Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
alternative medicine
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.
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.
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Professor George Lewith You’ll find plenty about George Lewith on this blog.
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Professor Mustafa Djamgoz Superficially respectable but seduced by ‘ancient wisdom’ He once wrote to me "There are many ‘eastern’ remedies (such as acupuncture that we witnessed dismissed 25 year ago) that work. ". Well it isn’t as simple as that.
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Professor Simon Gibbons A phytochemist with exaggerated ideas of what you can get from plants.
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Professor Jane Plant A respectable geochemist who became obsessed with alternative medicine, Read about her here,
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Dr Peter Fisher The Queen’s Homeopathic Physician. Advocate of the most discreded of all forms of quackery. Lots about him here.
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Dr Michael Loughlin A post-modernist-influenced theorist who hates Ben Goldacre. Read about him here.
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Dr Hugh MacPherson An acupuncturist and fellow traveller of the Prince of Wales. Read here.
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Professor Andrew Miles I’m sorry to see him in this company after the good job he did in ejecting quacks at the University of Buckingham.
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Simon Mills A man who thinks herbs can be classified as "hot"and "cold", See here and here
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Professor Nicola Robinson Head of the Centre for Complementary Healthcare & Integrated Medicine,Thames Valley University A well known advocate of unevidenced treatments. Try Googling her
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Dr Catherine Zollman Another hangover from the Princes’ Foundation, and believer in magic medicine
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.
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.
On Friday 25 August 2006, Michael Baum and I went to visit the rather palatial headquarters of the UCL Hospitals Trust (that is part of the NHS, not of UCL). We went to see David Fish, who was, at that time, in charge of specialist hospitals. That included world-leading hospitals like the National Hospital Queen Square, and Great Ormond Street children’s hospital. It also includes that great national embarrassment, the Royal London Homeopathic Hospital (RLHH).
It came as something of a surprise that the man in charge did not know the barmy postulates of homeopathy and he looked appropriately embarrassed when we told him.
Michael Baum is not only a cancer surgeon. but he has also taken the lead in thinking about palliative and spiritual needs of patients who suffer from cancer. Listen to his Samuel gee lecture: it is awe-inspiring. It is available in video, Concepts of Holism in Orthodox and Alternative Medicine.
The problem for UCLH Trust is that the RLHH has royal patronage One can imagine the frantic green-ink letters that would emanate form the Quacktitioner Royal, if it were to be shut down. Instead, we suggested that the name of the RLHH should be changed. Perhaps something like Hospital for palliative and supportive care? Well, four years later it has been changed, but the outcome is not at all satisfactory. From September it is to be known as the Royal London Hospital for Integrated Medicine.
What’s wrong with that? You have to ask what is to be "integrated" with what?. In practice it usually means integrating things that don’t work with things that do. So not much advance there. In fact the weasel word "integrated" is just the latest in a series of euphemisms for quackery. First it was ‘alternative’ medicine. But that sounds a bit ‘new age’ (it is), so then it was rebranded ‘complementary medicine’. That sounds a bit more respectable. Now it is often "integrated medicine" (in the USA, "integrative"). That makes it sound as though it is already accepted. It is intended to deceive. See, for example, Prince of Wales Foundation for magic medicine: spin on the meaning of ‘integrated’, and What ‘holistic’ really means.
Of course the amount of homeopathy practised at the RLHH has fallen considerably over the last few years. Already by 2007 there were signs of panic among homeopaths, They are beginning to realise that the game is up. Some of the gaps were filled with other sorts of unproven and disproved medicine.
What the hospital is called matters less than what they do, The current activities can be seen on the UCLH web site.
Services:
- Allergy Environmental and Nutritional Medicine
- Autogenics Training
- Children’s Clinic
- Complementary Cancer Care Programme
- Education services
- Musculoskeletal Medicine Clinic
- Pharmacy Services
- Skin Services
- Stress and Mood Disorders Clinic
- The Marigold Clinic – Homeopathic Podiatry and Chiropody
- Womens Clinic
It would be tedious to go through all of them, but here are some samples.
The Children’s Clinic
"The mainstay of treatments offered include Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture. We also assess nutritional status, provide dietary advice and supplementation. Psychotherapeutic techniques including Neuro-Linguistic Programming (NLP), and Visualisation are sometimes used where indicated, to gain better understanding of the presenting problems".
So a wide range of woo there. And they claim to be able to treat some potentially serious problems
"What can be treated
A wide variety of clinical conditions are being treated including:
- Recurrent infections
- Skin diseases such as eczema
- Allergic disorders including asthma
- Food intolerances and eating disorders
- Functional developmental and learning problems
- Behavioural disorders including ADHD (hyperactivity) and autism."
There is, of course, no evidence worth mentioning thar any of these conditions can be treated effectively by “Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture”.
They describe their success rate thus:
An internal audit questionnaire showed that 70% of children responded well to homeopathic treatment
So, no published data, and no control group. This is insulting to any patient with half a brain.
These claims should be referred to the Advertising Standards Authority and/or Trading standards. They are almost certainly illegal under the Consumer Protection Regulations (May 2008). The UCLH Trust should be ashamed of itself.
Education Services offers mainly courses in homeopathy, the medicines that contain no medicine,
Pharmacy Services stock thousands of bottles of pills, most of which are identical sugar pills. It’s hard to imagine a greater waste of money.
The Marigold Clinic – Homeopathic Podiatry and Chiropody
I was rather surprised to find this is still running. In 2006, I wrote about it in Conflicts of interest at the Homeopathic Hospital. It turned out that the prescription costs if the clinic were spent on Marigold paste, made by a company owned by the people who run the clinic. UCLH claimed that they were aware of this conflict of interest, but had no obligation to make it public. That is an odd ethics in itself. Even odder when I discovered that the Trust had been notified of the conflict of interest only after I’d started to ask questions.
The same people are still running the clinic. They may well be good chiropodists, If so why surround the service with woo. There are, almost needless to say, no good trials of the efficacy of marigold paste (and it isn’t homeopathic).
Conclusion
At the moment, it appears that the renaming of the RLHH is empty re-branding. No doubt UCLH Trust see homeopathy as something that brings shame on a modern medical service. But to remove the name while retaining the nonsense is simply dishonest. Let’s hope that the name change will be followed by real changes in the sort of medicine practised, Changes to real medicine, one hopes.
Other blogs on this topic
Gimpyblog was first, with Farewell to the RLHH, hello to the RLHIM
Quackometer posted An Obituary: Royal London Homeopathic Hospital, 1849-2010
Follow-up
Systems biology is all the rage, No surprise then, to see the University of Westminster advertising a job for a systems biologist in the The Department of Molecular and Applied Biosciences. Well, no surprise there -until you read the small print.
Much has been wriiten here about the University of Westminster, which remains the biggest provider of junk sciencne degrees in the UK, despite having closed two of them.
 Senior Lecturer in Systems BiologyUniversity of Westminster – Department of Molecular and Applied Biosciences, School of Life SciencesCavendish Site Salary £37,886 – £50,751 (Inc. LWA) The Department of Molecular and Applied Biosciences wishes to appoint a Senior Lecturer in Systems Biology. The post-holder will teach on the undergraduate and postgraduate degree programmes within the School of Life Sciences, particularly in the areas of Molecular Biology, Bioinformatics and/or statistics, establish their own and participate in ongoing research programmes and undertake external income generation activities. The candidate should have an active interest in bridging the gap between western life sciences and Chinese medicine using emerging systems biology approaches, specifically in metabolomics and proteomics with a goal of developing novel diagnostic technologies facilitating the creation of a personalised approach to medical care. They should therefore be willing to work closely with colleagues in the life sciences as well as with clinicians and clinical researchers from within the East Asian medical tradition. The post is available from 1st October 2010 or as soon as possible thereafter. The closing date for applications, together with a short statement on why you believe you are suitable for the position and a description of your research plans, is Monday 6th September 2010. Interviews are expected to be held later in September. Administrative contact (for queries only): Tayjal Tailor (t.tailor1@wmin.ac.uk) Reference Number: 50000360 Closing Date: Friday 3 September 2010 |
A note about systems biology
Systems biology is about about how whole organs behave, as opposed to single cells or single molecules, It has to be the ultimate aim of biology. There is one case in which this has been done with some success, That is the modelling of the behaviour of the whole heart by Denis Noble and his colleagues in the Phyiology department (now gone) in Oxford. They adopted a bottom up approach. They measured the currents that flow though many sorts of ion channels in single cells from various parts of the heart, and how individual cells communicate with each other. Starting from this solid basis, together with a lot of computer power, they were able to model successfully a lot of phenomena that occur in the whole heart, but can’t be investigated in single cells. For example their work cast light on abnormal heart rhythms like ventricular fibrillation, and on the effect of drugs on heart rhythm.
This work was mostly done before the term ‘systems biology" thought of. It was called physiology. It is impressive work, and systems biology became a fashionable buzzword among research administrators and funding agencies. Despite the amount of money thrown at the problem, I’m not aware of any success that remotely approaches Noble’s.. One reason for that is that people have not been willing to put in the groundwork. In the case of the heart, the models were built on -many years of basic research on the electrophysiology of single heart cells. People have tried to model from the top down, without doing the spade work first. There has developed a perception that computing power can compensate for lack of basic knowledge about things work. It can’t. The usual aphorism applies: garbage in, garbage out.
Here’s an example, which eas noted in the diary pages for 29 June, 2008. While in Edinbuurgh, to give a talk to the European Conference on Mathematical and Theoretical Biology, I noticed a poster. It described an attempt to model on a computer the entire metabolic network of yeast.
“81 of the 662 intracellular concentrations were defined . . . The remainder were set to the median concentration of c. 0.2 mM.”
Ahem. We didn’t know the concentrations so we just made them up so we could run the program.
It’s interesting that even people in the business seem to realise that even that it isn’t living up to the hype. The Fixing proteomics web site shows why.
Put another way, if you try to run before you can walk, you risk falling falling on your face.
For these reasons, it seems to me that that most attempts at system biology have been disappointing (please correct me if I’m wrong)
Systems biology for Chinese medicine
If systems biology suffers from trying to run before it can walk in regular biology, where at least something is known about the functions of cells, how much more true that must be of Chinese medicine. In Chinese medicine almost all the treatments have never been tested properly in man. The odds are that most don’t work at all, and some are very poisonous (not to mention the cruelty and destruction of endangered species that is involved in making some of their more bizarre medicines). The idea that you can explain it with systems biology, is ludicrous in the extreme.
One can’t imagine any vaguely competent biologist who’d want to touch a project as bizarre as this with a bargepole.
Eastmedicine
This advertisement stems presumably from EASTmedicine is the University of Westminster’s research centre for East Asian Sciences and Traditions in Medicine. The proclaimed aims are to focus on “understanding, development and evaluation of East Asian medicines as living traditions”. The director of EASTmedicine, Volker Scheid, is a herbalist and acupuncturist and, as such, a firm believer in alternative medicine. When he isn’t at the University he has a private practice, the Traditional Acupuncture Centre, in London.
The website of his private practice makes some astonishing claims
"Acupuncture is effective in the treatment of numerous conditions including headache, migraine, digestive problems, menstrual disorders, indeterminate aches and pains, asthma, hayfever, stress, tiredness, depression and anxiety. Also commonly treated are chronic conditions such as arthritis, back pain, ulcerative colitis, irritable bowel syndrome, eczema, sinusitis, high blood pressure and repetitive strain injuries."
These claims simply cannot be justified by any worthwhile evidence. It will be interesting to see what Trading Standards make of them.
Dr Scheid describes himself as a "scholar physician". Physician seems a rather pretentious description for someone whose qualifications are stated to be PhD, MBAcC, FRCHM. But in similar vein he describes himself thus "I am one of the West’s leading experts on Chinese medical formulas and treatment strategies".
Although Scheid sells acupuncture treatments to patients, he seems ro be more anthropologist than medical. In a discussion of two acupuncture papers
"From the Perspective of the Anthropologist –
Volker Scheid, London, UK
From a perspective anchored in the cultural studies of science, technology and medicine my main interest in these papers is their status as cultural artifacts that provide access to the lifeworlds of a particular research community. If any, life-world debate and argument marks sites of contestation." Forsch Komplementärmed 2007;14:371–375
Scheid shows not the slightest interest in whether acupuncture works other than as a placebo. Since he is selling acupuncture, he presumably starts from the premise that it works.
Volker Scheid has had a £205,000 Wellcome Trust for the History of Medicine Project Grant: 2009 2012; Treating the Liver: Towards a Transnational History of East Asian Medicine; There’s nothing wrong with writing the history of long-outdated systems of medicine, though one could hardly imagine that the history would be very impartial, when it is written by a true believer. Another taste of his style can be found in his paper on Globalising Chinese Medical Understandings of Menopause. There is lots of rather pretentious stuff about culture, but very little about what actually works, Towards the end of the paper we come to the usual feeble excuse.
" . . once traditional medicines allow themselves to be evaluated by biomedical research methods, the odds against receiving fair treatment are heavily stacked against them."
The translation of that into plain English is something like ‘when we test our treatments properly we find they don’t work, so we blame the methods and carry on with selling them anyway’.
Judging from its web site, EASTmedicine does not to do any serious clinical trials to test whether the treaments work in man, They just know that they do. But they are hoping to add some spurious scientific background to their dubious claims by hiring someone to do compuations that will cast no light whatsoever on the question that really matters, Do they work or not?
The agenda is made clear by the statement
EASTmedicine seeks to describe and analyse the dynamics of these transformations with a specific view of managing their integration into contemporary health care.
So it is just yet another group of people pushing to have unproven and disproved treatments accepted by real medicine.
The University of Westminster appears to be determined to make itself the laughing stock by persisting in promoting junk science at a time when most other universities have realise that the harm done to their reputations is not worth the income it generates, Plenty of it has been revealed here.
The vice-chancellor of Westminster, Prof Geoffrey Petts, made into the pages of Private Eye (see Crystal balls. Professor Petts in Private Eye when he announced that he wouldn’t get rid of the junk, but would make it more ‘scientific’. Well, credit where it’s due, They have dropped homeopathy. see The last BSc (Hons) Homeopathy closes! But look at what they still teach at Westminster University For 2010 they still off ten different “BSc (Hons)” degrees in pre-scientific forms of medicine. It will take more than a bit od talk about systems biology to make anyone believe that these courses have anything to do with science.
For example, look at some slides from their lectures on “energy medicine”, Westminster University BSc: “amethysts emit high yin energy”
More make-believe from the University of Westminster. This time it’s Naturopathy , or
Why degrees in Chinese medicine are a danger to patients
The Dean of the School of the Life Sciences, Jane Lewis, is an entirely respectable marine biologist. She has had the thankless task of merging the real science with the alternative medicine in a single school. I phoned her to get a reaction
" outcome of merger of the school and trying to bring various parts of the school together" " "things are much more rigorous than they were".
DC: "Why don’t you just phase it out?"
"I’m not in a poition to do that. i move things forward as seems best -for the whole school I have to say". We’re retaining those bits thatI think have some good standing -I see NICE has approved the use of acupuncture for lower back pain and some other bits and pieces so I see acupuncture as something that does have some standing, andwe make sure it rigorously taught"
"DCHave you looked at the stuff on naturopathy?" "Are amethysts emit high Yin energy still taught?" " i don’t think so".
It seems, as so often in this case, that the senior people don’t really know what’s being taught under their noses. Prof
Lewis says she has not read about the background
to the (unusually) daft advice from NICE. Neither has she read Barker Bausell’s book on acupuncture research. If she had done any of these things,I suspect she would not have such a high opinion of it as appears to be the case.
Bait and switch. Astonishingly there is a now a whole organisation devoted to the respectabalisation of Traditional Chinese Medicine Good Practice in Traditional Chinese Medicine Research in the Post-genomic Era It sounds nice and sciencey but, as usual, they are trying to run before they can walk. The first thing has to be to do good clinical trials to find out if there is anything there to be investigated. If, and only if, this is the case, would there be any case for fancy talk about "proteomics"
and "the post-genomic era".
I do hope that no funding agency would be fooled into parting with money on the basis of the present vacuous rhetoric.
Professor Lewis said that I have I have quoted things like "amethysts emit high Yin energy" out of context. There is a simple solution to that. I have asked Westminster to make available the entire contents of the courses. Then we shall all be able to see the context of what their sudents are being taught.
Follow up
A brief report of this matter has appeared in Times Higher Education. In a statement, the University of Westminster says “its research into Chinese medicine is following the lead of “top research institutions”. I’m not aware of anyhting quite like this from anywhere else. In any case, Westminster should be able to think for themselves.
Having recently been fired from Ofquack, the Complementary and Natural Healthcare Council (CNHC). I found I was missing the constant dribble of double-speak, Then, as luck would have it, a friend emailed me to draw my attention to a lucrative job at Ninewells Hospital, Dundee. On August 11th I put out a tweet, just in case any of my friends were interested.
How to save money. NHS Scorland (Tayside) advertises for homeopathic doctor http://bit.ly/9Ou9Yo Pathetic #fail
After the story appeared in the Daily Express it occurred to me that I should apply. It seems that NHS Scotland
Tayside) is determined to look idiotic in the eyes of the world. They advertised for a homeopathic doctor, The upper level of salary, £68,000 for two sessions a week, is a great deal more than I ever got paid as holder of the established chair of pharmacology at UCL, Then I discovered that a crystallographer, David Briggs (@xtaldave on twitter) had applied for the job. If he can, why not I? I found it hard to match the wit of his supporting statement, but just in case others want to apply, here’s my attempt. The more the merrier.
.
