Zeno's Blog

Posts Tagged ‘General Chiropractic Council (GCC)’

Czego mogę się spodziewać podczas wizyty u kręgarza?

If your Polish isn’t up to scratch, this roughly translates as: What can I expect when visiting a chiropractor?

Ah! I hear you say. Is it just a coincidence that this is suspiciously close to What can I expect when I see a chiropractor?

No, of course it isn’t. That was the title of the GCC’s leaflet that Simon Perry (Adventures in Nonsense, Leicester Skeptics in the Pub and skeptical columnist for the Leicester Mercury) complained to the Advertising Standards Authority about last year.

In his blogposts Quick Update on the Chiropractic Stuff, General Chiropractic Council to Change Patient Information Leaflet, The General Chiropractic Council is knowingly and deliberately violating its own code of practice, he tells the story of his complaint to the ASA about this leaflet and how, even after it was ‘informally resolved’ with the GCC, they didn’t immediately withdraw the electronic copy from their website. When Simon queried this, the GCC said:

Thank you for your enquiry of 6 October regarding the text of the GCC’s patient  information leaflet, which is published in nine languages plus Braille.

Following informal resolution of a complaint made to the Advertising Standards Authority, an amended version of the leaflet will be published as soon as reasonably practicable. including publication on our website.

You can read more about this in my post The trouble with leaflets, but it was discovered that the GCC had informed its members that, while corrective inserts would be available, there wasn’t a problem with any member using up stocks of the old leaflet (but if they really wanted the insert, they only had to ask).

Meanwhile, the GCC were re-writing the offending words in the leaflet and having it translated — presumably into all nine languages and Braille. The ASA do appreciate that re-printing leaflets takes some time:

We’d normally expect an advertiser to implement the changes as soon as is ‘reasonably practicable’ (bearing in mind the time involved in printing new leaflets).

But the GCC didn’t remove the old (misleading) leaflet from their website — something they could easily have done immediately, contrary to the ASA’s expectations:

However, if it’s a leaflet on a website then it should be taken down as soon as possible.

Anyway, they did eventually replace the downloadable leaflet. Meantime, they were presumably getting the new words translated so they could get them re-printed. How long should that take? It’s only one sentence that’s different, after all.

That was all at the beginning of October last year.

Over three months later, a GCC leaflet fell into my hands, obtained from a chiropractor who is a BCA member, and, yes, it was in Polish!

I don’t understand a word of the language, but it’s easy to get a rough translation of it with Google Translate. Much of it is similar to the English version of the leaflet, but one of the interesting bits is:

Można również osiągnać poprawę przy niektórych typach:

* astmy
* bólów glowy, w tym migreny; oraz
* kolki niemowlęcej

which translates as:

There may also be an improvement with certain types of:

* asthma
* headaches, including migraines, and
* infant colic

This is the old, old wording: the pre June 2009 English leaflet, written in 2007. It’s certainly not the words that were acceptable to the ASA. And there was no insert, giving the correct words, not even in English.

So why is this leaflet still being used by GCC members — particularly without an insert that corrects the misleading claims made?

The leaflet was soon winging its way to the ASA, who responded:

The ad makes reference to a number of serious medical conditions that our Code does not allow claims for.

They said that there was little point in adjudicating on the claims made in the leaflet because they had already done so:

The ad makes reference to a number of serious medical conditions that our Code does not allow claims for.  We have therefore decided to refer it to our Compliance team for further action.  Please note that they do not report back to complainants or publish the results of their work, but please rest assured that they will do their best to achieve a satisfactory outcome.

So, their Compliance Monitoring section would contact the GCC and have a few words with them:

Compliance take follow-up action when we have previously deemed a claim to be in breach of our Code.  For example, in the past we have investigated many similar claims for chiropractic and as we have no evidence that the claims (such as that asthma, sciatica and headaches can be treated) can be substantiated the Compliance team will approach the advertiser with evidence of our previous cases to show them why they cannot make such claims.  The advertiser is then required to give an assurance to the Compliance team.  If they persist in producing problematic ads, they can be referred to the OFT.  This system avoids us duplicating work that has been done by our Investigations team in the past when we already know that a claim cannot be substantiated.

Evidence, evidence, evidence

Just a few more words on the GCC’s newly-published Effectiveness of manual therapies: the UK evidence report (Bronfort et al.).

Many chiropractors seemed to think there was, indeed, good evidence for all sorts of medical conditions and proudly said so on their websites. However, it is clear that when the totality of evidence is examined there is a lot less evidence than many would like. Even the report, commissioned by the GCC and written by five chiropractors in the US, concluded that there was no evidence for conditions like colic and asthma. They were less sure about conditions such as ear infections, bed wetting and mid-back pain and declared the evidence to be ‘inconclusive’.

Remember, Bronfort et al. has done no new research — they simply reviewed what was already out there. But it remains to be seen whether their conclusions survive the spotlight of sceptical scrutiny.

Meantime, chiropractors are left with a dilemma: what about the conditions where Bronfort et al. concluded the evidence for the efficacy of ‘manipulation/mobilization’ was ‘inconclusive‘ (eg mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders and that old chiropractic favourite, fibromyalgia)?

