A. Things I want to consider in this post, the short version
1. Has homeopathy been banned from the NHS?
No, not yet
2. Is it likely that homeopathy will be removed from the NHS?
Seems pretty likely
3. Homeopathy costs a fraction of the total NHS costs, why do skeptics want it removed?
The evidence isn't good, also to minimise any unwarranted positive associations with healthcare
4. Are there any reasons to keep homeopathy on the NHS?
Slightly dishonest ones
5. What's been the role of skeptics in removing homeopathy from the NHS?
Probably helped
B. Things I want to consider in this post, the longer version
1. Has homeopathy been banned from the NHS?
Not yet. The document acknowledges that the evidence for homeopathy is poor and that homeopathy should not be prescribed, however this is a consultation document not an edict. Also this will affect England, not the whole UK.
2. Is it likely that homeopathy will be removed from the NHS?
I think so - it's widely acknowledged that it's a waste of money and there is little support for it being on the NHS. To be fair homeopathy has been declining on the NHS for two decades as this bar chart from the Nightingale Collaboration. This is more tidying up loose ends than a big new thing.
3. Homeopathy costs a fraction of the total NHS costs, why do skeptics want it removed?
While it's true that the homeopathy spend is now under £100,000 (a drop in the ocean compared with total NHS costs) it's not just about costs. We don't want money wasted on unevidenced treatments (this includes pharma drugs too), even if it is only a small amount of money. But there's also the 'halo effect': homeopathy benefits by its association with healthcare, the NHS is effectively giving its backing to nonsense. Removing it from the NHS removes this positive association. Annoyingly homeopathy also benefits from the fact that you can buy it in many highstreet pharmacists but that's a different argument.
Booting #homeopathy off NHS not *just* abt saving relatively small pot of cash, but also removes 'imprimatur' of a +ve assoc w 'healthcare'.— Jo Brodie (@JoBrodie) July 21, 2017
4. Are there any reasons to keep homeopathy on the NHS?
Not good ones, no. Some doctors have argued that patients who are distressed about perceived ill-health, despite not actually being unwell, might benefit from homeopathy or placebo pills.
"TEETH" stands for "Tried Everything Else, Try Homeopathy".TEETH— UK Homeopathy Regs (@UKHomeopathyReg) July 23, 2017
The idea would involve doctors knowingly (or perhaps even unwittingly) giving patients inert medication with the aim of making them feel better (placebo effects, being taken seriously etc) without causing any side-effects. Another possible benefit is keeping a link with a patient who might otherwise withdraw from appropriate healthcare and explore unhelpful and costly options from quacks.
To be honest I do have some sympathy with this notion. The dishonesty troubles me - it's basically lying to a patient 'for their own good' but I can see examples of where I might go along with this (which also troubles me!).
Here a GP writes about 'heartsink' patients (where your heart sinks as what's ailing them isn't clear, nor is the solution) in an article on the Faculty of Homeopaths website. The FoH is a society of medical doctors who are also homeopaths.
"Another group of patients for which homeopathy can be helpful is those who frequently appear in GPs’ surgeries presenting with a whole host of “functional disorders”. Despite undergoing the full gamut of blood and hospital tests, no abnormality in the body is found. Nevertheless, these “heart sink” patients are clearly suffering from pain and discomfort, which is blighting their lives. This is understandably frustrating for them, for they know full well something is awry but there is no medical evidence for this.
Sometimes conventional medicines can be useful, but once again they are symptomatic treatments which may also produce unpleasant side-effects, resulting in the patient feeling even worse. Homeopathy affords me another approach in trying to help these patients. It doesn’t work for them all, but I’m frequently surprised at how many it does help."
Source: https://facultyofhomeopathy.org/homeopathy-general-practice-2/
5. What's been the role of skeptics in removing homeopathy from the NHS?
The term 'Skeptics' is generally assumed to mean activist bloggers but obviously includes people who aren't bloggers but who are also skeptical of homeopathy - including scientists, doctors and other healthcare professionals, teachers, people who've tried it but experienced no real benefit from homeopathy, members of the public, anyone.
It's difficult to prove causality. My perception is that online skeptical activism, particularly targeted at homeopathy, really got going in the early-mid 2000s, coalescing around Ben Goldacre's Bad Science colummn and blog. Obviously scientists and doctors have obviously been skeptical of homeopathy pretty much since it was invented. Prof David Colquhoun has been blogging about homeopathy since the very early 2000s and published (in a journal) a re-analysis of some homeopathy data in a paper in 1990 - I'm sure others have too, it's just we happened to have a conversation about this recently!
