Zeno's Blog

Gimpy has written a good blog entry on the BCA’s use of the word ‘bogus’ in their 2003/2004 annual report.

So, I though I’d have a look at their last annual report (2007).

Chiropractic is not readily available on the National Health Service in the United Kingdom

Fantastic!

although some chiropractors do have contracts with PCT’s (Primary Care Trusts) which administer the funding of healthcare provision in a designated community.

!!!

In July 2006 the Department of Health published “The Musculo-Skeletal Services Framework : A Joint Responsibility : Doing It Differently”.

This can be found here.This document talks about chiros in the same breath as proper medical practitioners and this is shameful. I think we should be looking to get this document changed.

The UK is becoming more litigious…

LOL! Oh, the irony!

Currently there are concerns about the cost of defending our members who have complaints made against them to the General Chiropractic Council and the consequent impact this has on the claims history of the BCA’s block insurance policy.

Oh yes!

A recent review of statutory regulation by the Government has resulted in recommendations that all of the nine medically based statutory regulators should work towards standardisation in the management of their disciplinary processes. The BCA has been instrumental in putting forward a number of proposals to the GCC for change and it would appear that there is to be some movement in the way in which certain complaints against chiropractors are handled whereby the complaint would be considered by the Professional Conduct Committee without the need for a hearing. These discussions are at a very early stage and the BCA has taken action to ensure that its members have a professional indemnity insurance policy which is fit for purpose and which provides cover for £5m, £2m above the limit that is required by the GCC.

This move has to be resisted. As Prof David Colquhoun said last night, chiros should never have been registered in the first place. This move would make them seem even more respectable.

The majority of private medical insurance companies provide cover for chiropractic fees, if referred by an NHS Consultant. An increasing number accept GP referrals and a few companies permit open access by their clients up to agreed limits.

This needs to be addressed.

Where appropriate, chiropractors are able to refer a patient for blood testing and other laboratory based tests to the patient’s local hospital.

WTF? What’s a back-cracker got to do with blood tests?

Currently there are about 180 x-ray installations operated by BCA members across the UK.

Since there are just over 1,000 chiros registered with the BCA, this means that only about 1 in 6 chiros have their own x-ray machine. We should perhaps be thankful it is not higher.

…a number of chiropractors now will refer patients to their local hospital or discreet imaging centres…

WTF is a ‘discreet imaging centre’?

The films or scans are however normally read by a consultant radiologist practicing within the District General Hospital.

What the hell are NHS consultants doing this for? Is it just screening to see whether there is anything actually wrong with the patient before letting a chiro loose on them?

CHIROPRACTORS IN THE ASSOCIATION/COUNTRY WHO WORK IN HOSPITALS PART OR FULL TIME OR IN GOVERNMENTAL OFFICES

This question is very difficult to address, as there is no hard data across the profession which records those individuals who work in a hospital setting.

So, they have no idea how many of their members are working ‘in a hospital setting’. Bugger all, I hope.

In 2005 the BCA, distributed a questionnaire to its practicing members and one of the questions which was asked of those members was whether or not the respondents wished to work within the National Health Service either in a hospital setting or primary care facility. 41% of the BCA’s members responded and of those who did respond 40% said they would wish to work within the National Health Service framework, 22% sought further information and 37% said they did not wish to.

I’m sure they would like to work in the NHS! But I’m relieved there is a significant proportion that don’t (I’ve no idea what the 22% were after).