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As a Fellow of the Royal Society for the last 25 years, and author of a textbook on statistics, I feel sure that I am capable of dealing with the intellectual rigours of handing out placebos to patients. I feel that my academic qualifications, and my authorship of many research papers, including several articles about homeopathy, should more than make up for my lack of formal qualifications in medicine or homeopathy. Indeed I have spent more time than I care to remember on reading the extensive literature on homeopathy. Having some expertise in the statistical analysis of clinical trials, my reading of the literature has equipped me well to impress gullible patients with sciencey sounding words like “succussion”, “energy medicine” and “quantum theory”. As an additional qualification, I have read widely about crystal healing, magnetic bracelets, aura photography and other such fairground paraphernalia which are designed, like homeopathy, to impress those with no knowledge of science or medicine. I have had over two years’ experience of serving on the Conduct and Competence Committee of the Complementary and Natural Healthcare Council, which has provided me with valuable insights into the world of alternative medicine. Indeed I have been told that my name is well known in Clarence House itself. If appointed to this job, I should like to combine it with research in homeopathy. I would approach this by using systems biology, in the hope that proteomics and metabolomics would be able to explain the still mysterious ability of medicines that contain no medicine to satisfy patients. People whom I know at the University of Westminster have proposed to use systems biology to explain Traditional Chinese Medicine, and I imagine that its application to homeopathy will be every bit as successful as theirs. To have cutting edge research of this sort will, I believe, give NHS Scotland a reputation that will spread around the world. I would also propose to save the Tayside PCT a lot of money, something not to be ignored in these hard times. At present, homeopathic pharmacies stock many thousands of sorts of pill. Recognising that the majority of them contain nothing at all, I’d retain the labels but fill all the bottles with sugar pills. This would save huge amounts of time and money, while having no effect at all on the outcome for patients. Despite my lack of formal qualifications, I hope you will agree that I’m qualified intellectually to meet the rigours of your job. |
Follow-up
I was not the only person to follow the example of David Briggs (@xtaldave). So far I’ve seen Dean Burnett (@garboy) on Science Digestive, Peter Harrison on Reality is My Religion, and Torgwen.
Three days on, there are at least eleven applications, and the three earliest ones have been read something like 12.000 times.
18 August 2010. Astonished to receive by snail-mail a straight-faced acknowledgment of my application from NHS Tayside [download pdf]. They ask me to send four copies of my CV and fill in forms for Equal Opportunities and Fitness to Practise. Does this mean I’ve been short-listed? This gets more surreal by the minute.
Suggested twitter tag: #buckgate
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Number 19 Buckingham Street, London WC2N 6EF.is to be the home of the proposed "College of Medicine" that has arisen from the ashes of the late unlamented Prince’s Foundation for Integrated Health (their last accounts can be seen at Quackometer). Naturally one must ask if the "College of Medicine" will propagate the same sort of barmy ideas as the Prince’s Foundation used to do, A visit to Companies House shows the auguries are not good |
 19 Buckingham Street |
For one thing, the name College of Medicine has existed only since May 2010. The company was registered originally 19th November 2009 as The College of Integrated Health, but after a teleconference on 5th May 2010 it changed its name, presumably to make itself sound more like real medicine. This happened immediately after the closure of the Prince’s Foundation on April 30th.
There is no doubt that the "College of Medicine" is the direct descendent of the Prince of Wales’ Foundation. In a powerpoint show dated 9th November 2009 (before the name change) this slide is to be found.
The author of the slide show is specified as "Linda". That, it is a fair bet, must be Linda Leung, who was Operations Director of the Prince’s Foundation until it closed, and is now Company Secretary for the "College of Medicine".
The final form of the "College" is still being argued about, but guess who will open it?
When ask about how Charles’ relationship with the College, The Office of TRH The Prince of Wales and The Duchess of Cornwall declined to make any comment, but simply referred me to Michael Dixon, who, in turn referred me to Pat Goodall.
Recently a statement from Clarence House to the Guardian said that "the Prince of Wales was aware of the college, but “has not been involved with setting-up the college, is not launching it and has no official role with it". That’s the official line anyway.
It is, of course, almost impossible to find out exactly what the relationship is between Prince Charles himself and the new "College". He operates largely out of sight, and the Freedom of Information Act, disgracefully, excludes his interference in the democratic process from public scrutiny.
Who is paying?
Flat 5 at 19 Buckingham Street was recently valued at half a million pounds. There is some serious money behind this venture. The rumour is that it’s from a ‘private donor’. Small prize for anyone who finds out who it is.
Aims of the College
The stated object of the College is "to advance health for the public benefit". Sounds good, but what does it mean? It doesn’t take long to find out. It is laid out in the document from Companies House.
To further its objects the Charity may:
7.1 engage with and develop communities of health professionals, health care providers and patients;
7.2 set standards and promote excellence in the fields of health and care;
7.3 lead, represent, train and support stakeholders so that they are better equipped to serve the public in improving the health ofthe public;
7.4 establish an evidence base for integrated health and for individual complementary modalities;
7.5 promote, foster and advance an integrated approach to health and care;
7.6 raise public, professional and political awareness and cultivate a sentiment in favour of an integrated approach to health and care by publishing and distributing books, pamphlets, reports, leaflets, journals, films, tapes and instructional matter on any media;
and so on, for 36 paragraphs. Already in paragraph 4 to 6 we see their interest is to promote “integrated health” and “complementary modalities. These of course are just what most of the rest of the world calls quackery. The objects don’t differ greatly from the Prince’s Foundation from which this outfit sprang.
What will be taught at the College?
Some information about the preliminary plans can be gleaned from a letter that describes the new College (download the letter). The letter says
“The College is developing two groups of courses. The first is aimed at registered professionals such as doctors, nurses and physiotherapists. It will familiarise them with different aspects of CAM and develop skills they can use in their day to day practice – not least techniques they can pass on to patients to help them manage their own conditions.”
In other words, the only course for doctors will be to teach them about quackery. Final judgement on that must await information about who will teach it.
“The second group of courses is aimed at non-registered practitioners and will focus on developing their understanding of conventional medicine, including ‘red flag’ symptoms, familiarisation with conventional therapeutics and increased awareness of critical appraisal.”
The other course, it seems, will be for quacks, to try to teach them enough real medicine to prevent them from killing too many people. The bit about teaching them about “critical appraisal” is hard to believe. If that were really done the clients would mostly be out of business.
If you were in any doubt at all about the aims of the College, it is necessary only to look at the four directors of the Company
Directors of the College of Medicine.
- Dr Michael Dixon, general practitioner. Michael Dixon was Medical Director of the Prince’s Foundation until it closed down.
- Professor George Lewith, is Professor of Health Research in the Complementary Medicine Research Unit, University of Southampton. He was a Foundation Fellow of the Prince’s Foundation until it closed down.
- Professor David Peters. is Professor of Integrated Healthcare and Clinical Director at the University of Westminster’s School of Integrated Health.
He was a Foundation Fellow of the Prince’s Foundation until it closed down. - Mrs Christine Glover is a pharmacist who sells homeopathic pills. She was a Foundation Fellow of the Prince’s Foundation until it closed down.
The company secretary is named as Linda Leung, who was Operations Director of the Prince’s Foundation until it closed.
A request to Michael Dixon for information was deflected to Mrs Pat Goodall She is yet another connection with PFIH. Mrs Goodall acted as a spokesperson for the Prince’s Foundation until it closed down. Now she is scheduled to become Director of Policy and Communications for the "College of Medicine". Mrs Goodall declined to say where the money came from. But she did say that the College was not the "equivalent of a further education college,. . . or higher education college", That being the case, it seems very odd to use the name "College of Medicine". It is a downright misleading name.
These people are all well know advocates of alternative medicine, It is very obvious that the "College of Medicine", despite its misleadingly innocuous name, is simply a reincarnation of the Prince’s Foundation for Integrated Health.
The term "integrated" is, of course, simply a euphemism for alternative medicine. That means those forms of medicine for which there is little or no evidence that they work. When evidence that something works is found, it is called simply medicine.
It may be useful to give a bit more information about the Directors.
Dr Michael Dixon OBE
Michael Dixon is devoted to just about every form of alternative medicine. As well as being medical director of the Prince’s Foundation he also runs the NHS Alliance. Despite its name, the NHS Alliance is nothing to do with the NHS and acts, among other things, as an advocate of alternative medicine on the NHS, about which it has published a lot.
Dr Dixon is also a GP at College Surgery, Cullompton, Devon, where his “integrated practice” includes dozens of alternative practitioners. They include not only disproven things like homeopathy and acupuncture, but also even more bizarre practitioners in ‘Thought Field Therapy‘ and ‘Frequencies of Brilliance‘.
To take only one of these, ‘Frequencies of Brilliance’ is bizarre beyond belief. One need only quote its founder and chief salesperson.
“Frequencies of Brilliance is a unique energy healing technique that involves the activation of energetic doorways on both the front and back of the body.”
“These doorways are opened through a series of light touches. This activation introduces high-level Frequencies into the emotional and physical bodies. It works within all the cells and with the entire nervous system which activates new areas of the brain.”
“Frequencies of Brilliance is a 4th /5th dimensional work. The process is that of activating doorways by lightly touching the body or working just above the body.”
“Each doorway holds the highest aspect of the human being and is complete in itself. This means that there is a perfect potential to be accessed and activated throughout the doorways in the body.”
Best of all, it can all be done at a distance (that must help sales a lot). One is reminded of the Skills for Health “competence” in distant healing (inserted on a government web site at the behest (you guessed it) of the Prince’s Foundation, as related here)
“The intent of a long distance Frequencies of Brilliance (FOB) session is to enable a practitioner to facilitate a session in one geographical location while the client is in another.
A practitioner of FOB that has successfully completed a Stage 5 Frequency workshop has the ability to create and hold a stable energetic space in order to work with a person that is not physically present in the same room.
The space that is consciously created in the Frequencies of Brilliance work is known as the “Gap”. It is a space of nonlinear time. It contains ”no time and no space” or respectively “all time and all space”. Within this “Gap” a clear transfer of the energies takes place and is transmitted to an individual at a time and location consciously intended. Since this dimensional space is in non-linear time the work can be performed and sent backward or forward in time as well as to any location.
The Frequencies of Brilliance work cuts through the limitations of our physical existence and allows us to experience ourselves in other dimensional spaces. Therefore people living in other geographic locations than a practitioner have an opportunity to receive and experience the work.
The awareness of this dimensional space is spoken about in many indigenous traditions, meditation practices, and in the world of quantum physics. It is referred to by other names such as the void, or vacuum space, etc.”
This is, of course, preposterous gobbledygook. It, and other things in Dr Dixon’s treatment guide, seem to be very curious things to impose on patients in the 21st century.
You can read more about Michael Dixon at Dr Aust’s blog (Dr Michael Dixon is annoyed), and, from the USA, Steven Novella’s analysis in Dr. Michael Dixon – “A Pyromaniac In a Field of (Integrative) Straw Men”
Professor George Lewith,
George Lewith has appeared quite often in this blog. He first came to my attention when I discovered in 2006 that his private clinic was offering a well-known form of fraudulent allergy diagnosis, the Vega test, despite the fact that Lewith himself had written a paper that said it didn’t work.
Lewith is particularly keen on acupuncture and that most discredited form of quackery, homeopathy. On More 4 News, he actually claimed that there was no good sham form of acupuncture. That is simply not true: great ingenuity has gone into devising controls for acupuncture trials and ‘real’ acupuncture always comes out the same as sham.
Professor David Peters
David Peters comes from the University of Westminster, which is famous for offering more degrees than any other in anti-scientific nonsense.
Westminster is home of the quite remarkable teaching that "Amethysts emit high Yin energy". dowsing, aura photography and other such fairground frauds.
Westminster offers also a "BSc degree" in that quite remarkable branch of make-believe known as naturopathy, This teaches students about a totally insane form of psycho-babble called Emo-trance and they are taught (no. seriously) about diagnosis with dowsing and pendulums
Westminster also teaches about kinesiology. Sounds sort of sciencey, but Applied Kinesiology is actually a fraudulent and totally ineffective diagnostic method invented by (you guessed) a chiropractor. It has been widely used by alternative medicine to misdiagnose food allergies. It does not work (Garrow, 1988: download reprint).
Westminster offers “BSc degrees” in Chinese Medicine that are a menace to public health. Their unfortunate students are told "Legally, you cannot claim to cure cancer. This is not a problem because we treat people not diseases". It is hard to imagine anything more irresponsible,
David Peters, as Clinical Director at Westminster must bear responsibility for this load of irresponsible make-believe, I have no doubt that he is well-intentioned but some of the stuff on these courses is a serious danger to public health.
Mrs Christine Glover
Mrs Glover is an Edinburgh pharmacist. She claims
She believes symptoms rarely occur in isolation but are usually linked to a persons circumstancs [sic].
Illness occurs when there are imbalances in any of the physical, emotional and spiritual aspects of their life.
Well, yes and no, Would you really go to her if you had cancer, or tuberculosis, or even atrial flutter? Judging by her website, what you’d get is a bottle of her Liquid Iron & Vitamin Formula (for £16.25 !). Or any one of a range of homeopathic pills.
There is no branch of alternative medicine that is more totally discredited than homeopathy. Yet now it i being proposed to form a College of Medicine with four directors who are all part of the dwindling band that insists you can do magic with pills that contain no medicine.
Who else supports the College?
There are some pretty surprising people who are listed in the letter as supporting the College of Medicine, though it remains to be seen how many are left once the true nature of the College is known.
Some of the supporters were already Foundation Fellows of the Prince’s Foundation, despite having no obvious sympathy with quackery. These include Professor Sir Cyril Chantler, Professor Adrian Eddleston and Professor Simon Gibbons. They also include the notorious Karol Sikora, and the geochemist Professor Jane Plant.
Professor Jane Plant is, apparently, a distinguished geochemist, but she developed an obsession with dairy-free diets, after her own experiences with breast cancer. She has written a lot of books and, no doubt, made a lot of money from the desperate. An extracr from one of her books is titled “Why I believe that giving up milk is the key to beating breast cancer”. If you want to see the ‘evidence’ for some of her wild claims, her web site invites to join -at a cost of £30. To get a bit closer to the truth it is only necessary to quote the World Cancer Research Fund (WCRF) Report on diet and cancer, ‘Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective‘. The WCRF is inclined, in my view, to exaggerate the strength of the evidence for a causal link between diet and cancer (see Diet and health. What can you believe: or does bacon kill you?) but nevertheless their assessment of dairy products is very different from Plant’s.
"The strongest evidence, corresponding to judgements of ‘convincing’ and ‘probable’, shows that milk probably protects against colorectal cancer, and that diets high in calcium are a probable cause of prostate cancer."
It seems that Jane Plant’s claims are thoroughly irresponsible.
I’m told that two people who were also Foundation Fellows, and who were originally listed as supporters of the College seem to have already jumped ship, namely Professor Stephen Holgate and Baroness Finlay.
Professor Sir Graeme Catto is to be president, and I’m told, Professor Sir Ian Kennedy has agreed to be vice president.
It is incomprehensible to me why people like this should be willing to lend their names to the Prince’s Foundation in the first place, or to its replacement now..
Other people listed as supporters include Sir Donald Irvine, Professor John Cox, and, on the "scientific advisory committee, Professor Mustafa Djamgoz and Professor Ajit Lalvani.
None of these people has an obvious belief in quackery. sp what are they doing mixed up with a venture like this?
Graeme Catto tells me he “knows very little about CAM”, and Cyril Chantler says the College should deal with evidence-based integrated medicine “but not alternative medicine or homeopathy”. Since, during his time as a Foundation Fellow of the Prince’s Foundation, Cyril Chantler failed totally to shake the advocacy of homeopathy by them, it seems unlikely yhat he’ll be any more successful with the College.
The only member of the "scientific advisory committee" who has answered by invitation to comment on a draft of this post is Professor Mustafa Djamgoz. It seems that he is more gullible that meets the eye He said, for example,
“There are many ‘eastern’ remedies (such as acupuncture that we witnessed dismissed 25 year ago) that work.”
“We ourselves have already shown that natural substances like omega-3 polyunsaturated fatty acids, reseveratrol [sic] etc can produce anti-cancer effects by blocking ion channels.”
Clearly Professor Djamgoz has not been keeping up with research in these areas. Has he never read Barker Bausell’s book on acupuncture, Snake Oil Science.? Apparently not. And there is, of course, not the slightest reason to think that omega-3 or resveratrol help cancer in humans.
It is often said that the reason that eminent people support quackery is that they live in hopes of a peerage. That is, perhaps, a bit uncharitable. I think it more likely that they don’t bother to investigate closely what it is they are signing up to, and that they are fooled by the weasel words of “integrated medicine”.
People like Catto and Chantler seem to think they are supporting caring, human centred, medicine. I fear they have been fooled, They are supporting sheer quackery.
Patient centred medicine
One of the most infuriating characteristics of quacks is their attempt to hi-jack the ‘human side of medicine’. I suppose they have little else to offer, so it’s understandable. But there is nothing human about deceiving desperate patients and the human side of medicine is something that is emphasised in the education of every real doctor.
If you want to know more about it, there is no better exposition than Michael Baum’s Samuel Gee lecture. Baum has been at the forefront of thinking about supportive or spiritual care of cancer patients. His 2009 Samuel Gee lecture is available in video, Concepts of Holism in Orthodox and Alternative Medicine. It is a masterpiece. He ends the lecture thus.
“Alternative versions of “holistic medicine” that offer claims of miracle cures for cancer by impossible dietary regimens, homeopathy or metaphysical manipulation of non-existent energy fields, are cruel and fraudulent acts that deserve to be criminalized.”
A similar distinction has been made with beautiful clarity by Dr James May
“The use of the term ‘integrative medicine’ in your editorial seems to confuse more than clarify the problem of ‘holism’ in medicine. Complementary therapists for example often use the term ‘holistic’ to blur the boundaries between the therapies used and the practitioner’s interpersonal skills. It would be better, however, to keep these distinctions clear. Caring is different from curing.”
