Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
It’s hard enough to communicate basic ideas about how to assess evidence to adults without having the effort hindered by schools.
The teaching of quackery to 16 year-olds has been approved by a maze of quangos, none of which will take responsibility, or justify their actions. So far I’ve located no fewer than eight of them.
[For non-UK readers, quango = Quasi-Autonomous Non-Governmental Organisation].
A lot of odd qualifications are accredited by OfQual (see here). Consider, for example, Edexcel Level 3 BTEC Nationals in Health and Social Care (these exams are described here), Download the specifications here and check page 309.
Unit 23: Complementary Therapies for Health and Social Care
NQF Level 3: BTEC National
Guided learning hours: 60Unit abstract
“In order to be able to take a holistic view towards medicine and health care, health and social care professionals need to understand the potential range of complementary therapies available and how they may be used in the support of conventional medicine.”
Well, Goldacre has always said that homeopathy makes the perfect vehicle for teaching how easy it is to be deceived by bad science, so what’s wrong? But wait
“Learners will consider the benefits of complementary therapies to health and wellbeing, as well as identifying any contraindications and health and safety issues in relation to their use.”
Then later
“The holistic approach to illnesses such as cancer could be used as a focus here. For example, there could be some tutor input to introduce ideas about the role of complementary therapies in the treatment and management of cancer, this being followed up by individual or small group research by learners using both the internet and the services available locally/regionally. If available, a local homeopathic hospital, for example, would be an interesting place to visit.”
It’s true that to get a distinction, you have to “evaluate the evidence relating to the use of complementary therapies in contemporary society”, but it isn’t at all clear that this refers to evidence about whether the treatment works.
The really revealing bit comes when you get to the
“Indicative reading for learners
There are many resources available to support this unit.Websites
www.acupuncture.org.uk British Acupuncture Council
www.bant.org.uk British Association for Nutritional Therapy
www.exeter.ac.uk/sshs/compmed Exeter University’s academic department of Complementary medicine
www.gcc-uk.org General Chiropractic Council
www.nimh.org.uk National Institute of Medical Herbalists
www.nursingtimes.net The Nursing Times
www.osteopathy.org.uk General Osteopathic Council
www.the-cma.org.uk The Complementary Medical Association”
This list is truly astonishing. Almost every one of them can be relied on to produce self-serving inaccurate information about the form of “therapy” it exists to promote. The one obvious exception is the reference to Exeter University’s academic department of complementary medicine (and the link to that one is wrong). The Nursing Times should be an exception too, but their articles about CAM are just about always written by people who are committed to it.
It is no consolation that the 2005 version was even worse. In its classification of ‘therapies’ it said “Pharmaceutically mediated: eg herbalism, homeopathy “. Grotesque! And this is the examinng body!
The Teacher
This particular educational disaster came to my attention when I had a letter from a teacher. She had been asked to teach this unit, and wanted to know if I could provide any resources for it. She said that Edexcel hadn’t done so. She asked ” Do you know of any universities that teach CT’s [sic] so I could contact them about useful teaching resources?.” She seemed to think that reliable information about homeopathy could be found from a ‘university’ homeopathy teacher. Not a good sign. It soon emerged why.
She said.
“My students are studying BTEC National Health Studies and the link is Edexcel BTEC National Complimentary [sic] studies.”
“I am a psychotherapist with an MA in Education and Psychology. I am also trained in massage and shiatsu and have plenty of personal experience of alternative therapy”
Shiatsu uh? It seems the teacher is already committed to placebo medicine. Nevertheless I spent some time looking for some better teaching material for 16 year-old children. There is good stuff at Planet
Science, and in some of the pamphlets from Sense about Science, not least their latest, I’ve got nothing to lose by trying it – A guide to weighing up claims about cures and treatments. I sent all this stuff to her, and prefaced the material by saying
“First of all, I should put my cards on the table and say that I am quite appalled by the specification of Unit 23. In particular, it has almost no emphasis at all on the one thing that you want to know about any therapy, namely does it work? The reference list for reading consists almost entirely of organisations that are trying to sell you various sorts of quackery, There is no hint of balance; furthermore it is all quite incompatible with unit 22, which IS concerned with evidence.”
At this point the teacher the teacher came clean too, As always, anyone who disagrees with the assessment (if any) of the evidence by a true believer is unmeasured and inflammatory.
