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It is a good thing that clinical trials have to be registered, but is not good that there is no obligation to reveal the outcome. Many are never published. Nobody knows quite why they are not published but clearly it is a source of ‘publication bias’ if results that somebody doesn’t like, whether for financial or ideological reasons, simply vanish.

That has been a problem with the pharmaceutical industry, as discussed by Ben Goldacre in This is a very broken system. For example, It has turned out that the SSRI antidepressants are essentially ineffective in mild/moderate depression, but that fact was concealed because negative trials were hidden by the drug companies. Likewise, it must be very tempting for homeopaths and other advocates of magic medicine, to quietly forget about trials that don’t come out as they wish. Nobody knows how often that happens, and Homeopaths certainly don’t always bury negative results. Peter Fisher has published trials with negative results. So has George Lewith. Both, needless to say, continue to prescribe it.

It seemed until this month that burial had been the fate of a trial of homeopathy at the Bristol Homeopathic Hospital, run by Dr Elizabeth Thompson.

Dr Thompson was also an author of the infamous paper, Spence et al (2005) paper [download pdf]. This paper was no more than a customer satisfaction survey. Half the patients felt better or much better after a visiting the Homeopathic Hospital, but there was no control group and so not the slightest reason to think that they felt better because of the homeopathic treatment. This pathetic apology for a trial is, needless to say, widely cited by homeopaths. Children with asthma were the group who most often said they felt better, and that might have been taken as a hint ro do a proper trial.

That isn’t what happened though. A small unblinded trial was proposed and it was run between January 1st 2005 and September
30th 2007. In March 2006 the University Hospitals Bristol NHS Trust announced a trial that was being run by Dr Elizabeth Thompson at the Bristol Homeopathic Hospital. The press release has now vanished, but it was reported by the BBC in May 2008.

But no results appeared. Soon people stared asking where the results were. It was discussed on the UKSKeptics forum in October 2006, and on the James Randi Educational Forum. I wrote to Dr Thompson in December 2007 to ask if their results of the asthma study were available yet, and got a rather rude reply (some details below). I was also told by Dr Thompson that

"I have just submitted the funders report today and we have set ourselves the deadline to publish two inter-related papers by March 1st 2007.".

But it still didn’t appear. I and others wrote to the Hospital Trust but got nowhere. Two years later, In 2009, a Freedom of Information Act request was sent to the Hospital Trust (not by me) to try to discover what the still unpublished results were. In February 2010, the Hospital’s lawyers declined to provide the information on the grounds that publication was "imminent".

Then, at last, in July 2011,four years after it was promised, the paper appeared, in the journal Homeopathy. UCL does not, thank heavens, subscribe to that journal, but a request on Twitter produced three copies in no time: twitter is great for crowd-sourcing. The paper is The feasibility of a pragmatic randomised controlled trial to compare usual care with usual care plus individualised homeopathy, in children requiring secondary care for asthma.

It’s not surprising that publication was delayed. The results are completely negative. In fact it shows that the homeopathic treatment didn’t even produce a placebo effect, never mind an effect of its own.

Some details of the paper

The paper compared ‘usual treatment’ with ‘usual treatment plus homeopathic treatment’ for children with asthma. Children were allocated randomly to one treatment or the other (good) but of course they were aware of what treatment they were getting (not good). Ernst has pointed out that this sort of trial can never give a negative result unless the homeopathic treatment is actually harmful. The usual care plus homeopathy group can only benefit from any placebo effect produced by the homeopathic consultation.

The pills used were all 12C dilutions or even weaker, so none of them contained anything whatsoever.

The remarkable thing about this trial was that there was no detectable difference between the ‘usual treatment’ and ‘usual treatment + homeopathy’ groups.

The homeopathic treatment was not just ineffective in itself, but it didn’t even have any detectable placebo effect.

In that respect, the result resembles those in a recent paper in the British Journal of General Practice that showed acupuncture didn’t even produce any useful placebo effect.

The trial was quite small, 39 children aged 7 – 14 years, with moderate or severe asthma were divided into the two groups, and 35 finished the trial. The follow-up periods was 16 weeks which should be enough to show any substantial effect on asthma. Twelve different outcomes were measured and none showed any difference between the two groups (despite the fact that no allowance was made for multiple comparisons, and no primary outcome was specified in advance).

A cost-benefit analysis was done. There was no benefit but there was certainly a cost. On average, each of the children in the usual care group cost the NHS £323, but when homeopathy was added, the cost was £937. That’s an extra cost of £615 for no benefit.

The authors’ conclusions are simple

Conclusions: A future study using this design is not feasible,

That’s pretty feeble. They don’t state the conclusion as "homeopathy doesn’t work", far less that "homeopathy doesn’t even have a placebo effect". Just the eternal cry after every failed trial of magic medicine: the trial design was wrong and more research is needed. An excuse was offered in the form

"A further limitation was the length of the study period which may have needed to be longer in order for homeopathic treatment to make an impact in a complex disease with high variabilitythrough the year."

This is a paraphrase of the typical homeopathic modus operandi. Keep trying a different pill until the patient gets better anyway, then claim the credit.

Some details of the attempts to discover the results

Some of this was recounted in 2007, but it’s so bizarre I’ll repeat it here.

 On 11 December 2007 I wrote to Dr Thompson, thus

In March 2006, a press release http://www.ubht.nhs.uk/press/view.asp?257 announced a randomised trial for homeopathic treatment of asthma in children.

This was reported also on the BBC http://news.bbc.co.uk/1/hi/england/bristol/4971050.stm .

I’d be very grateful if you could let me know when results from this trial will become available.

Yours sincerely

David Colquhoun

The reply, dated 11 December 2007, was unsympathetic

I have just submitted the funders report today and we have set ourselves the deadline to publish two inter-related papers by March 1st 2007.

Can I ask why you are asking and what authority you have to gain this information. I shall expect a reply to my questions,

I answered this question politely on the same day, 11th December.

I know we disagree about the strength of the existing evidence, but nevertheless I was surprised by the strength of your reaction, and the rather abusive stance about my scientific credentials. I’m rather interested in evidence (my first academic work was a text book on statistics), and I’m always eager to see new data. From little I could learn it seemed that your data might be rather better quality than usual. If the evidence is good enough, I’m quite happy to change my mind. That’s how science works isn’t it?

With best regards

David Colquhoun

Nevertheless my innocent enquiry drew forth a rather vitriolic complaint from Dr Thompson to the Provost of UCL (dated 14 December 2007). Despite the fact that I’d replied on December 11th, she said to the provost (with a lot more invective)

"As yet I have not received a reply from Professor Colquhoun as to the authority he is using to make direct enquiries to me about my research. I would be grateful if you could reassure me th~t UCL have really thought through the implications of having someone, with such strong opinions that seem to extend beyond reason, promoting their opinions at such a high profile".
Dr. E. A. Thompson, BA Oxon, MBBS, MRCP, FFHom,
Lead Clinician/Consultant Homeopathic Physician &
Honorary Senior Lecturer in Palliative Medicine

In this case, the Provost came up trumps. On 14 January 2008 he replied to Thompson:

“I have looked at the email that you copied to me, and I must say that it seems an entirely proper and reasonable request. It is not clear to me why Professor Colquhoun should require some special authority to make such direct enquiries”. 

Dr Thompson seems to be very sensitive. Now we have seen the results of her trial, perhaps it’s not surprising

Follow-up

Jump to follow-up

Almost all the revelations about what’s taught on university courses in alternative medicine have come from post-1992 universities. (For readers not in the UK, post-1992 universities are the many new univerities created in 1992, from former polytechnics etc, and Russell group universities are the "top 20" research-intensive universities)

It is true that all the undergraduate courses are in post-1992 universities, but the advance of quackademia is by no means limited to them. The teaching at St Bartholomew’s Hospital Medical School, one of the oldest, was pretty disgraceful for example, though after protests from their own students, and from me, it is now better, I believe.

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Quackery creeps into all universities to varying extents. The good ones (like Southampton) don’t run "BSc" degrees, but it still infiltrates through two main sources,

The first is via their HR departments, which are run by people who tend to be (I quote) "credulous and moronic" when it comes to science.

The other main source is in teaching to medical students. The General Medical Council says that medical students must know something about alterantive medicine and that’s quite right, A lot of their patients will use it. The problem is that the guidance is shockingly vague .

“They must be aware that many patients are interested in and choose to use a range of alternative and complementary therapies. Graduates must be aware of the existence and range of such therapies, why some patients use them, and how these might affect other types of treatment that patients are receiving.” (from Tomorrow’s Doctors, GMC)

In many medical schools, the information that medical students get is quite accurate. At UCL and at King’s (London) I have done some of the familiarisation myself. In other good medical schools, the students get some shocking stuff. St Bartholomew’s Hospital medical School was one example. Edinburgh University was another.
But there is one Russell group university where alternative myths are propagated more than any other that I know about. That is the University of Southampton.

In general, Southampton is a good place, I worked there for three years myself (1972 – 1975). The very first noise spectra I measured were calculated on a PDP computer in their excellent Institute of Sound and Vibration Research, before I wrote my own programs to do it.

But Southanpton also has a The Complementary and Integrated Medicine Research Unit . Oddly the unit’s web site, http://www.cam-research-group.co.uk, is not a university address, and a search of the university’s web site for “Complementary and Integrated Medicine Research Unit” produces no result. Nevertheless the unit is “within the School of Medicine at the University of Southampton”

Notice the usual euphemisms ‘complementary’ and ‘integrated’ in the title: the word ‘alternative’ is never used. This sort of word play is part of the bait and switch approach of alternative medicine.

The unit is quite big: ten research staff, four PhD students and two support staff It is headed by George Lewith.

Teaching about alternative medicine to Southampton medical students.

The whole medical class seems to get quite a lot compared with other places I know about. That’s 250 students (210 on the 5-year course plus another 40 from the 4-year graduate-entry route).

Year 1:  Lecture by David Owen on ‘holism’ within the Foundation Course given to all 210 medical students doing the standard (5-year) course.

 

Year 2: Lecture by Lewith (on complementary medicine, focusing on acupuncture for pain) given within the nervous systems course to the whole medical student year-group (210 students).

 

Year 3 SBOM (scientific basis of medicine) symposium: The 3-hour session (“Complementary or Alternative Medicine: You Decide”). I’m told that attendance at this symposium is often pretty low, but many do turn up and all of them are officially ‘expected’ to attend.

 

There is also an optional CAM special study module chosen by 20 students in year 3, but also a small number of medical students (perhaps 2 – 3 each year?) choose to do a BMedSci research project supervised by the CAM research group and involving 16-18 weeks of study from October to May in Year 4. The CAM research group also supervise postgraduate students doing PhD research.

As always, a list of lectures doesn’t tell you much. What we need to know is what’s taught to the students and something about the people who teach it. The other interesting question is how it comes about that alternative medicine has been allowed to become so prominent in a Russell group university. It must have support from on high. In this case it isn’t hard to find out where it comes from. Here are some details.

Year 1 Dr David Owen

David Owen is not part of Lewith’s group, but a member of the Division of Medical Education headed by Dr Faith Hill (of whom, more below). He’s one of the many part-time academics in this area, being also a founder of The Natural Practice .

Owen is an advocate of homeopathy (a past president of the Faculty of Homeopathy). Homeopathy is, of course, the most barmy and discredited of all the popular sorts of alternative medicine. Among those who have discredited it is the head of the alt med unit, George Lewith himself (though oddly he still prescribes it).

And he’s also a member of the British Society of Environmental Medicine (BSEM). That sounds like a very respectable title, but don’t be deceived. It is an organisation that promotes all sorts of seriously fringe ideas. All you have to do is notice that the star speaker at their 2011 conference was none other than used-to-be a doctor, Andrew Wakefield, a man who has been responsible for the death of children from measles by causing an unfounded scare about vaccination on the basis of data that turned out to have been falsified. There is still a letter of support for Wakefield on the BSEM web site.

The BSEM specialises in exaggerated claims about ‘environmental toxins’ and uses phony allergy tests like kinesiology and the Vega test that misdiagnose allergies, but provide en excuse to prescribe expensive but unproven nutritional supplements, or expensive psychobabble like "neuro-linguistic programming".

Other registered "ecological physicians" include the infamous Dr Sarah Myhill, who, in 2010, was the subject of a damning verdict by the GMC, and Southampton’s George Lewith.

If it is wrong to expose medical students to someone who believes that dose-response curves have a negative slope (the smaller the dose the bigger the effect -I know, it’s crazy), then it is downright wicked to expose students to a supporter of Andrew Wakefield.

David Owen’s appearance on Radio Oxford, with the indomitable Andy Lewis appears on his Quackometer blog.

Year 2 Dr George Lewith

Lewith is a mystery wrapped in an enigma. He’s participated in some research that is quite good by the (generally pathetic) standards of the world of alternative medicine.

In 2001 he showed that the Vega test did not work as a method of allergy diagnosis. "Conclusion Electrodermal testing cannot be used to diagnose environmental allergies", published in the BMJ .[download reprint].

In 2003 he published "A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C” [download reprint] that showed homeopathic pills with no active ingredients had no effects: The conclusion was "”Ultramolecular homeopathy has no observable clinical effects" (the word ultramolecular, in this context, means that the belladonna pills contained no belladonna).

In 2010 he again concluded that homeopathic pills were no more than placebos, as described in Despite the spin, Lewith’s paper surely signals the end of homeopathy (again). [download reprint]

What i cannot understand is that, despite his own findings, his private practice continues to prescribe the Vega machine and continues to prescribe homeopathic pills. And he continues to preach this subject to unfortunate medical students.

Lewith is also one of the practitioners recommended by BSEM. He’s a director of the "College of Medicine". And he’s also an advisor to a charity called Yes To Life. (see A thoroughly dangerous charity: YesToLife promotes nonsense cancer treatments).

3rd year Student Selected Unit

The teaching team includes:

  • David Owen – Principal Clinical Teaching Fellow SoM, Holistic Physician
  • George Lewith – Professor of Health Research and Consultant Physician
  • Caroline Eyles – Homeopathic Physician
  • Susan Woodhead – Acupuncturist
  • Elaine Cooke – Chiropractic Practitioner
  • Phine Dahle – Psychotherapist
  • Keith Carr – Reiki Master
  • Christine Rose – Homeopath and GP
  • David Nicolson – Nutritionalist
  • Shelley Baker – Aromatherapist
  • Cheryl Dunford – Hypnotherapist
  • Dedj Leibbrandt – Herbalist

More details of the teaching team here. There is not a single sceptic among them, so the students don’t get a debate, just propaganda.

In this case. there’s no need for the Freedom of Information Act. The handouts. and the powerpoints are on their web site. They seem to be proud of them

Let’s look at some examples

Chiropractic makes an interesting case, because, in the wake of the Singh-BCA libel case, the claims of chiropractors have been scrutinised as never before and most of their claims have turned out to be bogus. There is a close relationship between Lewith’s unit and the Anglo-European Chiropractic College (the 3rd year module includes a visit there). In fact the handout provided for students, Evidence for Chiropractic Care , was written by the College. It’s interesting because it provides no real evidence whatsoever for the effectiveness of chiropractic care. It’s fairly honest in stating that the view at present is that, for low back pain, it isn’t possible to detect any difference between the usefulness of manipulation by a physiotherapist, by an osteopath or by a chiropractor. Of course it does not draw the obvious conclusion that this makes chiropractic and osteopathy entirely redundant -you can get the same result without all the absurd mumbo jumbo that chiropractors and osteopaths love, or their high-pressure salesmanship and superfluous X-rays. Neither does it mention the sad, but entirely possible, outcome that none of the manipulations are effective for low back pain. There is, for example, no mention of the fascinating paper by Artus et al [download reprint]. This paper concludes

"symptoms seem to improve in a similar pattern in clinical trials following a wide
variety of active as well as inactive treatments."

This paper was brought to my attention through the blog run by the exellent physiotherapist, Neil O’Connell. He comments

“If this finding is supported by future studies it might suggest that we can’t even claim victory through the non-specific effects of our interventions such as care, attention and placebo. People enrolled in trials for back pain may improve whatever you do. This is probably explained by the fact that patients enrol in a trial when their pain is at its worst which raises the murky spectre of regression to the mean and the beautiful phenomenon of natural recovery.”

This sort of critical thinking is conspicuously absent from this (and all the other) Southampton handouts. The handout is a superb example of bait and switch: No nonsense about infant colic, innate energy or imaginary subluxations appears in it.

Acupuncture is another interesting case because there is quite a lot of research evidence, in stark contrast to the rest of traditional Chinese medicine, for which there is very little research.

There is a powerpoint show by Susan Woodhead (though it is labelled British Acupuncture Council).

The message is simple and totally uncritical. It works.

acu-1

In fact there is now a broad consensus about acupuncture.

