Regulating nonsense: my response
The deadline was today, and I only just managed to get my response in to the Department of Health consultation (take a deep breath):
A joint consultation on the Report to Ministers from the DH Steering Group on the Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and Other Traditional Medicine Systems Practised in the UK
…otherwise known as the Pittilo consultation.
I covered the launch of this consultation in August (see Regulating nonsense). Since then, Professor David Colquhoun has blogged his response and urged everyone to respond to this consultation to ‘help to stop Department of Health making fool of itself‘.
David also published the excellent response by someone known as Allo V Psycho. David correctly summarised this response:
‘The document is a model of clarity, and it ends with constructive suggestions for forms of regulation that will, unlike the Pittilo proposals, really protect patients.
I have taken my lead from these responses and concentrated on my unique view of current statutory regulation: that of chiropractors.
My full response can be read here, but I conclude:
The consultation questions assume statutory regulation of alternative therapies is both necessary and desirable. These are dangerous assumptions.
There is no need to create a two-tier system of medicine: we already have an excellent NHS, which in the main, and with guidance from bodies such as NICE and the MHRA, provides an excellent evidence-based health system that all can benefit from.
There cannot be any room for treatment modalities that fall significantly below this existing standard. To introduce such a system will endanger the lives and health of many, misled into thinking non-evidence-based therapies such as homeopathy, herbalism, TCM and acupuncture can be effective for a wide variety of conditions.
It is with all this in mind that I urge you to wholly reject the recommendations of Pittilo and instead set up a system designed to truly protect the public.
In the Executive Summary (it always seems necessary to give a summary of even a short document), I highlight the issues raised by the Pitillo recommendations and list my own recommendations, broadly in agreement with David and Allo V Psycho:
- Current models of statutory regulation of alternative therapy practitioners have little interest in the efficacy of the treatments they are charged with regulating.
- Current models of statutory regulation of alternative therapy practitioners are failing to protect the public.
- Statutory regulation of alternative therapies has led to many practitioners heralding that regulation as a flag of undeserved and unfounded legitimacy, which misleads and endangers the public.
- To set up further statutory alternative therapy regulation along the same lines will be costly and will not lead to the public being protected.
- On the contrary, it will lead more — and frequently vulnerable— members of the public being misled into believing that homeopathy, herbalism, TCM and acupuncture are effective and safe, when there is no robust evidence that this is the case.
- With increased legitimacy given to alternative therapies by Government regulation, the public will have an even lower regard for evidence-based medicine. It is easy to see, given attitudes to the MMR vaccine and the increase in measles cases, that the public understanding of what is scientific could be disastrous for the health of the nation.
- That the misconceived and dangerous Pittilo proposals are abandoned in their entirety.
- That a new statutory body is set up or the role of Trading Standards and/or the MHRA enhanced to:
a) set clear guidance on what can and what cannot be claimed for alternative therapies;
b) ensure this guidance is based on best available scientific evidence;
c) enforce this guidance, such enforcement to be pro-active and not run on a complaints-only basis;
d) ensure such regulation does not give undeserved and unfounded legitimacy to alternative therapies.
It remains to be seen what heed the Department of Health pay to these informed views and what heed they pay to the proponents of unproven and dis-proven alternative therapies.
Lets hope sense will prevail.