“‘Holism’ is not a multifaceted approach to curing, it is a multifaceted approach to caring”
“Effective medicine is best measured with RCTs. Caring is not. ‘Integrative medicine’ therefore risks both damaging how we measure effective medicines (RCTs), as well as reducing caring to measurables. A better term for this might be ‘disintegrative medicine’.Effective medicine is best measured with RCTs. Caring is not. ‘Integrative medicine’ therefore risks both damaging how we measure effective medicines (RCTs), as well as reducing caring to measurables. A better term for this might be ‘disintegrative medicine’.”
I hope that the various eminent people who have lent their name to this mis-named ‘College of Medicine’ will look very carefully at what it actually does. And that will probably mean withdrawing their support.
Follow-up
The Guardian, 2nd August 2010, carried this story, written by their science correspondent, Ian Sample: College of Medicine born from ashes of Prince Charles’s holistic health charity. He quotes Tracey Brown of the Sense about Science charity as saying that the college’s emphasis on merging conventional medicine with unproven complementary therapies “would take society back a century”.
“Despite its mission to promote the integration of alternatives to medicine, this new body has chosen to call itself very grandly the College of Medicine. Perhaps someone thinks this will sound good with Royal in front of it? This wouldn’t be a surprise given the institution’s origins in the Prince of Wales’s efforts to integrate his favoured traditional remedies into medicine.”
Quotation from DC
The term ‘evidence-based medicine’ seemed to me, when I first heard it, utterly ludicrous. It still does. What’s the alternative? Guess-work based medicine?
Quacks are fond of using cuddly words like ‘holistic’ and ‘integrative’, partly, one suspects, in an attempt to gain respectability and to disguise some of their barmier views. See, for example, Prince of Wales Foundation for magic medicine: spin on the meaning of ‘integrated’.
Advocates of evidence-based medicine are often accused by quacks of being hard-hearted calculators who want to take the soul out of medicine. Nothing could be further from the truth in my view. But I don’t practise medicine so it seemed to me to be worth quoting two of the best definitions I know, both from people at the sharp end of medicine.
James Matthew May
James May is a general practioner in London. He is also chairman of Healthwatch, an organisation that was exposing health fraud long before the recent explosion in the ‘skeptical blogosphere’.
The following passage was written as comment (‘rapid reponse’) to an editorial in the British Medical Journal. The editorial itself was (in my view) silly and misguided (Closing the evidence gap in integrative medicine, by Hugh MacPherson, David Peters, and Catherine Zollman). It is best forgotten as soon as possible. But James May’s comment deserves to be preserved and publicised. The highlights in bold font are mine.
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The use of the term ‘integrative medicine’ in your editorial seems to confuse more than clarify the problem of ‘holism’ in medicine. Complementary therapists for example often use the term ‘holistic’ to blur the boundaries between the therapies used and the practitioner’s interpersonal skills. It would be better, however, to keep these distinctions clear. Caring is different from curing. The point of RCTs is to establish how much of a treatment’s efficacy is independent of the ideas, concerns, and expectations of either the patient or the clinician. Using ‘multi-modal’ or ‘synergistic’ research methods is likely to confuse this important distinction. ‘Holism’ is not a multifaceted approach to curing, it is a mulitfaceted approach to caring. A truly holistic clinician will ‘cure sometimes, relieve often and comfort always’. Comforting may not produce a positive clinical outcome – but we should still do it. Historically speaking caring pre-existed effective medicine by millenia, but it was a principle motive for finding effective medicine. Caring therefore is not a subset of medicine, instead medicine is one of the tools used for caring. ‘Integrative medicine’ as a concept, however, blurs this boundary. It has been wisely observed that ‘if we keep trying to measure what we value, we will end up only valuing what we can measure.’ This particular ‘evidence gap’ is therefore probably best left; filled instead by caring doctors. Effective medicine is best measured with RCTs. Caring is not. ‘Integrative medicine’ therefore risks both damaging how we measure effective medicines (RCTs), as well as reducing caring to measurables. A better term for this might be ‘disintegrative medicine’. Competing interests: Chairman of HealthWatch |
Michael Baum
Baum is a recently-retired cancer surgeon from UCLH. As well as being s surgeon with a strong interest in scientific medicine, he has been at the forefront of thinking about supportive or spiritual care of cancer patients. His 2009 Samuel Gee lecture is available in video, Concepts of Holism in Orthodox and Alternative Medicine. It is a masterpiece. The conclusion puts his view bluntly (again the emphasis is mine).
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Conclusion Holism in medicine is an open ended and exquisitely complex understanding of human biology that over time has lead to spectacular improvements in the length and quality of life of patients with cancer. This approach encourages us to consider the transcendental as much as the cell and molecular biology of the human organism. Alternative versions of “holistic medicine” that offer claims of miracle cures for cancer by impossible dietary regimens, homeopathy or metaphysical manipulation of non-existent energy fields, are cruel and fraudulent acts that deserve to be criminalized. Such “alternative” versions of holism are arid and closed belief systems, locked in a time warp, incapable of making progress yet quick to deny progress in the field of scientific medicine. |
Follow-up
Sometimes I wonder why one bothers with print. You don’t have active links, you don’t get discussion in comments, and editors alter what you want to say.
This post is about events that followed the removal by the University of Buckingham of its accreditation of the Diploma in Integrated Medicine, as described here.. This diploma was run by the "Faculty of Integrated Medicine" (FIM) which consists largely of Dr Rosy Daniel and Dr Mark Atkinson. The FIM is, in turn, the product of a charity, the Integrated Health Trust (IHT). Oddly enough, the IHT’s web site still says "The two-year, part-time Membership Programme in Integrated Medicine has been accredited as a post-graduate diploma by the University of Buckingham" (as of 13 May 2010). The FIM web site makes similar claims. "Used to be" accredited would be more appropriate.
The advisory board of IHT consists almost entirely of supporters of various forms of alternative medicine, some of whom have been mentioned already on this blog. The respectable supporters who appeared when FIM’s diploma was first announced have vanished, and now they rely entirely on a couple of celebrity endorsements, and a few anecdotes about miracle cures. This is behaviour that is characteristic of all quacks.
After the post here, the story was printed on 13th April in Times Higher Education, under the headline It’s terminal for integrated medicine diploma. On 25th April a reply from Dr Daniel on the THE web site, ‘Terminal’? We’ve only just begun. This attracted a lot of comments. I rather liked the first one,
“The question is: who will stand up and support the formalisation of IM education for doctors and nurses in the UK?”. Not anyone with more than one working neuron, that’s who.
My own comment was rather more restrained than some of the semi-literate abuse from alternative medicine enthusiasts.
On 29th April, Daniel got another go in on the Times Higher Education web site, with the title ‘Bad’ Scientist. This time she got rather personal. Realising that not everyone reads the web version, I thought a print response was called for. I sent them a full response. At their request it was
cut down to the length of a letter, and even then they cut out the reference to Andrew Weil. The abbreviated letter was published on 13th May as Don’t shoot the messenger.
For the record, here is the complete response that I sent.
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In response to your report [It’s terminal for integrated medicine diploma] and my blog Dr Daniel, in her two recent contributions to THE [‘Terminal’? We’ve only just begun, and ‘Bad’ Scientist], Dr Daniel describes me as misguided, intimidatory, undemocratic, antisocial and prejudiced. Ouch. I can understand that she may well be a bit upset, having recently been rejected by both the University of Buckingham and even by that bastion of all things barmy, the Prince’s Foundation for Integrated Health (now deceased). I’d like to remind her that it was not I who closed the Buckingham course. That decision was made by Terence Kealey (Buckingham’s VC) and Prof Andrew Miles. And it was the Office of Trading Standards, not I, who made her change the claims on her company’s web page about the alleged “healing” powers of a herbal concoction, Carctol, for cancer. All that I did was help to find out about some of the things that were being taught on her course. I find it quite surprising how often vice-chancellors have no idea what’s going on, but Kealey, unlike most, was interested to find out. Dr Daniel is right about one thing. I’m not a clinician. On the other hand, I do perhaps know a little bit about evidence. She claims that diet can save you from breast cancer but in the comments section it has already been pointed out that the 2007 study invoked by Dr Daniel does not come to the conclusion that she said it does. Furthermore she ignores entirely the 2010 EPIC study, published in the Journal of the National Cancer Institute (102:529-537). This study, of almost 500,000 people in ten European countries, found barely any relationship between intake of fruit and vegetables and cancer risk. This may be disappointing, but it can only harm patients to ignore the evidence when, as in this case, it exists. There are plenty of reasons to eat well, but apparently avoiding cancer is not one of them. It seems to be a bit more complicated than that. Dr Daniel says "IM in the UK is still clouded by complementary and alternative medicine (CAM) detractors owing to an important misunderstanding: IM is not CAM.". I beg to differ. The content of the course is about alternative as you can get. It included teachers who have advocated the Q-link pendant to "protect" you from evil radio waves. It is not long since Ben Goldacre opened one of these pendants and found it contained "No microchip. A coil connected to nothing. And a zero-ohm resistor, which costs half a penny, and is connected to nothing". You can’t get more alternative than that. We are told that a new programme is to be launched in May by "advisory board member, Andrew Weil. If you want to learn more about Weil, I suggest the article by ex-editor of the New England Journal of Medicine, Arnold Relman [A Trip to Stonesville: Some Notes on Andrew Weil (1998)]. That is the Dr Weil who has claimed he has insights into medical truth while under the influence of drugs. It is also the Dr Weil who, last year, was threatened with criminal prosecution in a warning letter sent jointly from the Food and Drugs Administration and the Federal Trade Commission because of “Unapproved/Uncleared/Unauthorized Products Related to the H1N1 Flu Virus” In fact every good doctor takes into account the " interaction of emotional, social and physical needs". There is no need to call this "integrative". it is just good medicine. I suggest looking at Michael Baum’s superb Samuel Gee lecture, "Concepts of holism in orthodox and alternative medicine". We are told that "The IHT is now looking for a strong collaborating university partner that will not be intimidated by the likes of Colquhoun". I’m sorry that Dr Daniel sees my approach as "intimidation" and “scare tactics”. The fact of the matter is that the content of the course is truly scary. Once what is taught on courses on alternative medicine is made public, the courses usually seem to close. The contents are just too embarrassing for even the most mercenary vice-chancellor to tolerate. Dr Daniel tells us she is “now looking for a strong collaborating university partner”. If any universities are tempted, I’d suggest that they should first write to the vice-chancellor of Buckingham, Terence Kealey, to seek his advice. |
Follow-up
Still no takers for FIM: June 2010. I made some enquiries about rumours that the Faculty of Integrated Medicine (FIM), having been fired by Buckingham, and rejected by the Prince’s Foundation (deceased), would seek validation from another institution. The University of Bristol says it has not been contacted by FIM. The University of Middlesex, which still runs several courses in magic medicine, was a more likely taker. However, after a long correspondence they responded as follows on June 15, 2010.
“Following an approach by Dr Rosy Daniel to the University, an informal meeting took place between Dr Daniel and our Associate Dean, Academic Development. As a result of that meeting and conversations with other colleagues in the University it was decided that proposals for the University to become a validating partner for the Faculty of Integrated Medicine would not be taken forward. The decision was relayed to Dr Daniel orally.”
3 March 2011. Unsurprisingly, Dr Daniel is up and running again, under the name of the British College of Integrated Medicine. The only change seems to be that Mark Atkinson has jumped ship altogether, and, of course, she is now unable to claim endorsement by Buckingham, or any other university. Sadly, though, Karol Sikora seems to have learned nothing from the saga at the University of Buckingham. He is still there as chair of the Medical Advisory Board, along with the usual suspects mentioned above.
There is something very offensive about the idea that a ‘bachelor of science’ degree can be awarded by a university, as a prize for memorising gobbledygook.
Once the contents of the ‘degrees’ has been exposed to public ridicule, many universities have stopped doing it. All (or nearly all) of these pseudo-degrees have closed at the University of Salford, the University of Central Lancashire, Robert Gordon University, the University of Buckingham, and even at the University of Westminster (the worst offender), one course has closed (with rumours of more to follow).
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I’ve already written about the course in Traditional Chinese Medicine at the University of Salford (Chinese medicine -acupuncture gobbledygook revealed) and at the University of Westminster: see Why degrees in Chinese medicine are a danger to patients. The former has closed, but not the latter. Here is another one. One place that has yet to come under close scrutiny is Middlesex University. |
Michael Driscoll, VC of Middlesex University. The buck stops with him. |
Their “Complementary Health” courses are as follows (April 2010).
- Complementary Health Sciences (Ayurveda) Degree, BSc Honours
- Herbal Medicine Degree, BSc Honours
- Traditional Chinese Acupuncture Degree, BSc Honours
- Traditional Chinese Medicine Degree, BSc Honours
and also two postgraduate courses
I asked Middlesex University for samples of their teaching materials under the Freedom of Information Act, and, as usual, the request was refused. As usual, I then asked for the mandatory internal review of the decision, and this time, most unusually, the internal review did not confirm the initial refusal and I was sent a bundle of teaching materials about Chinese Herbal Medicine, It was not all I asked for, but it is quite enough to show the absurd ideas that are still being taught as part of bachelor of Science degree in a UK University.
Not only are the ideas absurd, pre-scientific, indeed antiscientific. They are also dangerous. People who have been taught this nonsense are going out and being let loose on sick people.
The vice-chancellor of Middlesex University, Professor Michael Driscoll, is an economist, not a biologist. Surely you don’t need to be a scientist to feel a bit suspicious when you read on the Middlesex web site about
Traditional Chinese Acupuncture and Moxibustion including distribution of meridians-collaterals and location of acupoints; needling and moxibustion techniques;
Have any of the members of the Executive ever thought to ask about what goes on in these courses? Even if it is beyond an economist to see through the nonsense, surely it should be possible for Professor Margaret House, Deputy Vice-Chancellor Academic, whose interests lie in water quality, should be able to, though as Dean of the School of Health and Social Sciences she appears to sponsor the nonsense. And Professor Waqar Ahmad, Deputy Vice-Chancellor Research and Enterprise, who has written a s book on Ethnicity, Health and Health Care, should surely be able to distinguish sense from nonsense in health care? In that respect, I’d have less confidence in Katie Bell, Chief Marketing Officer, who joined Middlesex University in 2009 following a career in brand marketing for Nestlé UK and GlaxoSmithKline Consumer Healthcare. Marketing people seldom have much regard for truth.
Have any of the University’s Governors ever asked what is going on in their name? It’s true that none of the long list of distinguished-sounding governors is a scientist. Surely you don’t need to be to question whether or not what follows can be described as ‘science’.
My guess is that none of these distinguished people has ever bothered to look at the dangerous nonsense that is being taught in their University. It is not in the nature of ‘managers’ to look far beyond ticked-boxes and profit, They should have done of course, but to make it easier for them, here is a small selection of the slides that I was sent (the copyright for them lies with the university: these few slides come under the heading ‘ ‘fair quotation’ and it is undoubtedly in the public interest to show them).
Course CMH 1211
e 
Uhuh, my spleen qi is well and truly knotted already though when I learned physiology it was not thought that the spleen had much to do with emotions.
Ah so at least the problem of heavy breathers is solved. But high temperature, abdominal pain and abnormal pulse can be signs of serious illness. If your only explanation for them is “preponderant evil Qi”, you are a menace to public health.
All these symptoms could be the result of a serious disease. It is not only antiquated nonsense to talk about them in terms of Yin, Yang and Qi. It endangers people,
Course CMH 2212
Chinese materia medica. Some of the herbs are likely to contain active ingredients (indeed some are very dangerous). It would be quite possible to study the ingredients of these herbs and to investigate how they work in the light of what has been learned about physiology and pharmacology in the last 200 years. Pharmacology has a long history of doing that, But is seems to play no part in this course. Herbs are “cold” or “hot” and may “check the exuberance of yang”.
and so on, just preposterous, made-up nonsense from another era.
If it were taught as cultural history, it might be interesting. But it is being taught as though it were true, and an appropriate way to treat sick people.
Course CMH 3214
Would you trust your child to someone who’d been taught that “causes of paediatric diseases are relatively simple”, and “children are pure yang”?
Now some Chinese recipes
Course CMH 3100
This may or may not taste good, but to recommend it for diabetes is seriously irresponsible.
The programme specification for the “BSc (Hons) Traditonal Chinese medicine” can be found here. [local copy download]
It is written with all the official trappings, just as though the degree was about science. It isn’t. It is a danger to public health.
I have asked the vice-chancellor, Michael Driscoll, to express his view of these comments
Follow-up
A rather unexpected comment from a London acupuncturist.
“At least,I knew that Professor David Colquhoun is very skeptical about Chinese medicine. he comment Chinese medicine study”not only are the ideas absurd, pre-scientific, indeed antiscientific. They are also dangerous. People who have been taught this nonsense are going out and being let loose on sick people.” “
“But,I still like to read his blog as His article very is respectable. I think. Look this…”
The skeptic blog featured this post in its weekly roundup.
27 May 2010. Times Higher Education reported the decision of Middlesex University to close its philosophy department. This department seems to have a remarkable reputation, not least for a post-1992 university. Three academics and four students have been suspended and gagged in classical bullying style.
This has happened while they continue to teach dangerous rubbish like that described above.
I left a comment at Times Higher, as follows.
It is a reflection on the quality of university management that Middlesex has chosen to shut its philosophy department while continuing to run degrees in quackery. These courses not only offer an Hons BSc for memorising chunks of anti-scientific nonsense. They also pose a real danger to patients. See https://www.dcscience.net/?p=2923
I can think of no better illustration than this of the crass nature of the judgements made by Middlesex’s management. They are either ignorant of what constitutes science, or they are corrupt. I see no other possibilities. In either case they should not be running a university.