(1) Real acupuncture and sham acupuncture have been found to be indistinguishable in many trials. This is the case regardless of whether the sham is a retractable needle (or even a toothpick) in the "right" places, or whether it is real needles inserted in the "wrong" places. The latter finding shows clearly that all that stuff about meridians and flow of Qi is sheer hocus pocus. It dates from a pre-scientific age and it was wrong.

(2) A non-blind comparison of acupuncture versus no acupuncture shows an advantage for acupuncture. But the advantage is usually too small to be of any clinical significance. In all probability it is a placebo effect -it’s hard to imagine a more theatrical event than having someone in a white coat stick long needles into you, like a voodoo doll. Sadly, the placebo effect isn’t big enough to be of much use.

Needless to say, none of this is conveyed to the medical students of Southampton. Instead they are shown crude ancient ideas that date from long before anything was known about physiology as though they were actually true. These folks truly live in some alternative universe. Here are some samples from the acupuncture powerpoint show by Susan Woodhead.

acu-5

acu-2

acu-3

Well this is certainly a "different diagnostic language", but no attempt is made to say which one is right. In the mind of the acupuncurist it seems both are true. It is a characteristic of alternative medicine advocates that they have no difficulty in believing simultaneously several mutually contradictory propositions.

As a final exmple of barminess, just look at the acupuncture points (allegedly) on the ear The fact that it is a favoured by some people in the Pentagon as battlefield acupuncture, is more reminiscent of the mad general, Jack D. Ripper, in Dr Strangelove than it is of science.

acu-4

There is an equally uncritical handout on acupuncture by Val Hopwood. It’s dated March 2003, a time before some of the most valuable experiments were done.

The handout says "sham acupuncture
is generally less effective than true acupuncture", precisely the opposite of what’s known now. And there are some bits that give you a good laugh, always helpful in teaching. I like

“There is little doubt that an intact functioning nervous system is required for acupuncture to produce
analgesia or, for that matter, any physiological changes” 

and

Modern techniques: These include hybrid techniques such as electro-acupuncture . . . and Ryadoraku [sic] therapy and Vega testing. 

Vega testing!! That’s been disproved dozens of times (not least by George Lewith). And actually the other made-up nonsense is spelled Ryodoraku.

It’s true that there is a short paragraph at the end of the handout headed "Scientific evaluation of acupuncture" but it doesn’t cite a single reference and reads more like excuses for why acupuncture so often fails when it’s tested properly.

Homeopathy. Finally a bit about that most boring of topics, the laughable medicine that contains no medicine, homeopathy. Caroline Eyles is a member for the Society of Homeopaths, the organisation that did nothing when its members were caught out in the murderous practice of recommending homeopathy for prevention of malaria. The Society of Homeopaths also endorses Jeremy Sherr, a man so crazy that he believes he can cure AIDS and malaria with sugar pills.

The homeopathy handout given to the students has 367 references, but somehow manages to omit the references to their own boss’s work showing that the pills are placebos. The handout has all the sciencey-sounding words, abused by people who don’t understand them.

"The remedy will be particularly effective if matched to the specific/particular characteristics of the individual (the ‘totality’ of the patient) on all levels, including the emotional and mental levels, as well as just the physical symptoms. ‘Resonance’ with the remedy’s curative power will then be at it’s [sic] best." 

The handout is totally misleading about the current state of research. It says

"increasing clinical research confirms it’s [sic] clinical effectiveness in treating patients, including babies and animals (where a placebo effect would be hard to justify)."

The powerpont show by Caroline Eyles shows all the insight of a mediaeval vitalist

home1

hom2

Anyone who has to rely on the utterly discredited Jacques Benveniste as evidence is clearly clutching at straws. What’s more interesting about this slide the admission that "reproducibility is a problem -oops, an issue" and that RCTs (done largely by homeopaths of course) have "various methodological flaws and poor external validity". You’d think that if that was the best that could be produced after 200 yours, they’d shut up shop and get another job. But, like aging vicars who long since stopped believing in god, but are damned if they’ll give up the nice country rectory, they struggle on, sounding increasingly desperate.

How have topics like this become so embedded in a medical course at a Russell group university?

The details above are a bit tedious and repetitive. It’s already established that hardly any alternative medicine works. Don’t take my word for it. Check the web site of the US National Center for Complementary and Alternative Medicine (NCCAM) who, at a cost of over $2 billion have produced nothing useful.

A rather more interesting question is how a good university like Southampton comes to be exposing its medical students to teaching like this. There must be some powerful allies higher up in the university. In this case it’s pretty obvious who thay are.

Professor Stephen Holgate MD DSc CSc FRCP FRCPath FIBiol FBMS FMed Sci CBE has to be the primary suspect, He’s listed as one of Southampton’s Outstanding Academics. His work is nothing to do with alternative medicine but he’s been a long term supporter of the late unlamented Prince of Wales’ Foundation, and he’s now on the advisory board of it’s successor, the so called "College of Medicine" (for more information about that place see the new “College of Medicine” arising from the ashes of the Prince’s Foundation for Integrated Health, and also Don’t be deceived. The new “College of Medicine” is a fraud and delusion ). His description on that site reads thus.

"Stephen Holgate is MRC Clinical Professor of Immunopharmacology at the University of Southampton School of Medicine and Honorary Consultant Physician at Southampton University Hospital Trust. He is also chair of the MRC’s Populations and Systems Medicine Board. Specialising in respiratory medicine, he is the author of over 800 peer-reviewed papers and contributions to scientific journals and editor of major textbooks on asthma and rhinitis. He is Co-Editor of Clinical and Experimental Allergy, Associate Editor of Clinical Science and on the editorial board of 25 other scientific journals."

Clearly a busy man. Personally I’m deeply suspicious of anyone who claims to be the author of over 800 papers. He graduated in medicine in 1971, so that is an average of over 20 papers a year since then, one every two or three weeks. I’d have trouble reading that many, never mind writing them.

Holgate’s long-standing interest in alternative medicine is baffling. He’s published on the topic with George Lewith, who, incidentally, is one of the directors of the "College of Medicine"..

It may be unkind to mention that, for many years now, I’ve been hearing rumours that Holgate is suffering from an unusually bad case of Knight starvation.

The Division of Medical Education appears to be the other big source of support for. anti-scientific medicine. That is very odd, I know, but it was also the medical education people who were responsible for mis-educating medical students at. St. Bartholomew’s and at Edinburgh university. Southampton’s Division of Medical Education has a mind-boggling 60 academic and support staff. Two of them are of particular interest here.

Faith Hill is director of the division. Her profile doesn’t say anything about alternative medicine, but her interest is clear from a 2003 paper, Complementary and alternative medicine: the next generation of health promotion?. The research consisted of reporting anecdotes from interviews of 52 unnamed people (this sort of thing seems to pass for research in the social sciences). It starts badly by misrepresenting the conclusions of the House of Lords report (2000) on CAM. Although it comes to no useful conclusions, it certainly shows a high tolerance of nonsensical treatments.

Chris Stephens is  Associate Dean of Medical Education & Student Experience. His sympathy is shown by a paper he wrote In 2001, with David Owen (the homeopath, above) and George Lewith: Can doctors respond to patients’ increasing interest in complementary and alternative medicine?. Two of the conclusions of this paper were as follows.

"Doctors are training in complementary and alternative medicine and report benefits both for their patients and themselves"

Well, no actually. It wasn’t true then, and it’s probably even less true now. There’s now a lot more evidence and most of it shows alternative medicine doesn’t work.

"Doctors need to address training in and practice of complementary and alternative medicine within their own organisations"

Yes they certainly need to do that.

And the first thing that Drs Hill and Stephens should do is look a bit more closely about what’s taught in their own university, I hope that this post helps them,

Follow-up

4 July 2011. A correspondent has just pointed out that Chris Stephens is a member of the General Chiropractic Council. The GCC is a truly pathetic pseudo-regulator. In the wake of the Simon Singh affair it has been kept busy fending off well-justified complaints against untrue claims made by chiropractors. The GCC is a sad joke, but it’s even sadder to see a Dean of Medical Education at the University of Southampton being involved with an organisation that has treated little matters of truth with such disdain.

A rather unkind tweet from (ex)-chiropractor @RichardLanigan.

“Chris is just another light weight academic who likes being on committees. Regulatory bodies are full of them”

Jump to follow-up

Reply to David Katz.

The Atlantic is an American magazine founded (as The Atlantic Monthly) in Boston, Massachusetts, in 1857. It is a literary and cultural magazine with a very distinguished history. Its contributors include Mark Twain and Martin Luther King. So it was pretty exciting to be asked to write something for it, even with a 12 hour deadline.

atlantic logo

Sadly though, in recent years, the coverage of science in The Atlantic has been less than good The inimitable David Gorski has explained the problem in Blatant pro-alternative medicine propaganda in The Atlantic. The immediate cause of the kerfuffle was the publication of an article, The Triumph of New-Age Medicine. It was written by a journalist, David Freedman. It is very long and really not very good. It has been deconstructed also by Steven Novella.

Freedman’s article is very long, but it boils down to saying I know it doesn’t work but isn’t it nice. The article was followed up with Fix or Fraud: a ‘debate’., The debate is rather disappointing. It suffers from the problem, not unknown at the BBC, of thinking that ‘balance’ means giving equal time to people who think the earth is flat as it gives to people who think it is a oblate spheroid. The debate consists of 800 word contributions from seven people, six of whom are flat earthers, and one of which is very good. Try Steven Salzberg, A ‘triumph’ of hype over reality for some real sense. One of the flat earthers is director of a National Institutes of Health institute, NCCAM.

And this is a magazine that published not only Mark Twain, but Abraham Flexner, the man who, in 1910, put US medical education on a firm scientific footing, You can read Flexner in their archive. Mark Twain said

[A reply to letters recommending remedies]:

Dear Sir (or Madam):–I try every remedy sent to me. I am now on No. 67. Yours is 2,653. I am looking forward to its beneficial results. – quoted in My Father Mark Twain, by Clara Clemens

and

"allopathy is good for the sane and homeopathy for the insane"

So here is the piece, produced rather rapidly, for the debate. This is the original unedited version, slightly longer than appears in The Atlantic.

The title for The Atlantic piece, America, Land of the Health Hucksters, was theirs not mine. There is no shortage of health hucksters in the UK. but at least they mostly haven’t become as embedded within univerities and hospitals as much as in the USA.

David Freeman’s article, “The Triumph of New Age Medicine” starts by admitting that most alternative treatments don’t work, and ends by recommending them.  He takes a lot more words to say it, but that seems a fair synopsis.  It is the sort of thing you might expect in a cheap supermarket magazine, not in Atlantic.

The article is a prime example of rather effective sales technique, much beloved of used car salesmen and health hucksters. It’s called bait and switch.

It’s true that medicine can’t cure everything. That’s hardly surprising given that serious research has been going on for barely 100 years, and it turns out that the humans are quite complicated.  But the answer to the limitations of medicine is not to invent fairy stories, which is what the alternative medicine industry does.  There is no sensible option but to keep the research going and to test its results honestly.  It’s sad but true that Big Pharma has at times corrupted medicine, by concealing negative results.  But that corruption has been revealed by real scientists, not by health hucksters.  In the end, science is self-correcting and the truth emerges.  Health hucksters, on the other hand, seem incapable of giving up their beliefs whatever the evidence says.

The idea of patient-centered care is fashionable and care is great, if you can’t cure.  But there’s a whole spectrum in the wellbeing industry, from serious attempts to make people happier, to the downright nuts.  The problem is that caring for patients make a very good bait, and the switch to woo tends to follow not far behind.

I write from the perspective of someone who lives in a country that achieves health care for all its citizens at half the cost of the US system, and gets better outcomes in life expectancy and infant mortality. The view from outside is that US medicine rather resembles US religion. It has been taken over by fundamentalists who become very rich by persuading a gullible public to believe things that aren’t true.

One of Freedman’s problems is, I think, that he vastly overestimates the power of the placebo effect.  It exists, for sure, but in most cases, it seems to be small, erratic and transient.  Acupuncture is a good example.  It’s quite clear now that real acupuncture and sham acupuncture are indistinguishable, so it’s also quite clear that the ‘principles’ on which it’s based are simply hokum.  If you do a non-blind comparison of acupuncture with no acupuncture, there is in some trials (not all) a small advantage for the acupuncture group.  But it is too small to be of much benefit to the patient.

By far the more important reason why ineffective voodoo like acupuncture appears to work is the “get better anyway” effect (known technically as regression to the mean).  You take the needles or pills when you are at your worst, the next day you feel better.  It’s natural to attribute the fact that you feel better to the needles or pills, when all you are seeing is natural fluctuations in the condition.  It’s like Echinacea will cure your cold in only seven days when otherwise it would have taken a week.

If the article itself was naïve and uncritical, the follow up was worse. It is rather surprising to me that a magazine like Atlantic should think it worth printing an advertorial for Andrew Weil’s business.

Surely, though, Josephine Briggs, as director of an NIH institute is more serious?  Sadly, no.  Her piece is a masterpiece of clutching at straws. The fact is that her institute has spent over $ 2 billion of US taxpayers’ money and, for all that money it has produced not a single useful treatment.  All that NCCAM has done is to show that several things do not work, something we pretty much knew already. If I were a US taxpayer, I’d be somewhat displeased by that. It should be shut down now.

At first sight Dean Ornish sounds more respectable.  He bases his arguments on diet and life style changes, which aren’t alternative at all.  He’s done some research too.  The problem is that it’s mostly preliminary and inconclusive research, on the basis of which he vastly exaggerates the strength of the evidence for what can be achieved by diet alone. It’s classical bait and switch again.  The respectable, if ill-founded, arguments get you the foot in the door, and the woo follows later.

This is all very sad for a country that realized quite early that the interests of patients were best served by using treatments that had been shown to work. The Flexner report of 1910 led the world in the rational education of physicians. But now even places like Yale and Harvard peddle snake oil to their students through their "integrative medicine" departments. It’s hard to see why the USA is in the vanguard of substituting wishful thinking for common sense and reason.

The main reason, I’d guess, is money. Through NCCAM and the Bravewell Collaborative, large amounts of money have been thrown to the winds and businesses like Yale and Harvard have been quick to abandon their principles and grab the money. Another reason for the popularity of alternative medicine in parts of academia is that it’s a great deal easier to do ‘science’ when you are allowed to make up the answers. The "integrative medicine" symposium held at Yale in 2008 boggled the mind. Dr David Katz listed a lot of things he’d tried and which failed to work, His conclusion was not that they should be abandoned, but that we needed a "more fluid concept of evidence".  You can see it on YouTube,

Senator Tom Harkin’s promotion of NCCAM has done for the U.S. reputation in medicine what Dick Cheney did for the U.S. reputation in torture. It is hard to look at the USA from outside without thinking of the decline and fall of the Roman Empire.

One had hoped that era was over with the election of Obama, but the hucksters won’t give up without a fight. They are making too much money to do that.

Follow-up

The comments that appeared in The Atlantic on this piece were mostly less than enlightening -not quite what one expected of an intellectual magazine. Nevertheless I tried to answer all but the plain abusive comments.

More interesting, though, was an editorial by Jennie Rothenberg Gritz, the Atlantic Senior Editor who asked me to contribute. The Man Who Invented Medical School. It picked up on my mention of Abraham Flexner, and his famous 1910 report [download from Carnegie Foundation] which first put US medial education on a form rational footing. based on science. Now, 100 years later that’s being unpicked both in the USA and here. ms Gritz seemed to think that Flexner would have approved of Dean Ornish. In a response I begged to differ. I’m pretty sure that Felxner would have been furious of he could have seen the reecent march of quackademia, particularly, but not exclusively, in the USA. It is exactly the sort of thing his report set out, successfully, to abolish. He wrote, for example,

“the practitioner is subjected, year in, year out, to the steady bombardment of the unscrupulous manufacturer, persuasive to the uncritical, on the principle that “what I tell you three times is true.” Against bad example and persistent asseveration, only precise scientific concepts and a critical
appreciation of the nature and limits of actual demonstration can protect the young physician.” (Flexner report, 1910, pp 64-65)

It is this very “appreciation of the nature and limits of actual demonstration” that is now being abandoned by the alternative medicine industry. despite the fact that real medicine was in its infancy at the time he w as writing, he was very perceptive about the problems. Perhaps Freedman should read the report.

David Katz seems to have spotted my piece in The Atlantic, and has responded at great length in the Huffington Post (quite appropriate, given the consistent support of HuffPo for nonsense medicine). HuffPo allows only short comments with no links so I’ll reply to him here.

I fear that Dr Katz doth protest a great deal too much. He seems to object to a comment that I made about him in The Atlantic.

“… [He] listed a lot of things he’d tried and which failed to work. His conclusion was not that they should be abandoned, but that we needed a ‘a more fluid concept of evidence.'”