“I have found your responses very unmeasured and inflammatory and I am sorry to say that this prejudicial attitude has meant that I have not found your comments useful.”
shortly followed by
“I am not coming from a scientific background, neither is the course claiming to be scientific.”
That will teach me to spend a couple of hours trying to help a teacher.
What does Edexcel say?
I wrote to Edexcel’s science subject advisors with some questions about what was being taught. The response that I got was not from the science subject advisors but from the Head of Customer support, presumably a PR person.
| From: (Bola Arabome) 12/11/2008 04.31 PM
Dear Professor Colquhoun Thank you for email communication concerning the complementary therapies unit which is available in our BTEC National in Health and BTEC National in Health and Social Care qualifications. I have replied on behalf of Stephen Nugus, our science subject advisor, because your questions do not refer to a science qualification. I would like to answer your questions as directly as possible and then provide some background information relating to the qualifications. The units and whole qualifications for all awarding bodies are accredited by the regulator, the Qualifications and Curriculum Authority. The resource reading list is also produced by us to help teachers and learners. The qualification as a whole is related to the National Occupational Standards for the vocational sectors of Health and Health and social care with consultation taken from the relevant sector skills councils . As you will be aware many of these complementary therapies are available in care centres and health centres under the NHS and in the private sector. The aim of BTEC qualifications is to prepare people for work in these particular sectors. Clearly a critical awareness is encouraged with reference to health and safety and regulation. There are other units, in some cases compulsory, within the qualification with a scientific approach. ‘ ‘ ‘ ‘ ‘ Stephen Harris Head of Customer Support |
Aha, so it seems that teaching people to treat sick patients is “not a science qualification”. Just a business qualification perhaps?. I haven’t yet managed to reach the people who make these decisions, so I persisted with the PR man. Here is part of the next letter (Edexcel’s reply in italic).
| 19 November
I find it quite fascinating that Edexcel regards the treatment of sick patients as not being part of science (“do not refer to a science qualification”). Does that mean Edexcel regard the “Health” part of “Health and Social Care” as being nothing to do with science, and that it therefore doesn’t matter if Health Care is unscientific, or even actively anti-scientific? I am sorry if my answer lacked clarity. My comment, that I had taken your enquiry on behalf of our Science Advisor because this was not a science qualification, was intended to explain why I was replying. It was not intended as a comment on the relationship between Health and Social Care and science. At Edexcel we use bureaucratic categories where we align our management of qualifications with officially recognised occupational sectors. Often we rely on sector bodies such as Sector Skills Councils to endorse or even approve the qualifications we offer. Those involved in production of our Science qualifications and our (4) You say “The qualification as a whole is related to the National Occupational Standards for the vocational sectors of Health and Health and social care with consultation taken from the relevant sector skills councils”. Are you aware that the Skills for Health specifications for Alternative medicine were written essentially by the Prince of Wales Foundation? The qualification was approved by both ‘Skills for Health’ and ‘Skills for Care and Development’ prior to being accredited by QCA. It uses the NOS in Health and Social Care as the basis for many of the mandatory units. The ‘Complementary Therapies’ NOS were not used. This was not a requirement of a ‘Health and Social Care’ qualification. “Are the NOS in Health and Social Care that you mention the ones listed here? http://www.ukstandards.org/Find_Occupational_Standards.aspx?NosFindID=1&ClassificationItemId=174 If so, I can see nothing there about ‘complementary therapies’. if I have missed it, I’d be very grateful if you could let me know where it is. If it is not there, I remain very puzzled about the provenance of Unit 23, since you say it is not based on Skills for Health.” |
Now we are immediately at sea, struggling under a tidal wave of acronyms for endless overlapping quangos. In this one short paragraph we have no fewer than four of them. ‘Skills for Health’, ‘Skills for Care and Development’ , ‘Quality and Curriculum Authority (QCA) and NOS.
It seems that the specification of unit 23 was written by Edexcel, but Harris (25 Nov) declines to name those responsible
“When I refer to our “Health and Social care team” I mean the mix of Edexcel Staff and the associates we employ on a contract basis as writers, examiners and external verifiers. The writers are generally recruited from those who are involved in teaching and assessment the subjects in schools and colleges. The editorial responsibility lies with the Edexcel Staff. I do not have access to the names of the writers and in any case would not be able to pass on this information. Specifications indicate the managers responsible for authorising publication”
“Edexcel takes full responsibility for its ethical position on this and other issues. However we can not accept responsibility for the opinions expressed in third party materials. There is a disclaimer to this effect at the beginning of the specification. ”
” You have the correct link to the Health NOS . These are the standards, which where appropriate, influence our qualifications. However in the case of Unit 23 I understand that there is no link with the Health NOS. I don’t know if the NOS cover the unit 23 content.”