I think Prof Michael Driscoll owes the world an explanation.
This post recounts a complicated story that started in January 2009, but has recently come to what looks like a happy ending. The story involves over a year’s writing of letters and meetings, but for those not interested in the details, I’ll start with a synopsis.
Synopsis of the synopsis
In January 2009, a course in "integrated medicine" was announced that, it was said, would be accredited by the University of Buckingham. The course was to be led by Drs Rosy Daniel and Mark Atkinson. So I sent an assessment of Rosy Daniel’s claims to "heal" cancer to Buckingham’s VC (president), Terence Kealey, After meeting Karol Sikora and Rosy Daniel, I sent an analysis of the course tutors to Kealey who promptly demoted Daniel, and put Prof Andrew Miles in charge of the course. The course went ahead in September 2009. Despite Miles’ efforts, the content was found to be altogether too alternative. The University of Buckingham has now terminated its contract with the "Faculty of Integrated Medicine", and the course will close. Well done.Buckingham.
Synopsis
- January 2009. I saw an announcement of a Diploma in Integrated Medicine, to be accredited by the University of Buckingham (UB). The course was to be run by Drs Rosy Daniel and Mark Atkinson of the College of Integrated Medicine, under the nominal directorship of Karol Sikora (UB’s Dean of Medicine). I wrote to Buckingham’s vice-chancellor (president), Terence Kealey, and attached a reprint of Ernst’s paper on carctol, a herbal cancer ‘remedy’ favoured by Daniiel.
- Unlike most vice-chancellors, Kealey replied at once and asked me to meet Sikora and Daniel. I met first Sikora alone, and then, on March 19 2009, both together. Rosy Daniel gave me a complete list of the speakers she’d chosen. Most were well-known alternative people, some, in my view, the worst sort of quack. After discovering who was to teach on the proposed course, I wrote a long document about the proposed speakers and sent it to the vice-chancellor of the University of Buckingham, Terence Kealey on March 23rd 2009.. Unlike most VCs, he took it seriously. At the end of this meeting I asked Sikora, who was in nominal charge of the course, how many of the proposed tutors he’d heard of. The answer was "none of them"
- Shortly before this meeting, I submitted a complaint to Trading Standards about Rosy Daniel’s commercial site, HealthCreation, for what seemed to me to be breaches of the Cancer Act 1939, by claims made for Carctol. Read the complaint.
- On 27th April 2009, I heard from Kealey that he’d demoted Rosy Daniel from being in charge of the Diploma and appointed Andrew Miles, who had recently been appointed as Buckingham’s Professor of Public Health Education and Policy &Associate Dean of Medicine (Public Health). Terence Kealey said "You’ve done us a good turn, and I’m grateful". Much appreciated. Miles said the course “needs in my view a fundamental reform of content. . . “
- Although Rosy Daniel had been demoted, she was still in charge of delivering the course at what had, by this time, changed its name to the Faculty of Integrated Medicine which, despite its name, is not part of the university.
- Throughout the summer I met Miles (of whom more below) several times and exchanged countless emails, but still didn’t get the revised list of speakers. The course went ahead on 30 September 2009. He also talked with Michael Baum and Edzard Ernst.
- By January 2010, Miles came to accept that the course was too high on quackery to be a credit to the university, and simply fired The Faculty of Integrated Medicine. Their contract was not renewed. Inspection of the speakers, even after revision of the course, shows why.
- As a consequence, it is rumoured that Daniel is trying to sell the course to someone else. The University of Middlesex, and unbelievably, the University of Bristol, have been mentioned, as well as Thames Valley University, the University of Westminster, the University of Southampton and the University of East London. Will the VCs of these institutions not learn something from Buckingham’s experience? It is to be hoped that they would at the very least approach Buckingham to ask pertinent questions? But perhaps a more likely contender for an organisation with sufficient gullibility is the Prince of Wales newly announced College of Integrated Medicine. [but see stop press]
The details of the story
The University of Buckingham (UB) is the only private university in the UK. Recently it announced its intention to start a school of medicine (the undergraduate component is due to start in September 2011). The dean of the new school is Karol Sikora.
Karol Sikora shot to fame after he appeared in a commercial in the USA. The TV commercial was sponsored by a far-right Republican campaign group, “Conservatives for Patients’ Rights” It designed to prevent the election of Barack Obama, by pouring scorn on the National Health Serrvice. A very curious performance. Very curious indeed. And then there was a bit of disagreement about the titles that he claimed to have.
As well as being dean of medicine at UB. Karol Sikora is also medical research director of CancerPartnersUK. a private cancer treatment company. He must be a very busy man.
Karol Sikora’s attitude to quackery is a mystery wrapped in an enigma. As well as being a regular oncologist, he is also a Foundation Fellow of that well known source of unreliable information, The Prince of Wales Foundation for Integrated Health. He spoke at their 2009 conference.
In the light of that, perhaps it is not, after all, so surprising thet the first action of UB’s medical school was to accredit a course a Diploma in Integrated Medicine. This course has been through two incarnations. The first prospectus (created 21 January 2009) advertised the course as being run by the British College of Integrated Medicine.But by the time that UB issued a press release in July 2009, the accredited outfit had changed its name to the Faculty of Integrated Medicine That grand title makes it sound like part of a university. It isn’t.
Rosy Daniel runs a company, Health Creation which, among other things, recommended a herbal concoction. Carctol. to "heal" cancer, . I wrote to Buckingham’s vice-chancellor (president), Terence Kealey, and attached a reprint of Ernst’s paper on Carctol. . Unlike most university vice-chancellors, he took it seriously. He asked me to meet Karol Sikora and Rosy Daniel to discuss it. After discovering who was teaching on this course, I wrote a document about their backgrounds and sent it to Terence Kealey. The outcome was that he removed Rosy Daniel as course director and appointed in her place Andrew Miles, with a brief to reorganise the course. A new prospectus, dated 4 September 2009, appeared. The course is not changed as much as I’d have hoped, although Miles assures me that while the lecture titles themselves may not have changed, he had ordered fundamental revisions to the teaching content and the teaching emphases.
In the new prospectus the British College of Integrated Medicine has been renamed as the Faculty of Integrated Medicine, but it appears to be otherwise unchanged. That’s a smart bit of PR. The word : “Faculty” makes it sound as though the college is part of a university. It isn’t. The "Faculty" occupies some space in the Apthorp Centre in Bath, which houses, among other things, Chiropract, Craniopathy (!) and a holistic vet,
The prospectus now starts thus.
The Advisory Board consists largely of well-know advocates of alternative medicine (more information about them below).
Most of these advisory board members are the usual promoters of magic medicine. But three of them seem quite surprising,Stafford Lightman, Nigel Sparrow and Nigel Mathers.
Stafford Lightman? Well actually I mentioned to him in April that his name was there and he asked for it to be removed, on the grounds that he’d had nothing to do with the course. It wasn’t removed for quite a while, but the current advisory board has none of these people. Nigel Sparrow and Nigel Mathers, as well as Lightman, sent letters of formal complaint to Miles and Terence Kealey, the VC of Buckingham, to complain that their involvement in Rosy Daniel’s set-up had been fundamentally misrepresented by Daniel. With these good scientists having extricated themselves from Daniel’s organisation, the FIM has only people who are firmly in the alternative camp (or quackery, as i’d prefer to call it). For example, people like Andrew Weil and George Lewith.
Andrew Weil, for example, while giving his address as the University of Arizona, is primarily a supplement salesman. He was recently reprimanded by the US Food and Drugs Administration
“Advertising on the site, the agencies said in the Oct. 15 letter, says “Dr. Weil’s Immune Support Formula can help maintain a strong defense against the flu” and claims it has “demonstrated both antiviral and immune-boosting effects in scientific investigation.”
The claims are not true, the letter said, noting the “product has not been approved, cleared, or otherwise authorized by FDA for use in the diagnosis, mitigation, prevention, treatment, or cure of the H1N1 flu virus.”
This isn’t the first time I’ve come across people’s names being used to support alternative medicine without the consent of the alleged supporter. There was, for example, the strange case of Dr John Marks and Patrick Holford.
Misrepresentation of this nature seems to be the order of the day. Could it be that people like Rosy Daniel are so insecure or, indeed, so unimportant within the Academy in real terms (where is there evidence of her objective scholarly or clinical stature?), that they seek to attach themselves, rather like limpets to fishing boats, to people of real stature and reputation, in order to boost their own or others’ view of themselves by a manner of proxy?
The background
When the course was originally proposed, a brochure appeared. It said accreditation by the University of Buckingham was expected soon.
Not much detail appeared in the brochure, Fine words are easy to write but what matters is who is doing th teaching. So I wrote to the vice-chancellor of Buckingham, Terence Kealey. I attached a reprint of Ernst’s paper on carctol, a herbal cancer ‘remedy’ favoured by Daniel (download the cached version of her claims, now deleted).
Terence Kealey
Kealey is regarded in much of academia as a far-right maverick, because he advocates ideas such as science research should get no public funding,and that universities should charge full whack for student fees. He has, in fact, publicly welcomed the horrific cuts being imposed on the Academy by Lord Mandelson. His piece in The Times started
“Wonderful news. The Government yesterday cut half a billion pounds from the money it gives to universities”
though the first comment on it starts
"Considerable accomplishment: to pack all these logical fallacies and bad metaphors in only 400 words"
He and I are probably at opposite ends of the political spectrum. Yet he is the only VC who has been willing to talk about questions like this. Normally letters to vice-chancellors about junk degrees go unanswered. Not so with Kealey. I may disagree with a lot of his ideas, but he is certainly someone you can do business with.
Kealey responded quickly to my letter, sent in January 2009, pointing out that Rosy Daniel’s claims about Carctol could not be supported and were possibly illegal. He asked me to meet Sikora and Daniel. I met first Sikora alone, and then, on March 19 2009, both together. Rosy Daniel gave me a complete list of the speakers she’d chosen to teach on this new Diploma on IM.
After discovering who was to teach on the proposed course, I wrote a long document about the proposed speakers and sent it to Terence Kealey on March 23rd 2009. It contained many names that will be familiar to anyone who has taken an interest in crackpot medicine, combined with a surprisingly large element of vested financial interests. Unlike most VCs, Kealey took it seriously.
The remarkable thing about this meeting was that I asked Sikora how many names where familiar to him on the list of people who had been chosen by Rosy Daniel to teach on the course. His answer was "none of them". Since his name and picture feature in all the course descriptions, this seemed like dereliction of duty to me.
After seeing my analysis of the speakers, Terence Kealey reacted with admirable speed. He withdrew the original brochure, demoted Rosy Daniel (in principle anyway) and brought in Prof Andrew Miles to take responsibility for the course. This meant that he had to investigate the multiple conflicts of interests of the various speakers and to establish some sort of way forward in the ‘mess’ of what had been agreed before Miles’ appointment to Buckingham
Andrew Miles.
Miles is an interesting character, a postdoctoral neuroendocrinologist, turned public health scientist. I’d come across him before as editor-in-chief of the Journal of Evaluation in Clinical Practice This is a curious journal that is devoted mainly to condemning Evidence Based Medicine. Much of its content seems to be in a style that I can only describe as post-modernist-influenced libertarian.
The argument turns on what you mean by ‘evidence’ and, in my opinion, Miles underestimates greatly the crucial problem of causality, a problem that can be solved only by randomisation, His recent views on the topic can be read here.
An article in Miles’ journal gives its flavour: "Andrew Miles, Michael Loughlin and Andreas Polychronis, Medicine and evidence: knowledge and action in clinical practice". Journal of Evaluation in Clinical Practice 2007, 13, 481–503 [download pdf]. This paper launches an attack on Ben Goldacre, in the following passage.
“Loughlin identifies Goldacre [36] as a particularly luminous example of a commentator who is able not only to combine audacity with outrage, but who in a very real way succeeds in manufacturing a sense of having been personally offended by the article in question. Such moralistic posturing acts as a defence mechanism to protect cherished assumptions from rational scrutiny and indeed to enable adherents to appropriate the ‘moral high ground’, as well as the language of ‘reason’ and ‘science’ as the exclusive property of their own favoured approaches. Loughlin brings out the Orwellian nature of this manoeuvre and identifies a significant implication.”
"If Goldacre and others really are engaged in posturing then their primary offence, at least according to the Sartrean perspective adopted by Murray et al. is not primarily intellectual, but rather it is moral. Far from there being a moral requirement to ‘bend a knee’ at the EBM altar, to do so is to violate one’s primary duty as an autonomous being.”
This attack on one of my heroes was occasioned because he featured one of the most absurd pieces of post-modernist bollocks ever, in his Guardian column in 2006. I had a go at the same paper on this blog, as well as an earlier one by Christine Barry, along the same lines. There was some hilarious follow-up on badscience.net. After this, it is understandable that I had not conceived a high opinion of Andrew Miles. I feared that Kealey might have been jumping out of the frying pan into the fire.
After closer acquaintance I have changed my mind, In the present saga Andrew Miles has done an excellent job. He started of sending me links to heaven knows how many papers on medical epistemology, to Papal Encyclicals on the proposed relationship between Faith and Reason and on more than one occasion articles from the Catholic Herald (yes, I did read it). This is not entirely surprising, as Miles is a Catholic priest as well as a public health academic, so has two axes to grind. But after six months of talking, he now sends me links to junk science sites of the sort that I might get from, ahem, Ben Goldacre.
Teachers on the course
Despite Andrew Miles best efforts, he came in too late to prevent much of the teaching being done in the parallel universe of alternative medicine, The University of Buckingham had a pre-Miles, legally-binding contract (now terminated) with the Faculty of Integrated Medicine, and the latter is run by Dr Rosy Daniel and Dr Mark Atkinson. Let’s take a look at their record.
Rosy Daniel BSc, MBBCh
Dr Rosy Daniel first came to my attention through her commercial web site, Health Creation. This site, among other things, promoted an untested herbal concoction, Carctol, for "healing" cancer.
Carctol: Profit before Patients? is a review by Edzard Ernst of the literature, such as it is, and concludes
Carctol and the media hype surrounding it must have given many cancer patients hope. The question is whether this is a good or a bad thing. On the one hand, all good clinicians should inspire their patients with hope [6]. On the other hand, giving hope on false pretences is cruel and unethical. Rosy Daniel rightly points out that all science begins with observations [5]. But all science then swiftly moves on and tests hypotheses. In the case of Carctol, over 20 years of experience in India and almost one decade of experience in the UK should be ample time to do this. Yet, we still have no data. Even the small number of apparently spectacular cases observed by Dr. Daniel have not been published in the medical literature.
On this basis I referred Health Creation to Trading Standards officer for a prima facie breach of the Cancer Act 1939. ]Download the complaint document]. Although no prosecution was brought by Trading Standards, they did request changes in the claims that were being made. Here is an example.
A Google search of the Health Creation site for “Carctol” gives a link
Dr Daniel has prescribed Carctol for years and now feels she is seeing a breakthrough. Dr Daniel now wants scientists to research the new herbal medicine
But going to the link produces
Access denied.
You are not authorized to access this page.
You can download the cached version of this page, which shows the sort of claims that were being made before Trading Standards Officers stepped in. There are now only a few oblique references to Carctol on the Health Creation site, e.g. here..
Both Rosy Daniel and Karol Sikora were speakers at the 2009 Princes’s Foundation Conference, in some odd company.
Mark Atkinson MBBS BSc (Hons) FRIPH
Dr Mark Atkinson is co-leader of the FiM course. He is also a supplement salesman, and he has promoted the Q-link pendant. The Q-link pendant is a simple and obvious fraud designed to exploit paranoia about WiFi killing you. When Ben Goldacre bought one and opened it. He found
“No microchip. A coil connected to nothing. And a zero-ohm resistor, which costs half a penny, and is connected to nothing.”
Nevertheless, Mark Atkinson has waxed lyrical about this component-free device.
“As someone who used to get tired sitting in front of computers and used to worry about the detrimental effects of external EMF’s, particularly as an avid user of mobile phones, I decided to research the various devices and technologies on the market that claim to strengthen the body’s subtle energy fields. It was Q Link that came out top. As a Q link wearer, I no longer get tired whilst at my computer, plus I’m enjoying noticeably higher energy levels and improved mental performance as a result of wearing my Q Link. I highly recommend it.” Dr Mark Atkinson, Holistic Medical Physician
Mark Atkinson is also a fan of Emo-trance. He wrote, In Now Magazine,
"I wanted you to know that of all the therapies I’ve trained in and approaches that I have used (and there’s been a lot) none have excited me and touched me so deeply than Emotrance."
"Silvia Hartmann’s technique is based on focusing your thoughts on parts of your body and guiding energy. It can be used for everything from insomnia to stress. The good news is that EmoTrance shows you how to free yourself from these stuck emotions and release the considerable amounts of energy that are lost to them."
Aha so this particular form of psychobabble is the invention of Silvia Hartmann. Silvia Hartmann came to my attention because her works feature heavily in on of the University of Westminster’s barmier “BSc” degrees, in ‘naturopaths’, described here. She is fanous, apart from Emo-trance, for her book Magic, Spells and Potions
“Dr Hartmann has created techniques that will finally make magic work for you in ways you never believed to be possible.”
Times Higher Education printed a piece with the title ‘Energy therapy’ project in school denounced as ‘psychobabble’. They’d phoned me a couple of days earlier to see whether I had an opinion about “Emotrance”. As it happens, I knew a bit about it because it had cropped up in a course given at, guess where, the University of Westminster . It seems that a secondary school had bought this extreme form of psychobabble. The comments on the Times Higher piece were unusually long and interesting.