You don’t have to take my word for it. You can take it from the words of Dr Katz.

"What do we do when the evidence we have learned, or if we care to be more provocative, with which we have been indoctrinated, does now fully meet the needs of our patients"

It seems odd to me to regard teaching about how you distinguish what;s true and what isn’t as "indoctrination", though I can understand that knowledge of that subject could well diminish the income of alternative practitioners. You went on to say

"Some years ago the CDC funded us with a million dollars to do what they referred to initially as a systematic review of the evidence base for complementary and alternative medicine,  Anybody who’s ever been involved in systematic reviews knows that’s a very silly thing. . . . Well we knew it was silly but a million dollars sounded real [mumbled] took the money and then we figurered we’d figure out what to do with it [smiles broadly]. That’s what we did ". . .

I do hope you told the CDC that you did not spend the million dollars for the sensible purpose for which it was awarded.

This infusion of calcium, magnesium and D vitamins and vitamin C ameliorates the symptoms of fibromyalgia.  . . .  We did typical placebo controlled randomized double-blind trial for several months . . . we saw an improvement in both our treatment and placebo groups . . .

You then describe how you tested yoga for asthma and homeopathy for attention deficit hyperactivity disorder, Neither of them worked either. Your reaction to this string of failures was just to say “we need a more fluid concept of evidence”

After telling an anecdote about one patient who got better after taking homeopathic treatment you said £I don’t care to get into a discussion of how, or even whether, homeopathy works”.  Why not?  It seems it doesn’t matter much to you whether the things you sell to patients work or not.

You then went on to describe quite accurately that anti-oxidants don’t work and neither do multivitamin supplements for prevention of cardiovascular problems,  And once again you fail to accept the evidence, even evidence you have found yourself. Your response was

“So here too is an invitation to think more fluidly about of evidence. Absence of evidence is not evidence of absence.” 

That last statement is the eternal cry of every quack.  It’s true, of course, but that does not mean that absence of evidence gives you a licence to invent the answer.  But inventing the answer is what you do, time after time, You seem quite incapable of saying the most important thing that anyone in your position should. I don’t know the answer.

Jump to follow-up

Universities, like most businesses, cite glowing testimonials from grateful students, I doubt whether universities are any more honest than anyone else in their choice of what to publish. When I asked to see any letters that had been sent to the university, I was sent only one and extracts from it appear in the last post on Westminster. More dangerous nonsense from the University of Westminster: when will Professor Geoffrey Petts do something about it? But I knew (don’t ask how) that there had been more than that, and a slightly widened FOIA request produced some interesting results (though I’m aware of other letters that were not supplied -not good).

As always, the information came with the caveat

"Copyright in our response to your request belongs to the University of Westminster. All rights are reserved. This document is for personal use only and may not be copied, or stored in any electronic form, or reproduced in any other way or used for any other purpose, either in whole or in part, without the prior written consent of the University of Westminster.".

Why else would anyone ask for information but to make it public? And since the letter was sent in electronic form, it would be hard to comply with the second part. As always, I rely on the fair quotation and public interest defences to quote parts of the letters.

The main players here are Peter Davies (Head of herbal medicine and nutritional therapy), Julie Whitehouse (Course Leader for MSci Herbal Medicine and the BSc Honours Health Sciences), David Peters (Clinical director of Westminster’s School of Integrated Health), and the dean of the School of Life Sciences. Jane Lewis. There’s no woo about Jane Lewis. I suspect she’d have got rid of all the nonsense, given a chance. Who, I wonder, is stopping her?

Julie Whitehouse is, I see, a co-author of Brock et al. (2010) American skullcap (Scutellaria lateriflora): an ancient remedy for today’s anxiety, British Journal of Wellbeing1 (4), 25-30. I had no idea there was such a journal. UCL does not subscribe so if anyone has a reprint I’d love to see it. Judging by the abstract it’s yet more ‘preliminary work’. That’s very typical. Next to no CAM research gets past the preliminary report.

Some testimonials

Here are some quotations from “a part-time student on the herbal medicine (HM) BSc course, currently in my 3rd year of study. I have first class honours degree in ecology, am a qualified staff nurse, and am an experienced performance and business manager."

cc Professor Jane Lewis, Dean of School: Biosciences

"Dear Professor Petts,

I hope you do not mind me writing to you personally. I am a part-time student on the herbal medicine (HM) BSc course, currently in my 3rd year of study. I have first class honours degree in ecology, am a qualified staff nurse, and am an experienced performance and business manager. I regard myself as scientist."

"I would like to express to you my disappointment and frustration with my own studies at Westminster. I thought (erroneously, I have since discovered) that I was paying for a Bachelor of Science degree, and that science and scientific thinking would underpin my studies. How wrong I have been.

Based on my experience at Westminster, two things really need to be done to restore credibility in the herbal medicine degree, viz. removing the antiscience and pseudoscience, and strengthening the scientific basis of both our core and herbal medicine modules. The current degree is confusing and infuriating in that it really does not know what it is."

"Here is a quote from a handout (on ‘The Galenic Constitutional System in Practice’) given to 3rd year herbalists last semester: ‘Treating particular disease/conditions is more successful if the disease can be analysed in terms on hot, cold, wet and dry’. If I showed this to any modern (not 17th century) doctor they would be rolling around on the floor in hysterics and condemning this type of nonsense in the strongest possible language. I am ashamed to tell anybody what we are being taught. Is this clandestine teaching or is the University actually sanctioning this pre-scientific view of medicine?"

Anti-science ideas need to be, not only banished from teaching material, but also robustly challenged every time they are raised by students (or lecturers) in the polyclinic or the classroom. But, constantly challenging anti-scientific and erroneous ideas is very wearing and wearying for me as a student, as I am sure it is for scientists on your staff. (I should say here that there are some excellent scientists who have supported and encouraged me in my studies at Westminster; Dr Gillian Shine in the core modules and Christopher Robbins in HM, leap to mind).
Your ‘You Tube’ video says that you hope we enjoy our studies at Westminster. I do want to enjoy my studies. I want to think that Westminster is a respected

academic institution. I should not feel threatened by challenging what I am taught when it is plainly pseudoscience or antiscience and my University should be supporting me in my challenge, which I am sure you will.

And from the same student, this time addressed to Julie Whitehouse and copied to the dean, Jane Lewis (in 2009) [some details removed to preserve patient confidentiality].

… a patient attended who had been treated with a Reiki [typo for Reishi] mushroom tincture and another herbal tincture (about 6 herbs) by an HM clinic supervisor. The patient had also been advised to do ‘body brushing’ which I understand was for ‘detoxification’. This lady is being treated by an oncologist for [***] cancer and is currently undergoing chemotherapy. I do not believe her oncology team were informed before we initiated treatment and the bottles of tincture were not labelled with what they contained.

I have serious ethical problems with treating anyone with cancer with herbs, but someone in the middle of chemotherapy?

Not only are patients’ lives being put at risk, but students are not getting clear messages about the limitations of HM or the professional ethics involved in treating someone with cancer. I have seen patient files with ‘anti-mitotic’ or ‘anti-cancer’ herbs written in the notes. I question whether this is also bordering on the illegal. At the very least it betrays a naive belief that herbs can treat cancer. I was ignored earlier this year when I queried students being encouraged to go to a herbalist’s cancer seminars in Bristol (and she claimed to cure cancer) and this case highlights to me the dangers of Wmin condoning and teaching the ‘we treat people not diseases’ mantra.

This second letter elicited a response from the university, and the response is worth looking at.

The response

2 What was done following the complaint

021209 Clinical Director met with the tutor. Reviewed notes. No indication that the patient was seeking ‘alternatives’ to chemo, nor that she was led to believe the prescription was designed to do other than support her coping with chemo which in her experience had previously been physically demanding and distressing. Procedures regarding communication with oncologists, informed consent, labeling of medicines need reviewing and reinforcing. Action by Course leader/herbal team. Report back to PC Exec 210110

151209 The student who (though she had not been present during this session, had objected to way this case was handled met with the course leader in the presence of the Senior Clinical supervisor and another tutor. The meeting was supportive rather than confrontational. The student was asked to reflect on the consequences of her (frequent) impulsive emailing and the time and effort she demands of others – and to consider the Code of Conduct she has signed.

So the whistle-blowing student seems to have been patted on the head and told to shut up. Nevertheless the complaint had some effect, though not much.

050110 Course leader proposed to review current Polyclinic policies and procedures, and discuss current practice in cases of serious disease and how doctors are informed and patients consented

The response included "Extracts from Smith J, Rowan N & Sullivan (2000) Medicinal Mushrooms: Their therapeutic properties and current medical usage with special emphasis on cancer treatment” from Cancer Research UK."

In almost all the examples that will be discussed in this chapter the polysaccharides act mainly as immune- stimulants with little or no adverse drug reactions. Furthermore, several of these extracts have been shown to stimulate apoptosis in cancer cells (e.g. Fullerton et al., 2000). While there are examples where the mushroom polysaccharides have shown efficacy against specific types of cancer as monotherapy, the overwhelming successes have been demonstrated when they function together with proven and accepted chemotherapeutic agents.

I could not find that document at Cancer Research UK though there is a similar report, dated May 2002, "Medicinal Mushrooms: Their therapeutic properties and current medical usage with special emphasis on cancer treatments" by Smith, Rowan and Sullivan. It can be downloaded at the Cancer Research UK page, Medicinal Mushrooms and Cancer. That page, last updated 7 August 2006, lists John Smith BSc MSc PhD DSc FIBiol FRSE as Emeritus Professor of Applied Microbiology, University of Strathclyde. amd Chief Scientific Officer, MycoBiotech Ltd, Singapore, and Richard Sullivan BSc MD PhD as Head of Clinical Programmes, Cancer Research UK (a job he left in 2008). Professor John Smith is still Chief Scientific Advisor to Mycobiotech Inc, based in Singapore. This company sells various mushroom products. They are all marketed as “nutriceuticals” or “functional foods”, not as pharmaceuticals. These descriptions are a very common way of making medicinal claims for products, while describing them as foods to avoid the strict regulations about claims made for medicines.

It does not seem to me to be a good idea for Cancer Research UK to have advice on its web site from someone with a very obvious financial interest.

The quotations from the Smith report are obviously intended to defend the practice of prescribing mushrooms to people on chemotherapy. But the fact that in 2011, five years after the CRUK page, Mycobiotech still has no approved medicine approved for cancer speaks for itself. They sell Shiitake Herbal Soups. They also sell Essence of Shiitake which, they say, contains Lentinan, “which has been confirmed through research, to be an immuno-enhancer. Lentinan has been found to reduce tumour growth and to prolong the life of cancer patients”. That sounds to me like a rather strong medicinal claim for a “food”. Even Nutra-ingredients, the industry site for nutriceuticals, doesn’t claim much for it.

Now back to Westminster’s response to the student’s complaint.

I have found no evidence that herbal practitioners in the Polyclinic are making explicit claims to treat cancer.
However, the use of the term ‘anti-tumour’ in the notes implies an ambivalent rationale for prescribing. It also illustrates the potential for ambiguity in the clinical notes. However, there is substantial research – both laboratory and clinical – to support the ‘anti-tumour’ and ‘immune stimulant’ properties of certain mushroom species. p222 see appx 2

And, from David Peters.

DP**There is one item in the notes however which I think we need to comment on. While the paper-trail in all other respects shows that the herbal prescription was supportive, one herb in the prescription is categorised as ‘anti-tumour’. Although I am convinced after reviewing the notes and talking with the tutor involved, that the aim was to support the patient through her chemotherapy, this part of the prescription nonetheless signifies some ambivalence at least, about whether the aim was or was not to treat cancer

But then, from Julie Whitehouse

JW Yes there is antitumour as an action for many herbs and nutritional components – and several relevant actions including anything as general as anti- oxidant even – it doesn’t mean we are suggesting they are being used as treatment

It doesn’t take much reading between the lines to see the tension between Whitehouse and Peters. The former is very reluctant to give up the myths, the latter is slightly more cautious about claims to treat cancer.

Let’s be clear about one thing. The student was dead right. There is so little reliable information about mushrooms that neither Cochrane Reviews nor NCCAM has anything relevant to say about them. Antioxidants are a myth, much beloved by marketing people and "boosting the immune system" is the universal mantra of every advocate of magic medicine when they can’t think of anything else to make up. Why can’t Peters and Whitehouse admit it?

More complaints

This one is from a member of staff who teaches on the herbal medicine course. It was addressed to Julie Whitehouse and copied to the dean and vice-chancellor.(10 July 2009).

"During last week (5-9th May) I witnessed a member of the Herbal Team and a student dowsing with a pendulum to divine herbal drugs to prescribe for the student. When I approached and spoke, they defensively hid the pendulum and were clearly embarrassed. I discussed what they were doing. They freely said they were prescribing herbal medicine and cited other staff as their ‘authority’ and ‘instructors’.

Diagnosing or prescribing by pendulum has no scientific credibility. Further, it is dangerous for prescribing as it both fails to identify any appropriate drugs (except by chance) and may select dangerous drugs for a patient.

I know other staff have raised with you the teaching or use of such mediaeval and unscientific practices on the Wmin HM course."

"I feel that such practice in the HM Course teaching or in the Polyclinic should be proscribed. I would like to suggest that you address and resolve this matter urgently.

Dowsing is in conflict with the VC’s recent letter to SIH staff, specifically expecting more evidence of science within the teaching of CT Courses."

"I expect that were the Department of Health to be aware of the unscientific teaching and promotion of practices like dowsing, (and crystals, iridology, astrology, and tasting to determine pharmacological qualities of plant extracts) on the Wmin HM Course, progress towards the Statutory Regulation of Herbal Medicine could be threatened."

The writer seems to have overestimated the sense in the Department of Health. They were aware of these practices (I told them) but nevertheless went ahead with a silly form of statutory regulation.

The same lecturer wrote on 27 July 2009

"This happened with a supervisor, students and patient in the consultation room. The patient was invited to dowse her own "remedies" using a pendulum. A set of Bach Flower remedies (also proscribed in the HM Clinics) was placed in front of the patient and a pendulum was produced. On the basis of the dowsing, a prescription of ‘remedies’ was dispensed."

"Although Julie says dowsing has been proscribed, she has been unable to present and document saying as such. Bach Flower Remedies have been proscribed for HM Clinics."

Some of the replies were sent to me. Julie Whitehouse replied to the lecturer and Peter Davies on 10 August 2009

“I have written and circulated the text to be put into the handbook and have had approval from most members of the herbal team – but [the lecturer who complained] was not there at the time – hope he approves of the statement. It does not specifically say we do not dowse – but it does I think state clearly what we do – we surely do not want a list of what we don’t do – where would it end – there could be many things in a list of what we don’t do.”

So she explicitly refused to ban the use of dowsing in Westminster’s clinic. The lecturer replied, pointing out the unreasonableness of this attitude.

Dear Julie,

I am afraid that I have not received any copy (home or University) of your ‘statement’ so cannot comment. Please resend me another copy.

I don’t understand your not wanting ‘a list of what we don’t do – where would it end’. It is commonplace to have proscribed activities in both social and professional activities, and these are usually for clear reasons of safety and public good. Eg.: Herbal practice is constrained by the prohibitions in the Medicines Act 1968 and following, the maximum dosages under Schedule III of that Act, the prohibited herbal drugs under the MCA, Trading Standards regulations, etc.

It seems that, despite the vice-chancellor’s assurance that the courses would become more scientific, there are still apologists for diagnosis with a pendulum, and for treating cancer with mushrooms at Westminster University.

This saga sounds only top characteristic. Complaints through official channels usually get you nowhere with big organisations. Sadly, the only way to get change is public embarrassment.

Some action from Vice-chancellor Geoftrey Petts is long overdue.

Follow-up

A kind reader sent me a copy of Brock, Whitehouse, Tewfik & Towell,. (2010) American skullcap (Scutellaria lateriflora): an ancient remedy for today’s anxiety, British Journal of Wellbeing1 (4), 25-30.. This is the paper that I described above, on the basis of the abstract, as "preliminary study".. Now that I’ve seen it I realise it isn’t study at all. They simply emailed 377 members of the National Institute of Medical Herbalists to ask what they thought of S. laterifloria. Only 62 replied (16%) and their anecdotes are listed in the paper. It is this sort of worthless information that gets herbal medicine a bad name.

10 August 2011. I notice that Professor Petts has replied to a letters sent to him by the Nightingale Collaboration. He said “Whilst I understand your concerns, colleagues of the School of Life Sciences where these courses are offered do not share them. They are not teaching pseudo-science, as you claim,…”. Well I know at least two member of the Life Sciences department who are very worried. One has now left and one has retired. The rest are presumably too scared to speak out. How he has the nerve to claim that they don’t teach pseudo-science all the teaching materials that have been revealed on this blog is hard to imagine. It is simply not true and he must know it. I find it deeply worrying when vice-chancellors say things which they know to be untrue.