So, contrary to what I was told at first, neither Skills for Health, nor NOS were involved Or were they (see below)?
So who does take responsibility? Aha that is secret. And the approval by the QCA is also secret.
“I cannot provide you with copies of any correspondence between Skills for Health and Edexcel. We regard this as confidential. “
What does the QCA say?
The strapline of the QCA is
“We are committed to building a world-class education and training framework. We develop and modernise the curriculum, assessments, examinations and qualifications.”
Referring school children to the Society of Homeopaths for advice seems to be world-class bollocks rather than world-class education.
When this matter was brought to light by Graeme Paton in the Daily Telegraph, he quoted Kathleen Tattersall, CEO of the QCA. She said
“The design of these diplomas has met Ofqual’s high standards. We will monitor them closely as they are delivered to make sure that learners get a fair deal and that standards are set appropriately.”
Just the usual vacuous bureaucratic defensive sound-bite there. So I wrote to Kathleen Tattersall myself with some specific questions. The letter went on 2nd September 2008. Up to today, 26 November, I had only letters saying
“Thank you for your email of 12 November addressed to Kathleen Tattersall, a response is being prepared which will be forwarded to you shortly.”
“Thank you for your email of 25th November addressed to Kathleen Tattersall. A more detailed response is being prepared which will be sent to you shortly.”
Here are some of the questions that I asked.
| I wrote to Edexcel’s subject advisors about unit 23 and I was told “your questions do not refer to a science qualification”. This seems to mean that if it comes under the name “Health Care” then the care of sick patients is treated as though it were nothing to do with science, That seems to me to be both wrong and dangerous, and I should like to hear your view about that question.
Clearly the fundamental problem here is that the BTEC is intended as a vocational training for careers in alternative medicine, As a body concerned with education, surely you cannot ignore the view of 99% of scientists and doctors that almost all alternative medicine is fraud. That doesn’t mean that you can’t make a living from it, but it surely does create a dilemma for an educational organisation. What is your view of that dilemma? |
Eventually, on 27th November, I get a reply (of sorts) It came not from the Kathleen Tattersall of the QCA but from yet another regulatory body, OfQual, the office of the Qualifications and Examinations Regulator. You’d think that they’d know the answers, but if they do they aren’t telling, [download whole letter. It is very short. The “more detailed response” says nothing.
|
Ofqual does not take a view on the detailed content of vocational qualifications as that responsibility sits with the relevant Sector Skills Council which represents employers and others involved in the sector. Ofqual accredits the specifications, submitted by sector-skilled professionals, after ensuring they meet National Occupational Standards. Ofqual relies on the professional judgement of these sector-skilled professionals to include relevant subjects and develop and enhance the occupational standards in their profession. The accreditation of this BTEC qualification was supported by both Skills for Health, and Skills for Care and Development, organisations which represent the emerging Sector Qualifications Strategies and comply with the relevant National Occupational Standards Isabel Nisbet Acting Chief Executive |
So no further forward. Every time I ask a question, the buck gets passed to another quango (or two, or three). This letter, in any case, seems to contradict what Edexcel said about the involvement of Skills for Health (that’s the talking to trees outfit),
A nightmare maze of quangos
You may well be wondering what the relationship is between Ofqual and the QCA. There is an ‘explanation’ here.
Ofqual will take over the regulatory responsibilities of the Qualifications and Curriculum Authority (QCA), with stronger powers in relation to safeguarding the standards of qualifications and assessment and an explicit remit as a market regulator. The QCA will evolve into the Qualifications and Curriculum Development Agency (QCDA): supporting Ministers with advice and undertaking certain design and delivery support functions in relation to the curriculum, qualifications, learning and development in the Early Years Foundation Stage, and National Curriculum and Early Years Foundation Stage assessments.
Notice tha QCA won’t be abolished. There will be yet another quango.
The result of all this regulatory bureaucracy seems to be worse regulation, Exactly the same thing happens with accreditiation of dodgy degrees in universities.
At one time, a proposal for something like Unit 23 would have been shown to any competent science teacher, who would have said”you must be joking” and binned it. Now a few hundred bureaucrats tick their boxes and rubbish gets approved.