It turned out that the inventor of “Emotrance”, Dr Silvia Hartmann PhD., not only wrote books about magic spells and potions, but also that her much vaunted doctorate had been bought from the Universal Life Church, current cost $29.99.
The rest of the teachers
The rest of the teachers on the course, despite valiant attempts at vetting by Andrew Miles, includes many names only too well-known to anybody who has taken and interest in pseudo-scientific medicine. Here are some of them.
Damien Downing:, even the Daily Mail sees through him. Enough said.
Kim Jobst, homoepath and endorser of the obviously fraudulent Q-link
pendant. His Plaxo profile says
About Kim A. Jobst
Consultant, Wholystic Care Physician [sic!] , Medical Homoeopath, Specialist in Neurodegeneration and Dementia, using food state nutrition, diet and lifestyle to facilitate Healing and Growth;
Catherine Zollman, Well known ally of HRH and purveyer of woo.
Harald Walach, another homeopath, fond of talking nonsense about "quantum effects".
Nicola Hembry, a make-believe nutritionist and advocate of vitamin C and laetrile for cancer
Simon Mills, a herbalist who is inclined to diagnoses like “hot damp”, ro be treated with herbs that tend to “cool and dry.”
David Peters, of the University of Westminster. Enough said.
Nicola Robinson of Thames Valley University. Advocate of unevidenced treatmsnts.
Michael Dixon, of whom more here.
And last but not least,
Karol Sikora.
The University of Buckingham removes accreditation of the Faculty of Integrated Medicine
The correspondence has been long and, at times, quite blunt. Here are a few quotations from it, The University of Buckingham, being private, is exempt from the Freedom of Information Act (2000) but nevertheless they have allowed me to reproduce the whole of the correspondence. The University, through its VC, Terence Keeley, has been far more open than places that are in principle subject to FOIA, but which, in practice, always try to conceal material. I may post the lot, as time permits, but meanwhile here are some extracts. They make uncomfortable reading for advocates of magic medicine.
Miles to Daniel, 8 Dec 2009
” . . . now that the University has taken his [Sikora’s] initial advice in trialing the DipSIM and has found it cost-ineffective, the way forward is therefore to alter that equation through more realistic financial contribution from IHT/FIM at Bath or to view the DipSIM as an experiment that has failed and which must give way to other more viable initiatives."
"The University is also able to confirm that we hold no interest in jointly developing any higher degrees on the study of IM with IHT/FIM at Bath. This is primarily because we are developing our own Master’s degree in Medicine of the Person in collaboration with various leading international societies and scholars including the WHO and which is based on a different school of thought. "
Miles to Daniel 15 Dec 2009
"Dear Rosy
It appears that you have not fully assimilated the content of my earlier e-mails and so I will reiterate the points I have already made to you and add to them.
The DipSIM is an external activity – in fact, it is an external collaboration and nothing more. It is not an internal activity and neither is it in any way part of the medical school and neither will it become so and so the ‘normal rules’ of academic engagement and scholarly interchange do not apply. Your status is one of external collaborator and not one of internal or even visiting academic colleague. There is no “joint pursuit” of an academically rigorous study of IM by UB and IHT/FIM beyond the DipSIM and there are no plans, and never have been, for the “joint definition of research priorities” in IM. The DipSIM has been instituted on a trial basis and this has so far shown the DipSIM to be profoundly cost-ineffective for the University. You appear to misunderstand this – deliberately or otherwise."
Daniel to Miles 13 Jan 2010
"However, I am aware that weather permitting you and Karol will be off to the Fellows meeting for the newly forming National College (for which role I nominated you to Dr Michael Dixon and Prof David Peters.)
I have been in dialogue with Michael and Boo Armstrong from FIH and they are strongly in favour of forming a partnership with FIM so that we effectively become one of many new faculties within the College (which is why we change our name to FIM some months ago).
I have told Michael about the difficulties we are having and he sincerely hopes that we can resolve them so that we can all move forward as one. "
Miles to Daniel 20 Jan 2010
"Congratulations on the likely integration of your organisation into the new College of Integrative Health which will develop out of the Prince’s Foundation for Integrated Health. This
will make an entirely appropriate home for you for the longer term.Your image of David Colquhoun "alive and kicking" as the Inquisitor General, radiating old persecutory energy and believing "priestess healers" (such as you describe youself) to be best "tortured, drowned and even burnt alive", will remain with me, I suspect, for many years to come (!). But then, as the Inquisitor General did say, ‘better to burn in this life than in the next’ (!). Overall, then, I reject your conclusion on the nature of the basis of my decision making and playfully suggest that it might form part of the next edition of Frankfurt’s recent volume ["On Bullshit] http://press.princeton.edu/titles/7929.html I hope you will forgive my injection of a little academic humour in an otherwise formal and entirely serious communication.
The nature of IM, with its foundational philosophy so vigorously opposed by mainstream medicine and the conitnuing national and international controversies which engulf homeopaths, acupuncturists, herbalists, naturopaths, transcendental meditators, therapeutic touchers, massagers, reflexologists, chiropractors, hypnotists, crystal users, yoga practitioners, aromatherapists, energy channelers, chinese medicine practitioners et al, can only bring the University difficulties as we seek to establish a formal and internationally recognised School of Medicine and School of Nursing.
I do not believe my comments in relation to governance at Bath are "offensive". They are, on the contrary, entirely accurate and of concern to the University. There have been resignations at senior level from your Board due to misrepresentation of your position and there has been a Trading Standards Authority investigation into further instances of misrepresentation. I am advised that an audit is underway of your compliance with the Authority’s instructions. You have therefore not dealt with my concerns, you have merely described them as "offensive".
I note from your e-mail that you are now in discussions with other universities and given the specific concerns of the University of Buckingham which I have dealt with exhaustively in this and other correspondences and the incompatibility of the developments at UB with the DipSIM and your own personal ambitions, etc., I believe you to have taken a very wise course and I wish you well in your negotiations. In these circumstances I feel it appropriate to enhance those negotiations by confirming that the University of Buckingham will not authorise the intake of a second cohort of students and that the relationship between IHT and the University will cease following the graduation of those members of the current course that are successful in their studies – the end of February 2011."
From Miles 2 Feb 2010
"Here is the list of teachers – you can subtract me (I withdrew from teaching when the antics ay Bath started) and also Professor John Cox (Former President of The Royal College of Psychiatrists and Former Secretary General of the World Psychiatric Association) who withdrew when he learned of some of the stuff going on…. Karol Sikora continues to teach. Michael Loughlin and Carmel Martin are both good colleagues of mine and, I can assure you – taught the students solid stuff! Michael taught medical epistemology and Carmel the emerging field of systems complexity in health services (Both of them have now withdrawn from teaching commitments).
The tutors shown are described by Rosy as the finest minds in IM teaching in the country. I interviewed tham all personally on (a) the basis of an updated CV & (b) via a 30 min telephone interview with me personally. Some were excluded from teaching because they were not qualified to do so academically (e.g. Boo Armstrong, Richard Falmer, not even a first degree, etc, etc., but gave a short presentation in a session presided over by an approved teacher) and others were approved because of their academic qualifications, PhD, MD, FRCP etc etc etc) and activity within the IM field. Each approved teacher was issued with highly specific teaching guidance form me (no bias, reference to opposing schools of thought, etc etc) and each teacher was required to complete and sign a Conflicts of Interest form. All of these documentations are with me here. Short of all this governance it’s impossible to bar them from teaching because who else would then do it?! Anyway, the end is in sight – Hallelujah! "
From Miles 19 Feb 2010
"Dear David
Just got back to the office after an excellent planning meeting for the new Master’s Degree in Person-centred Medicine and a hearty (+ alcoholic) lunch at the Ath! Since I shall never be a FRS, the Ath seems to me the next best ‘club’ (!). Michael Baum is part of the steering committee and you might like to take his thoughts on the direction of the programme. Our plans may even find their way into your Blog as an example of how to do things (vs how not to do things, i.e. CAM, IM, etc!). This new degree will sit well alongside the new degrees in Public Health – i.e. the population/utilitarian outlook of PH versus the individual person-centred approach., etc. "
And an email from a senior UB spokesperson
"Rumour has it that now that Buckingham has dismissed the ‘priestess healer of Bath’, RD [Rosy Daniel] , explorations are taking place with other universities, most of which are subject to FoI request from DC at the time of writing. Will these institutions have to make the same mistakes Buckingham did before taking the same action? Rumour also has it that RD changed the name of her institution to FIM in order to fit neatly into the Prince’s FIH, a way, no doubt, of achieving ‘protection’ and ‘accreditation’ in parallel with particularly lucrative IM ‘education’ (At £9,000 a student and with RD’s initial course attracting 20 mainly GPs, that’s £180,00 – not bad business…. And Buckingham’s ‘share of this? £12,000!”
The final bombshell; even the Prince of Wales’ FIH rejects Daniel and Atkinson?
Only today (31 March) I was sent, from a source that I can’t reveal, an email which comes from someone who "represent the College and FIH . . . ".. This makes it clear that the letter comes from the Prince of Wales’ Foundation for Integrated Health
|
Dr Rosy Daniel BSc MBBCh Director of the Faculty of Integrated Medicine Medical Director Health Creation 30th March 2010 RE: Your discussion paper and recent correspondence Thank you for meeting with [XXXXXX] and myself this evening to discuss your proposals concerning a future relationship between your Faculty of Integrated Medicine and the new College. As you know, he and I have been asked to represent the College and FIH in this matter. We are aware of difficulties facing your organisations and the FIM DipSIM course. As a consequence of these, it is not possible for the College to enter into an association with you, any of your organisations nor the DipSIM course at the present time. It would, therefore, be wrong to represent to others that any such association has been agreed. You will appreciate that, in these circumstances, you will not receive an invitation to the meeting of 15th April 2010 nor to other planned events. I am sorry to disappoint you in this matter. Yours sincerely |
Conclusions
I’ll confess to feeling almost a little guilty for having appeared to persecute the particular individuals involved in thie episode. But patients are involved and so is the law, and both of these are more important than individuals, The only unfair aspect is that, while it seems that even the Prince of Wales’ Foundation for Integrated Health has rejected Daniel and Atkinson, that Foundation embraces plenty of people who are just as deluded, and potentially dangerous, as those two. The answer to that problem is for the Prince to stop endorsing treatments that don’t work.
As for the University of Buckingham. Well, despite the ‘right wing maverick’ Kealey and the ‘anti-evidence’ Miles, I really think they’ve done the right thing. They’ve listened, they’ve maintained academic rigour and they’ve released all information for which I asked and a lot more. Good for them, I say.
Follow-up
15 April 2010. This story was reported by Times Higher Education, under the title “It’s terminal for integrated medicine diploma“. That report didn’t attract comments. But on 25th April Dr Rosy Daniel replied with “‘Terminal’? We’ve only just begun“. This time there were some feisty responses. Dr Daniel really should check her facts before getting into print.
3 March 2011. Unsurprisingly, Dr Daniel is up and running again, under the name of the British College of Integrated Medicine. The only change seems to be that Mark Atkinson has jumped ship altogether, and, of course, she is now unable to claim endorsement by Buckingham, or any other university. Sadly, though, Karol Sikora seems to have learned nothing from the saga related above. He is still there as chair of the Medical Advisory Board, along with the usual suspects mentioned above.
Every single request for information about course materials in quack medicine that I have ever sent has been turned down by universities,
It is hardly as important as as refusal of FoI requests to see climate change documents, but it does indicate that some vice-chancellors are not very interested in openness. This secretiveness is exactly the sort of thing that leads to lack of trust in universities and in science as a whole.
The one case that I have won took over three years and an Information Tribunal decision against the University of Central Lancashire (UCLAN) before I got anything.
UCLAN spent £80,307.95.(inc VAT at 17.5%) in legal expenses alone (plus heaven knows how much in staff time) to prevent us from seeing what was taught on their now defunct “BSc (Hons) homeopathy”. This does not seem to me to be good use of taxpayers’ money. A small sample of what was taught has already been posted (more to come). It is very obvious why the university wanted to keep it secret, and equally obvious that it is in the public interest that it should be seen.
UCLAN had dropped not only its homeopathy "degree" before the information was revealed, They also set up an internal inquiry into all the rest of their courses in magic medicine which ended with the dumping of all of them.
Well, not quite all, There was one left. An “MSc” in homeopathy by e-learning. Why this was allowed to continue after the findings of UCLAN’s internal review, heaven only knows. It is run by the same Kate Chatfield who ran the now defunct BSc. Having started to defend the reputation against the harm done to it by offering this sort of rubbish, I thought I should finish. So I asked for the contents of this course too. It is, after all, much the same title as the course that UCLAN had just been ordered to release. But no, this request too was met with a refusal
Worse still, the refusal was claimed under section 43(2) if the Freedom of Information Act 2000. That is the public interest defence, The very defence that was dismissed in scathing terms by the Information Tribunal less than two months ago,
To add insult to injury, UCLAN said that it would make available the contents of the 86 modules in the course under its publication scheme, at a cost of £20 per module, That comes to £1,720 for the course, Some freedom of information.
Because this was a new request, it now has to go through the process of an internal reviw of the decision before it can ne referred to the Information Commissioner. That will be requested, and since internal reviews have, so far, never changed the initial judgment. the appeal to the Information Commissioner should be submitted within the month. I have been promised that the Information Commissioner will deal with it much faster this time than the two years it took last time.
And a bit more unfreedom
Middlesex University
I first asked Middlesex for materials from their homeopathy course on 1 Oct 2008. These courses are validated by Middlesex university (MU) but actually run by the Centre for Homeopathic Education. Thw MU site barely mentions homeopathy and all I got was the usual excuse that the uninsersity did not possess the teaching materials. As usual, the validation had been done without without looking at what was actually being taught. The did send me the validation document though [download it] As usual, the validation document shows no sign at all of the fact that the usbject of the "BSc" is utter nonsense. One wonderful passage says
“. . . the Panel were assured that the Team are clearly producing practitioners but wanted to explore what makes these students graduates? The Team stated that the training reflects the professional standards that govern the programme and the graduateness is achieved through developing knowledge by being able to access sources and critically analyse these sources . . . “
Given that the most prominent characteristic of homeopaths (and other advocates of magic medicine) is total lack of critical ability, this is hilarious. If they had critical ability they wouldn’t be homeopaths. Hilarious is not quite the right word, It is tragic that nonsense like this can be found in an official university document.
Middlesex, though it doesn’t advertise homeopathy, does advertise degrees in Traditional Chinese Medicine, Herbal Medicine and Ayurveda. On 2nd February 2010 I asked for teaching materials from these courses. Guess what? The request was refused. In this case the exemptions under FOIA were not even invoked but I was told that "All these materials are presently available only in one format at the University – via a student-only accessed virtual learning environment. ". Seems that they can’t print out the bits that I asked for, The internal review has been requested, then we shall see what the Information Commissioner has to say.
Two other cases are at present being considered by the Information Commissioner (Scotland), after requests under the Scottish FoIA were refused. They are interesting cases because they bear on the decision, currently being considered by the government, about whether they should implement the recommendations of the execrable Pittilo report.
Napier University Edinburgh. The first was for teaching material form the herbal medicine course at Napier University Edinburgh. I notice that this course no longer appears in UCAS or on Napier’s own web site, so maybe the idea that its contents might be disclosed has been sufficient to make the university do the sensible thing.
Robert Gordon University Aberdeen The second request was for teaching material from the “Introduction to Homeopathy” course at the Robert Gordon University Aberdeen. The particular interest that attaches to this is that the vice-chancellor of Robert Gordon university is Michael Pittilo. The fact that he is willing to tolerate such a course in his own university seems to me to disqualify him from expressing any view on medical subjects.
Michael Pittilo, Crohn’s disease and Andrew Wakefield
Michael Pittilo has not been active in science for some time now, but Medline does show scientiifc publications for Pittilo RM, between 1979 anf 1998. Between 1989 and 1995 there are five papers published jointly with one Andrew Wakefield. These papers alleged a relationship between measles virus and Crohn’s disease. The papers were published before tha infamous 1998 paper by Wakefield in the Lancet (now retracted) that brought disgrace on Wakefield and probably caused unnecessary deaths.. The link between measles and Crohn’s disease is now equally disproved.
The subject has been reviewed by Korzenik (2005) in Past and Current Theories of Etiology of IBD. Toothpaste, Worms, and Refrigerators
“Wakefield et al proposed that Crohn’s results from a chronic infection of submucosal endothelium of the intestines with the measles virus [Crohn’s disease: pathogenesis and persistent measles virus infection. Wakefield AJ, Ekbom A, Dhillon AP, Pittilo RM, Pounder RE., Gastroenterology, 1995, 108(3):911-6]”
"This led to considerable media interest and< public concern over use of live measles vaccine as well as other vaccines. A number of researchers countered these claims, with other studies finding that titers to measles were not increased in Crohn’s patients, granulomas were not associated with endothelium 49 , measles were not in granulomas50 and the measles vaccine is not associated with an increased risk of Crohn’s disease51–55 "
This bit of history is not strictly relevant to the Pittilo report, but I do find quite puzzling how the government chooses people from whom it wishes to get advice about medical problems.
Follow-up
I notice that the Robert Gordon university bulletin has announced that
“Professor Mike Pittilo, Principal of the University, has been made an MBE in the New Year Honours list for services to healthcare”.
That is a reward for writing a very bad report that has not yet been implemented, and one hopes, for the sake of patients, will never be implemented. I do sometimes wonder about the bizarre honours system in the UK.
Postcript.
On 16th February, the death of Michael Pittilo was announced. He had been suffeing from cancer and was only 55 years old. I wouldn’t wish that fate on my worst enemy.