The latest example to come to light is cited by Andy Lewis on his Quackometer blog

“There are some even odder characters too, such as Roy Riggs B.Sc who descibes himself as a “Holistic Geobiologist” and is “an “professional Earth Energy dowser”. He guest lectures at the London Westminster University’s School of Integrative Medicine and The Baltic Dowser’s Association of Lithuania.”

I do wonder who Professor Petts thinks he’s fooling.

This is a slightly-modified version of the article that appeared in BMJ blogs yesterday, but with more links to original sources, and a picture. There are already some comments in the BMJ.

The original article, diplomatically, did not link directly to UCL’s Grand Challenge of Human Wellbeing, a well-meaning initiative which, I suspect, will not prove to be value for money when it comes to practical action.

Neither, when referring to the bad effects of disempowerment on human wellbeing (as elucidated by, among others, UCL’s Michael Marmot), did I mention the several ways in which staff have been disempowered and rendered voiceless at UCL during the last five years. Although these actions have undoubtedly had a bad effect on the wellbeing of UCL’s staff, it seemed a litlle unfair to single out UCL since similar things are happening in most universities. Indeed the fact that it has been far worse at Imperial College (at least in medicine) has probably saved UCL from being denuded. One must be thankful for small mercies.

There is, i think, a lesson to be learned from the fact that formal initiatives in wellbeing are springing up at a time when university managers are set on taking actions that have exactly the opposite effect. A ‘change manager’ is not an adequate substitute for a vote.  Who do they imagine is being fooled?

BMJ blogs logo
Click logo to go to BMJ

The A to Z of the wellbeing industry
From angelic reiki to patient-centred care

Nobody could possibly be against wellbeing. It would be like opposing motherhood and apple pie. There is a whole spectrum of activities under the wellbeing banner, from the undoubtedly well-meaning patient-centred care at one end, to downright barmy new-age claptrap at the other end.  The only question that really matters is, how much of it works? 

Let’s start at the fruitcake end of the spectrum.

One thing is obvious. Wellbeing is big business. And if it is no more than a branch of the multi-billion-dollar positive-thinking industry, save your money and get on with your life.

In June 2010, Northamptonshire NHS Foundation Trust sponsored a “Festival of Wellbeing” that included a complementary therapy taster day. In a BBC interview one practitioner used the advertising opportunity, paid for by the NHS, to say “I’m an angelic reiki master teacher and also an angel therapist.” “Angels are just flying spirits, 100 percent just pure light from heaven. They are all around us. Everybody has a guardian angel.” Another said “I am a member of the British Society of Dowsers and use a crystal pendulum to dowse in treatment sessions. Sessions may include a combination of meditation, colour breathing, crystals, colour scarves, and use of a light box.” You couldn’t make it up.
 
The enormous positive-thinking industry is no better. Barbara Ehrenreich’s book, Smile Or Die: How Positive Thinking Fooled America and the World, explains how dangerous the industry is, because, as much as guardian angels, it is based on myth and delusion. It simply doesn’t work (except for those who make fortunes by promoting it). She argues that it fosters the sort of delusion that gave us the financial crisis (and pessimistic bankers were fired for being right). Her interest in the industry started when she was diagnosed with cancer.  She says

”When I was diagnosed, what I found was constant exhortations to be positive, to be cheerful, to even embrace the disease as if it were a gift. If that’s a gift, take me off your Christmas list,”

 It is quite clear that positive thinking does nothing whatsoever to prolong your life (Schofield et al 2004;   Coyne et al 2007; 2,3), any more than it will cure tuberculosis or cholera. “Encouraging patients to “be positive” only may add to the burden of having cancer while providing little benefit” (Schofield et al 2004). Far from being helpful, it can be rather cruel.

Just about every government department, the NHS, BIS, HEFCE, and NICE, has produced long reports on wellbeing and stress at work. It’s well known that income is correlated strongly with health (Marmot, M., 2004). For every tube stop you go east of Westminster you lose a year of life expectancy (London Health Observatory).  It’s been proposed that what matters is inequality of income (Wilkinson & Pickett, 2009). The nature of the evidence doesn’t allow such a firm conclusion (Lynch et al. 2004), but that isn’t really the point. The real problem is that nobody has come up with good solutions. Sadly the recommendations at the ends of all these reports don’t amount to a hill of beans. Nobody knows what to do, partly because pilot studies are rarely randomised so causality is always dubious, and partly because the obvious steps are either managerially inconvenient, ideologically unacceptable, or too expensive.

Take two examples:

Sir Michael Marmot’s famous Whitehall study (Marmot, M., 2004)  has shown that a major correlate of illness is lack of control over one’s own fate: disempowerment. What has been done about it? 

In universities it has proved useful to managers to increase centralisation and to disempower academics, precisely the opposite of what Marmot recommends.

As long as it’s convenient to managers they are not going to change policy. Rather, they hand the job to the HR department which appoints highly paid “change managers,” who add to the stress by sending you stupid graphs that show you emerging from the slough of despond into eternal light once you realise that you really wanted to be disempowered after all. Or they send you on some silly “resilience” course.

change diagram
Pyschobabble from UCL’s HR department

A second example comes from debt. According to a BIS report (Mental Capital and Wellbeing), debt is an even stronger risk factor for mental disorder than low income. So what is the government’s response to that? To treble tuition fees to ensure that almost all graduates will stay in debt for most of their lifetime. And this was done despite the fact that the £9k fees will save nothing for the taxpayer: in fact they’ll cost more than the £3k fees. The rise has happened, presumably, because the ideological reasons overrode the government’s own ideas on how to make people happy.

Nothing illustrates better the futility of the wellbeing industry than the response that is reported to have been given to a reporter who posed as an applicant for a “health, safety, and wellbeing adviser” with a local council. When he asked what “wellbeing” advice would involve, a member of the council’s human resources team said: “We are not really sure yet as we have only just added that to the role. We’ll want someone to make sure that staff take breaks, go for walks — that kind of stuff.”

The latest wellbeing notion to re-emerge is the happiness survey. Jeremy Bentham advocated “the greatest happiness for the greatest number,” but neglected to say how you measure it. A YouGov poll asks, “what about your general well-being right now, on a scale from 1 to 10.” I have not the slightest idea about how to answer such a question. As always some things are good, some are bad, and anyway wellbeing relative to whom?  Writing this is fun. Trying to solve an algebraic problem is fun. Constant battling with university management in order to be able to do these things is not fun. The whole exercise smacks of the sort of intellectual arrogance that led psychologists in the 1930s to claim that they could sum up a person’s intelligence in a single number.  That claim was wrong and it did great social harm.

HEFCE has spent a large amount of money setting up “pilot studies” of wellbeing in nine universities. Only one is randomised, so there will be no evidence for causality. The design of the pilots is contracted to a private company, Robertson Cooper, which declines to give full details but it seems likely that the results will be about as useless as the notorious Durham fish oil “trials”(Goldacre, 2008).

Lastly we get to the sensible end of the spectrum: patient-centred care. Again this has turned into an industry with endless meetings and reports and very few conclusions.  Epstein & Street (2011) say

“Helping patients to be more active in consultations changes centuries of physician-dominated dialogues to those that engage patients as active participants. Training physicians to be more mindful, informative, and empathic transforms their role from one characterized by authority to one that has the goals of partnership, solidarity, empathy, and collaboration.”

That’s fine, but the question that is constantly avoided is what happens when a patient with metastatic breast cancer expresses a strong preference for Vitamin C or Gerson therapy, as  advocated by the YesToLife charity. The fact of the matter is that the relationship can’t be equal when one party, usually (but not invariably) the doctor, knows a lot more about the problem than the other. 

What really matters above all to patients is getting better.  Anyone in their right mind would prefer a grumpy condescending doctor who correctly diagnoses their tumour, to an empathetic doctor who misses it. It’s fine for medical students to learn social skills but there is a real danger of so much time being spent on it that they can no longer make a correct diagnosis.  Put another way, there is confusion between caring and curing. It is curing that matters most to patients. It is this confusion that forms the basis of the bait and switch tactics (see also here) used by magic medicine advocates to gain the respectability that they crave but rarely deserve.

If, as is only too often the case, the patient can’t be cured, then certainly they should be cared for. That’s a moral obligation when medicine fails in its primary aim. There is a lot of talk about individualised care. It is a buzzword of quacks and also of the libertarian wing which says NICE is too prescriptive. It sounds great, but it helps only if the individualised treatment actually works.

Nobody knows how often medicine fails to be “patient-centred.”. Even less does anyone know whether patient-centred care can improve the actual health of patients. There is a strong tendency to do small pilot trials that are as likely to mislead as inform. One properly randomised trial (Kinmonth et al., 1998) concluded

“those committed to achieving the benefits of patient centred consulting should not lose the focus on disease management.”

Non-randomised studies may produce more optimistic conclusions (e.g. Hojat et al, 2011), but there is no way to tell if this is simply because doctors find it easy to be empathetic with patients who have better outcomes.

Obviously I’m in favour of doctors being nice to patients and to listening to their wishes. But there is a real danger that it will be seen as more important than curing. There is also a real danger that it will open the doors to all sorts of quacks who claim to provide individualised empathic treatment, but end up recommending Gerson therapy for metastatic breast cancer. The new College of Medicine, which in reality is simply a reincarnation of the late unlamented Prince’s Foundation for Integrated Health, lists as its founder Capita, the private healthcare provider that will, no doubt, be happy to back the herbalists and homeopaths in the College of Medicine, and, no doubt, to make a profit from selling their wares to the NHS.

In my own experience as a patient, there is not nearly as much of a problem with patient centred care as the industry makes out. Others have been less lucky, as shown by the mid-Staffordshire disaster (Delamothe, 2010),  That seems to have resulted from PR being given priority over patients. Perhaps all that’s needed is to save money on all the endless reports and meetings (“the best substitute for work”), ban use of PR agencies (paid lying) and to spend the money on more doctors and nurses so they can give time to people who need it.  This is a job that will be hindered considerably by the government’s proposals to sell off NHS work to private providers who will be happy to make money from junk medicine.

Reference

Wilkinson. R & Pickett, K.  2009 , The Spirit Level, ISBN 978 1 84614 039 6


A footnote on Robertson Cooper and "resilience"

I took up the offer of Robertson Cooper to do their free "resilience" assessment, the company to which HEFCE has paid an undisclosed amount of money.

guff

The first problem arose when it asked about your job. There was no option for scientist, mathematician, university or research, so I was forced to choose "education and training". (a funny juxtaposition since training is arguably the antithesis of education). It had 195 questions. mostly as unanswerable as in the YouGov happiness survey. I particularly liked question 124 "I see little point in many of the theoretical models I come across". The theoretical models that I come across most are Markov models for the intramolecular changes in a receptor molecule when it binds a ligand (try, for example, Joint distributions of apparent open and shut times of single-ion channels and maximum likelihood fitting of mechanisms). I doubt the person who wrote the question has ever heard of a model of that sort. The answer to that question (and most of the others) would not be worth the paper they are written on.

The whole exercise struck me as the worst sort of vacuous HR psychobabble. It is worrying that HEFCE thinks it is worth spending money on it.

Follow-up

Times Higher Education published today a version of an earlier post on this blog, Why should a postman pay for your university education?.

Although the submtted version was within length, it got shortened and, worse, a bit garbled in places. I got no chance to check the final version. The penultimate paragraph was not written by me. So here, for the record, is what I sent them.

.We hear a lot about lifelong education, and a good thing too. But we have a government that seems to think socially-useful learning does end at 18. This age is a watershed in official attitudes to education particularly in two areas, religious discrimination and education as a public good.

In 1871 the Universities Tests Act made it illegal for a university to discriminate among applicants on the basis of religious beliefs (or lack thereof) and forced Oxford, Cambridge, and Durham to follow in the footsteps of UCL.  For the last 140 years it has been unimaginable that any university would allow religious discrimination.  In stark contrast, in 2010, religious discrimination (and the accompanying social discrimination) in entry to primary and secondary schools is not only legal, but is actively encouraged by the government. It was a trend that got worse while the ‘reverend’ Tony Blair was prime minister. The minister of education under the new conservative regime promised even more religious schools.  Why the rules should be diametrically opposite when you are under 18 from when you are over 18 is baffling.

It is equally baffling (and perhaps a partial explanation) that universities are not regarded as part of education at all by this government and its immediate predecessors. Universities are governed by the Department of Business, not the Department of Education. Education is not regarded as a continuum, or as a life-long project: it’s something you do at school.

The government has managed the remarkable feat of devising a system for universities in which everybody loses.  It saves the taxpayer little or no money (according to HEPI). It leaves universities worse off.  And it does both of these while tripling the debt incurred by students.  It’s hard to believe that such monumental ineptitude has motives that are other than ideological.  The virtual privatisation of post-18 teaching, particularly of humanities, was a step too far even for Margaret Thatcher.

The only too brief debate on these changes focussed almost entirely on how to repay an enormous debt.  That was the wrong starting point.  The first thing that should have been decided was what sort of university system we want. It is arguable that the honours degree system is quite unsuited to an age when half the population get higher education. A general first degree, at a teaching-only institution, would be much cheaper, and it would be a social leveller.  If that were followed, for those who wanted and merited it, by a properly taught graduate school (as opposed to the present powerpoint-teaching charades), and this was taught by active researchers at research intensive places, the standard of education would be increased.  There might be some problems with such a system, but they were not even discussed before rushing the changes through.

The organisation that should have been at the forefront of fresh thinking, UUK, was paralysed as the elite VCs, all in favour of maximum fees, wrangled with the post-1992 VCs who saw themselves at greater risk. The result was total inaction. They may have been on leadership courses, but they failed to lead.  The elite VCs are now finding that even £9000 will leave them worse off than before.  They really should have thought a bit more about how to adapt to tertiary education for half the population rather than trying to fund things as they are at the moment.

Whatever the system, the question will always arise: why should a postman pay for your university education?  My answer is that they should pay, but not very much. They should pay because, although they may not get any direct benefit themselves, their children certainly may. The fairest, most progressive, tax is income tax. If you are a postman, or indeed a graduate, on a low income, you shouldn’t pay much tax, so you won’t pay much for other people’s university education.

I can see no reason for the sudden change in attitude to, and funding of, education that happens when you reach 18.

I see every reason why kids should be angry. I doubt that we have seen the last of the riots.

I hope not anyway.

Follow-up

Jump to follow-up

One of my greatest scientific heros is A.V.Hill, and its one of my great regrets that I saw him only in the distance. He’s a hero partly because of his science, but also because of his other interests, in particular his efforts to help scientists escape from pre-war Germany. Read the Biographical Memoir of Hill, written by Bernard Katz [download pdf], and comments in my obituary for Katz.

 

A.V. Hill, c. 1935 (drawn by Edward Halliday in 1978, from a photograph)

Hill 1935

There are some amazing pictures from Hill’s photo album here. And you can read an account of a visit to the lab on Boxing Day 1960 written by AV’s grandson, Nicholas Humphrey (his father, John Humphrey, was external examiner of my PhD). And Tom Chivers, who writes a rather good column in the Telegraph is Alison Hill’s son, and so he’s the great grandson of AV. In yet another irrelevant coincidence, I lived for a year in a Max Planck Institute house that had previously been occupied by Otto Meyerhof who, in 1922, got the Nobel prize jointly with AV Hill.

Some of the scientific background is given by Austin Elliott, as I did in The quantitative analysis of drug–receptor interactions: a short history.

This post was prompted not so much by the science as by the curious conjunction of the New Year’s Honours List, and a discovery from Twitter. Hill won the Nobel prize for Physiology or Medicine in 1922, but refused the customary knighthood or peerage that gets offered on such occasions. Dr Alison Hill, AV’s granddaughter, mentioned on Twitter that Hill loved quoting a verse by A.A. Milne (author of Winnie the Pooh) that I had never heard before. It appears to come from a book, The Sunny Side, that Milne publshed in 1921. It’s worth quoting in full.

O.B.E.

I know a Captain of Industry,
Who made big bombs for the R.F.C.,
And collared a lot of £ s. d.–
And he–thank God!–has the O.B.E.

I know a Lady of Pedigree,
Who asked some soldiers out to tea,
And said “Dear me!” and “Yes, I see”–
And she–thank God!–has the O.B.E.

I know a fellow of twenty-three,
Who got a job with a fat M.P.–
(Not caring much for the Infantry.)
And he–thank God!–has the O.B.E.

I had a friend; a friend, and he
Just held the line for you and me,
And kept the Germans from the sea,
And died–without the O.B.E.
Thank God!
He died without the O.B.E.

This also led to the unexpected discovery that A.A. Milne, like A.V. Hill, had done a mathematics degree at Trinity College Cambridge before moving on to teddy bears.