There seems to be nobody in any of these quangos with the education to realise that if you want to know the truth about homeopathy, the last person you ask is the Society of Homeopaths or the Prince of Wales.
What next?
So the mystery remains. I can’t find out who is responsible for the provenance of the appallingly anti-science Unit 23, and I can’t find out how it got approved. Neither can I get a straight answer to the obvious question about whether it is OK to encourage vocational qualifications for jobs that are bordering on being fraudulent.
.All I can get is platitudes and bland assurances. Everything that might be informative is clouded in secrecy.
The Freedom of Information requests are in. Watch this space. But don’t hold your breath.
Follow-up
Here are some attempts to break through the wall of silence.
Edexcel. I sent them this request.
Freedom of Information Act
Hello
I should like to see please all documents from Edexcel and OfQual or QCA (and communications between then) that concern the formulation and approval of Unit 23 (Complementary Therapies) in the level3 BTEC (page 309 in attached document). In vew of the contentious nature of the subject matter, I believe that is is in the public interest that this information be provided
David Colquhoun
The answer was quite fast, and quite unequivocal, Buzz off.
| Dear Mr Colquhoun,
Thank you of your e-mail of today’s date. I note your request for information pursuant to The Freedom of Information Act. As you may know this Act only applies to public bodies and not to the private sector. Edexcel Limited is privately owned and therefore not subject to this Act. Edexcel is therefore not obliged to provide information to you and is not prepared to give you the information you seek. Please do not hesitate to contact me again if you have any further queries. Kate Gregory |
This lack of public accountability just compounds their appalling inability to distinguish education from miseducation.
International Therapy Examination Council (ITEC)
Mojo’s comment, below, draws attention to the Foundation degree in Complementary Therapies offered by Cornwall College, Camborne, Cornwall (as well as to the fact that the Royal National Lifeboat Institution has been wasting money on ‘research’ on homeopathy –write to them).
At least the courses are held on the Camborne campus of Cornwall College, not on the Duchy campus (do we detect the hand of the Quacktitioner Royal in all this nonsense?).
Cornwall College descends to a new level of barminess in its course Crystal Healing VTCT Level 3
“Who is this course for?
This course is designed to enhance the skills of the Holistic Therapist. Crystals may be used on their own in conjunction with other therapies such as Indian Head Massage, Aromatherapy and Reflexology. Due to the nature of the demands of the holistic programme this course is only suitable for students over the age of 18.”
“What will I be doing on the course?
Students will study the art of Crystal healing which is an energy based treatment where crystals and gemstones are used to channel and focus various energy frequencies.”
| .VTCT stands for the Vocational Training Charitable Trust.
It is yet another organisation that runs vocational exams, and it is responsible for this particular horror |
|
The crystals are here. I quote.
Objectives
- the use of interpersonal skills with client
- how to complement other therapies with crystals
- the types and effects of different crystals
- uses of crystals including cleansing, energising, configurations
- concepts of auras and chakras
This is, of course, pure meaningless nonsense. Utter bollocks being offered as further education
Cornwall College has many courses run by ITEC.
The College says
“You will become a professional practitioner with the International Therapy Examination Council (ITEC), study a number of essential modules to give a vocational direction to your study that include: Homeopathy and its application,”
| Who on earth, I hear you cry, are ITEC? That brings us to the seventh organisation in the maze of quangos and private companies involved in the miseducation of young people about science and medicine. It appears, like Edexcel, to be a private company though its web site is very coy about that. |  |
After the foundation degree you can go on to “a brand new innovative BSc in Complementary Health Studies (from Sept 2009)”
The ITEC web site says
- ITEC qualifications are accredited by the Office of the Qualifications and Examination Regulator (OFQUAL)
- ITEC qualifications are funded in the uk by the on behalf of Department for Innovation, Universities and Skills (DIUS)
- ITEC qualifications have been mapped to the National Occupational Standards, where they exist
Oddly enough, there is no mention of accreditation by a University (not that that is worth much). So a few more Freedom of Information requests are going off, in an attempt to find out why are kids are being miseducated about science and medicine.
Meanwhile you can judge the effect of all that education in physiology by one of the sample questions for ITEC Unit 4, reflexology.
The pancreas reflex:
A Extends across both feet
B Is on the right foot only
C Is on the left foot only
D Is between the toes on both feet
Uhuh, they seem to have forgotten the option ‘none of the above’.