The purpose of this post is to reveal a few samples of things that are taught on a homeopathy ‘degree’ course. The course in question was the "BSc Hons homeopathy course at the University of Central Lancashire (UCLAN). Entry to this course was closed in 2008 and, after an internal review, UCLAN closed almost all of the rest of its courses in alternative medicine too. The university is to be commended for this .
The purpose of making public some of what used to be taught is not to embarrass UCLAN, which has already done the sensible thing, but to make it clear that the sort of thing taught on such courses is both absurd and dangerous, in the hope of discouraging other courses
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.Three years after I first asked for teaching materials, the Information Commisioner ruled that all the reasons given for refusal were invalid, and they must be handed over. However UCLAN then appealed against the decision, so the appeal went to an Information Tribunal. That appeal was lost decisively and UCLAN was.obliged to provide the whole of the course material. On Christmas Eve I got five large box files, 13.7 kg of documents, or 30 pounds, in old money. |
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Because these documents are copyright, I rely on the twin defences of fair quotation (only a tiny proportion is being quoted) and public interest. The Information Tribunal decided very firmly that it was in the public interest that it should be known what is taught on such courses, and that can be achieved if some of it is made public. Here are a few extracts.
Code of ethics
The students are given a copy of the code of ethics of the Society of Homeopaths. This is 25 pages long, but paragraph 48 is especially interesting.
48 Advertisements, stationery and name plates maintain a high standard of propriety and
integrity to enhance the reputation of homeopathy.
- Advertising shall not contain claims of superiority.
- No advertising may be used which expressly or implicitly claims to cure named diseases.
- Advertising shall not be false, fraudulent, misleading, deceptive, extravagant or sensational.
No mention though, of the fact that this code of ethics has been repeatedly breached by the Society of Homeopaths itself, on its own website. See, for example, here in 2007 and again in 2009. as well as Ernst’s article on this topic.
Anyone who has followed dialogues among homeopaths knows that "claims to cure named diseases" is the norm not the exception. The code of ethics is just a bad joke. And the (late) course at UCLAN was no exception. Take, for example, course HP3002, Therapeutic Homeopathy, module leader Jean Duckworth.
Homeopathic treatment of cancer
There was a lecture on HP3002 called "A Homeopathic Approach to Cancer (Ramakrishnan methodology [sic])".. Here are 10 slides from that lecture. It is illegal to claim to be able to cure cancer under the Cancer Act 1939. If a homeopath were to make claims like these in public they’d be open to prosecution, not to mention in breach of the SoH’s code of ethics. If cancer is not a "named disease", what is?
Specific treatments for a named disease are recommended.
What happened to treating the whole person? Now specific organs are being treated. The term "affinity", as used here, is of course sheer hocus pocus.
It is easy to forget when reading this that none of the “medicines” contain any medicine whatsoeever.
Notice that the term "remedy" is used throughout. Any reasonable person would interpret "remedy" to imply "cure", though no doubt a homeopath, if challenged, would claim that "remedy" carried no such implication. The last slide is typical of junk medicine: the personal testimonial, supplied with no detail whatsoever. Just an anecdote which is useless as evidence.
This lecture alone strikes me as a cruel (and possibly illegal) hoax perpetrated on desperate patients. Of course a true believer might get some solace from taking the sugar pills, but that is not sufficient justification.
The same course dealt with quite a lot of other "named diseases", autism, ADHD and coping with a heart attack. And, you are asked, did you think arnica is just a first aid remedy?
If that isn’t a list of "named diseases", what is? The code of ethics appears to be a total sham.
And of course never forget that the “arnica” doesn’t contain any arnica anyway. And if you don’t believe that you can read the words of Kate Chatfield, module leader on thie very course, as recorded in the minutes of evidence to the Select Committee on Science and Technology .
Q538 Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?
Ms Chatfield: Only by the label.
You can read a lovely analysis of the views of Kate Chatfield by physicist A.P. Gaylard here.
Follow-up
The Daily Telegraph. January 8th 2009 Ian Douglas reported on this post: The workings of a BSc in homeopathy
The Lancashire Evening Post carried a big spread on January 15th, Professor seeks out the truth about ‘quackery’.
River’s Edge. News and thoughts from Preston, Lancashire reviewed the Lancashire Evening Post article on Saturday January 16th: Homeopathy at UCLAN, a degree in quackery.
The cost of trying to stop this material being revealed. UCLAN told me on 5 February 2010 that the legal costs alone were £80,307.94 (inc. VAT). That doesn’t include staff time and photocopying. I’m not convinced that this was a good way to spend taxpayers’ money.
Snow on December 18th Roaring fire
Lindy contributes acute comments regularly here. She is also an accomplished musician. She has kindly allowed me to post here four of her re-written carols.
Adam lay ybounden | Hark the Herald | Holly and the Ivy | Merry Gentlemen
Adam lay ybounden
The Middle English dialect is not easy to follow. In fact Wikipedia reveals that it is oit even standard Middle English, but Macaronic English. The original words are reproduced in the right hand column. The original, sung by choir of King’s College Chapel, is on YouTube.
| Atoms lay y’bounden In primordial soup; Six billion years did pass A’fore they could regroup. For first had bin a big bang The universe was shook; Though through milennia For god it was mistook. Then particles of light did shine, ema- -nating from the sun. Out of soup arose archaea And so life was begun. Thanks be to the man This mystery did solve; Through him we celebrate how we Did from the bugs evolve. |
Adam lay ybounden, Bounden in a bond: Four thousand winter Thought he not too long. And all was for an apple, An appil that he took, As clerkè finden Written in their book. Ne had the apple taken been, The appil taken been, Ne had never our lady Abeen heavenè queen. Blessèd be the time That appil taken was, Therefore we moun singen, Deo gracias! . |
Hark the Herald Angels sing.
This version is for Simon Singh. If you haven’t yet signed the new peition, please do it here.
Mark this very dang’rous thing,
Story is of Simon Singh.
He got chiropractors riled,
“Sod it! We have been defiled!
Ployful all ye woosters rise,
Join us to defend our lies,
With us loudly please proclaim,
Subluxations are our game”
Christ, they all with one accord
Took young Simon off to court.
“We’ll put you before a judge,
Since we always bear a grudge
‘Gainst all those who say our modus
Operandi is all bogus;
Mark the words of justice Eady,
Gave his ruling oh so speedy.
Mark the case of Simon Singh
With support the web does ring.
Ditch draconian libel laws,
Without which they’d have no cause
To sue those who would speak freely,
Truth, opinion-and reason really
Should prevail o’er all such things,
Surely he his case must win.
The Holly and the Ivy
Dedicated to the Prince of Wales, certain vice-chancellors and other champions of the endarkenment.
The folly and the lies, see
How they’ve become full-blown;
The braying of th’quackti’tioner Roy-
Al, th’enlightenment has flown.
Refrain: For deriding all the data
(Such stunning stuff we hear)!
The displaying of such cherry pick-
-Ing, beats bringing in Chi square.
The folly hears no critics
It makes you quite struck dumb,
Just put a poison substance in,
And dilute to kingdom come.
For deriding all the data etc.
The folly so does blossom,
Beguiles you with its charm,
Just make some movements with your wrist
And it will do no harm.
For deriding all the data etc.
The folly’s given credence
If you are qualified
With a BSc in pseudosci-
-Ence, th’endarkenment is nigh!
For deriding all the data etc.
The folly bears a burden
Now it has fallen down;
F.O.I requests and publicity
Have giv’n D.C. the crown.
For deriding all the data etc.
The folly is so fickle,
How did they have the gall
To tell us how their remedies
Were here to treat us all?
For deriding all the data etc.
The folly and the lies, see
How they must surely fail
We’ll drink a toast to good evidence
And let real science prevail!
Alternative refrain:
Oh the rising of the Reiki,
Of acupuncture too,
All Rolfering* and Tuina-ish,
They all amount to woo.
*The names Rolf and Roger seem remarkably similar in some circumstances so I get a little confused.
Merry gentlemen.
Here is Lindy’s version of "god rest ye merry gentleman", composed in the wake of the admission by the Professional Standards director of Boots the Chemists that they sell homeopathic pills despite being aware of the fact that there is no reason to think they work.
I arrest you merry gentlemen,
Please kindly step this way.
For you are selling sugar pills
For which the people pay;
We’re from the Trading Standards and through courts we’ll find a way
To stop your profit-making ploy, Profiting ploy,
We’ll stop your profiteering ploy”!
The chemists calmly did defend
Themselves though they were riled;
“The people do demand these pills
Because they’re not defiled
With molecules (nor ‘owt at all), despite the claims so wild;
We’ll continue our profiteering ploy, Profiting ploy,
We’ll continue our profiteering ploy”.
So Trading Standards did respond
“We understand your aim
To make more money, though if you
Persist with bogus claim
To cure disease with sugar pills,
We’ll put you all to shame!
We are stopping your profiteering ploy, Profiting ploy,
We are stopping your profiteering ploy”.
“You breach the regulations by selling pills, you see,
Which claim to contain ‘aqua’ (dilute to 30C),
Or ‘dolphin song’ or ‘canine testes’ – even ‘ATP’!
So you’ll stop all this profiteering ploy, profiting ploy,
So you’ll stop all this profiteering ploy”.
The Dept of Health bangs on and on
About a patient’s choice,
But all good people must condemn
These lies with one great voice.
We dream of days when fibs are gone and we can all rejoice
‘Cos they’ve stopped all their profiteering ploy, Profiting ploy,
‘Cos they’ve stopped all their profiteering ploy
The Yuletide edition of the BMJ carries a lovely article by Jeffrey Aronson, Patent medicines and secret remedies. (BMJ 2009;339:b5415).
I was delighted to be asked to write an editorial about it, In fact it proved quite hard work, because the BMJ thought it improper to be too rude about the royal family, or about the possibility of Knight Starvation among senior medics. The compromise version that appeared in the BMJ is on line (full text link).
The changes were sufficient that it seems worth posting the original version (with links embedded for convenience).
The cuts are a bit ironic, since the whole point of the article is to point out the stifling political correctness that has gripped the BMA, the royal colleges, and the Department of Health when it comes to dealing with evidence-free medicine. It has become commonplace for people to worry about the future of the print media, The fact of the matter is you can often find a quicker. smarter amd blunter response to the news on blogs than you can find in the dead tree media. I doubt that the BMJ is in any danger of course. It has a good reputation for its attitude to improper drug company influence (a perpetual problem for clinical journals) as well as for clinical and science articles. It’s great to see its editor, Fiona Godlee, supporting the national campaign for reform of the libel laws (please sign it yourself).
The fact remains that when it comes to the particular problem of magic medicine, the action has not come from the BMA, the royal colleges, and certainly not from the Department of Health, It has come from what Goldacre called the “intrepid, ragged band of bloggers”. They are the ones who’ve done the investigative journalism, sent complaints and called baloney wherever they saw it. This article was meant to celebrate their collective efforts and to celebrate the fact that those efforts are beginning to percolate upwards to influence the powers that be.
It seems invidious to pick on one example, but if you want an example of beautiful and trenchant writing on one of the topics dealt with here, you’d be better off reading Andrew Lewis’s piece "Meddling Princes, Medical Regulation and Licenses to Kill” than anything in a print journal.
I was a bit disappointed by removal of the comment about the Prince of Wales. In fact I’m not particularly republican compared with many of my friends. The royal family is clearly good for the tourist industry and that’s important. Since Mrs Thatcher (and her successors) destroyed large swathes of manufacturing and put trust in the vapourware produced by dishonest and/or incompetent bankers, it isn’t obvious how the UK can stay afloat. If tourists will pay to see people driving in golden coaches, that’s fine. We need the money. What is absolutely NOT acceptable is for royals to interfere in the democratic political process. That is what the Prince of Wales does incessantly. No doubt he is well-meaning, but that is not sufficient. If I wanted to know the winner of the 2.30 at Newmarket, it might make sense to ask a royal. In medicine it makes no sense at all. But the quality of the advice is irrelevant anyway. The royal web site itself says “As a constitutional monarch, the Sovereign must remain politically neutral.”. Why does she not apply that rule to her son? Time to put him over your knee Ma’am?
Two of the major bits that were cut out are shown in bold, The many other changes are small.
BMJ editorial December 2009
Secret remedies: 100 years onTime to look again at the efficacy of remedies Jeffrey Aronson in his article [1] gives a fascinating insight into how the BMA, BMJ and politicians tried, a century ago, to put an end to the marketing of secret remedies. They didn’t have much success. The problems had not improved 40 years later when A.J. Clark published his book on patent medicines [2]. It is astounding to see how little has changed since then. He wrote, for example, “On the other hand the quack medicine vendor can pursue his advertising campaigns in the happy assurance that, whatever lies he tells, he need fear nothing from the interference of British law. The law does much to protect the quack medicine vendor because the laws of slander and libel are so severe.”> Clark himself was sued for libel after he’d written in a pamphlet “ ‘Cures’ for consumption, cancer and diabetes may fairly be classed as murderous”. Although he initially tried to fight the case, impending destitution eventually forced him to apologise [3]. If that happened today, the accusation would have been repeated on hundreds of web sites round the world within 24 hours, and the quack would, with luck, lose [4]. As early as 1927, Clark had written “Today some travesty of physical science appears to be the most popular form of incantation” [5]. That is even more true today. Homeopaths regularly talk utter nonsense about quantum theory [6] and ‘nutritional therapists’ claim to cure AIDS with vitamin pills or even with downloaded music files. Some of their writing is plain delusional, but much of it is a parody of scientific writing. The style, which Goldacre [7] calls ‘sciencey’, often looks quite plausible until you start to check the references. A 100 years on from the BMA’s efforts, we need once again to look at the efficacy of remedies. Indeed the effort is already well under way, but this time it takes a rather different form. The initiative has come largely from an “intrepid, ragged band of bloggers” and some good journalists, helped by many scientific societies, but substantially hindered by the BMA, the Royal Colleges, the Department of Health and a few vice-chancellors. Even NICE and the MHRA have not helped much. The response of the royal colleges to the resurgence in magic medicine that started in the 1970s seems to have been a sort of embarrassment. They pushed the questions under the carpet by setting up committees (often populated with known sympathizers) so as to avoid having to say ‘baloney’. The Department of Health, equally embarrassed, tends to refer the questions to that well-known medical authority, the Prince of Wales (it is his Foundation for Integrated Health that was charged with drafting National Occupational Standards in make-believe subjects like naturopathy [8]. Two recent examples suffice to illustrate the problems. The first example is the argument about the desirability of statutory regulation of acupuncture, herbal and traditional Chinese medicine (the Pittilo recommendations) [9]. Let’s start with a definition, taken from ‘A patients’ guide to magic medicine’ [10]. “Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety”. It seems to me to be self-evident that you cannot start to think about a sensible form of regulation unless you first decide whether what you are trying to regulate is nonsense, though this idea does not seem to have penetrated the thinking of the Department of Health or the authors of the Pittilo report. The consultation on statutory regulation has had many submissions [11] that point out the danger to patients of appearing to give official endorsement of treatments that don’t work. The good news is that there seems to have been a major change of heart at the Royal College of Physicians. Their submission points out with admirable clarity that the statutory regulation of things that don’t work is a danger to patients (though they still have a blank spot about the evidence for acupuncture, partly as a result of the recent uncharacteristically bad assessment of the evidence by NICE [12]). Things are looking up. Nevertheless, after the public consultation on the report ended on November 16th, the Prince of Wales abused his position to make a well-publicised intervention on behalf of herbalists [13]. Sometimes I think his mother should give him a firm lesson in the meaning of the term ‘constitutional monarchy’, before he destroys it. The other example concerns the recent ‘evidence check: homeopathy’ conducted by the House of Commons Science and Technology Select Committee (SCITECH). First the definition [10]: “Homeopathy: giving patients medicines that contain no medicine whatsoever”. When homeopathy was dreamt up, at the end of the 18th century, regular physicians were lethal blood-letters, and it’s quite likely that giving nothing saved people from them. By the mid-19th century, discoveries about the real causes of disease had started, but homeopaths remain to this day stuck in their 18th century time warp. In 1842 Oliver Wendell Holmes said all that needed to be said about medicine-free medicine [14]. It is nothing short of surreal that the UK parliament is still discussing it in 2009. Nevertheless it is worth watching the SCITECH proceedings [15]. The first two sessions are fun, if only for the statement by the Professional Standards Director of Boots that they sell homeopathic pills while being quite aware that they don’t work. I thought that was rather admirable honesty. Peter Fisher, clinical director of the Royal Homeopathic Hospital, went through his familiar cherry-picking of evidence, but at least repeated his condemnation of the sale of sugar pills for the prevention of malaria. But for pure comedy gold, there is nothing to beat the final session. The health minister, Michael O’Brien, was eventually cajoled into admitting that there was no good evidence that homeopathy worked but defended the idea that the taxpayer should pay for it anyway. It was much harder to understand the position of the chief scientific advisor in the Department of Health, David Harper. He was evasive and ill-informed. Eventually the chairman, Phil Willis, said “No, that is not what I am asking you. You are the Department’s Chief Scientist. Can you give me one specific reference which supports the use of homeopathy in terms of Government policy on health?”. But answer came there none (well, there were words, but they made no sense). Then at the end of the session Harper said “homeopathic practitioners would argue that the way randomised clinical trials are set up they do not lend themselves necessarily to the evaluation and demonstration of efficacy of homeopathic remedies, so to go down the track of having more randomised clinical trials, for the time being at least, does not seem to be a sensible way forward.” Earlier, Kent Woods (CEO of the MHRA) had said “the underlying theory does not really give rise to many testable hypotheses”. These two eminent people seemed to have been fooled by the limp excuses offered by homeopaths. The hypotheses are testable and homeopathy, because it involves pills, is particularly well suited to being tested by proper RCTs (they have been, and when done properly, they fail). If you want to know how to do it, all you have to do is read Goldacre in the Guardian [16]. It really isn’t vert complicated. “Imagine going to an NHS hospital for treatment and being sent away with nothing but a bottle of water and some vague promises.” “And no, it’s not a fruitcake fantasy. This is homeopathy and the NHS currently spends around £10million on it.” That was written by health journalist Jane Symons, in The Sun [17]. A Murdoch tabloid has produced a better account of homeopathy than anything that could be managed by the chief scientific advisor to the Department of Health. And it isn’t often that one can say that. These examples serve to show that the medical establishment is slowly being dragged, from the bottom up, into realising that matters of truth and falsehood are more important than their knighthoods. It is all very heartening, both for medicine and for democracy itself. David Colquhoun. Declaration of interests. I was A.J. Clark chair of pharmacology at UCL, 1985 – 2004. 1. Aronson, JK BMJ 2009;339:b5415 2. Clark, A,J, (1938) Patent Medicines FACT series 14, London. See also Patent medicines in 1938 and now https://www.dcscience.net/?p=257 3. David Clark “Alfred Joseph Clark, A Memoir” (C. & J. Clark Ltd 1985 ISBN 0-9510401-0-3) 4. Lewis, A. (2007) The Gentle Art of Homeopathic Killing 5. A.J. Clark (1927) The historical aspect of quackery, BMJ October 1st 1927 6. Chrastina, D (2007) Quantum theory isn’t that weak, (response to Lionel Milgrom). 7 Goldacre, B. (2008) Bad Science. HarperCollins 8. Skills for Health web site 9. A very bad report: gamma minus for the vice-chancellor 10. A Patients’ Guide to Magic Medicine, and also in the Financial Times. 12. NICE fiasco, part 2. Rawlins should withdraw guidance and start again 13. BBC news 1 December 2009 Prince Charles: ‘Herbal medicine must be regulated’. 14. Oliver Wendell Holmes (1842) Homeopathy and Its Kindred Delusions. 15. House of Commons Science and technology committee. Evidence check: homeopathy. Videos and transcripts available at http://www.viewista.com/s/fywlp2/ez/1 16. Goldacre, B. A Kind of Magic Guardian 16 November 2007. 17. Homeopathy is resources drain says |
Follow-up
There is a good account of the third SCITECH session by clinical science consultant, Majikthyse, at The Three Amigos.
