Zeno's Blog

Guest post by Blue Wode. Originally published on The Twenty First Floor on 14 March 2012.

Introduction

In recent times, the two main UK chiropractic associations, the British Chiropractic Association (BCA) and the McTimoney Chiropractic Association (MCA), have come under intense scrutiny. The BCA was brought to its knees by the misconceived libel case it brought against the science writer and broadcaster, Simon Singh, and, as a direct result of it, the MCA suffered the humiliation of having a confidential email to its members leaked online which revealed that it had urged all of them to take down their websites as they were a real threat to both them and their practices. By comparison, the Scottish Chiropractic Association (SCA) has enjoyed a relatively uncontroversial existence. Until now.

Jubilation in the chiropractic world! But, as usual, all is not what it might first seem…

Chiropractors granted Royal Charter:

The College of Chiropractors will soon be given the honour of being named the Royal College of Chiropractors. In doing so, Chiropractors become the first complementary health specialty to be awarded a Royal Charter. It is great news for Chiropractors and the development of the chiropractic profession in general.

Royal Charters have traditionally been awarded to specialty areas of Medicine such as the Royal College of Surgeons or Royal College of Dentists. It recognises the value of the College of Chiropractors unique position as a leader in the profession. (Source)

College of Chiropractors receives Royal Charter. Feels great to now be part of The Royal College of Chiropractors (Source)

The College of Chiropractors have been granted Royal Charter. Congratulations to the Royal College of Chiropractors! (Source)

The College of Chiropractors will soon be given the honour of being named the Royal College of Chiropractors. (Source)

One chiro was quick to update their website (or maybe he always thought it was a Royal College?) with this new imprimatur:

 I am registered with the General Chiropractic Council…and a member of the British Chiropractic Association (BCA) and the Royal College of Chiropractors. (Source)

The British Chiropractic Association (BCA) published a press release (cached) that probably started this all off:

College of Chiropractors granted Royal Charter

Dated: 12 November 2012

At a meeting of the Privy Council on Wednesday, the Queen approved the grant of a Royal Charter to the College of Chiropractors, the first Royal Charter to be granted to a complementary medicine organisation in the UK.

The College is an academic, professional membership body, established along the lines of the Medical Royal Colleges, which over the past 13 years has sought to ensure quality, safety and excellence are at the forefront of chiropractic practice in the public interest.

Chiropractic is regulated by statute and although chiropractors provide their services largely within the private sector, NHS funding for chiropractic treatment is now emerging region by region under the Department of Health’s new commissioning arrangements. Chiropractors specialise in the diagnosis and treatment of problems affecting the joints, muscles and nerves and are probably best known for treating low back pain, a condition which costs the equivalent of between 1% and 2% of the UK GDP and has a significant impact on people’s lives.

Rarely granted, a Royal Charter signals permanence and stability and, in the College of Chiropractors’ case, a clear indication to others of the leadership value and innovative approach the College brings to the development of the chiropractic profession. The Royal Charter essentially formalises the College’s position as a unique, apolitical, consultative body, recognising its role in promoting high practice standards and certifying quality and thus securing public confidence.

Tim Jay, President of the College, said, “The College of Chiropractors’ Royal Charter emphasises to the public and other health bodies that chiropractic is a healthcare profession with parity in the field of musculoskeletal health, providing a viable and recognised option for patients.”

All the usual spin, of course.

In his Guardian article, Homeopaths offer to rebrand products as ‘confectionery’, Martin Robbins tells the story that, faced with being unable to sell their products as homeopathic medicines because they were unlicensed, a manufacturer offered to re-brand them as sweets. The irony of that won’t be lost on many, but what else has been going on?

Thanks to his FOIA request, we now know that the medicines regulator, the MHRA, told homeopathy manufacturers Helios and Ainsworths to discontinue the sale and supply of a number of their kits of homeopathic products because they contained homeopathic products that were not registered (under the HR scheme) or authorised (under the NR scheme) and because the names of the kits were not as had been registered with the MHRA.

These two issues are important: under the Medicines Regulations, individual homeopathic products have to be registered or authorised by the MHRA, and so do kits of these products, with the name of the kits agreed with the MHRA.

Helios and Ainsworths fell foul of the Medicines Regulations on both counts.

What does the Swiss Government really think about homeopathy?

By Sven Rudloff and Zeno

Jump to Postscript

A lot has been made by homeopaths about the ‘neutral’ Swiss Government’s report and its unequivocal support of homeopathy. It’s been lauded by the luminaries of the homeopathic world as further proof — as if any was needed, of course — that homeopathic ‘medicines’ are superior in every way to those dangerous and expensive pharmaceutical drugs.