The focus of skeptic activism can be both narrow and targeted (for example getting something changed, eg getting an advert taken down, getting an event moved from an academic setting etc) or wider (eg contributing to people's awareness of what homeopathy actually is) and I think both feed into each other. I think of the former as 'meat' and the latter as 'marinade' and I think skeptic activism has done both very well. It seems as if articles in the press about homeopathy are much more critical and less credulous than they have been in the past - I don't know if this can be attributed to skeptics but I know that quite a few of us have contacted journalists to point to better information.
In late 2009 the UK Government announced that it was seeking examples of topics in which a science Select Committee could "assess the Government’s use of evidence in policy-making", inviting the public to suggest topics. Homeopathy was one of many, and was chosen to be the second 'evidence check' resulting in a 2010 document recommending that funding be withdrawn.
The fact that homeopathy's been included in the current consultation is also largely due to the efforts of the Good Thinking Society which has mounted legal challenges to Clinical Commissioning Groups to get them to stop funding homeopathy, as well as trying to get it blacklisted from NHS spending.
Further reading
Skeptic successes in homeopathy (originally published 24 August 2015 but regularly updated)
Tuesday, 18 July 2017
A couple of useful mildly passive-aggressive phrases I learned from my dad
These two phrases, passed on from father to daughter (I've no idea where Dad got them from) have been occasionally useful and I thought I'd share them in case others want to adopt them too.
1. To what fault in yourself do you attribute that?
I'm not sure I can really carry this one off as well as my dad (though he annoyingly remains dead when he was alive he was 6ft 2, large, loud and commanding) so I tend to use it more in jest but I leave it to you to decide how to use it :)
Dad probably used it most with jobsworth types. Or people lacking in insight.
2. Well to be fair they're probably not as well-advised as me
This one's good for rebuffing annoying people who tell you that 'everyone is doing X', particularly if they're trying to sell you something or beat you in a game of I Remain Unconvinced. It's not an actual game but I tend to gamify efforts to sell me things.
Here's a bonus one from my mum...
3. X permanently has his/her foot in the stirrup of his/her high-horse
Funnily enough it's quite possible Mum might have been talking about Dad or me. She used to ring me occasionally with news of Dad's victories against companies that had foolishly tried to rip him off; he was never happier than when a proper fight was in the offing. Honestly my dad used to have the most amazingly protracted arguments (and the weird thing was they were nearly always really amiable) with companies about something failing to turn up, the wrong thing turning up, something needing replaced etc. An awful lot of Mum's, or his, stories seemed to be about vacuum cleaners - our house was like some sort of graveyard for them, a lot went there to die. Companies kept sending them, particularly after they'd spoken to my dad for upwards of half an hour.
Anyway, make sure you don't die by knowing what a failing smoke alarm sounds like or get out of the house and go and see a film in the open air (admittedly this link only relevant if you live in London).
1. To what fault in yourself do you attribute that?
I'm not sure I can really carry this one off as well as my dad (though he annoyingly remains dead when he was alive he was 6ft 2, large, loud and commanding) so I tend to use it more in jest but I leave it to you to decide how to use it :)
Dad probably used it most with jobsworth types. Or people lacking in insight.
2. Well to be fair they're probably not as well-advised as me
This one's good for rebuffing annoying people who tell you that 'everyone is doing X', particularly if they're trying to sell you something or beat you in a game of I Remain Unconvinced. It's not an actual game but I tend to gamify efforts to sell me things.
Here's a bonus one from my mum...
3. X permanently has his/her foot in the stirrup of his/her high-horse
Funnily enough it's quite possible Mum might have been talking about Dad or me. She used to ring me occasionally with news of Dad's victories against companies that had foolishly tried to rip him off; he was never happier than when a proper fight was in the offing. Honestly my dad used to have the most amazingly protracted arguments (and the weird thing was they were nearly always really amiable) with companies about something failing to turn up, the wrong thing turning up, something needing replaced etc. An awful lot of Mum's, or his, stories seemed to be about vacuum cleaners - our house was like some sort of graveyard for them, a lot went there to die. Companies kept sending them, particularly after they'd spoken to my dad for upwards of half an hour.
Anyway, make sure you don't die by knowing what a failing smoke alarm sounds like or get out of the house and go and see a film in the open air (admittedly this link only relevant if you live in London).
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