Or how about a sample question from ITEC Unit 47 – Stone Therapy Massage
Which organ of the body is associated with the element fire?
A Heart
B Liver
C Spleen
D Pancreas
Or perhaps this?
Which incantation makes hot stones work best?
A Incarcerous
B Avada Kedavra,
C Dissendium
D Expelliarmus.
(OK I made the last one up, with help from Harry Potter, but it makes just about as much sense as the real ones).
And guess what? You can’t use the Freedom of Information Act to find out how this preposterous rubbish got into the educational system because ” ITEC is a private organisation therefore does not come under this legislation”. The ability to conduct business in secret is a side effect of the privatisation of public education is another reason why it’s a bad idea.
Ofsted
|
Ofsted has inspected Cornwall College. They say “We inspect and regulate to achieve excellence in the care of children and young people, and in education and skills for learners of all ages.”. I can find no mention of this nonsense in their report, so I’ve asked them. |
|
Ofsted has admitted a spectacular failure in its inspection of child care in the London Borough of Haringey. Polly Curtis wrote in the Guardian (6 Dec 2008) “We failed over Haringey – Ofsted head”. It was the front page story. But of course Ofsted don’t take the blame, they say they were supplied with false information,
That is precisely what happens whenever a committee or quango endorses rubbish. They look only at the documents sent to them and they don’t investigate, don’t engage their brains.
In the case of these courses in utter preposterous rubbish, it seems rather likely that the ultimate source of the misinformation is the Princes’ Foundation for Integrated Health. Tha views of the Prince of Wales get passed on to the ludicrous Skills for Health and used as a criterion by all the other organisations, without a moment of critical appraisal intervening at any point.
2 December 2008 A link from James Randi has sent the hit rate for this post soaring. Someone there left are rather nice comment.
“A quango seems to be a kind of job creation for the otherwise unemployable ‘educated ‘( degree in alternative navel contemplation) middle classes who can’t be expected to do anything useful like cleaning latines ( the only other thing they seem qualified for ). I really hate to think of my taxes paying for this codswollop.”
45 Responses to Teaching bad science to children: OfQual and Edexcel are to blame
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[…] of those who create conspiracies from their own incompetence and misunderstandings or who have an interest in CAM but no interest in science.[a] And, fabulous as it would be for both Ben Goldacre and Gimpy to be mentioned in the august […]
[…] sashok wrote an interesting post today onHere’s a quick excerptClearly the fundamental problem here is that the BTEC is intended as a vocational training for careers in alternative medicine, As a body concerned with education, surely you cannot ignore the view of 99% of scientists and doctors that … […]
“…neither is the course claiming to be scientific.”
Eh? A course on Health and Social Care that’s not scientific? What the hell is it then, some post-modern critique on oil paintings in hospital corridors? A course on health that’s not scientific – great.
DC, great analysis of how the box-ticking ‘regulation-lite’ of education leads to a fundamental decline in quality – they simply can’t see the wood for the trees.
You might care to look at “Doctors” (BBC 1, 13:45 – 14:15 Weekdays), based at “Letherbridge”.
One of the Practice Doctors is keen on “Complementary” medicine, and this story-thread surfaces quite regularly. Just recently, a clinical trial for “Big Pharma” has been accepted and, of course, this has been roundly condemned by several of the staff.
Some of the episodes do deal with real situations: a recent episode featured a Downs’ syndrome child, but in a 30-minute clip the outcome was fairly predictably simplistic.
Perhaps I should confess that my background was in industrial Research & Development in papermaking/printing. To solve a production problem to solve a tendency to curl (which impedes passage through photocopiers & printers), I had to do a month’s worth of research in the technical media, and produce an minutely detailed schedule before I was allowed anywhere near the paper-machine to conduct the actual trial (It turned out successfully, in that I managed to show that the curl inverted depending on initial conditions). It seems that human treatment is nowhere near as rigorously managed as industrial production, doesn’t it?
With at least six quangos involved I expect they can happily fill their days meeting each other. No need to bother with the actual subject matter. Isn’t that what we call ‘following the correct procedures’ -“best practice”?
I love that one of the ‘learning resources’ is the grandly titled “Complementary Medical Association”. This is actually much one woman – Jayney Goddard, remarkable for her claim to be a professor – from a Nepalese Sanskrit university that was burnt down by maoist rebels some years ago.