Arch proponent of homeopathy, Dana Ullman, proclaimed:

The Swiss government’s exceedingly positive report on homeopathic medicine

The Swiss government has a long and widely-respected history of neutrality, and therefore, reports from this government on controversial subjects need to be taken more seriously than other reports from countries that are more strongly influenced by present economic and political constituencies.

…

In late 2011, the Swiss government’s report on homeopathic medicine represents the most comprehensive evaluation of homeopathic medicine ever written by a government and was just published in book form in English (Bornhoft and Matthiessen, 2011). This breakthrough report affirmed that homeopathic treatment is both effective and cost-effective and that homeopathic treatment should be reimbursed by Switzerland’s national health insurance program.

…

The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this new study, the Swiss government’s health insurance program once again began to reimburse for homeopathy and select alternative treatments. (Source, cached)

Ullman again:

this report from the Swiss government has confirmed the efficacy and cost-effectiveness of homeopathic treatment. (Source, cached)

The Society of Homeopaths:

Swiss scientists endorse homeopathy evidence

Report says homeopathic medicine is clinically effective

A comprehensive and authoritative research study by Swiss scientists has offered an unambiguous endorsement of the evidence base for homeopathy as a clinically effective system of medicine.

Their report, part of a Swiss government evaluation of complementary and alternative medicines, gives a massive boost to the growing body of research underpinning the therapeutic effects of homeopathic medicine. (Source, cached)

The Faculty of Homeopathy and the British Homeopathic Association:

Evidence for homeopathy builds

Long-awaited English translation of Swiss study endorses evidence for homeopathy

This important report addresses the evidence for the effectiveness of homeopathic therapy in everyday use (i.e. the real world), its safety and its cost-effectiveness.

The authors, Doctor Gudrun Bornhöft and Professor Peter Matthiessen, state: “There is sufficient evidence for the preclinical effectiveness and the clinical efficacy of homeopathy and for its safety and economy compared with conventional treatment.”

Following on from the initial publication of this report, a public referendum in Switzerland in 2009 supported the inclusion of homeopathy and other complementary and alternative medicines in the Swiss national health insurance, with 67% of the people voting in favour. Earlier this month, the Swiss government passed legislation to enact the referendum’s conclusion. (Source, cached and source, cached)

GP and homeopath Dr Andrew Sikorski:

In 2009 a Swiss national referendum voted in favour of complementary medicine being part of the public health service which is now covered by the obligatory public health insurance system. This decision was partly informed by the findings of the 2006 Health Technology Assessment report commissioned by the Swiss Government on the effectiveness, safety and cost-effectiveness of homeopathy in general practice. (Source, cached)

Many other websites have echoed these sentiments, with many taking their lead from Ullman’s article and possibly placing far too much reliance on what he had to say, eg Swiss Government finds homeopathy effective and cost efficient (cached).

You’d think from all this that the ‘neutral’ Swiss Government had taken to homeopathy like the proverbial quacking duck to water.

Of course, to state in this context that the Swiss Government has a ‘widely-respected history of neutrality’ is to conflate political neutrality with scientific objectivity.

As usual, research of truly homeopathic proportions, misrepresentation and cherry picking are the order of the day.

I have never been 100%  sure of the exact numbers of complaints of mine the General Chiropractic Council had to deal with.

I certainly submitted a list of 524 names, but the number changed as the complaints were processed. Quite a few chiros were added to my initial list because they were at the same clinic as another I had complained about and some have been removed for various reasons. Then there were more than a few issues of chiros changing their names, moving clinics, moving abroad and other things that made it difficult to keep track, so I didn’t bother to keep my list absolutely up to date. There didn’t really seem any point in fretting over the minutiæ. After all, the GCC are a statutory regulator and they could be trusted to keep track because it was their statutory duty to deal with these things, couldn’t they?

I’m not sure how I came across it, but it was probably on Twitter.

A conference on alternative cancer treatments is being held in Totnes in Devon this coming Saturday, organised by Dr Stephen Hopwood (cached) of the Totnes Cancer Health Centre (TCHC).

Because of its content, I immediately complained to Consumer Direct (the central point for Trading Standards complaints) on 2 March who passed it on to Devon Trading Standards (TS).

There are many nutritional therapists who will give responsible, evidence and science-based advice. What is OfQuack doing to ensure their nutritional therapists don’t mislead the public? Their new ‘therapy descriptor’ needs careful analysis.