Wikepedia gives a list of the alternative roll of honour, those who have declined an honour.

The list of honours in Higher Education contains the usual administrators and vice-chancellors. It contains next to no scientists. I can’t say i find it very inspiring. The main effect of the honours system seems to be to keep people from rocking the boat until the day they die.

One is once again reminded of the definition from A Sceptic’s Medical Dictionary (BMJ publishing, 1997). by Michael O’Donnell.

Knight starvation

“Affective disorder that afflicts senior doctors . . . A progressive condition that deteriorates with the publication of each Honours List and, in longstanding cases, can produce serious erosion of judgement and integrity.”

Here’s a 1932 picture with several scientific heros. Hill is in the centre, with A.J. Clark on his left and Verney on his right, J.H.Gaddum is on the left end of the back row (all holders of the UCL chair in Pharmacology). .

Hill 1932
Taken from K J Franklin’s History of the International Physiological Congress – it is a photo taken on the SS Minnekhda, charted by European physiologists to attend the 1932 Boston congress. [Dr Tilli Tansey, FMedSci., Hon FRCP.,Historian of Modern Medical Sciences Wellcome Trust Centre for the History of Medicine, UCL

Follow-up

Here are two more documents that are relevant to the life of A.V. Hill.

Gerta Vrbová (born 1926, in Slovakia) wrote "Archibald V. Hill’s contribution to science and society" [download pdf]. She herself lived through the holocaust. The story of her escape to England is like an adventure novel. She became a professor at UCL where I met her many times.

" as an academic she was able to gain permission to travel between the Soviet states of Eastern Europe, and on a visit to a conference in Poland in 1958, she decided to make her escape. Travelling on foot across the mountains back to Czechoslovakia, she collected her children aged four and six, crossed the Polish Czechoslovak border with them and took a train to Warsaw. Having unofficially entered the names of children on her passport, she was able to obtain a transit visa for Copenhagen, from where, after a year, she was able finally to come to England." [from UCL news]

gv
Gerta Vrbová in 2014, and with husband, Rudolf Vrba, in Bratislava after the war [picture from Daily Mirror]

There is another interview with Vrbová in the Physiological Society’s Oral History series.

A.V. Hill and alphabetical order of authors

In the first 50 years of its existence, the Journal of Physiology allowed authors to choose the order in which authors appeared, But for 60 years, from the 1930s to the 1990s, the journal insisted that authors’ names be listed in alphabetical order. That, for example, is why our 1985 paper is listed as Colquhoun & Sakmann. A.V.Hill was one of the people who proposed this system and a history of it has appeared recently [download pdf]. Personally, I liked this system. though having a name that begins the "C", I couldn’t be very active in advocating it. The alphabetical system worked well when authors did experiments themselves, and most papers had 1 – 3 authors. Nobody judges contributions based on author order for Hodgkin & Huxley, or for Katz & Miledi. In the 1990s, alphabetical order was abandoned. Too few other journals used that system, and it could not survive the era of guest authors that has accompanied the publish-or-perish regime imposed on academics by managers.

2 February 2017

A.V. Hill is one of my scientific heroes, because of his science, his humanity, his running (and because he turned down a knighthood after he got the Nobel Prize in 1922 -see above.

Hilda Bastian has written a timely article about him:The same folly,the same fury. It was posted shortly after Holocaust Memorial Day (27 January), the day on which Donald Trump chose to exclude from the USA all the refugees who are fleeing from the war in Syria.

AV Hill played a central role in helping German scientists escape from the Nazis -to the enormous benefit of UK science. He spoke from the same stage as Mussolini.
He said

“Freedom itself is again at stake… It is difficult to believe in progress, at least in decency and commonsense, when this can happen almost in a night in a previously civilised State… [W]e must ensure that the same folly, the same fury, does not occur elsewhere.” A.V. Hill (Nature, 1933).

The post doesn’t mention Trump, Farage or May. It doesn’t need to.

Jump to follow-up

We hear a lot about lifelong education, and a good thing too. But we have a government that seems to think life ends at 18. The contrast between official attitudes to schools and post-school education is striking. The contrast is most striking in two areas: religious discrimination and public support for costs.

Religous discriminatiion and selection

The Universities Tests Act was passed on 18 June 1871, while William Gladstone (Liberal) was Prime minister. It was "An Act to alter the law respecting Religious Tests in the Universities of Oxford, Cambridge, and Durham, and in the Halls and Colleges of those Universities". Of course UCL was founded in 1826, partly as a place that was free of religious discrimination. Since 1871 it has been illegal for a university to discriminate among applicants on the basis of their religious beliefs or lack of them. For the last 140 years it has been unimaginable that anyone would try to do such a thing.

In stark contrast, in 2010, religious discrimination among entrance to primary and secondary schools is not only legal, but is actively encouraged by the government. It was a trend that got worse while the ‘reverend’ Tony Blair (illiberal) was prime minister. The minister of education under the new conservative regime promised even more religious schools.

Why the rules should be diametrically opposite when you are younger than 18 from when you are over 18 is baffling.

It is equally baffling (and perhaps a partial explanation) that universities are not regarded by this government, or by Blair’s, as part of education at all. They are governed by the Department of Business, not the Department of Education.

Why should a postman pay for your university education?

I imagine that I’m not the only person who has wrestled with this question in the last few weeks (Stephen Law’s thoughts here)

In the UK it is a legal requirement to stay in full time education until the age of 16, and that should be increased to 18 by 2015. Although most children stay in school until 18, around 25% or 30% don’t. I have never heard anybody question the idea that education from 16 to 18 should not be supported 100 percent by the state, out of general taxation. That is the case despite the fact that not everybody stays in education up to 18.

Education up to the age of 18 is regarded as a common good and nobody questions for a moment that it should be free at the point of use.

Once again, everything changes entirely when you reach 18. Education is not regarded as a continuum, or as a life-long project. Suddenly at the age of 18, it stops being a public good worthy of state support, and becomes an optional extra for those who are rich, or those who are not deterred by the idea of going though life paying a debt that will, in some cases, approach the size of the mortgage on their house.

The ConDem coalition, on December 9th 2010, has come very close to privatising the teaching of humanities in universities. You are encouraged to learn languages from 16 – 18 and then these are dropped like a hot cake.

The result has been riots by schoolchildren and total discrediting of Liberal democrats who voted for one of the most philistine measures in living memory.

The discussion of this legislation has, in my view, focussed on the wrong thing. It has been almost entirely about the mechanisms for paying off an enormous debt. That was the wrong place to start. This is what should have been done.

(1) Consider what is being funded. Should the university system adapt to present circumstances, e.g by abolishing honours degrees and creating real graduate schools, as I suggested recently in the Times?   Disgracefully, the government has rushed headlong into changes in funding without waiting to consider what it should be funding. Equally disgracefuly, Universities UK (the vice-chancellors’ trade union) has made no constructive suggestions for change, but appears to be rendered immobile by a rift between the Russell group VCs who want to grab as much as they can as soon as possible, and other VCs who fear for their existence.

(2) After deciding what form universities should have in the future, you can then go on to discuss how much public money should be used to support the system.

(3) Only after both of these have been done, does it make sense to talk about how you pay back any contribution made by the student (and that contribution should be, at most, no bigger than now).

In their haste to make people pay high fees, the government seems to have got the worst of both worlds. They have devised a scheme that, in the long run, is likely to cost the taxpayer as much as, or even more than, the present system, while at the same time trebling fees to students. It’s hard to imagine greater incompetence than that.

But the question still lurks: why should a postman pay for your university education? My answer is yes, but not much. They should pay because, although they may not get any direct benefit themselves, their children certainly may. The fairest, most progressive, tax is income tax. If you are a postman, or indeed a graduate, on a low income you shouldn’t pay much tax, so you won’t pay much for, inter alia, other people’s university education.

I can see no reason for the sudden change in attitude to, and funding of, education that happens when you reach 18.

I see every reason why kids should be angry. I doubt that we have seen the last of the riots.

I hope not anyway.

Follow-up

See also UCL’s Beautiful Occupation. Students seem to think more clearly about what’s happening than either university management or the government.

December 10 2010, The New York Times points out that tuition fees in the UK will, under this scheme, be double those of public universities in the USA."this new policy is an utter failure."

December 11 2010. An NHS doctor writes

"I was slightly dissapointed when 7/8 of my first year medical students showed up for their last day of teaching at my practice on thursday December 9th. The eighth student was ill, so not one of them was protesting. When I asked them why not they said that in their first week as medical students they were told not to get involved in any protests because even a police caution would mean they might be thrown off the course and almost certainly they wouldn’t get a job. Images of Fascist Spain or Nazi Germany came immediately to mind (I have just read Alone in Berlin)"

December 11 2010. The Guardian reports:

Liberal Democrat grassroots hit back over tuition fees
Richard Grayson, former director of policy, says Liberal Democrats should move closer to Ed Miliband and Labour

That sounds better.

December 12 2010. The Observer reports:
“Police officers ‘tried to stop hospital staff treating injured protester’ Mother of injured student Alfie Meadows said that her son’s life could have been put at risk by the journey to another hospital”.

Jump to follow-up

Research quangos lead to mediocrity is the headline title of a letter to The Times appeared on 6 December 2010. It is reproduced below for those who can’t (or won’t) pay Rupert Murdoch to see it.

rcuk1

The letter is about the current buzzword, "research impact", a term that trips off the lips of every administrator and politician daily. Since much research is funded by the taxpayer, it seems reasonable to ask if it gives value for money. The best answer can be found in St Paul’s cathedral.

The plaque for Christopher Wren bears the epitaph

LECTOR, SI MONUMENTUM REQUIRIS, CIRCUMSPICE.

Reader, if you seek his memorial – look around you.

Much the same could be said for the impact of any science. Look at your refrigerator, your mobile phone, your computer, your central heating boiler, your house. Look at the X-ray machine and MRI machines in your hospital. Look at the aircraft that takes you on holiday. Look at your DVD player and laser surgery. Look, even, at the way you can turn a switch and light your room. Look at almost anything that you take for granted in your everyday life, They are all products of science; products, eventually, of the enlightenment.

BUT remember also that these wonderful products did not appear overnight. They evolved slowly over many decades or even centuries, and they evolved from work that, at the time, appeared to be mere idle curiosity. Electricity lies at the heart of everyday life. It took almost 200 years to get from Michael Faraday’s coils to your mobile phone. At the time, Faraday’s work seemed to politicians to be useless. Michael Faraday was made a fellow of the Royal Society in 1824.

. . . after Faraday was made a fellow of the Royal Society[,] the prime minister of the day asked what good this invention could be, and Faraday answered: “Why, Prime Minister, someday you can tax it.”

Whether this was really said is doubtful, but that hardly matters. It is the sort of remark made by politicians every day.

In May 2008, I read a review of ”The myths of Innovation” by Scott Berkun. The review seems to have vanished from the web, but I noted it in diary. These words should be framed on the wall of every politician and administrator. Here are some quotations.

“One myth that will disappoint most businesses is the idea that innovation can be managed. Actually, Berkun calls this one ‘Your boss knows more about innovation than you’. After all, he says, many people get their best ideas while they’re wandering in their bathrobes, filled coffee mug in hand, from the kitchen to their home PC on a day off rather than sitting in a cubicle in a suit during working hours. But professional managers can’t help it: their job is to control every variable as much as possible, and that includes innovation.”

“Creation is sloppy; discovery is messy; exploration is dangerous. What’s a manager to do?
The answer in general is to encourage curiosity and accept failure. Lots of failure.”

I commented at the time "What a pity that university managers are so far behind those of modern businesses. They seem to be totally incapable of understanding these simple truths. That is what happens when power is removed from people who know about research and put into the hands of lawyers, HR people, MBAs and failed researchers."

That is even more true two years later. The people who actually do research have been progressively disempowered. We are run by men in dark suits who mistake meetings for work. You have only to look at history to see that great discoveries arise from the curiosity of creative people, and that,. rarely, these ideas turn out to be of huge economic importance, many decades later.

The research impact plan, has been now renamed "Pathways to Impact". It means that scientists are being asked to explain the economic impact of their research before they have even got any results.

All that shows is how science is being run by dimwits who simply don’t understand how science works. This amounts to nothing less than being compelled to lie if you want any research funding. And, worse stiil, the pressure to lie comes not primarily from government, but from that curious breed of ex-scientists, failed scientists and non-scientists who control the Research Councils.

rcuk2
How much did RCUK pay for the silly logo?

We are being run by people who would have told Michael Faraday to stop messing about with wires and coils and to do something really useful, like inventing better leather washers for steam pumps.

Welcome to the third division. Brought to you be Research Counclls and politicians.

Here is the letter in The Times. It is worded slightly more diplomatically than my commentary. but will, no doubt, have just as little effect. What would the signatories know about science? Several off them don’t even wear black suits.

times headline

Sir,

The governance of UK academic research today is delegated to a quangocracy comprising 11 funding and research councils, and to an additional body – Research Councils UK. Ill considered changes over the past few decades have transformed what was arguably the world’s most creative academic sector into one often described nowadays as merely competitive.

In their latest change, research councils introduce a new criterion for judging proposals – “Pathways to Impact” – against which individual researchers applying for funds must identify who might benefit from their proposed research and how they might benefit. Furthermore, the funding councils are planning to begin judging researchers’ departments in 2014 on the actual benefits achieved and to adjust their funding accordingly, thereby increasing pressure on researchers to deliver short-term benefits. However, we cannot understand why the quangocracy has ignored abundant evidence showing that the outcomes of high-quality research are impossible to predict.

We are mindful of the need to justify investment in academic research, but “Pathways to Impact” focuses on the predictable, leads to mediocrity, and reduces returns to the taxpayer. In our opinion as experienced researchers, few if any of the 20th century’s great discoveries and their huge economic stimuli could have happened if a policy of focussing on attractive short-term benefits had applied because great discoveries are always unpredicted. We therefore have an acutely serious problem.

Abolishing “Pathways to Impact” would not only save the expense of its burgeoning bureaucracy; it would also be a step towards liberating creativity and indicate that policy-makers have at last regained their capacity for world-class thinking.

Donald W Braben
University College London,
And the following scientists who also sign in a personal capacity: 

John F Allen, Queen Mary, University of London;
William Amos, University of Cambridge;
Michael Ashburner FRS, University of Cambridge;
Jonathan Ashmore FRS, University College London;
Tim Birkhead FRS, University of Sheffield;
Mark S Bretscher FRS, MRC Laboratory of Molecular Biology, Cambridge;
Peter Cameron, Queen Mary, University of London;
Richard S Clymo, Queen Mary, University of London;
Richard Cogdell FRS, University of Glasgow;
David Colquhoun FRS, University College London;

Adam Curtis, Glasgow University;
John Dainton FRS, University of Liverpool;
Felipe Fernandez-Armesto, University of Notre Dame;
Pat Heslop-Harrison, University of Leicester;
Dudley Herschbach, Harvard University, Nobel Laureate;
Herbert Huppert FRS, University of Cambridge;
H Jeff Kimble, Caltech, US National Academy of Sciences;
Sir Harry Kroto FRS, Florida State University, Tallahassee, Nobel Laureate;
James Ladyman, University of Bristol;
Michael F Land FRS, University of Sussex;

Peter Lawrence FRS, University of Cambridge;
Sir Anthony Leggett FRS, University of Illinois at Urbana-Champaign, Nobel Laureate;
Angus MacIntyre FRS, Queen Mary, University of London;
Sotiris Missailidis, Open University;
Philip Moriarty, University of Nottingham;
Andrew Oswald, University of Warwick;
Lawrence Paulson, University of Cambridge;
Iain Pears, Oxford;
Beatrice Pelloni, University of Reading;
Douglas Randall, University of Missouri, US National Science Board member;

David Ray, BioAstral Limited;
Sir Richard J Roberts FRS, New England Biolabs, Nobel Laureate;
Ian Russell FRS, University of Sussex;
Ken Seddon, Queen’s University of Belfast;
Steve Sparks FRS, University of Bristol;
Harry Swinney, University of Texas, US National Academy of Sciences;
Iain Stewart, University of Durham;
Claudio Vita-Finzi, Natural History Museum;
David Walker FRS, University of Sheffield;
Glynn Winskel, University of Cambridge;

Lewis Wolpert FRS, University College London;
Phil Woodruff FRS, University of Warwick.

Now cheer yourself up by reading Captain Cook’s Grant Application.

Follow-up

Scientists should sign the petition to help humanities too. See the Humanities and Social Sciences Matter web site.

Nobel view. 1. Andre Geim’s speech at Nobel banquet, 2010

"Human progress has always been driven by a sense of adventure and unconventional thinking. But amidst calls for “bread and circuses”, these virtues are often forgotten for the sake of cautiousness and political correctness that now rule the world. And we sink deeper and deeper from democracy into a state of mediocrity and even idiocracy. If you need an example, look no further than at research funding by the European Commission."

