Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
A flood of complaints against chiropractors has arrived at the General Chiropractic Council (GCC) in the wake of the British Chiropractic Association (BCA) v Singh affair. It is really rather beautiful that people have put some such enormous effort into writing complaints for no gain to themselves.
My own paltry two complaints to the GCC produced an interesting reaction. Yesterday I was told by the GCC
“Under the provisions of the General Chiropractic Council (Investigating Committee) Rules
2000 (“the Rules”), the Committee is required to invite you to make a statement of evidence in relation to your complaint by way of statutory declaration or affidavit. If you wish to, you can discuss your complaint with a solicitor who acts on behalf of the Committee who could help you draft a statement of evidence that meets the requirements of the Rules. The General Chiropractic Council will pay for the Investigating Committee solicitor’s costs and will reimburse you for any fee you subsequently pay for having your witness statement sworn at a location convenient to you.”
Naturally I shall take up this offer. If the same offer is made to everyone who complained (must be approaching 600), the legal fees incurred by the GCC would presumably be enough to bankrupt them. No wonder they are wriggling.
Here is a letter sent by the GCC’s Chief Executive and Registrar, Margaret Coats, a couple of days ago. It reached me by more than one route, but it is already on the web anyway, on Richard Lanigan’s site, Told you the General Chiropractic Council would find a way to dismiss the complaints. “Protecting the public” my arse! Protecting themselves more like it.. (The GCC has been under attack from within for some time, though mainly because some chiropractors think it regulates too much, not too little)
The bit that is especially interesting is para 2
In quangos like the GCC, complaints don’t necessarily get considered at all. First they go to an investigating committee (IC) which has to decide if there is a ‘case to answer’. Now the GCC wants that criterion to be changed to ‘realistic prospect of success’. Given the GCC’s attitude to evidence it is hard to imagine that any complaint will have a ‘realistic prospect of success’.
The second idea is even more grotesque. The GCC want to be able to dismiss without consideration rafts of complaints where in their opinion, referral to the Professional Conduct Committee (PCC) ‘is not required in the public interest. Or, more likely, not required in the interests of the GCC.
Will the Privy Council acquiesce in this disgraceful attempt to evade complaints? Wel, until January 2008, Graham Donald was a senior civil Servant at the Privy Council bit he now works for the GCC. That must help.
The GCC has been contacted by several Trading Standards Offices too, after complaints made to them about chiropractors. . A response was sent by the GCC on 5 June [download the whole response]. It includes
“It is important to emphasise that the GCC doesn’t claim that chiropractors ‘treat’ asthma, headaches (including migraine) and infant colic. It is possible that chiropractic care may help to alleviate the symptoms of some of these conditions.”
What on earth is that meant to mean?
One hopes that Trading Standards officers are too smart to be taken in by weasel words like that.
The attitude of the GCC to evidence is amply illustrated by the fact that they have said that the rather crude myths known as craniosacral therapy and applied kinesiology fall within their definition of evidence-based care.
Any organisation that can say that is clearly incompetent.
Follow-up
17 Responses to The General Chiropractic Council (GCC) wants to waive the rules
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Fascinating!
Thanks –Zeno has done more than anyone else to help with the rooting out of unfounded claims. Great stuff.
Could I suggest that the GCC’s squirming, and trying to weasel out by distinguishing “treat” and “help to alleviate the symptoms of”, be widely publicised to journalists?
It is, of course, typical of the kind of evasion practiced by Alt.Medicine folk when pressed to justify their claims. I am eerily reminded of the homeopaths and their responses when Le Canard Noir complained a while back.
As with the homeopathic medicines and the MHRA, the problem here is what the most people who READ the claims, or hear them, will normally take them to mean.
And further, I seriously doubt that someone visiting a chiroquacktor with their asthmatic child gets told anything other then:
Now, what do the worried parents take that to mean?
I find it extremely odd – not to say surreal – that the Chiroquacktors can sue Simon Singh, and try and bankrupt him, by dragging him into in a courtroom – a place, recall, where the strict meaning of individual phrases “as an ordinary person would interpret them”, as defined by Mr Justice Eady, is Holy Writ.
Meanwhile, out in the rest of the world, chiropractors’ verbal weasel-ings (“It means what I say it means, even if that’s not what I said”) are used to absolve themselves from any charge of misleading people.
Really, you couldn’t make it up.
I am not in a position to check this at the moment, but an important part of this will be the oversight played by the HPC. They can do various audits and appeals on complaints.
However, I have a nasty feeling that if the GCC are arbitrarily able to not refer complaints for whatever reason it will also have the effect of taking that complaint out of the statutory role played by the HPC. That would be quite appalling, and I hope the HPC will have something to say about this.
Dr Aust
I know one says “you couldn’t make it up” several times per day. It seems to me to be more than a metaphor. It is quite literally true that if you were asked to invent a new bogus therapy it would be hard to come up with anything as far-fetched as curing ear infections by manipulating the spine, or anything remotely as daft as ‘applied kinesiology’.
lecanardnoir
That’s a good thought, but the Health Professions Council seems to be quite happy to ignore its own rules when it is politically expedient to do so.
