The random thoughts of a sceptical activist

Regulation

Beware the spinal spin

Finding a document on the website of the British Chiropractic Association titled  “CONFIDENTIAL FOR BCA MEMBERS ONLY” is an open invitation…

Perusing the BCA’s website usually finds extremely useful advice on schoolbagsgardeningbrasshopping, Bank Holidays, bakinggadgets, sitting and, of course, Christmas.

This time, however, I was bravely looking for what they said about the differences between chiropractic and osteopathy after a comment by a chiro on Prof Edzard Ernst’s blog:

Chiropractic and osteopathy have different origins. They are separate forms of spinal manip. Typically osteopaths use long level techniques, chiros use short lever. Both aim to achieve the same thing – spinal health.

This highlights a frequent question asked by skeptics: Are chiropractic and osteopathy substantially or even significantly different forms of healthcare?

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The bitter sugar pill

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?

…sceptics [are] posing as genuine members of the public…

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.

McCarthy-style reporting, encouraged by the self-appointed detractors of homoeopathy…has protracted this decline [in the homeopathy industry]

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.

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Chiro regulator admits systemic failures

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?

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Which nutritional therapist?

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.

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Changing times for homeopaths

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.

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Dangerous homeopathy

It’s bad enough when homeopaths take good money from people, claiming they can cure their colds or clear up their eczema with sugar pills. It’s another thing entirely to claim to prevent or treat serious diseases with identical sugar pills.

But this is precisely what the BBC’s Newsnight programme discovered homeopaths were doing. Broadcast in January, Pallab Ghosh exposed the disgraceful behaviour of a north London homeopath and a homeopathic ‘pharmacy’ selling sugar pills as a malaria preventative.

Watch the whole sorry exposure, even if you’ve watched it before:

As Dr Simon Singh said on the programme:

Choice is fine as long as it’s based on accurate information. And the information that’s being given out by pharmacists, by celebrities endorsing homeopathy, by the NHS offering homeopathy — the implication here that homeopathy must be effective otherwise people wouldn’t sell it, profit from it or offer it in the high street. And I am utterly shocked that we have a woman here [Zofia Dymitr, Chairwoman of the Society of Homeopaths] saying that she’s not going to forbid her members from offering homeopathic prevention of malaria to the general public. There are people coming back from tropical countries with multiple organ failure having used homeopathy and yet this woman is not prepared to stop it.

I was here four years ago when Newsnight did your last investigation and BBC Scotland have done an investigation and BBC South West have done an investigation. The BBC are the only people regulating homeopathy at the moment, because the Society itself seems to be oblivious to its responsibility.

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Homeopathy regulation: there’s nothing in it

Is ‘homeopathic’ an accurate description of self-regulation?

The Advertising Standards Authority (ASA) are paragons of efficiency and professionalism. They may well have a lot to deal with at the moment, but that does not stop them investigating complaints thoroughly and responsibly. They take the business of regulation seriously and have a well-deserved reputation for being fair, independent and impartial.

That’s how a regulator should conduct its business if they are to be seen as thorough and effective, particularly where there is a need to protect the public from those who would prey on their trust, ignorance or vulnerability.

The ASA have an advantage over the trade bodies that parade their Code of Ethics as banners of respectability to entice the public to believe their members are being properly regulated. The ASA operate at arms length from those who fund them: those who decide on whether an advert is legal, decent, honest and truthful treat all complaints equally, regardless of who the advertiser is or who the complainant is.

It’s a pity the same cannot be said for the ‘regulators’ of purveyors of ‘alternative’ therapies.

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