16 December 2009.. Recorded an interview for BBC Radio 5 Live. It was supposed to go out early on 17th.
17 December 2009. The editorial is mentioned in Editor’s Choice, by deputy editor Tony Delamothe. I love his way of putting the problem "too many at the top of British medicine seem frozen in the headlights of the complementary medicine bandwagon". He sounds remarkably kind given that I was awarded (by the editor, Fiona Godlee, no less) a sort of booby prize at the BMJ party for having generated a record number of emails during the editing of a single editorial (was it really 24?). Hey ho.
17 December 2009. More information on very direct political meddling by the Prince of Wales in today’s Guardian, and in Press Association report.
17 December 2009. Daily Telegraph reports on the editorial, under the heading “ ‘Nonsense’ alternative medicines should not be regulated“. Not a bad account for a non-health journalist.
17 December 2009. Good coverage in the excellent US blog, Neurologica, by the superb Steven Novella.’ “Intrepid, Ragged Band of Bloggers” take on CAM‘ provides a chance to compare and contrast the problems in the UK and the USA.’
18 December 2009. Article in The Times by former special advisor, Paul Richards. “The influence of Prince Charles the lobbyist is out of hand. Our deference stops us asking questions.”
“A good starting point might be publication of all correspondence over the past 30 years. Then we will know the extent, and influence, of Prince Charles the lobbyist.”
Comments in the BMJ Quite a lot of comments had appeared by January 8th, though sadly they were mostly from the usual suspects who appear every time one suggests evidence matters. A reply was called for, so I sent this (the version below has links).
After a long delay, this response eventually appeared in the BMJ on January 15 2010.
It’s good to see so many responses, though somewhat alarming to see that several of them seem to expect an editorial to provide a complete review of the literature. I ‘ll be happy to provide references for any assertion that I made.
I also find it a bit odd that some people think that an editorial is not the place to express an opinion robustly. That view seems to me to be a manifestation of the very sort of political correctness that I was deploring. It’s a bit like the case when the then health minister, Lord Hunt, referred to psychic surgery as a “profession” when he should have called it a fraudulent conjuring trick. Anything I write is very mild compared with what Thomas Wakley wrote in the Lancet, a journal which he founded around the time UCL came into existence. For example (I quote)
“[We deplore the] “state of society which allows various sets of mercenary, goose-brained monopolists and charlatans to usurp the highest privileges…. This is the canker-worm which eats into the heart of the medical body.” Wakley, T. The Lancet 1838-9, 1
I don’t think it is worth replying to people who cite Jacques Benveniste or Andrew Wakefield as authorities. Neither is it worth replying to people who raise the straw man argument about wicked pharmaceutical companies (about which I am on record as being as angry as anyone). But I would like to reply directly to some of the more coherent comments.
Sam Lewis and Robert Watson. [comment] Thank you for putting so succinctly what I was trying to say.
Peter Fisher [comment]. I have a lot of sympathy for Peter Fisher. He has attempted to do some good trials of homeopathy (they mostly had negative outcomes). He said he was "very angry" when the non-medical homeopaths were caught out recommending their sugar pills for malaria prevention (not that this as stopped such dangerous claims which are still commonplace). He agreed with me that there was not sufficient scientific basis for BSc degrees in homeopathy. I suppose that it isn’t really surprising that he continues to cherry pick the evidence. As clinical director of the Royal London Homeopathic Hospital and Homeopathic physician to the Queen, just imagine the cognitive dissonance that would result if he were to admit publicly that is all placebo after all. He has come close though. His (negative) trial for homeopathic treatment of rheumatoid arthritis included the words "It seems more important to define if homeopathists can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response” [2]. [download
the paper]. When it comes to malaria, it matters a lot.
Adrian White [comment] seems to be cross because I cited my own blog. I did that simply because if he follows the links there he will find the evidence. In the case of acupuncture it has been shown time after time that "real" acupuncture does not differ perceptibly from sham. That is true whether the sham consists of retractable needles or real needles in the "wrong" places. A non-blind comparison between acupuncture and no acupuncture usually shows some advantage for the former but it is, on average, too small to be of much clinical significance [3]. I agree that there is no way to be sure that this advantage is purely placebo effect but since it is small and transient it really doesn’t matter much. Nobody has put it more clearly than Barker Bausell in his book, Snake Oil Science [4]
White also seems to have great faith in peer review. I agree that in real science it is probably the best system we have. But in alternative medicine journals the "peers" are usually other true believers in whatever hocus pocus is being promoted and peer reveiw breaks down altogether.
R. M. Pittilo [comment] I’m glad that Professor Pittilo has replied in person because I did single out his report for particular criticism. I agree that his report said that NHS funding should be available to CAM only where there is evidence of efficacy. That was not my criticism. My point was that in his report, the evidence for efficacy was assessed by representatives of Herbal Medicine, Chinese Medicine and Acupuncture (four from each). Every one of them would have been out of work if they had found their subjects were nonsense and that, no doubt, explains why the assessment was so bad. To be fair, they did admit that the evidence was not all that it might be and recommended (as always) more research I’d like to ask Professor Pittilo how much money should be spent on more research in the light of the fact that over a billion dollars has been spent in the USA on CAM research without producing a single useful treatment. Pittilo says "My own view is that both statutory regulation and the quest for evidence should proceed together" but he seems to neglect the possibility that the quest for evidence might fail. Experience in the USA suggests that is exactly what has, to a large extent, already happened.
I also find it quite absurd that the Pittilo report should recommend, despite a half-hearted admission that the evidence is poor, that entry to these subjects should be via BSc Honours degrees. In any case he is already thwarted in that ambition because universities are closing down degrees in these subjects having realised that the time to run a degree is after, not before, you have some evidence that the subject is not nonsense. I hope that in due course Professor Pittilo may take the same action about the courses in things like homeopathy that are run by the university of which he is vice-chancellor. That could only enhance the academic reputation of Robert Gordon’s University.
George Lewith [comment] You must be aware that the proposed regulatory body, the Health Professions Council, has already broken its own rules about "evidence-based practice" by agreeing to take on, if asked, practitioners of Herbal Medicine, Chinese Medicine and Acupuncture. They have (shamefully) excluded the idea that claims of efficacy would be regulated. In other word they propose to provide exactly the sort of pseudo-regulation which would endanger patients They are accustomed to the idea that regulation is to do only with censoring practitioners who are caught in bed with patients. However meritorious that may be, it is not the main problem with pseudo-medicine, an area in which they have no experience. I’m equally surprised that Lewith should recommend that Chinese evaluation of Traditional Chinese medicine should be included in meta-analyses, in view of the well-known fact that 99% of evaluations from China are positive: “No trial published in China or Russia/USSR found a test treatment to be ineffective” [5]. He must surely realise that medicine in China is a branch of politics. In fact the whole resurgence in Chinese medicine and acupuncture in post-war times has less to do with ancient traditions than with Chinese nationalism, in particular the wish of Mao Tse-Tung to provide the appearance of health care for the masses (though it is reported that he himself preferred Western Medicine).
1. Lord Hunt thinks “psychic surgery” is a “profession”. https://www.dcscience.net/?p=258
2. Fisher, P. Scott, DL. 2001 Rheumatology 40, 1052 – 1055. [pdf file]
3. Madsen et al, BMJ 2009;338:a3115 [pdf file]
4. R, Barker Bausell, Snake Oil Science, Oxford University Press, 2007
5. Vickers, Niraj, Goyal, Harland and Rees (1998, Controlled Clinical Trials, 19, 159-166) “Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials”. [pdf file]
15 January 2010. During the SciTech hearings, Kent Woods (CEO of the MHRA) made a very feeble attempt to defend the MHRA’s decision to allow misleading labelling of homeopathic products. Now they have published their justification for this claim. It is truly pathetic, as explained by Martin at LayScience: New Evidence Reveals the MHRA’s Farcical Approach to Homeopathy. This mis-labelling cause a great outcry in 2006, as documented in The MHRA breaks its founding principle: it is an intellectual disgrace, and Learned Societies speak out against CAM, and the MHRA.
22 January 2010 Very glad to see that the minister himself has chosen to respond in the BMJ to the editorial
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Rt Hon. Mike O’Brien QC MP, Minister of State for Health Services I am glad that David Colquhoun was entertained by my appearance before the Health Select Committee on Homeopathy. But he is mistaken when he says, “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense.” Regulation is about patient safety. Acupuncture, herbal and traditional Chinese medicine involve piercing the skin and/or the ingestion of potentially harmful substances and present a possible risk to patients. The Pittilo Report recommends statutory regulation and we have recently held a public consultation on whether this is a sensible way forward. Further research into the efficacy of therapies such as Homeopathy is unlikely to settle the debate, such is the controversy surrounding the subject. That is why the Department of Health’s policy towards complementary and alternative medicines is neutral. Whether I personally think Homeopathy is nonsense or not is besides the point. As a Minister, I do not decide the correct treatment for patients. Doctors do that. I do not propose on this occasion to interfere in the doctor-patient relationship. |
Here is my response to the minister
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I am very glad that the minister himself has replied. I think he is wrong in two ways, one relatively trivial but one very important. First, he is wrong to refer to homeopathy as controversial. It is not. It is quite the daftest for the common forms of magic medicine and essentially no informed person believes a word of it. Of course, as minister, he is free to ignore scientific advice, just as the Home Secretary did recently. But he should admit that that is what he is doing, and not hide behind the (imagined) controversy. Second, and far more importantly, he is wrong, dangerously wrong, to say it I was mistaken to claim that “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense". According to that view it would make sense to grant statutory regulation to voodoo and astrology. The Pittilo proposals would involve giving honours degrees in nonsense if one took the minister’s view that it doesn’t matter whether the subjects are nonsense or not. Surely he isn’t advocating that? The minister is also wrong to suppose that regulation, in the form proposed by Pittilo, would do anything to help patient safety. Indeed there is a good case to be made that it would endanger patients (not to mention endangering tigers and bears). The reason for that is that the main danger to patients arises from patients being given “remedies” that don’t work. The proposed regulatory body, the Health Professions Council, has already declared that it is not interested in whether the treatments work or not. That in itself endangers patients. In the case of Traditional Chinese Medicine, there is also a danger to patients from contaminated medicines. The HPC is not competent to deal with that either. It is the job of the MHRA and/or Trading Standards. There are much better methods of ensuring patient safety that those proposed by Pittilo. In order to see the harm that can result from statutory regulation, it is necessary only to look at the General Chiropractic Council. Attention was focussed on chiropractic when the British Chiropractic Association decided, foolishly, to sue Simon Singh for defamation. That led to close inspection of the strength of the evidence for their claims to benefit conditions like infant colic and asthma. The evidence turned out to be pathetic, and the result was that something like 600 complaints were made to the GCC about the making of false health claims (including two against practices run by the chair of the GCC himself). The processing of these complaints is still in progress, but what is absolutely clear is that the statutory regulatory body, the GCC, had done nothing to discourage these false claims. On the contrary it had perpetrated them itself. No doubt the HPC would be similarly engulfed in complaints if the Pittilo proposals went ahead. It is one thing to say that the government chooses to pay for things like homeopathy, despite it being known that they are only placebos, because some patients like them. It is quite another thing to endanger patient safety by advocating government endorsement in the form of statutory regulation, of treatments that don’t work. I would be very happy to meet the minister to discuss the problems involved in ensuring patient safety. He has seen herbalists and other with vested interests. He has been lobbied by the Prince of Wales. Perhaps it is time he listened to the views of scientists too. |
Both the minister’s response, and my reply, were reformatted to appear as letters in the print edition of the BMJ, as well as comments on the web..
It seems very reasonable to suggest that taxpayers have an interest in knowing what is taught in universities. The recent Pittilo report suggested that degrees should be mandatory in Acupuncture, Herbal Medicine and Traditional Chinese Medicine. So it seems natural to ask to see what is actually taught in these degrees, so one can judge whether it protects the public or endangers them.
Since universities in the UK receive a great deal of public money, it’s easy. Just request the material under the Freedom of Information Act.
Well, uh, it isn’t as simple as that.
Every single application that I have made has been refused. After three years of trying, the Information Commissioner eventually supported my appeal to see teaching materials from the Homeopathy "BSc" at the University of Central Lancashire. He ruled that every single objection (apart from one trivial one) offered by the universities was invalid. In particular, it was ruled that univerities were not "commercial" organisations for the purposes of the Act.
So problem solved? Not a bit of it. I still haven’t seen any of the materials from the original request because the University of Central Lancashire appealed against the decision and the case of University of Central Lancashire v Information Commissioner is due to be heard on November 3rd, 4th and 5th in Manchester. I’m joined (as lawyers say) as a witness. Watch this space.
UCLan is not the exception. It is the rule. I have sought under the Freedom of Information Act, teaching materials from UClan (homeopathy), University of Salford (homeopathy, reflexology and nutritional therapy), University of Westminster (homeopathy, reflexology and nutritional therapy), University of West of England, University of Plymouth and University of East London, University of Wales (chiropractic and nutritional therapy), Robert Gordon University Aberdeen (homeopathy), Napier University Edinburgh (herbalism).
In every single case, the request for teaching materials has been refused. And that includes the last three, which were submitted after the decision of the Information Commissioner. They will send things like course validation documents, but these are utterly uninformative box-ticking documents. They say nothing whatsoever about what is actually taught.
The fact that I have been able to discover quite a lot about what’s being taught owes nothing whatsoever to the Freedom of Information Act. It is due entirely to the many honest individuals who have sent me teaching materials, often anonymously. We should be grateful to them. Their principles are rather more impressive than those of their principals.
Since this started about three years ago, two of the universities, UCLan and Salford, have shut down entry to all of their CAM courses. And Westminster has shut two of them, with more rumoured to be closing soon. They are to be congratulated for that, but is far from being the end of the matter. The Department of Health, and some of the Royal Colleges, have yet to catch up with the universities, The Pittolo report, which recommends making degrees compulsory, is being considered by the Department of Health. The consultation ends on November 2nd: if you haven’t yet responded, please do so now (see how here, and here).
A common excuse: the university does not possess teaching materials (yes, really)
Several of the universities claim that they cannot send teaching materials, because they have no access to them. This happens when the university has accredited a course that is run by another, privately run, institution. The place that does the actual teaching, being private, is exempt from the Freedom of Information Act.
The ludicrous corollary of this excuse is that the university has accredited the course without checking on what is taught, and in some cases without even having seen a timetable.
The University of Wales
In fact the University of Wales doesn’t run courses at all. Like the (near moribund) University of London, it acts as a degree-awarding authority for a lot of Welsh Universities. It also validates a lot of courses in non-university institutions, 34 or so of them in the UK, and others scattered round the world.
Many of them are theological colleges. It does seem a bit odd that St Petersburg Christian University, Russia, and International Baptist Theological Seminary, Prague, should be accredited by the University of Wales.
They also validate the International Academy of Osteopathy, Ghent (Belgium), Osteopathie Schule Deutschland, the Istituto Superiore Di Osteopatia, Milan, the Instituto Superior De Medicinas Tradicionales, Barcelona, the Skandinaviska Osteopathögskolan (SKOS) Gothenburg, Sweden and the College D’Etudes Osteopathiques, Canada.
The 34 UK institutions include the Scottish School of Herbal Medicine, the Northern College of Acupuncture and the Mctimoney College of Chiropractic.
The case of the Nutritional Therapy course has been described already in Another worthless validation: the University of Wales and nutritional therapy. It emerged that the course was run by a grade 1 new-age fantasist. It is worth recapitulating the follow up.