I blogged a few days ago about the investigation by the consumers’ organisation Which? that revealed nutritional therapists giving dangerous and misleading advice — most of those investigated were members of the British Association for Applied Nutrition and Nutritional Therapy (BANT).

In 2009, BANT passed any regulatory responsibilities they had on to OfQuack, aka the Complementary and Natural Healthcare Council, and they have just published a revised ‘therapy descriptor’ for nutritional therapy.

This version has been revised — and the previous one removed — after discussion with the Advertising Standards Authority. Presumably this new one is accepted as being compliant with the CAP Code — the Code all advertisers have to abide by in their advertising, whether in the media or on their own websites.

Nutritional therapists are a varied bunch and come in several ‘flavours’, with the science and evidence-based practitioners at one end of the spectrum and at the other, what @skepticstu on Twitter referred to as the ‘Supplement Salesforce’.

At this far end, some seem to think many ills — particularly chronic conditions — are due to dairy intolerance or wheat intolerance, or both or ‘toxins’, or ‘imbalances’, or ‘chemicals’, or deficiencies. And, of course, they have just the personalised detoxification or supplement for you to address the ‘underlying causes’ of your health issues. And they may make extensive use of iridology, hair mineral analysis and applied kinesiology tests to work out your own, optimum health, individualised, holistic, supplement plan. For a price. All major credit cards accepted.

Others, I am sure, give good, evidence-based diet advice without a supplement in sight. They are not the problem here.

As a last hope for cancer sufferers, his name regularly appears in the media with many a fund-raising appeal launched to enable sufferers to travel to the US to visit his clinic and be treated by the great man himself.

Even a cursory search of the Internet will find many grateful customers of Dr Stanislaw R Burzynski telling how he single-handedly saved their lives, when the NHS or other cancer experts had failed or who could do no more.

If it was your last hope — or the last chance for your child — then who could blame you for wanting to give it a try?

After an uncritical article in The Observer about the heartbreaking tale of a young girl diagnosed with a brain tumour and whose parents were desperate to raise the necessary money to take their daughter to see Dr Burnzynski for treatment, Andy Lewis — quite understandably — felt compelled to write about it: The False Hope of the Burzynski Clinic.

It was not long before Andy received a threatening email from someone claiming to represent the clinic. The tactics this representative used to try to silence Andy and to force him to take his blog post down can be gauged by the title of Andy’s subsequent post: The Burzynski Clinic Threatens My Family. Despicable.

Because there are so many unanswered questions about his treatment, the spotlight of skeptical thinking has been shining brightly on the controversial promoter of his own proprietary, ‘pioneering’ cancer treatments, but the intensity has been turned up all the way to eleven in the aftermath of these and other recent threats.

There has been an avalanche of blog posts in the last few days and it is to be hoped that the name of Burzynski will be appearing high up in search rankings alongside some more skeptical comment that the clinic might be used to or want. The blogger Josephine Jones is trying to keep the list of posts up to date: Stanislaw, Streisand and Spartacus.

Even Cancer Research UK felt they had to speak up: Hope or false hope?

Many websites of homeopaths are changing. Some as a direct result of being contacted by the Advertising Standards Authority (ASA) and some, no doubt, because, now they are aware of the ASA’s rules, want to be responsible and abide by them.

I’ve been watching several websites change over recent months: some delete a few words here and there; some have had to make substantial changes; and some have yet to make the necessary changes.

One of the websites I’ve been watching is the one belonging to the Society of Homeopaths.

Their home page had this:

Homeopathy is an evidence-based medicine which offers holistic, individual and integrated treatment with highly diluted substances with the aim of triggering the body’s natural system of healing.

A few days ago, they changed it to say:

Homeopathy is a form of holistic medicine in which treatment is tailored to the individual.

Have they finally realised that it’s not ‘an evidence-based medicine’; that there is no robust scientific evidence (ie the kind required by the ASA to protect the public from misleading claims) that homeopathic sugar pills have any effect over placebo?

I doubt it, but sooner or later homeopaths have to realise that they have to abide by the same rules as every other advertiser: if you make a claim, you must have robust evidence to substantiate it.

If a double-glazing seller claims his windows use an alternative glass that works far better than ‘conventional’ glass, then we would — rightly — expect him to be able to back up that with good evidence. There cannot be one standard for, say, double-glazing sellers and different, lower standard, for homeopaths.

And so with the homeopaths or any other advertiser of alternative therapies. Indeed, there could be a case made for requiring an even higher standard of evidence for claims about healthcare made to an unsuspecting public.