Nevertheless, I am sure the title ‘Professor’ allows a few more boxes to be ticked.
Is this one of the motives for privatisation?
This is the response I just got from Edexcel (see Follow-up)
They are entirely unaccountable to the public.
Good GUT!
Who did that teacher think she was contacting?! How hard can it be to discover the position of the emminent dr Colquhoun (one of these days I’ll learn to spell that without peeking)?
The cynic in me wants to say that she did it just to make you waste your time.
Poor poor kids.
Ofqual is covered by the FOI Act so I would go at it that way. They might try the commercial confidetiality exemption though.
Thanks Betty M
I’ve already sent requests to them. We’ll see.
Every university that I have asked for teaching material has pleaded the commercial exemption. After over two years, the Information Commissioner is, at last, about to judge whether teaching material counts as commercial (which is a valid exemption) or financial (which isn’t). If the judgement goes my way, the desperate secretiveness shown by universities, and now by Edexcel, will be at an end.
Goodness, David.
Talk about a hall of mirrors. You are definitely doing a public service exposing just how bureaucratically unaccountable and buck-passing the whole process is.
What. A. Con.
The whole thing has an air of Candide about it… or Catch 22: “If you’re asking about how these are validated you’re obviously just the kind of person that can’t be told”… although, as ever, maybe “The Emperor’s New Clothes” comes nearest to the mark.
Anyway, the pay-off of Edexcel simply stonewalling you with “commercial confidentiality” is priceless. I am reminded again of Michael O’Donnell’s mock-definition that you quote over on the Laughter Page:
Education.
“Aha, so it seems that teaching people to treat sick patients is “not a science qualification”. Just a business qualification perhaps?”
I noticed, when the RNLI/Cornwall College homoeopathic weaverfish sting treatment project was recently discussed that according to this document it appeared to have been carried out under the auspices of the Cornwall Business School (see pp. 20-28, with the Weaverfish bit on pp. 21-23).
BTW, I’m sure you’ll be delighted to know that in September 2009 they are going to be launching “a brand new innovative BSc in Complementary Health Studies”.
Mojo
That is very interesting, if only because it leads to quango #7. ITEC.Well I suspect it is not actually a quango, but a private company like Edexcel, so doubtless it will all be secret.
This seems worth a closer look, and I’ll put anything that comes up in the Follow-up, above.
Since the mind-bogglingly preposterous Reflexology has come up, it seems like a good time to quote a chunk of Richard Feynman’s famous lecture on “Cargo Cult Science”:
[…] Next year I’m gonna learn me to write like DC. […]
Brilliant post
…actually – brilliant site
Dr C. and others,
I would like to propose this conundrum to those who would see CAMs banned.
If CAMs are banned entirely, and they go underground, no one will be regulating them. If the more ‘respected’ CAMs join the Health Professions Council (as is expected under the new EU regulations coming in after 2011), they will be regulated and subject to the law. For all of your indignation, I think you should consider very carefully which scenario you would rather see for the benefit of the public.
Besides, (Dr Aust) I like having my feet rubbed. I just don’t happen to believe it means my pancreas is being rubbed, as well.
Well, I’ve got nothing against people offering a soothing foot massage, NAWD. I just think it should be called “a foot massage” and come without a vast steaming helping of bullshit. And I think it is completely indefensible to teach flagrant bullshit to 15 yr olds and badge it as “education and training”.
The conundrum you identify about regulating CAM therapies is indeed a “million dollar question”. I am personally in favour, albeit somewhat reluctantly, of regulation of the less nutty therapies, rather along the lines of the German Heilpraktikergesetz. However, I think one of the quid pro quos for taking any CAm modalities into the HPC must be that the CAM therapies stop making unsupportably ridiculous claims, which they all do currently as a matter of routine. Another one must be that therapists that cannot adhere to meaningful codes of practise must be stopped from practising, or at least have their licences revoked and be subject to serious legal sanction if they keep working.
The other million dollar question is – who would set the standards of what is acceptable practise in an HPC-incorporated scheme? The CAM therapies are all for self-regulation via their existing “professional bodies”. But, as David and others have highlighted repeatedly, these bodies cannot currently be trusted to police themselves by setting meaningful standards, e.g. of what practitioners can claim to treat and when they should admit they can’t and refer on. For every practitioner one comes across who seems to have some sense of their limits, one sees many more who don’t have a clue and are only too happy to say they can treat diabetics with aromatherapy and chanting. And don’t even get me started on homeopathy.