Nobel view. 2. Ahmed Zewail won the 1999 Nobel Prize in Chemistry. He serves on Barack Obama’s Council of Advisors on Science and Technology. He wrote in Nature

“Beware the urge to direct research too closely, says Nobel laureate Ahmed Zewail. History teaches us the value of free scientific inquisitiveness.”

“I have emphasized that without solid investment in science education and a fundamental science base, nations will not acquire the ground-breaking knowledge required to make discoveries and innovations that will shape their future.”

“Preserving knowledge is easy. Transferring knowledge is also easy. But making new knowledge is neither easy nor profitable in the short term. Fundamental research proves profitable in the long run, and, as importantly, it is a force that enriches the culture of any society with reason and basic truth.”

How many more people have to say this before the Research Councils take some notice?

Jump to follow-up

The press may like to portray students as irresponsible and revolting . When I visited the occupied Jeremy Bentham room last week, i got a very different impression. That was more than confirmed yesterday (29 November). The students aren’t just sitting around grumbling. They have organised a very impressive series of events. Here is yesterday’s programme.

I volunteered to discuss with them some ideas of what could be done to further their aims. It was the same day that our letter came out in the Daily Telegraph, that pointed out the foolishness of deciding on funding before deciding what form universities should have in the future, I also suggested some possible changes along the lines of those proposed in the Times in October.

DC at UCLoccupation

I didn’t talk for long and the discussion that followed was lively and constructive. It was about education, not revolt.

I was asked if I’d like to come back a bit later for group discussions, so I did. I found the students had split into groups. It could well have been an academic conference.

group at uclocc

There was a cheerful but entirely serious discussion about what universities should be doing, about teaching methods and about research. There was also discussion about how the good atmosphere could be continued when the occupation eventually ends. Perhaps the most obvious thing is that the students were enjoying immensely being thrown together with people from other disciplines, whom they would never have met otherwise. There were two scientists in the group I joined, the rest being from a whole range of disciplines.

It is to the credit of UCL that they haven’t brought in bailiffs or cut off access to toilets. So a lot more sensible than Warwick university’s management for example. An email was shown on the screen from Rex Knight, vice provost (operations) who seems to have been put in charge of mediation. He’s the one who refused to do anything about it when HR were advertising for people trained in that curious form of psychobabble/pyramid selling scheme, neurolinguistic programming. He decined to meet the students. These days, you just can’t get the staff.

You can just walk in and out of the Jeremy Bentham room quite freely. Some students left for lectures and then returned. Others were away that afternoon on a demonstration outside TopShop on Oxford Street. If people like Top Shop owner Philip Green paid the taxes that they should do, the crisis might not be as bad as it is.

And between the earnest intellectual stuff they have fun too. This is the dance-off against the Oxford occupation.

And this is their weekend Ceilidh

Their blog is impressive. as is their organisation. They they have an events organiser with their own email address. You can follow the activities on Twitter @ucloccupation. In just a few days they have picked up more followers on Twitter than I have,

Even the BBC reporter, Sean Coughlan, sees this a something a bit different.

These are well-dressed, articulate youngsters, there’s no damage to the room, and the occupation leaflets are mixed up with sleeping bags and text books about biology and Spanish grammar.

This looks like a revolution that probably does the hoovering when it’s finished. Any stereotypes about rent-a-rioter are way off the mark.

,

It’s the Hogwarts kids, with their strong sense of right and wrong, who are now putting up the barricades.

And they seem as distant from the old left as they do from the new right.

This could be the best educational experience of the year for some of them, and they were making the most of it.

It is really rather beautiful.

Follow-up

Sad to say. UCL’s management soon managed to lose the moral high ground and went to court to evict the students. Their blog says

On Friday 3rd December two students on behalf of the UCL Occupations attended a hearing to resist the university’s application for a possession order. After almost an hour of legal debate, the judge acknowledged the occupying students’ rights to freedom of expression and freedom of assembly and concluded that no possession order could be granted without a full hearing of all the legal arguments. The hearing has been adjourned till Tuesday 7th December at 10:30am.

6 December 2010.Hobbled into work, for hospital appointment. The Slade School of Art is now occupied too. The signs are quite, eh, artistic.

slade

One problem with the Browne report is that it didn’t consider the whole picture. It looked only at how to fund universities as they are now, and concluded that arts and humanities weren’t worth funding at all. What it failed to do (and to be fair, it wasn’t asked to do) was think what universities should be like. Perhaps that is just as well, given Browne’s views, but it means that the job is only half done.

I have argued that the present system, which was essentially dictated by John Major’s conservative government, is simply not working for an age when 45 percent of kids go into higher education. It makes no sense to decide on a funding mechanism before deciding what sort of university system we want.

Michael Collins is a lecturer in 20th Century history at UCL. On November 23rd he wrote a very interesting piece on the OpenDemocracy web site, Universities need reform – but the market is not the answer. He said

“As students begin a wave of occupations in university campuses across the UK, Michael Collins argues that academics should stand united in determined opposition to government cuts, but at the same time make a positive contribution to thinking about how the existing system of teaching and research can be reformed and restructured.”

His suggestions have much in common with mine, though mine were a bit more specific. I wrote about some concrete proposals in the Times Thunderer column. This is available without pay wall on this blog. (this was  on October 11th, before the Browne report was published). .I immediately contacted Collins and we met on 25 November and the same day he published, again on OpenDemocracy, We need a Public Commission of Enquiry on the future of higher education. That was distilled into a letter and I spent most of the next day trying to get some support from scientists. A Saturday close to Christmas isn’t the best time to get responses to emails, but the result was satisfactory nonetheless.

On Monday 29th November the letter appeared in the Daily Telegraph

We need a Public Commission of Enquiry on the future of higher education

It is clear from the scale of last week’s largely peaceful demonstrations across Britain that there is an enormous amount of concern amongst young people over the future of higher education. They are not alone.

A wide range of commentators, politicians, public figures and academics have expressed closely argued reservations about the government’s attempt to rush through changes, the far-reaching consequences of which are so uncertain and potentially so damaging.

Within universities there is considerable unease about what reforms based on the Browne report will mean. How might a ‘supply and demand’ model for arts and humanities funding function in practice? Education and research institutions cannot be set up, shut down and restarted according to market demand. With so much uncertainty about future employment prospects and economic conditions, student numbers will ebb and flow. Higher education needs greater stability.

The Higher Education Policy Institute (HEPI) ­ a respected independent think tank ­ has pointed out that the government’s proposals for higher education funding “will increase public expenditure through this parliament and into the next”. The income stream from repayments ­ which is supposed to form the long term basis for funding ­ will not come back to the treasury for many years to come.

This weakens the argument that planned changes to higher education funding are necessarily concurrent with a deficit reduction strategy in this parliament. The pledges on university tuition fees made at the 2010 general election mean the mandate for change is weak. We therefore do not believe that present circumstances are propitious for far reaching reforms.

Instead, we propose the government set up a Public Commission of Enquiry, which should include wide consultations with politicians, academics, students, business leaders and others to examine the function and funding of higher education from first principles.

Such an approach would be more likely to produce the consensus required to make reform deliverable and place the future of UK higher education on a sustainable footing.

Sir Harold Kroto KCB FRS, Emeritus Professor of Chemistry, University of Sussex (Nobel Prize 1996)

Sir Christopher Bayly FBA FRSL, Vere Harmsworth Professor of Imperial History, University of Cambridge

Hermione Lee CBE FBA FRSL, Goldsmith’s Professor of English Literature, University of Oxford (1998-2008)

John Dainton FRSA FRS, Sir James Chadwick Professor of Physics, University of Liverpool

Christopher Pelling FBA, Regius Professor of Greek, University of Oxford

Quentin Skinner FBA, Barber Beaumont Professor of the Humanities, University of London

Linda Colley FBA, Shelby M.C. Davis 1958 Professor of History, Princeton University

Jonathan Tennyson FRS, Massey Professor of Physics, University College London

Christopher Wickham FBA, Chair of the Faculty of History, University of Oxford

Richard Carwardine FBA, Rhodes Professor of American History, University of Oxford (2002-2009)

Mary Beard FBA, Professor of Classics, University of Cambridge

Steve Jones, Professor of Genetics, University College London

Stefan Collini FBA, Professor of English Literature, University of Cambridge

David Colquhoun FRS, Professor of Pharmacology, University College London

Robert Gildea FBA, Professor of Modern History, University of Oxford

J. N. Adams FBA, Emeritus Fellow, All Souls College, University of Oxford

The letter in the Telegraph was accompanied by a front page story (despite competition from Wikileaks and the snow).

telegraph-story

For a Tory newspaper, it was surprisingly sympathetic.

Meanwhile, the student occupations continue. More of that in the next post.

Follow-up

Jump to follow-up

The mainstream media eventually catch up with bloggers. BBC1 TV (Wales) produced an excellent TV programme that exposed the enormous degree validation scam run by the University of Wales. It also exposed the uselessness of the Quality Assurance Agency (QAA). Both these things have been written about repeatedly here for some years. It was good to see them getting wider publicity.

Watch the video of the programme (Part 1, and Part 2) "Week In Week Out – University Challenged." “The programme examines how pop stars and evangelical Christians are running colleges offering courses validated by the University of Wales.” (I make a brief appearance, talking about validation of degrees in Chinese Medicine).

U of W

In October 2008 I posted Another worthless validation: the University of Wales and nutritional therapy. With the help of the Freedom of Information Act, it was possible to reveal the mind-boggling incompetence of the validation process used by the University of Wales.

McTimoney College of Chiropractic

The Chiropractic “degrees” from the McTimoney College of Chiropractic are also validated by the University of Wales by an equally incompetent, or perhaps I should say bogus, procedure. More details can be found at The McTimoney Chiropractic Association would seem to believe that chiropractic is “bogus”, and in a later post, Not much Freedom of Information at University of Wales, University of Kingston, Robert Gordon University or Napier University.

Andy Lewis has also written about chiropractic in The University of Wales is Responsible for Enabling Bogus* Chiropractic Claims to be Made.

Sadly the BBC programme did not have much to say about these domestic courses, but otherwise it was excoriating. In particular it had extensive interviews with Nigel Palastanga, whose astonishing admission that courses were validated withour seeing what was taught on them was revealed here two years ago. After that revelation, the vice-chancellor of UoW, Marc Clement BSc PhD CEng CPhys FIET FInstP, promoted Palastanga to be pro-vice-chancellor in charge of Learning, Teaching and Enhancement (I know, you couldn’t make it up).

Palastanga

In the documentary Palastanga said

"It’s a major business. We earn a considerable amount of money."

That was obvious two years ago, but it’s good to hear it from the horse’s mouth.

After a section that revealed a bit about what goes on at two very fundamentalist bible colleges which gave University of Wales degrees, A. C. Grayling commented thus.

"They are there to train advocates for the biblical message and that is absolutely not, by a very very long chalk, what a university should be doing.. . . A respectable British Higher education institution like the University of Wales shouldn’t be touching them with a bargepole."

Undaunted, Palastanga responded

“That’s his opinion. I would say they are validated to the highest standards. They match what are called QAA benchmark. We have serious academics looking at them, and their academic standards are established at the very highest level.”

And if you believe that, you will truly believe anything.

You can download here one of many moderator’s reports obtained under the Freedom of Information Act. This one is for the BSc (Hons) Chiropractic. It is entirely typical of theuncritical boxticking approach to validation, Nowhere does it say "subluxation is nonsense", though even the GCC now admit that.

Traditional Chinese Medicine

The University of Wales validates several courses in what almost everyone but them classifies as quackery. As well as chiropractic and “nutritional therapy”, there is herbalism. For example a course at a college in Barcelona issues University of Wales degrees in Traditional Chinese medicine, a subject that is a menace to public health.. I was asked to comment on the course, and on a bag of herbs that the presenter had been sold to treat depression.

Radix Bupleuri Chinensis
Radix Angelicae Sinensis
Radix Paeoniae Lactiflorae
Rhizoma Atractylodis Macrocephalae
Sclerotium Poriae Cocos
Radix Glycyrrhizae Uralensis
Cortex Moutan Radicis (Paeonia Suffruticosa)
Fructus Gardeniae Jasminoidis
Herba Menthae Haplocalycis
Zingiber officinale rhizome-fresh
herbs
Ingredients of a custom mixture.

There is no good evidence that any of the ingredients help depression, in fact next to nothing is known about most of them, apart from liquorice and ginger. Swallowing them would be rather reckless. They fall right into the description of any herbal medicine, in the Patients’ Guide, "Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety. "

Univ Wales prog

Of the degrees, I said

"There’s no evidence that it [the herbs] does you any good. It may be dangerous because you have no idea of the dose. Degrees in Chinese Medicine consist of three years spent memorising myths and pre-scientific, er, untruths. That isn’t a degree, it’s a travesty."

Palastanga. responded

"We’ve had long debates in the Health Committee about where we would draw the line about what we validate. They have to demonstrate to us that there is some scientific basis for the practice, that there is an established curriculum, that there is an established safe practice."

The presenter asked him "So you are confident that Chinese medicine works? Palastanga replied

" I didn’t say that. I said that there is evidence that it does work . . We are trying to enforce these professions to undertake effective research."

That statement is simply not true, as shown by the response of the validation committee to the application for validation of the course in “Nutritional Therapy” at the Northern College of Acupuncture, documented previously. The fact of the matter is that the validation proceeded without looking at what was actually taught, and without even a detailed timetable of lectures. The committee looked only at the official documents presented to it and was totally negligent in failing to discover some of the bizarre beliefs of the people who were giving the course.

Palastanga went on to raise the usual straw man argument, about how little regular medicine is based on good evidence (though admittedly that is certainly true in his own field -he is a physiotherapist).

Fazley International College Kuala Lumpur

Fazley

This business college in Kuala Lumpur offered University of Wales degrees. Its 32-year old president is a part time pop star with impressive looking qualifications

Fazley 2

The presenter pointed out that

" His doctorate and his MBA were awarded in that citadel of education, Cambridge. Here he is, pictured at the city’s prestigious business school. He was there for all of four days and walked away with a doctorate. But the degree was not from the University of Cambridge, but from the now defunct "European Business School Cambridge". It never had the right to award degrees."

Neither the University of Wales nor the QAA had noticed this unfortunate fact. Once the TV team had done their job for them, the UoW withdrew support. though, as of 15 November 2010, that is not obvious from Fazley’s web site.

Mr (not Dr) Fazley seemed rather pleased about how students were attracted by the connection with the Prince of Wales. The fact that he is Chancellor of the University of Wales seems not inappropriate, given the amount of quackery they promote.

Quality Assurance Agency (QAA)

In 2007, I wrote, in Nature (see also here),

“Why don’t regulators prevent BSc degrees in anti-science? The Quality Assurance Agency for Higher Education (QAA) claims that “We safeguard and help to improve the academic standards and quality of higher education in the UK.” It costs taxpayers £11.5 million (US$22 million) annually. It is, of course, not unreasonable that governments should ask whether universities are doing a good job. But why has the QAA not noticed that some universities are awarding BSc degrees in subjects that are not, actually, science? The QAA report on the University of Westminster courses awards a perfect score for ‘curriculum design, content and organization,’ despite this content consisting largely of what I consider to be early-nineteenth-century myths, not science. It happens because the QAA judges courses only against the aims set by those who run the QAA, and if their aims are to propagate magic as science, that’s fine.”

That was illustrated perfectly in the documentary when Dr Stephen Jackson of the QAA appeared to try to justify the fact that the QAA had, like the University of Wales, failed entirely to spot any of the obvious problems. He had a nice dark suit, tie and poppy, but couldn’t disguise the fact that the QAA had given high ratings to some very dubious courses.

The QAA sent nine people to the other side of the globe, at a cost of £91,000. They could have done a lot better if they’d spent 10 minutes with Google at home.

Universities UK (UUK)

Needless to say, the Committee of Vice-Chancellors and Principals has said nothing at all. As usual, Laurie Taylor had it all worked out in Times Higher Education (4th November).

Speaking to our reporter Keith Ponting (30), he commended UUK’s decision to say absolutely nothing whatsoever about the abolition of all public funding for the arts and humanities.

He also praised UUK’s total silence on Lord Browne’s view that student courses should primarily be evaluated by their employment returns.

When pressed by Ponting for his overall view of UUK’s failure to respond in any way at all to any aspect of the Browne Review, he described it as “welcome evidence, in a world of change, of UUK’s consistent commitment over the years to ineffectual passivity”.

Meanwhile, a University of Wales video on YouTube

UOW video

Caveat emptor

Follow-up

A couple of days later, a search of Google news for the “University of Wales” shows plenty of fallout. The vice-chancellor claims that ““The Minister’s attack came as a complete and total surprise to me”. That can’t be true. It is over two years since I told him what was going on, and if he was unaware of it, that is dereliction of duty. It is not the TV programme that brought the University into disrepute, it was the vice-chancellor.