Certainly, the ASA are considering Bronfort et al. but it will take some time before they make changes — if any — to their guidance. Meantime, why is the GCC leaving the decision to their members about whether claims for these conditions are acceptable? Each chiropractor has to now decide for his/herself and it is a foregone conclusion that there will be different interpretations of ‘inconclusive’!

While we all wait for the ASA, perhaps the GCC  — as an organisation who are supposed to protect the public — should take the lead?

But of course, the extreme irony of all this is that we have a consumer advertising watchdog, with no statutory regulatory powers and funded by a voluntary levy on the marketing spend of ad agencies and companies — and not the statutory regulator — who is regulating the clinical claims of chiropractors who apparently see themselves as primary healthcare professionals.

(In case you haven’t worked it out and desperately need to know, the Polish for ‘chiropractor’ is ‘kręgarz’.)

Well. The GCC’s ‘independent’ review of the effectiveness of chiropractic has finally been published: Effectiveness of manual therapies: the UK evidence report (although not yet on the GCC’s website).

Paid for by the GCC (see page 77), this document runs to 113 pages and there is additional commentary by two others, adding a further 13 pages.

It’ll take time to read through and digest fully, but here’s a handy summary of what they did — and didn’t — find evidence for. They have listed conditions in three categories: effective, inconclusive and ineffective. Read the rest of this entry »

No. I’ve not been converted and I’m not urging you all to realise that the future of humanity and an end to all pain, suffering and diseases known to man lies in the chiropractic way.

It’s the name of a chiropractic clinic in Edinburgh. They wanted to spread the word about the benefits of chiropractic and decided to advertise.

Oops! You’d have thought… No. I won’t say it again.

Read the rest of this entry »

When it comes to supplying the Advertising Standards Authority with evidence that backs up claims you’ve made in an advert, it’s a good idea to make sure it does actually back up the claims you’ve made. Common sense, really. Saves a lot of hassle. And an adverse adjudication. And adverse publicity.

It’s a fallacy of personal incredulity I know, but I’d have thought that Philips Electronics UK Ltd — part of giant Royal Philips Electronics of The Netherlands — would have been circumspect when it came to ensuring they have the appropriate evidence for claims they were making.

Read the rest of this entry »

The General Chiropractic Council publishes annual Fitness to Practice reports, which contain summaries of all complaints dealt with over the year and useful advice and guidance for chiropractors on topics like:

1. Professional boundaries
2. Abuse of trust or exploitation of lack of knowledge
3. Communication with patients and obtaining consent
4. Record keeping
5. Management and care: initial examination and review of treatment
6. Use of X-rays
7. Local complaints procedure
8. Treatment prescribed by another health professional
9. Protecting patients and colleagues from risk of harm
10. Honesty, integrity and trustworthiness
11. Politeness and consideration towards patients
12. Respecting confidentiality

Read the rest of this entry »

Some light relief.

Genius! Sheer genius.

And another one, found by Dr Aust: Chiropraktischer Untergang – updated with added Sturm und Drang. See his excellent blog for several more.

Pharmacies are in the news again this week. Not Boots this time, but that other well-known high street chemist, Lloyds Pharmacy.

An ASA adjudication, published today, upheld a complaint against a TV advert about their ‘light therapy device‘.  The advert claimed:

Hay fever seasons [sic] here again.  But heres [sic] something you might not have tried before, the Lloyds Pharmacy hay fever reliever.  Its [sic] been shown to help reduce symptoms like your runny nose and itchy eyes … Just pop it up your nose for a couple of minutes two or three times a day and start making the most of your summer.

Although I wouldn’t be entirely keen on sticking anything up my nose, I don’t suffer from hay fever. However, I do know it can be a miserable condition and anything that might help would be worth a try. But you’d want something for which there was good evidence for efficacy before you splashed out your hard-earned cash, wouldn’t you? And you’d want the seller to be able to provide that good evidence when asked?

Read the rest of this entry »

Phew! This has been a spectacular week or so for alternative medicine.

Firstly, we had the Landmark ASA ruling on asthma and colic. Then we have the spectacle of some of its major proponents being tortured and exposed before the House of Commons Science and Technology Sub-committee looking into the evidence (or lack of it) for homeopathy. Skepticat tells it far better than I could, but the admission by Boots of the absence of evidence for homeopathy and that they just sell the stuff  ‘cos their customers want to buy it has been described as a Ratner moment.

That was Wednesday; but today was another significant day for the regulation of quackery.

Read the rest of this entry »

The Code of Practice for chiropractors clearly states that claims made by chiropractors have to be:

…consistent with the law and the guidance issued by the Advertising Standards Authority.

There have been several cases where the ASA have found chiropractors to be in breach of this guidance by making claims for all sorts of medical conditions, some serious. Since the adjudications form part of the ASA guidance, you’d have thought that chiropractors would be somewhat cautious about making claims that the ASA either have already rejected or ones not on the list of conditions they will allow (providing the advertiser provides convincing evidence, of course). The only condition the ASA will allow without asking for evidence is migraines (not headaches). Not even lower back pain.

And now there’s another one.

Read the rest of this entry »

There has been a lot of speculation today after some media reports about Google and the ASA.

One article was in Revolution magazine: ASA imposes paid search tax to police websites and another in the Guardian: Google deal with Advertising Standards Authority will fund regulation.

It is not clear from either of these articles exactly what has been proposed or whether the ASA’s remit is to be extended.

Read the rest of this entry »