I have never heard anyone propose to ban any sort of alternative medicine, so that is just a straw man.
I don’t think, though, that they could join the HPC since that organisation requires that practise be evidence-based. The question of implementation of the appalling Pittilo report has yet to be decided.
Everyone is subject to the law whether or not they are part of the HPC, though the new laws on making false health have not yet to be enforced properly.
I fear that the sort of voluntary self-regulation that is advocated by the alternative medicine industry will not protect the public, but it will undoubtedly protect those who wish to make untrue claims Just look at the case of chiropractic.
Dr Aust,
You and I are in perfect agreement on this. Except, ‘self-regulation’ is something that no longer exists under the current move to ward statutory regulation of CAMs.
Dr Colquhoun,
Both the NIMH and CPP are in negotiations with the HPC to join as soon as terms can be negotiated between the bodies. There is no longer such a thing as ‘voluntary self-regulation’ under the 2011 EU directives and the changes to Section 12(1) of the 1968 Medicines Act. Herbal Medicine practitioners, at least, will join the HPC as soon as next year. I’m interested that so many people from my own profession and the medical professions pay so little attention to legislation and politics. But not really surprised.
No I am sorry, you are wrong. That is what the Pitillo report recommended but the government has, very sensibly, said their will be a consultation to decide whether to go ahead with it.
The HPC’s criteria for membership state that its members must have “Practise based on evidence of efficacy”. That would make it quite impossible for most sorts of alternative medicine to join it. I’ll agree that, given the pathetic performance of the Department of Health in this area, they are quite capable of bending the rules. but to do so would be simply dishonest.
Dear Dr Colquhoun,
I’m not sure how you can say I am ‘wrong’ when I have been given assurance that we will join the HPC next year. I’m sorry if this dissappoints you, but I think that the government would rather keep an eye on us than let us work without regulation. Medical Herbalism will join the HPC whether you approve it or not. I don’t particularly care what the Pitillo Report says. It’s happening.
I celebrate the regulation of Medical Herbalism. I wonder why you oppose it?
“Assurance” by whom? not any government source I suspect. I know Michael McIntyre is very keen on it (he was one of the Pitillo group), but the October 2008 issue of the European Herbal & Traditional Practitioners Association says this.
If you have more recent information I’d be interested to know about it.
Dear Dr Colquhoun,
Perhaps we should have this discussion in a less public setting?
All the best.
NAWD
Agreed. I’ll write.
Interestingly enough, the osteopathic profession fought to stay OUT of the HPC as the majority (not me actually) thought that the profession would lose control. Interesting still, the government have now insisted that regulators like the GOsC now independently appoint (rather than the professions self-electing) the regulating council – this surely is a step forward for common sense (or CAMon sense….sorry).
JH
JH I agree. The sort of ‘regulation’ that I oppose is the sort of utterly ineffective self-regulation that we have seen up to now, and is essentially what Pitillo seems to want to extend.. If we had real regulation that would be a different matter, but, as you say, that would have to involve people outside the area being regulated.
At present the regulators believe exactly the same myths as the regulated so of course it doesn’t work.
The government tasked the appointments commission to recruit the 7 osteopathic members of the GOsC council (plus the additional 8 lay members). I think I am correct in thinking that there are other regulators (not all CAM) that are undergoing the same changes.
The thought of an objective regulator for all professions (but particularly CAM) is something that should have been insisted on from the beginning – it’s not rocket science is it?
Anyway – I’ve taken this post ‘off-topic’ so I should hang my head in shame and punish myself with an arnica poultice and some 100ml acupuncture needles in my genitals!
JH
JH,
I will share an anecdote, but, no doubt, many will discount my experience. I had a very bad back injury at Lake Placid, skiing, in 1996. At the time, I had no insurance (I was an American national) and I could not afford treatment or physiotherapy. I was given painkillers and told to rest. I lived on my couch for three months.
In 1999, I moved to Britain. I was having trouble walking, sometimes. As I was, amongst other things, involved in landscape design, my back was in agony almost every night. I went to my GP and he sent me for an x-ray. When I went in for the consultation, he sniffed at me, looked me up-and-down, and told me to go swimming. He said I wasn’t ill, and that he couldn’t imagine why I was bothering him with what was obviously nothing serious.
I decided to go see the local chiropractor, because I thought I probably had nothing to lose. I went for 6 treatments, and have had no lower-back pain since. That was nine years ago.