As far as I’m concerned, the GCC is a joke. It’s bad enough that it’s been left to unpaid bloggers (such as Zeno and the author of Adventures in Nonsense) to flag up the lack of regulation of unsubstantiated claims by chiropractors – and to bring these daft claims to the attention of the GCC. That the GCC can move the goalposts in order to avoid investigating complaints is disgraceful. I second Dr Aust’s suggestion that “the GCC’s squirming, and trying to weasel out by distinguishing “treat” and “help to alleviate the symptoms of”, be widely publicised to journalists”.
Re this quote from the GCC: “It is important to emphasise that the GCC doesn’t claim that chiropractors ‘treat’ asthma, headaches (including migraine) and infant colic. It is possible that chiropractic care may help to alleviate the symptoms of some of these conditions.”
Yesterday, I was writing about some chiropractors in New Zealand using weasel words (specifically regarding their claims that they don’t treat or cure asthma – they claim that they release nerve pressure by spinal manipulation and as a result, stimulate the nervous system to open up the lungs and bronchus). Andy D from the Thinking is Real blog came up with some interesting re-definitions for conventional medicine:
“Surgery involves cutting things out and throwing them away, not treating them. Prescribing pills is just writing on a piece of paper. No treatment involved.”
Well, I don’t know what justification the GCC have given to the Privy Council Office. However, the PC can be contacted – details on http://www.privy-council.org.uk/output/page21.asp . I suggest a few letters pointing out the weakness and poor governance of the profession by the GCC could go a long way.
Back again, having researched “portmanteau order”.
Here’s the list of draft orders – http://www.opsi.gov.uk/si/dsis2009
There’s only one “healthcare” order listed for 2009, it was signed into law in May, and it didn’t mention chiropractors.
Presumaby the Dept of Health is cooking up another one, and there’s plenty of time to lobby them on the grounds that the GCC’s request is unreasonable and it really ought to be doing its job better instead of looking for exemptions and let-outs.
BobP
Excellent idea. All this letter-writing gets tedious but it really can be effective. Every time they put their head of the parapet, take a pot shot.
Interesting. Para 2.2 says
“Review of evidence for chiropractic care. GCC has commissioned a project focussed on what underpins evidence based care for a variety of conditions. It will use the Sackett, D (2000) definition
“The integration of best research evidence with clinical expertise and patient values.”
(for those who don’t recognise this reference it is Sackett DL et al (2000) Evidence Based Medicine: how to practice and teach EBM, 2nd ed, Churchill Livingstone). Since the GCC have adopted this definition, they are also logically required to adopt all of Sackett’s criteria for analysing evidence in their project. Because surely it would be beyond hypocritical to do anything else? This will reveal there is no significant evidence for all of the issues under contention. A letter is under way to Margaret Coats asking for confirmation.
Letter is sent, asking for a copy of the report when it is complete, and for confirmation that it will use the Sackett criteria. I keep Sackett within easy reach of my desk: the chapter on Therapies is the most relevant for anyone with access to it. I almost relish seeing the report!
@BobP: I’ve written to the Privy Council expressing my concerns regarding the GCC’s ability to give accurate and meaningful definitions of ‘in the public interest’ and ‘realistic prospect of success’.
[…] The Goalposts Here is my letter to the Privy Council regarding the GCC’s attempt to waive the rules: Dear Sirs / […]
Just spotted this (written on the chiropractic live blog yesterday) from Richard Lanigan:
“Yesterday The GCC chief executive Margaret Coats saw her salvation in hurrying up the section 60 amendment which would have allowed the Investigating Committee to weed out vexations cases against chiropractors. The furious response of the sceptics to this decision has made Coats reconsider and she has decided to push ahead with all the 500 complaints”.
[…] and the Privy Council Having read on David Colquhoun’s blog that the GCC wanted to “waive the rules” regarding complaints, I noted a suggestion […]
[…] with David Colquhoun than the people who run the chiropractic profession. Its reassuring to see the sceptics agreeing with 77% of the chiropractic profession that the GCC are incompetent and now they are complaining to the Privy Council. Before long we will be sitting around the camp […]
For those watching the Gcc can I suggest a few lines of enquiry? Why not try a freedom of information request on the regulator of the gcc? http://www.chre.org.uk/ ask for copies of complaints about the gcc, particularly the dismissing of cases and the lack of investigation into the death of john Savidies and compare those against the gosc the osteopath council. The other “you couldn’t make it up” the second in command at the gcc was sacked for pretending to be a member of the British Chiropractic Association, sacked reported to the police then unbelievably he got a job at another regulator investigating complaints about psychotherapists. http://www.psychotherapy.org.uk/ where he departed company after his past became an issue.
“You couldn’t make it up” well you can in quango land, what do you do if you lose a vote of confidence by 77%? Dismiss it as a questionable questionnaire! Now I may be wrong here but I thought the author of that phrase was none other than the chairman of the gcc Peter Dixon.
Please feel free to ridicule me or post amusing comments about my sanity below. David missed the point about the reason some people dislike the gcc. The overwhelming majority of people are ethical and honest, I include Simon Singh here. We dislike this behaviour, retrospectively changing rules and taking people to court over disputes.