Jump to follow-up

The Prince of Wales’ Foundation for Integrated Health shut down amidst scandal in April 2010. In July, we heard that a new “College of Medicine” was to arise from its ashes. It seemed clear from the people involved that the name “College of Medicine” would be deceptive.

Now the College of Medicine has materialised, and it is clear that one’s worst fears were well justified.

coll med logo

At first sight, it looks entirely plausible and well-meaning. Below the logo one reads

“There is a new force in medicine. A force that brings patients, doctors, nurses and other health professionals together, instead of separating them into tribes.”

"That force is the new College of Medicine. Uniquely, it brings doctors and other health professionals together with patients and scientists.”

It is apparent from the outset that the well-meaning words fall into the trap described so clearly by James May (see What ‘holistic’ really means). It fails to distinguish between curing and caring.

As always, the clue lies not in the words, but in the people who are running it.

Who is involved?

After a bit of digging on the web site, you find the names of the people on the Science Council of the “College of Medicine”, The preamble says

“Good medicine must be grounded in good science as well as compassion. The College’s Science Council brings a depth of knowledge from many senior figures.”

But then come the names. With the odd exception the “science council” is like a roll-call of quacks, the dregs left over from the Prince’s Foundation. The link (attached to each name) gives the College’s bio, My links tell a rather different story.

It seems that the "Scientific Council" of the College of Medicine could more properly be called an "Antiscientific Council".

There are a few gaps in this table, to be filled in soon. One can guarantee that a great deal more will appear about the College on the web, very soon.

The Governing Council of the College is equally replete with quacks (plus a few surprising names). It has on it, for example, a spiritual healer (Angie-Buxton King), a homeopath (Christine Glover), a herbalist (Michael McIntyre). Westminster University’s king of woo (David Peters), not to mention the infamous Karol Sikora. Buxton-King offers a remarkable service to heal people or animals at a distance.

Meanwhile, it seemed worthwhile to provide a warning that the title of the College is very deceptive. It hides an agenda that could do much harm.

It is, quite simply, the Prince of Wales by stealth.

Follow-up

28 October 2010

Professor Sir Graeme Catto, who has, disgracefully, allowed his name to be used as president of this “College” has said to me “There are real problems in knowing how to care for folk with chronic conditions and the extent of the evidence base for medicine is pretty limited”.

Yes of course that is quite true. There are many conditions for which medicine can still do little. There is a fascinating discussion to be had about how best to care for them. The answer to that is NOT to bring in spiritual healers and peddlers of sugar pills to deceive patients with their fairy stories. The “College of Medicine” will delay and pervert the sort of discussion that Catto says, rightly, is needed.

29 October 2010

I need a press card. I see that the BMJ also had a piece about the “College of Medicine” yesterday: Prince’s foundation metamorphoses into new College of Medicine, by Nigel Hawkes. He got the main point right there in the title.

As was clear since July, the driving force was Michael Dixon, Devon GP and ex medical director of the Prince’s Foundation. Hawkes goes easy on the homeopaths and spiritual healers, but did spot something that I can’t find on their web site. The “Faculties” will include

“in 2011, neuromusculoskeletal care. Two of the six strong faculty members for this specialty are from the British Chiropractic Association, which sued the author Simon Singh for libel for his disobliging remarks about the evidence base for their interventions.”

The College certainly picks its moment to endorse chiropractic, a subject that is in chaos and disgrace after they lost the Singh affair.

One bit of good news emerges from Hawkes’ piece, There is at least one high profile doubter in the medical establishment, Lord (John) Walton (his 2000 report on CAM was less than blunt, and has been widely misquoted by quacks) is reported as saying, at the opening ceremony

“I’m here as a sceptic, and I’ve just told my former houseman that,” he said. The target of the remark was Donald Irvine, another former GMC president and a member of the new college’s advisory council.”

31 October 2010. I got an email that pointed out a remarkable service offered by a member of College’s Governing Council. Angie Buxton-King, a “spiritual healer” employed by UCLH seems to have another web site, The Beacon of Healing Light that is not mentioned in her biography on the College’s site. Perhaps it should have been because it makes some remarkable claims. The page about distant healing is the most bizarre.

Absent Healing/Distant Healing

"Absent healing is available when it is not possible to visit the patient or it is not possible for the patient to be brought to our healing room. This form of healing has proved to be very successful for humans and animals alike."

"We keep a healing book within our healing room and every night spend time sending healing to all those who have asked for it. We have found that if a picture of the patient is sent to us the healing is more beneficial, we also require a weekly update to monitor any progress or change in the patients situation. Donations are welcome for this service."

I wonder what the Advertising Standards people make of the claim that it is “very successful”? I wonder what the president of the College makes of it? I’ve asked him.

Other blogs about the “College of Medicine”

30 October 2010. Margaret McCartney is always worth reading. As a GP she is at the forefront of medicine. She’s written about the College in The Crisis in Caring and dangerous inference. She’s also provided some information about a "professional member" of the College of Medicine, in ..and on Dr Sam Everington, at the Bromley by Bow Centre….

It is one of the more insulting things about alternative medicine addicts that they claim to be the guardians of caring (as opposed to curing), They are not, and people like McCartney and Michael Baum are excellent examples.


19 January 2011

Prince of Wales to become honorary president of the “College of Medicine?”

Last night I heard a rumour that the Prince of Wales is, despite all the earlier denials, to become Honorary President of the “College”. If this is true, it completes the wholesale transformation of the late, unlamented, Prince’s Foundation for Integrated Medicine into this new “College”. Can anybody take it seriously now?

Text messages to Graeme Catto and Michael Dixon, inviting them to deny the rumour, have met with silence.

Herbal nonsense at the College

29 July 2011. I got an email from the College if Medicine [download it]. It contains a lot of fantasy about herbal medicines, sponsered by a company that manufactures them. It is dangeroous and corrupt.

This is part 2 of a critique of Steiner Waldorf schools. Part 1 was The true nature of Steiner (Waldorf) education. Mystical barmpottery at taxpayers’ expense. Part 1

The part 3 is Steiner Waldorf Schools Part 3. The problem of racism.


This essay is largely devoted to the methods used by the Steiner movement in the hope of getting state funding. That involves concealing from ministers and inspectors some of the less desirable aspects of the cult. That is sadly easy to do, because ministers and inspectors usually use a tick box approach that can easily be corrupted (just have a look, for example, at what goes on at the University of Wales). It is a classical case of bait and switch, a method that was used by chiropractors and acupuncturists to pervert the normally high standards of NICE. The technique is standard in alternative medicine, as described by the excellent Yale neurologist Steven Novella, in The Bait and Switch of Unscientific Medicine..

Steiner 1905
Steiner’s bible of the cult, 1905

The involvement of a few universities with Steiner training is every bit as disgraceful as their involvement with quack medicine, In fact Anthroposophical medicine is among the barmier forms of quackery.

Here is part 2 of the essay by two of the most knowledgeable people on the topic. They are known on Twitter as @thetismercurio and @lovelyhorse_.

 

Steiner Waldorf Free Schools – ‘Do we have to mention Steiner, or Anthroposophy?’

At the time of writing we are aware of 16 Steiner Waldorf schools and new initiatives in the UK applying for or publicly expressing interest in Free School Funding. The established schools are:

Initiatives & kindergartens:

The umbrella organisation for Steiner Waldorf schools in the UK is the Steiner Waldorf Schools Fellowship. The Chief Executive Director of the SWSF is Christopher Clouder but another prominent figure is Development Director Sylvie Sklan. As representatives of the SWSF they have been the plausible public face of Anthroposophy, working for many years within the establishment to create the conditions for wholesale public funding of Steiner Waldorf schools in the UK. As pragmatists they see Michael Gove’s Free Schools Initiative as the Movement’s big chance.

We will take you into the woods to show how the Steiner edifice of nonsense has been obscured by smoke and mirrors. A government report indicates the truth, but the schools themselves are reluctant to share their Special Knowledge.

Into the Woods. A government report, and a very special inspection service

There is no independent evidence to support the pedagogy of Steiner Waldorf education. But supporting the funding of the Steiner Academy Hereford, the only state funded Steiner school to date (created under New Labour), is a government report from 2005, The Woods Report ‘Steiner Schools in England’. Mike Collins of UK Anthroposophy, home to some meticulous investigative work, demonstrates how the Woods Report describes Steiner Waldorf as Anthroposophical education.

In fact the Report’s authors are unusually candid about the occult nature of Steiner schools. They also, elsewhere, make no secret of their own immersion in the ‘spiritual’ assuming a common understanding of that ambiguous word, a word which is rarely defined. But whether or not they are themselves to any degree adherents of Anthroposophy, they clearly believe that education would benefit from Steiner’s spiritual vision, stating in the Forum Journal in 2006:

"The point is that Steiner education offers a distinctive process of opening and nurturing children and educating the whole child in the twenty-first century."

There is, in the Woods Report, an elaboration of the pivotal role of karma and reincarnation [p93] a description of the use of ‘temperaments’ to classify children [p89] and of the variance in the precise nature of allegiance to Anthroposophy amongst teachers [p94] (as observed in our first post: reflecting the nature of an esoteric religion). But ‘Steiner says’ is nevertheless the dominant code:

"Steiner’s lectures are referred to and teachers constantly update themselves on the pedagogical principles outlined by Steiner, testing these in the practice of collegial discussion.” [p105]"

This should be no surprise:

“Steiner education takes a particular perspective and entails a set of practices which relate to each other in order to give Steiner schools their character. These include the role of the teacher understood as a sacred task in helping each child’s soul and spirit grow, which underpins the commitment to each pupil and is the basis of sustaining the class teacher-pupil relationship over eight years” [p120]

This may strike the reader as rather an unusual educational aim, especially if a school is not formally classed as a ‘faith’ or religious school. Would it not take sophistry to maintain that this is not an essentially religious impulse? (It does. p97/125/129) But we must remember that we are handicapped by our ignorance of Spiritual Science. The clue is given by one of the Steiner teachers quoted, who suggests what is needed is to:

“communicate to [the] wider educational community that in essence Steiner education is a spiritual approach beyond religion” [p116]

To do them justice, in other published work the Woods are cautious, although this problem strikes us as inevitable:

“None of this should be taken to mean that Steiner schools achieve their ideals or are entirely without their flaws. Many teachers, in our view, are too dependent on following the guidance and ideas of Steiner as if they were ‘sacred’ directions.” ‘In Harmony with the child’: Philip A Woods & Glenys J Woods: Forum 48/3 2006

The Woods Report ignores the consequences for children of teachers’ adherence to the anthroposophical belief in karma and reincarnation. It is obvious that the potential for harm has not been recognised, nor taken seriously by those who should have read the Report. Instead it has been accepted that because the pedagogy is ‘spiritual’ it must be good: and the Hereford Academy has been handed funds, allowed exemptions (including the freedom to teach Steiner’s ‘Goethean science’) and stands as the precedent for further expansion of Steiner Waldorf into the State sector.

What kind of barmpottery would be too extreme for the Woods? The fact that Glenys Woods maintains she is a Reiki Healer (Angelic and Atlantaen) suggests that her beliefs about what is real would seem extravagant to those working within even the most complex and nuanced concepts of modern neuroscience.

The Woods Report suggests that Anthroposophy should be better understood by educationalists and parents; the writers clearly believe that, as a spiritual entity, it is of value. But they also attempt to diffuse the presence of Anthroposophy by stating that the “curriculum is not designed to guide and encourage young people into becoming adherents of anthroposophy…” [p120] which may appear to lessen the obligation to know what it is. When we are told the disingenuous line: ‘Anthroposophy is not taught to the children”, we should not forget that it is not explained to prospective parents either, even if there may be a few (ill-attended & bewildering) study groups for parents who have already joined. It isn’t explained to the government officials who anyway appear so incurious, or to taxpayers. We have none of us earned the right to the Movement’s Special Knowledge.

But Ofsted understands this. It knows it is not qualified.

As of September 2009 Steiner schools in the UK have been inspected not by Ofsted, who used to do so but by the Schools Inspection Service. The SIS inspects only two types of schools: those run by the Exclusive Brethren and now Steiner Waldorf.

The lay Inspectors in each case are expected to understand the distinct character of the schools. In the case of Steiner Waldorf, they have all been connected in some way with Steiner schools or with the Anthroposophical Movement.

Ofsted, which we believe feels unqualified to understand the pedagogy, has effectively allowed Steiner Waldorf schools greater powers to inspect themselves.

Free school funding relies on these inspections: the results of which are rather more positive under the new regime.

The Hereford Steiner Academy – the Academy nobody wanted.

 
The only state funded Steiner school in the UK has already caused controversy. Francis Beckett wrote in the Guardian in 2008 that former director of education Eddie Oram had turned down initial plans submitted on his watch because “he did not think the Steiner staff had the right expertise to deal with pupils with individual needs.”

Oram’s proof of evidence: to the Public Inquiry for the original applications by the DCSF to build a new school for the Steiner Academy, is comprehensive. There is no need, no desire and no justification for such a school in Herefordshire, especially in the village of Much Dewchurch. The Project Lead for the DCSF, sponsoring the Academy, was the Rev. Mark Evans, a church of England priest on secondment to the Department. His proof of evidence glowed with praise for Dr. Steiner:

“The outcomes of this education can be seen in the quiet confidence of its pupils, their balanced approach to life and their capacity for innovative thinking.”

But the Rev. Evans produced no evidence for this assertion, nor did he mention karma, or reincarnation. This seems a significant omission; he was in all probability unaware of the nature of the pedagogy he was selling.

The Hereford Steiner Academy site does mentions Anthroposophy, although to find it involves a little searching. The assertion that “Anthroposophy is a developing body of research”, as stated here by Hereford, should rightly be disputed. Essentially Anthroposophy is dogma; gained through ‘clairvoyance’, inherited by studying Steiner’s words, comprehended by those ascending the ladder of esoteric Knowledge. But something has to be said about it, now the Movement is forced to do so.

The Steiner Academy followed one of the recommendations of the Woods Report: unusually for a Steiner school it has a Principal, Trevor Mepham. In a long exposition to ‘Herefordshire Life’ on the nature of Steiner Waldorf education, Mepham misses the chance to satisfy another of the Woods Report’s suggestions: he doesn’t explain, by name, the system’s fundamental credo.

Free School Hopefuls

The current group of Steiner Free School hopefuls vary in their willingness to discuss Anthroposophy. As an example, on the website of the Norwich Steiner School Anthroposophy is not mentioned, although in reality it is never absent. The Norwich curriculum policy describes the pedagogy without mentioning its essence but we catch stray glimpses of angelic forms. So, a moral aim is to cultivate ‘reverence’ for nature, the children stand not in a doorway but on a ‘threshold’ and ‘The narrative thread for Ancient civilisations often begins with the fall of Atlantis’.

In the March 2010 newsletter from Norwich (‘Talking Trees’) there is an observation by a class teacher which exemplifies the Steiner Waldorf attitude to less spiritual forms of education: 

“I look at the children in Oak Class and see a luminosity that cannot be measured. When we do measure children, we diminish that luminosity. The world seems to be full of children whose inner light has been subdued, if not entirely extinguished.”

There is at the time of writing no mention of Anthroposophy on the website of the Rudolf Steiner School South Devon, except towards the end of the parents’ handbook. Although this is hard for outsiders to find, the handbook’s author still neglects to describe karma and reincarnation and includes the unusual proviso that this is ‘not a cult’. South Devon has stated on its site:

“The department [DofE] appears to be impressed by our application, in particular what they call our "strong educational vision". But before they can proceed to the next step they have asked to see stronger evidence of demand for Steiner education in the area, including from those outside the school community. They would prefer this to be in the form of a petition.”

Many of those who have agreed to sign the South Devon petition have done so in ignorance of even the name of the ‘philosophy’ that is so vital to the school, imagining that their plausible description of Steiner Waldorf is sufficient.  

In a ‘circle meeting’ held at the South Devon School in 2008, found on the web, someone even asks the question: “Do we need to mention Steiner, or Anthroposophy?” It’s hard to lose the guru’s name without changing all the signs. But surely local people might be put off if they understood how the education at this school is intimately informed by the clairvoyant visions of the Mystic Barmpot. We’ve screenshot the site, in case there are any alterations.

This concern about mentioning Anthroposophy is driven by a fear that an undercurrent of critical analysis will become mainstream.

Critics

We trust we presented in our previous post a description of Steiner Waldorf Education that identifies the intrinsic role of Anthroposophy, making the system and its flaws intelligible, but we are not suggesting that our observations are original.