I don’t care if he believed in subluxations or not, I am standing up today because he gave me the opportunity the GP didn’t. He listened to me and tried to help.
Please don’t put arnica on your private parts. Or acupuncture needles. We need to be able to speak freely about cases in modern medicine.
Many thanks for your story,
NAWD
An interesting anecdote, NAWD – my self-mutilation was more a lighthearted attempt at apologising to Professor Colquhoun for taking his subject off-topic.
I’d love to comment on your anecdote though (perhaps on my own blog). I would like to defend the GP and explain just how the DoH’s MSK Service Framework has changed the NHS approach to patients with a similar history to yours. It’s not ALL bad these days.
JH
JH,
We seem to agree on a number of subjects. I was very impressed by your blog. Perhaps I might contact you there and discuss a few things we probably both would find interesting?
I am full to the brim of anecdotes. Just trying to find a place to reflect on them properly.
All the best,
NAWD
Jonathan
No need to apologise, because it isn’t entirely off topic. Your points and mine were both about the utter ineffectiveness of regulation by self-serving quangos who tick boxes but seem to have trouble engaging the brain. Is it my imagination, or is there a parallel in the recent horror story of “Baby P”?
…a direct parallel to ‘Baby P’. Certainly.
CAM regulators and teaching establishments are too soft by far. The general feeling is that they need to be fair to all – give everyone a warm cuddle if things go wrong.
Not now – I really believe that the regulators will change, this will enforce the colleges to change and then, hopefully, the CAMs will change.
Something needs to be done. I suggest that your readers have a look at some CAM forums – the conversations and poorly debated topics are outstanding.
I agree, completely with you both.
I know I have banged on about it a bit, but my course was extremely difficult and had a massive drop-out rate because the tutors didn’t dole out hugs every time you didn’t want to get in the lab and the count eosinophils in mouse lung sections. I saw more than one student in tears after the biochem, pharm and tox, and clinical medicine exams. But that is what should be required if we are going to be entrusted with the care of the public. Frankly, university courses should be about earning an academic qualification, not having group cuddles.
I have had to leave a number of forums, including one made up of people from my own profession because the stress was causing me to have increased blood pressure. I would share anecdotes, but I fear tarring myself with the same brush. I have to belong to a professional body, and so my hands are tied.
Of the 33 people in my cohort, 5 of us graduated on time. Some haven’t qualified two years later. In the year behind me half the cohort (15) people left in the second year when they were faced with plant pharmacology and biochem.
I don’t know if I would compare this directly to baby ‘P’, but the regulators must tighten the screws and address the serious health and safety issues in CAMs in order to protect the public.
A sound appraisal of poor-quality care within the NHS would also not go amiss. I have plenty of stories from working in the surgical wards that would raise hairs.
“In the year behind me half the cohort (15) people left in the second year when they were faced with plant pharmacology and biochem.”
A few years ago I taught a short part-time course in a local FE college. I was told that the college was judged on: (1) exam results and (2) the drop out rate.
Are you saying that 50% of students in the year behind you dropped out? That sounds a very high figure. Did the course receive any subsidy from the taxpayer? If so I would imagine the funding bodies were none too pleased.
Did the college recruit unsuitable students? Were they lacking in motivation? Was the teaching not up to scratch? I would be interested to know the answer to the above questions. It seems strange you say people left because they were faced with pharmacology and biochemistry.
The failure of Ofsted to so much as mention that kids are being taught nonsense seems to bear a precise analogy to their failure to detect failures of child care in Haringey. After reading Polly Curtis in Saturday’s Guardian, I added a bit to the follow-up.
Dear LeeT,
I suppose it’s quite unusual. But, yes, 15 students dropped out of the cohort in the year after mine.
My course didn’t want to teach ‘vibrational medicine’ or ‘Goetian science’. It wanted to teach people plant pharmacology. That is an extremely difficult subject. In addition, our medicine classes were extremely rigorous. As were our clinical diagnosis classes. I think that many of the people who joined my course had no idea what it means to be responsible for the health and well being of patients.
I am extremely depressed that healthcare practitioners at every level don’t know how to take care of their charges and give them the best treatment and care possible.
Dr. Colquhoun, I’ve had a very disappointing letter from the NIMH today. I don’t think they understand why we should be regulated. And that means, I have to leave my professional body in the next two weeks.
I might have to go to medical school, after all.
🙁
NAWD
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