What does the University of Wales say? So far, nothing. Last week I sent brief and polite emails to Professor Palastanga and to
Professor Clement to try to discover whether it is true that the validation process had indeed missed the fact that the course organiser’s writings had been described as “preposterous, made-up, pseudoscientific nonsense” in the Guardian.
So far I have had no reply from the vice-chancellor, but on 26 October I did get an answer from Prof Palastanga.
As regards the two people you asked questions about – J.Young – I personally am not familiar with her book and nobody on the validation panel raised any concerns about it. As for P.Holford similarly there were no concerns expressed about him or his work. In both cases we would have considered their CV’s as presented in the documentation as part of the teaching team. In my experience of conducting degree validations at over 16 UK Universities this is the normal practice of a validation panel.
I have to say this reply confirms my worst fears. Validation committees such as this one simply don’t do their duty. They don’t show the curiosity that is needed to discover the facts about the things that they are meant to be judging. How could they not have looked at the book by the very person that they are validating? After all that has been written about Patrick Holford, it is simply mind-boggling that the committee seems to have been quite unaware of any of it.It is yet another example of the harm done to science by an unthinking, box-ticking approach.
Incidentally, Professor Nigel Palastanga has now been made Pro Vice-Chancellor (Quality) at the University of Wales and publishes bulletins on quality control. Well well.
The McTimoney College of Chiropractic was the subject of my next Freedom of Information request to the University of Wales. The reasons for that are, I guess, obvious. They sent me hundreds of pages of validation documents, Student Handbooks (approx 50 pages), BSc (Hons) Chiropractic Course Document. And so on. Reams of it. The documents mostly are in the range of 40 to 100 pages. Tons of paper, but none of it tells you anyhing whatsover of interest about what’s being taught. They are a testament to the ability of universities to produce endless vacuous prose with
very litlle content.
They did give me enough information to ask for a sample of the teaching materials on particular topics. But I gor blank refusal, on the grounds that they didn’t possess them. Only McTimoney had them. Their (unusually helpful) Freedom of Information officer replied thus.
“The University is entirely clear about the content of the course but the day to day timetabling of teaching sessions is a matter for the institution rather than the University and we do not require or possess timetable information. The Act does not oblige us to request the information but there is no reason you should not approach McTimoney directly on this.”
So the university doesn’t know the timetable. It doesn’t know what is taught in lectures, but it is " entirely clear about the content of the course".
This response can be described only as truly pathetic.
Either this is a laughably crude form of obstruction of my request, or perhaps, even more frighteningly, the university really believes that its endless box-ticking documents actually provide some useful control of quality. Perhaps the latter interpretation is more charitable. After all, the QAA, CHRE, UUK and every HR department share similar delusions about what constitutes quality.
Perhaps it is just yet another consequence of having science run largely by people who have never done it and don’t understand it.
Validation is a business. The University of Wales validates no fewer than 11,675 courses altogether. Many of these are perfectly ordinary courses in universities in Wales, but they validate 594 courses at non-Welsh accredited institutions, an activity that earned them £5,440,765 in the financial year 2007/8. There’s nothing wrong with that if they did the job properly. In the two cases I’ve looked at, they haven’t done the job properly. They have ticked boxes but they have not looked at what’s being taught or who is teaching it.
The University of Kingston
The University of Kingston offers a “BSc (Hons)” in acupuncture. In view of the fact that the Pittilo group has recommended degrees in acupuncture, there is enormous public interest in what is taught in such degrees, so I asked.
They sent the usual boring validation documents and a couple of sample exam papers . The questions were very clinical, and quite beyond the training of acupuncturists. The validation was done by a panel of three, Dr Larry Roberts (Chair, Director of Academic Development, Kingston University), Mr Roger Hill (Accreditation Officer, British Acupuncture Accreditation Board) and Ms Celia Tudor-Evans (Acupuncturist, College of Traditional Acupuncture, Leamington Spa). So nobody with any scientific expertise, and not a word of criticism.
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Further to your recent request for information I am writing to advise that the University does not hold the following requested information: (1) Lecture handouts/notes and powerpoint presentations for the following sessions, mentioned in Template 3rd year weekend and weekday course v26Aug2009_LRE1.pdf (a) Skills 17: Representational systems + Colour & Sound ex. Tongue feedback 11 (b) Mental Disease + Epilepsy Pulse feedback 21 (c) 18 Auricular Acupuncture (d) Intro. to Guasha + practice Cupping, moxa practice Tongue feedback 14 (2) I cannot see where the students are taught about research methods and statistics. I would like to see Lecture handouts/notes and PowerPoint presentations for teaching in this area, but the ‘timetables’ that you sent don’t make clear when or if it is taught. The BSc Acupuncture is delivered by a partner college, the College of Integrated Chinese Medicine (CICM), with Kingston University providing validation only. As such, the University does not hold copies of the teaching materials used on this course. In order to obtain copies of the teaching materials required you may wish to contact the College of Integrated Chinese Medicine directly. This completes the University’s response to your information request. |
So again we see that Kingston has validated the course but has not seen a timetable, far less what is taught. My reply was thus
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Yes I am exceedingly unhappy about it. The university attaches its name to the course so it must obviously be able to get the material simply by asking for it (I’m surprised that the university should endorse a course without knowing what is taught on it, but that’s another matter). I request formally that you obtain this material. If necessary please read this as a formal appeal. |
I await with interest. In every single case so far, the internal review has merely confirmed the initial refusal. It means a bit of a delay before the case goes to the Information Commisssioner’s Office.
Napier University Edinburgh
Napier University runs a "BSc (Hons) Herbal medicine". (brochure here). Since herbal medicine is a subject of the Pittilo recommendations, there is enormous public interest in what they teach. So I asked, under the Freedom of Information (Scotland) Act (2002). They sent quite quickly validation and accreditation documents, some examination papers, timetables and lecture lists.
The validation was the usual vacuous box-ticking stuff though it did reveal that the course “made extensive use of techniques such as tongue and pulse diagnosis”, which are well known phoney diagnosis methods, about as much use as a pendulum (as used at Westminster University).
As at Kingston University, the exam papers they chose to send were mostly "pretend doctor" stuff. One of them was
Discuss the herbal practitioner’s role in the management of IHD [ischaemic heart disease)
How one would like to see what the students said, and, even more one would like to see the model answer. Amateurs who try to treat potentially serious conditions are a danger to the public.
So then we got to the interesting bit, the request for actual teaching materials.
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I have looked at the material that you sent and I’d now like to make the following supplementary request (A) Lecture notes/handouts and powerpoint slides for the following small smaple of lectures HRB09102 Materia Medica 4 Materia Medica 3 HRB08103 Clinical Medicine and Diagnosis 4 (HRB09104) HRB09100 Materia Medica & Herbal Practice BSc Herbal Medicine : Materia Medica HRB07102 Lastly, I can see nowhere in the timetable, lectures that deal with Research methods, clinical trial design and statistics. |
No prizes for guessing the result Total refusal to send any of them. To make matters worse, the main grounds for refusal were the very "commercial interests" which, after careful legal examination, the Information Commissioner (for England and Wales) had decided were invalid. They say too that "The public interest in withholding the information is greater than the public interest in its release".. It is hard to see how the public interest is served by concealing from the people who pay for the degrees what is taught on degrees that Pittilo wants to make compulsory. [Download the whole response]
The matter is now under internal appeal (read the appeal) and eventually we shall find out whether the Scottish Information Commissioner backs the judgement.
Robert Gordon University Aberdeen
This case has particular interest because the Vice-Chancellor of Robert Gordon University is Professor Michael Pittilo, chair of the highly contentious steering group that recommended degress in CAM. Robert Gordon University (RGU) does not teach herbal medicine or acupuncture. But they do run An Introduction to Homeopathy. All the degrees in homeopathy have closed. It is perhaps the daftest and most discredited of all the popular forms of Magic Medicine. But Professor Pittilo thinks it is an appropriate subject to teach in his university.
So again I asked for information under the Freedom of Information (Scotland) Act 2002. They sent me quite quckly a list of the powerpoint presentations used on the courses [download it]. I asked for a small sample of the powerpoints. And again the university did not possess them!
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I should like to see only the following three powerpoint presentations in the first instance, please.
Please can you let me know also who produced the powerpoints. (1) Evidence for homeopathy I note that you will have to request them but since they are being offered as part of a course offered by RGU, so RGU is responsible for their quality, I presume that this should cause no problem. |
The request was refused on much the same grounds as used by Napier University. As usual, the internal review just confirmed the initial proposal (but dropped the obviously ludicrous public interest defence). The internal review said
“it is mainly the quality of our courses (including course material) and teaching which has given us the position of "the best modern university in Scotland"
I am bound to ask, if the university is so proud of its course material, why is it expending so much time and money to prevent anyone from seeing a small sample of it?
My appeal has been sent to the Scottish Information Commissioner [download the appeal].
What are vice-chancellors thinking about?
I find it very difficult to imagine what is going through the heads of vice-chancellors who run courses in mumbo-jumbo. Most of them don’t believe a word of it (though Michael Pittilo might be an exception) yet they foist it on their students. How do they sleep at night?
Recently the excellent Joe Collier wrote a nice BMJ blog which applauded the lack of respect for authority in today’s students, Joe Collier says good riddance to old-fashioned respect. I couldn’t resist leaving a comment.
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I couldn’t agree more. There is nothing quite so unnerving as being addressed as “Sir”. It is an advantage of age that you realise what second-rate people come to occupy very grand positions. Still odder since, if occasionally they are removed for incompetence, they usually move to an even grander position. I guess that when I was an undergraduate, I found vice-chancellors somewhat imposing. That is, by and large, not a view that survives closer acquaintance. |
Should teaching materials be open to the public?
There is only one university in the world that has, as a matter of policy, made all of its teaching material open to the public, that is the Massachusetts Institute of Technology (MIT). I can recommend strongly course 18.06, a wonderful set of lectures on Linear Algebra by Gilbert Strang. (It is also a wonderful demonstration of why blackboards may be better than Powerpoint for subjects like this). Now they are on YouTube too.
A lot of other places have made small moves in the same direction, as discussed recently in Times Higher Education, Get it Out in the Open.
Now the OU is working with other British universities to help them develop and share open course materials. In June, at the celebrations for the 40th anniversary of the OU, Gordon Brown announced funding to establish the Support Centre for Open Resources in Education at the OU, as part of a £7.8 million grant designed to enhance the university’s national role.
The funding follows a separate grant of £5.7 million from the Higher Education Funding Council for England for universities across the sector to make thousands of hours of free learning materials available.
Much material is available on the web, when individual teachers choose to place it there, but at the same time there is a move in the other direction. In particular, the widespread adoption of Moodle has resulted in a big decrease in openness. Usually you have to be registered on a course to see the material. Even other people in the university can’t see it. I think that is a deplorable development (so, presumably, does HEFCE).
Conclusion
I was told by the Univerity of Kingston that
“The course is one which the University has validated and continues to be subject to the University’s quality assurance procedures, such as internal subject reviews, annual monitoring and external examining”
The only conclusion to be drawn from this is that “quality arrurance procedures” work about as well in universities as they did in the case of baby Peter. No doubt they were introduced with worthy aims. But in practice they occupy vast amounts of time for armies of bureaucrats, and because the brain does not need to be engaged they end up endorsing utter nonsenes. The system is broken.
Resistance is futile. You can see a lot of the stuff here
It is hard to keep secrets in the internet age. Thanks to many wonderful people who have sent me material. you can see plenty of what is taught, despite the desperate attempts of vice-chancellors to conceal it. Try these links.
What is actually taught
Chinese medicine -acupuncture gobbledygook revealed
https://www.dcscience.net/?p=1950
Consultation opens on the Pittilo report: help top stop the Department of Health making a fool of itself
https://www.dcscience.net/?p=2007
Why degrees in Chinese medicine are a danger to patients
https://www.dcscience.net/?p=2043
More make-believe from the University of Westminster. This time its Naturopathy
https://www.dcscience.net/?p=1812
The last BSc (Hons) Homeopathy closes! But look at what they still teach at Westminster University.
https://www.dcscience.net/?p=1329
The opposite of science
https://www.dcscience.net/?p=1191
Bad medicine. Barts sinks further into the endarkenment.
https://www.dcscience.net/?p=1143
A letter to the Times, and progress at Westminster
https://www.dcscience.net/?p=984
Nutritional Fairy Tales from Thames Valley University
https://www.dcscience.net/?p=260
Westminster University BSc: amethysts emit high yin energy
https://www.dcscience.net/?p=227
References for Pittilo report consultation
A very bad report: gamma minus for the vice-chancellor
https://www.dcscience.net/?p=235
The Times (blame subeditor for the horrid title)
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article4628938.ece
Some follow up on the Times piece
https://www.dcscience.net/?p=251
The Health Professions Council breaks its own rules: the result is nonsense
https://www.dcscience.net/?p=1284
One month to stop the Department of Health endorsing quackery. The Pittilo questionnaire,
https://www.dcscience.net/?p=2310
An excellent submission to the consultation on statutory regulation of alternative medicine (Pittilo report)
https://www.dcscience.net/?p=2329
Follow-up
Two weeks left to stop the Department of Health making a fool of itself. Email your response to tne Pittilo consultation to this email address HRDListening@dh.gsi.gov.uk
I’ve had permission to post a submission that has been sent to the Pittilo consultation. The whole document can be downloaded here. I have removed the name of the author. It is written by the person who has made some excellent contributions to this blog under the pseudonym "Allo V Psycho".
The document is a model of clarity, and it ends with constructive suggestions for forms of regulation that will, unlike the Pittilo proposals, really protect patients
Here is the summary. The full document explains each point in detail.
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Executive Summary
Instead, safe regulation of alternative practitioners should be through:
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The first two recommendations for effective regulation are much the same as mine, but the the third one is interesting. The problem with the Cancer Act (1939), and with the Unfair Trading regulations, is that they are applied very erratically. They are the responsibility of local Trading Standards offices, who have, as a rule, neither the expertise nor the time to enforce them effectively. A Health Advertising Standards Authority could perhaps take over the role of enforcing existing laws. But it should be an authority with teeth. It should have the ability to prosecute. The existing Advertising Standards Authority produces, on the whole, excellent judgements but it is quite ineffective because it can do very little.
A letter from an acupuncturist
I had a remarkable letter recently from someone who actually practises acupuncture. Here are some extracts.
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“I very much enjoy reading your Improbable Science blog. It’s great to see good old-fashioned logic being applied incisively to the murk and spin that passes for government “thinking” these days.” “It’s interesting that the British Acupuncture Council are in favour of statutory regulation. The reason is, as you have pointed out, that this will confer a respectability on them, and will be used as a lever to try to get NHS funding for acupuncture. Indeed, the BAcC’s mission statement includes a line “To contribute to the development of healthcare policy both now and in the future”, which is a huge joke when they clearly haven’t got the remotest idea about the issues involved.” “Before anything is decided on statutory regulation, the British Acupuncture Council is trying to get a Royal Charter. If this is achieved, it will be seen as a significant boost to their respectability and, by implication, the validity of state-funded acupuncture. The argument will be that if Physios and O.T.s are Chartered and safe to work in the NHS, then why should Chartered Acupuncturists be treated differently? A postal vote of 2,700 BAcC members is under-way now and they are being urged to vote “yes”. The fact that the Privy Council are even considering it, is surprising when the BAcC does not even meet the requirement that the institution should have a minimum of 5000 members (http://www.privy-council.org.uk/output/Page45.asp). Chartered status is seen as a significant stepping-stone in strengthening their negotiating hand in the run-up to statutory regulation.” “Whatever the efficacy of acupuncture, I would hate to see scarce NHS resources spent on well-meaning, but frequently gormless acupuncturists when there’s no money for the increasing costs of medical technology or proven life-saving pharmaceuticals.” “The fact that universities are handing out a science degree in acupuncture is a testament to how devalued tertiary education has become since my day. An acupuncture degree cannot be called “scientific” in any normal sense of the term. The truth is that most acupuncturists have a poor understanding of the form of TCM taught in P.R.China, and hang on to a confused grasp of oriental concepts mixed in with a bit of New Age philosophy and trendy nutritional/life-coach advice that you see trotted out by journalists in the women’s weeklies. This casual eclectic approach is accompanied by a complete lack of intellectual rigour. My view is that acupuncturists might help people who have not been helped by NHS interventions, but, in my experience, it has very little to do with the application of a proven set of clinical principles (alternative or otherwise). Some patients experience remission of symptoms and I’m sure that is, in part, bound up with the psychosomatic effects of good listening, and non-judgemental kindness. In that respect, the woolly-minded thinking of most traditional acupuncturists doesn’t really matter, they’re relatively harmless and well-meaning, a bit like hair-dressers. But just because you trust your hairdresser, it doesn’t mean hairdressers deserve the Privy Council’s Royal Charter or that they need to be regulated by the government because their clients are somehow supposedly “vulnerable”.” |
Earlier postings on the Pittilo recommendations
A very bad report: gamma minus for the vice-chancellor https://www.dcscience.net/?p=235
Article in The Times (blame subeditor for the horrid title)
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article4628938.ece
Some follow up on The Times piece
https://www.dcscience.net/?p=251
The Health Professions Council breaks its own rules: the result is nonsense
https://www.dcscience.net/?p=1284
Chinese medicine -acupuncture gobbledygook revealed
https://www.dcscience.net/?p=1950
Consultation opens on the Pittilo report: help top stop the Department of Health making a fool of itself https://www.dcscience.net/?p=2007
Why degrees in Chinese medicine are a danger to patients https://www.dcscience.net/?p=2043
One month to stop the Department of Health endorsing quackery. The Pittilo questionnaire, https://www.dcscience.net/?p=2310