EDUCATION

The GCC has responsibility for accrediting educational institutions in the UK. The Anglo European College of Chiropractic (AECC) currently runs a five year full time course leading to an MChiro in Chiropractic. The Welsh Institute of Chiropractic at the University of Glamorgan, offers a four year full time course leading to a BSc Hons in Chiropractic. Both of these institutions have full GCC and ECCE accreditation. The University of Surrey formerly offered a two-year post-graduate MSc course in chiropractic but the course had limited GCC accreditation and has now graduated its last students. The McTimoney College of Chiropractic in Abingdon has in place a BSc Hons five year course. As of June 2006, the General Chiropractic Council sought the approval of the Privy Council for recognition in respect of awards achieved during the period 1st December 2006 – 31st March 2009 by students currently in Years 3, 4 and 5 of the programme. As at September 2006, the GCC also sought the approval of the Privy Council for recognition of awards achieved by students currently in years 1 and 2 of the programme – this will be during the period 1st December 2009 – 31st March 2011. The General Chiropractic Council requires its education providers to provide an annual report to its Education Committee so that the GCC may be sure that the programme continues to meet their criteria and any conditions of recognition. If problems arise that cannot be rectified, then subject to the approval of the Privy Council, the GCC can remove recognition. The full recognition process is repeated every five years.

I thought it was worthwhile giving the whole section on education. So, it looks like the Privy Council has to approve courses – and they want them approved in retrospect!

At the end of the cycle, which occurs on 31st August each year, the chiropractor is required to sign a self-certification declaration that they have completed the learning cycle and evidence may be sought by the GCC to support this.

They rely on the ‘students’ themselves to verify they’ve done the work?!

The General Chiropractic Council, in common with the other medical statutory regulators in the UK is considering the requirement for re-validation which the Government is making a mandatory requirement for healthcare professionals in the UK within the next five years.

This needs looked into to see how we can influence any decision.

RESEARCH

In 2006, the BCA has set up a research budget of £50,000, under the chairmanship of Dr Neil Osborne. Thus far, two grants have been made for the fund and the funding will continue in 2008.

This £50,000 allocated to ‘research’ amounts to a measly 2.67% of their income. Not much considering they have £838,918 in the bank. Kinda shows they’re not that interested in research. Never mind, perhaps they spent it wisely…

Professor Jenni Bolton and Dr Haymo Thiel also have the results of their study “Safety of Chiropractic Manipulation of the Cervical Spine – Prospective National Survey”, published in the October 2007 edition of Spine.

It’s not clear this was research done in 2007, but they don’t mention any other ‘research’. Thiel (that is Haymo Thiel DC, MSc, PhD, DipMedEd, FIACA, FCCS(C), FCC, FBCA, FHEA, FFEAC) is a chiro at the Anglo European College of Chiropractic. Thiel does not appear on the GMC register so could not use the prefix ‘Dr’ if he was advertising himself/herself as a chiro. Bolton does not appear on the BCA register, the GCC register nor the GMC register.

However, this research was simply a survey of their members, asking about adverse reactions to treatment. How the hell they hoped this to be unbiased, I’ll never understand.Quote:

There were no reports of serious adverse events (defined as “referred to hospital A&E and/or severe onset/worsening of symptoms immediately after treatment and/or resulted in persistent of significant disability/incapacity”).

No reports? Now there’s a surprise!

This is the largest study of its kind undertaken in the world and it is hoped that these results will provide the chiropractic profession with a more robust defence to its detractors. At the time of writing this report, discussions are underway on how to optimise the publicity with the results of this study in the UK.

I wonder if they did publicise this?

Then they mention Prof Edzard Ernst’s study:

On the 1st July 2007, the Journal of the Royal Society of Medicine published a research paper from Edzard Ernst, entitled “Adverse Effects of Spinal Manipulation : A Systematic Review”.

Fortunately this study did not receive very much media publicity and the results outlined by Ernst are at odds with the study undertaken by Dr Thiel and Professor Bolton. Robust responses were sent to the Journal of the Royal Society of Medicine by the BCA President and Dr Thiel and Professor Bolton and these are to be published in the October 2007 edition. It is also hoped that this correspondence will provide an opportunity for further engagement with the Royal Society of Medicine and its publications on this important issue.

Their (inevitably biased) research is just so much better than anyone else’s…

Ongoing research into the chiropractic profession is vital as one of the key requirements to assist decision making within the National Health Service is the presence of evidence based research and cost effectiveness.

Oh, my irony meter just got bent again! I really should invest in one more robust.

VAT is not chargeable by registered healthcare professionals.

Fuck! We subsidise them as well!

First posted: 19 May 2009