Not only have there been comprehensive posts about Steiner schools on the popular political blog Liberal Conspiracy (with much additional material from Unity, including the 5 Big Ideas of science that Steiner education can’t handle); there has been in the last few years an international stream of criticism from those who have experienced Waldorf pedagogy and its effects on families. Ex-parents, students and teachers of Steiner Waldorf schools have appeared on-line, seeking answers; making sense of their own distressing experiences, expressing bewilderment and anger and frequently offering support to others.

Their words appear on blogs, on internet forums and in the press in some countries, although no UK journalist has so far grasped the significance of their warnings. What should be reiterated is that it is difficult to make sense of an esoteric (hidden) philosophy in action, even if you have chosen to be involved at its aesthetically  pleasing outer edges. For many parents, Waldorf is a form of bait and switch.

mumsnet: “You don’t expect a school to lie,”

In the New Schools Network document cited in our previous post, Free School hopefuls are advised how to advertise their projects: “Post something on mumsnet, netmums, or facebook.” If the NSN had done their homework, they would know that mumsnet Steiner threads have been so controversial (and incomprehensible to those not involved) that in 2008 parents were asked by mumsnet’s co-founder Justine Roberts not to post about Steiner education at all. Indeed the forum was threatened with legal action by Sune Nordwall, (also known as Thebee, Tizian, Excalibur, Mycroft etc) a Swedish anthroposophist; since discovered to be in the employment of the Swedish Waldorf School Federation. Blogger Alicia Hamberg aka zooey quotes (in translation):

“In England, the attacks on [waldorf] pedagogy have led to parents withdrawing their children from the waldorf schools. The [Swedish Waldorf School] Federation has employed Sune on a part-time basis to monitor the debate.”

We do not suggest on this blog that the Swedish Waldorf School Federation are responsible for or complicit in Nordwall’s activities on mumsnet or elsewhere, although as Alicia Hamberg points out, they have not sought to distance themselves from his behaviour. What is notable though is that representatives of Waldorf education in Sweden were concerned to monitor a UK debate held not in the press but in the relative obscurity of the supposedly safe, supportive world of mothers‘ chatrooms. The Steiner Waldorf movement understands the importance of a positive profile on the UK’s most influential meeting place for parents; the very people who form their customer base. But their tactics are counterintuitive. In anthro-speak everywhere, critics, the majority of whom are parents who have had children in Steiner schools, become attackers.

Even the Steiner Waldorf Schools Fellowship’s Communications Officer Jeremy Smith felt drawn to issue a call-to-arms to rebuff those who dared to question Waldorf’s ‘good intentions’:

“I would be very grateful if teachers and parents who share these concerns would be willing to join me in posting replies to anti-Waldorf threads in an attempt to give a more accurate picture to the outside world of what Steiner education is all about. We are also co-ordinating this internationally through the European Council for Steiner Waldorf Education. Please contact me at smithj@rsskl.org if you are interested in becoming involved.”

We invite them to answer us here, instead.

Stockholm University: “scientifically unacceptable… simply untrue”

There are other interesting comparisons with Sweden. A recent announcement that UK Free Schools will not be required to employ qualified teachers indicates that the UK is traveling in the opposite direction to Sweden which, in an attempt to raise standards has just introduced more stringent teacher training requirements for all its schools, including Waldorf (the state funding of which pre-dates Sweden’s own Free Schools experiment). Swedish Waldorf schools will have to apply for exemptions from these guidelines (as well as from new requirements regarding early years literacy and numeracy), since there are no university accredited Waldorf teacher training courses in Sweden.

Indeed the aspirations of Swedish anthroposophists suffered a blow in 2008 when Stockholm University closed the Waldorf teacher training courses in the Institute of Education it had recently taken over. The VC of Stockholm, Kåre Bremer, agreed with his Education Faculty that the Waldorf literature did not satisfy the University’s standards of “scientific validity” and that “Some of the content is not only scientifically unacceptable, it is simply untrue.”

Alicia Hamberg described the ensuing outcry from the Waldorf community; quoting the dean of the faculty of natural sciences and professor of bio-chemistry, Stefan Nordlund, who stated in a Swedish newspaper article:

“In parts, the students’ course literature is not simply unscientific. It is in fact dangerous, and it conveys misconceptions which are worse than muddled. We are supported by the department of natural sciences as well as the department of humanities in taking this position.”

A relaxation of teaching qualifications here in the UK is essential if Steiner Free Schools are to be given the green-light, since the UK’s only Steiner BA and the Foundation Course in Steiner Early Years education at the University of Plymouth are also closing. Plymouth’s new VC, Prof Wendy Purcell, herself a scientist, can claim credit for ejecting the Mystic Barmpot from her faculty of education.  It is certainly true that the course didn’t attract sufficient numbers to be viable, even though it appears that Steiner trainee teachers were supported by the beneficence of a ‘godparents anthroposophical training fund.’

Mike Collins posted a fascinating investigative report into the Plymouth closures in November last year. At the time of writing this, a representative of the University told us that they have no plans to reintroduce Steiner teacher training. 

However: in a plot twist which links both countries, it is not Stockholm University (which had rejected their Steiner courses for being unscientific) but the University of Plymouth which is accrediting a European Masters Programme in Eurythmy, described as an anthroposophical ‘dance form’: in  collaboration with Rudolf Steiner University College Järna, 50 km South of Stockholm. Except that Rudolf Steiner College, Järna is not regarded as a university college by the Swedish National Agency for Higher Education, nor can it issue formally recognized degrees. We do not imagine that anyone at Plymouth outside the dwindling Steiner BA is familiar with eurythmy, or its therapeutic arm, curative eurythmy.

One of the aims of the European Masters course is: “to place Eurythmy in the context of modern education,” but this can only apply to Waldorf.

Eurythmy is a physical expression of Rudolf Steiner’s anthroposophical image of the relationship between the ‘spirit’ and the physical worlds. It is steeped in the supernatural. Of course what is happening in reality as participants sway and dash is not exactly what eurythmists imagine is happening, as anyone familiar with CAM will understand. But an intention clearly exists. Once again, in Steiner Waldorf schools, there is that anthroposophical concern for the ‘incarnating’ child.  As Steiner told his teachers:

“You cannot teach anthroposophy directly to children but they can do eurythmy. And they will face life in quite a different way than if they didn’t do eurythmy.”

From “Times of Expectation: New Forms of Ancient Beauty out of the World of the Spirit.” Lecture, Dornach, 7th October 1914 (final section). Steiner introduces eurythmy to the anthroposophists

Where are the teachers to come from for these new UK Steiner Free Schools? More to the point: will taxpayers have any access to the content of their courses?

Waldorf Critics: criticism and scandal

Steiner Waldorf causes scandals across the world. In Norway earlier this year, Kristín Sandberg and Trond Kristoffersen, both former Steiner Waldorf teachers, published their book:  "What They Don’t Tell Us = The Occult Foundation of the Steiner School." They have been part of a fierce debate, subject to threats from certain elements of the Steiner community, but Kristin is positive. What really matters to her, she says, are the many messages of support:

“…The young people, former pupils who twitter and blog – and send us sms´s and e-mails from all over Norway supporting the debate and reminding us that this is a really, really important thing to do.”

What they don't tell you
What They Don’t Tell Us. The Occult Foundation of the Steiner School

In Germany too, Steiner Waldorf has many critics. It’s interesting to reflect on the German Waldorf demographic, which suggests that their appeal lies in their status as ‘elite’ (although not academically elite) institutions.
 
In Australia, the introduction of ‘Steiner’ streams into public schools in the State of Victoria: ‘The Steiner Cult’s Grab for Schools’ has caused great controversy (see The delusional world of Rudolf Steiner). A document by the Australian Rationalist Society mirrors our initial post. After serious concerns were raised in a government report as long ago as 2000, and ignored; great division has been caused between parents in the schools involved and academic standards have proved to be low. Australian newspaper reports rehearse what will be in the news in the UK if Free School funding goes ahead for Steiner Waldorf. To quote from The Age:

“One parent, who did not wish to be named, said she moved her son out of the school after a Steiner teacher recommended he repeat prep "because his soul had not been reincarnated yet".

"I just don’t believe it is educationally sound," she said.”

Humanists are not the only Waldorf critics in Australia: some worry that Anthroposophy doesn’t sit happily with their Christian beliefs. Plus, independent Steiner schools have been accused of misappropriating Federal grants designed for new classrooms and libraries. It’s tempting to ask what use anthroposophists have for books.

In New Zealand, flaws in the accountability of independent schools compounds one family’s alarming treatment at the Titirangi Steiner School. Whether or not their experience is a direct consequence of Steiner pedagogy, the school’s reported ineptitude, delaying tactics and exclusion of children reflects behaviour familiar to many other Steiner Waldorf parents. 

But by far the most well-known site for analysis of Steiner Waldorf is the US based PLANS: People for Legal and Non-Sectarian Schools, an organization which opposes the presence of religious schools: Steiner Waldorf, informed by Anthroposophy, in American public education. It is difficult to imagine that any UK government intending to spend millions on funding a school system within Academy or Free Schools funding (and concerned with a responsibility to children regardless of the mantra ‘parent choice’) can have entirely overlooked the presence of such criticism, or of the existence of a Waldorf Survivors’ Group. Indeed, if they read the Woods Report, they will find PLANS featured there. (p35)

There are clues to the reasons for the generally positive Waldorf press in the US in a series of posts by artist and animation art director Carol Wyatt:

“The vast majority of parents at PWS [Pasadena Waldorf School] work in entertainment. Actors, producers, art directors, writers, and all others in TV, film and technology. Almost all tuitions are paid for by media. They could not function without our industry.”

The most comprehensive (and readable) critical guide to Anthroposophy’s relationship to Steiner Waldorf schools is at Roger Rawling’s ‘Waldorf Watch’. Rawlings was for many years a pupil at a New York Waldorf school, so he’s familiar with how it feels to be inside the system. His pages on Karma, central to Steiner’s doctrines, as well as those on the background to Waldorf’s distinct attitude to Special Educational Needs (including the use of Curative Eurythmy) are particularly instructive.

eurythmy
Eurythmy students 2008

Steiner Waldorf – “We must worm our way through”

Steiner Waldorf Schools all over the UK are applying for Free School funding. Millions could be diverted from local schools to support them. The decision to fund lies ultimately with the Secretary of State. We have every reason to believe that he is now personally aware of Anthroposophy, even of the critical role of karma and reincarnation within Steiner schools and the content of the course literature that forms a central part of Steiner Waldorf teacher training courses. We would like to ask him: who would be served by the funding of these schools? We do not believe it can be the children, or the families (many involved with hopeful, small initiatives) who do not understand what Steiner education really is. So, Mr Gove: cui bono?

“We must worm our way through…[I]n order to do what we want to do, at least, it is necessary to talk with the people, not because we want to, but because we have to, and inwardly make fools of them.”

Rudolf Steiner, Conferences with Teachers of the Waldorf School in Stuttgart, vol.1, 1919 to 1920 Forest Row, East Sussex, England: Steiner schools Fellowship Publications, 1986 [pp. 125]

Follow-up

Very sorry to see that the University of Aberdeen is running what seems to be a very dubious Steiner course.

Jump to follow-up

The proposals made here are intended to improve postgraduate education with little harm to undergraduate education and no extra cost. It is not intended to get the government off the hook when it comes to funding of either teaching or research. The recent Royal Society report, The Scientific Century: securing our future prosperity, makes it very clear that research funding in the UK is already low.

There is a good summary of the financial case at Science is Vital. Even before cuts the UK invested only 1.8% of its GDP in R&D in 2007. This is short of the UK’s own target of 2.5%, and further behind the EU target of 3.8%. If you haven’t already, sign their petition.

science is vital

The article reproduced here is the original 800-word version of proposals made already on this blog.

It was published today in The Times, in a 500 word version that was skilfully shortened by Times journalist, Robbie Millen [download web version, or print version] . It made the Thunderer column (page 22) It was written before I had seen the Browne report on University finance, Comments on that will be added in the follow-up.

Times-headline

Honours degrees have had their day

Universities have problems. The competition for research money is already intense in the extreme, and many excellent research applications get turned down.   Vice-chancellors want students to pay huge fees.  A financial crisis looms.  It is time for a rethink the entire university system.

The traditional honours degree has had its day

The UK’s honours degree system is a relic left over from the time when a tiny fraction of the population went to university.  The aim is now for half the population to get some sort of higher education, and the old system doesn’t work.  It tries to get children from school to the level where they can start research in only three years.  Even in its heyday it often failed to do that.  Now teachers in vastly bigger third year classes try to teach quite advanced stuff to students most of whom have long since decided that they don’t want to do research.  It’s just as well they decided that, because academia doesn’t have jobs for half the population.

The research funding system is strained to breaking point

Vince Cable’s cockup over the amount of money spent on mediocre science has long since been corrected   But despite the intense competition for research funds, anyone who listens to Radio 4’s Today Programme (I do), or reads the Daily Mail (I don’t) might get the impression that some pretty trivial research gets published.    One reason for this is that science reporters always prefer the simple and trivial to basic research.  But another reason is that the system places enormous pressure to publish vast amounts. Quantity matters more than quality.  The Research Assessment Exercise determines the funds that a university gets from government, and although started with the best of intentions, it has done more to reduce the quality of research than any other single change in the last 20 years. 

Promotion in universities is dependent on publication, and so is university funding.  Since 1992, when John Major’s government converted polytechnics into universities at a stroke of the pen, their staff too have been expected to publish to be promoted.  We need a lot of teachers to cope with 50 percent of the population, but there just aren’t enough good researchers to go round.  It is a truth universally acknowledged that advanced teaching should be done by people who are themselves doing research, but the numbers don’t add up. So what can be done?

Another way to organise higher education

The first essential is to abolish the honours degree (cue howls of outrage from the deeply conservative vice-chancellors).  It is simply too specialist for an age of mass education.  Rather, there should be more general first degrees. They should still, by and large, aim to produce critical thinking rather than being vocational, but cover a wider range of subjects to a lower level,

If this were done, the necessity to have the first degrees taught by active researchers would decrease.  Many of them could be taught in ‘teaching only’ institutions.  They could do it more cheaply too, if their staff were not under pressure to publish papers constantly.  It would take fewer people and less space.  It isn’t ideal, but I see no other way to increase the numbers in higher education without spending much more than we do now.

After the first degree, that modest fraction of students who had the ability and desire to get more specialist knowledge would go to graduate school.  There they could be taught at a rather higher level than the present third year of an honours degree, and be prepared for research, if that is what they wanted to do. 

Hang on though, isn’t it the case that UK Universities already have graduate schools?  Yes, but they are largely offshoots of HR that provide courses in advanced powerpoint and life-style psychobabble.  Vast amounts of money have been wasted in the “Roberts Agenda”.  What we need is real graduate schools that teach advanced stuff. Education not training.

There is another problem. It is very hard now for anyone in research to find time to think about their subject.  Most of their time is occupied writing grant applications (with 15% chance of success), churning out trivial papers and teaching.  If much of the lower level undergraduate teaching were to be done, more cheaply, in places that did little or no research, the saving would, with luck, fund the extra year for the minority who go on the graduate school.  The research intensive universities would do less undergraduate teaching. Their staff would have more time to do research and teach the graduate school.  They would turn into something more like Institutes of Advanced Studies. 

A lot of details would have to be worked out, and it isn’t ideal, just the least bad solution I can think of.  It has not escaped my attention that this system has some resemblance to that in the USA.  The USA does rather well in science.  Perhaps we should try it.

What we should not copy is the high fees charged in the USA.  Education is a public good, and the costs should be met by people paying according to their means. I think that is called income tax.

Follow-up

The Browne report is a retrogressive disaster

As I understand it. the recommendations not only remove the cap on fees but also make it more expensive for most people to repay loans. It is the most retrogressive thing that has happened in education in my lifetime. According to an analysis cited in the Guardian

“Graduates earning between £35,000 and £60,000 a year are likely to have to pay back more in fees and interest than those earning more than £100,000”

That is far to the right of anything that Mrs Thatcher contemplated. If it were to be adopted, it would be a national disgrace.

The Lib Dems are our only hope to stop the recommendations being implemented. They must hold the line.

15 October 2010.

It is getting clearer now. Numbers from the Social Market Foundation (SMF) were quoted in the Financial Times as showing that the rich pay less than the poor for their degrees. At first the Institute of Fiscal Studies (IFS) seemed to disagree. Now the IFS has rethought the analysis and there is little difference between the predictions of the liberal (SMF) and conservative predictions, There is, unsurprisingly, some difference in the spin. ISF says that you only pay less in the top two deciles of lifetime income, ie. the top 20 percent. That’s not quite the point though.

Both analyses agree that anyone above the median income pays back much the same (until it decreases for the top 20 percent). In other words, unless you earn less than around £22k. there is little or no progressive element whatsoever.

It is an ill thought-out disaster.