Regulating fantasies

[Asolepius]

I am posting this with a deep sense of weariness. Yes, the Complementary and Natural Healthcare Council opens its doors today. BBC news story here. I feel like complaining to the BBC about its use of the term `crackdown', for such a toothless watchdog. We are told that in a year's time the public will demand to see only regulated practitioners. I can't really see the logic. If people are undemanding enough not to ask whether anything works, why should they care about whether the person lying to them about CAM is a qualified liar?

But it all fits together - the MHRA studiously avoids talking about efficacy of CAM. And needless to say our heir to the throne is behind the whole thing.

 

[Puppycow]

And she estimated thousands of clinics may go out of business in the process.

Well, if that really is the effect (which remains to be seen) it could end some of the worst abuses.

It will not judge clinics on whether therapies are effective, but rather on whether they operate a professional and safe business.

To get on to the government-backed register, therapists will have to show they have the right training and experience, abide by a code of conduct and ensure they have insurance in place.

At least if they have insurance, when they do cause harm, there is recourse for the vistims.

 

[Asolepius]

Well, if that really is the effect (which remains to be seen) it could end some of the worst abuses.

My feeling is that those who are attracted by the most extreme `practitioners' are the least likely to be concerned about using a regulated one.

At least if they have insurance, when they do cause harm, there is recourse for the victims.

Direct harm is not the point. Most of these `therapies' do nothing - neither harm nor good. You can bet your bottom dollar that any insurance policy is going to exclude consequential loss. Mine does (I am a freelance clinical science consultant). So a patient with say heart failure gives up their drugs and takes homeopathy. They then die faster that they would have. Is this covered by insurance? Would the policy cover them for negligence (which this is)? Actually you have raised an interesting piont which I will follow up with CNHC.

My concern is with the greater harm. This scheme puts the stamp of credibility on people who lie to sick patients. It gets people to believe the unbelievable, and we all know where that takes us.

 

[Aitch]

As applying to the register is voluntary, Ms Dunn accepted that some therapists might not put themselves forward.

'specially as it costs £45 a year to get on the register.

But she said they would be found out in the end as "within a year or so" customers will be looking to only use therapists who have met the regulator's standards.

People who believe what they want to believe will be influenced by a meaningless piece of paper? Possibly; but I have my doubts.

 

[Ivor the Engineer]

I think the following comment says it all:

Health minister Ben Bradshaw welcomed the establishment of the CNHC.

"Members of the public who use these therapies will be able to check whether the practitioner they're seeing is registered with the CNHC," he said.

"If they are, they have the reassurance of knowing that they have had to meet minimum standards of qualification and that they have signed up to a rigorous code of conduct.

"Practitioners too will benefit by increased public confidence."

I predict in a few years alt. med will be considered a valid choice for patients who wish for their favourite woo therapy to be provided at the expense of the NHS.

I also predict the NHS will cease to exist in a few decades time in all but name. Those who require health care will given a wad of cash to spend on whatever treatment they like.

 

[Aitch]

I also predict the NHS will cease to exist in a few decades time in all but name. Those who require health care will given a wad of cash to spend on whatever treatment they like.

No; they will be given a voucher - which will cover part of the cost of the treatment. If they're luck, it will be most of the cost; if not, well, tough titty.

 

[Asolepius]

I also predict the NHS will cease to exist in a few decades time in all but name. Those who require health care will given a wad of cash to spend on whatever treatment they like.

Already happening.

 

[Blue Wode]

I predict in a few years alt. med will be considered a valid choice for patients who wish for their favourite woo therapy to be provided at the expense of the NHS.

It’s already on the drawing board…

Patients to be given 'personal health budgets'

They will allow patients to buy anything that their local healthcare service deems a good use of NHS resources, including private and national health service treatments, and alternative therapies.

http://www.telegraph.co.uk/health/h...ents-to-be-given-personal-health-budgets.html

ETA: I see Asolepius beat me to it.

 

[Blue Bubble]

Already happening.

Interesting:

Patients are to get their own health budgets so they can pick and choose what NHS services they want.
Ministers will include legislation in the Health Bill, due to be unveiled later, to allow the scheme to be piloted in England later this year.
...

Scotland and Wales currently have no plans to introduce personal health budgets.

Yet another case where Scotland and Wales are so much more advanced than England. We (in England) are doomed.

 

[Ivor the Engineer]

The idea is to please the right-of-center majority in England who resent their slice of the health budget being used to treat people whose needs are greater.

"Oh look Darling, I've £50 left this year to spend on health care. I'll go and have 2 sessions of reflexology to help me deal with the stress of buying all those Christmas presents we cannot afford on the credit card."

 

[Asolepius]

The idea is to please the right-of-center majority in England who resent their slice of the health budget being used to treat people whose needs are greater.

"Oh look Darling, I've £50 left this year to spend on health care. I'll go and have 2 sessions of reflexology to help me deal with the stress of buying all those Christmas presents we cannot afford on the credit card."

More likely the idea is to offload responsibility for health decisions to the patients, because the politicians have given up trying to run the NHS effectively.

 

[Blue Wode]

A good write-up on the whole fiasco has just been put up by lecanardnoir:

Today sees the long awaited launch of the government backed Ofquack, better known in some circles as the Complementary and Natural Healthcare Council (CNHC). Ofquack is the "national voluntary regulator for complementary healthcare practitioners" and was set up by Prince Charles' Foundation for Integrated Health and funding from the Department of Health. You can find their sparkly new website at http://www.ofquack.org.uk.

-snip-

The House of Lords, in a 2000 report, said that such a move was desirable. It has been a dismal failure. The reasons for this are many, but principally stem from the daft decision by the Department of Health to put the set-up of the new body in the hands of Prince Charles. This is a man with a blind faith in all sorts of wooly alternative health ideas and no critical ability to appraise the problem rationally. His sycophants have assured that Ofquack has been set up so that it presents little challenge to his beliefs.

http://www.quackometer.net/blog/2009/01/ofquack-toothless-squawk.html

As you might expect, there’s a bit of back-slapping going on over at the Princes’ Foundation for Integrated Health’s website today:

Patients who opt for complementary healthcare need to know their practitioner is properly trained, understands the limits of his or her competence, and will treat them safely.

That is why the Prince’s Foundation for Integrated Health has worked hard with government and a dozen complementary healthcare professions to establish a robust voluntary regulation system for therapies that are not subject to statutory rules.

So it wants to be first to congratulate the new, independent Complementary and Natural Healthcare Council (CNHC) on setting up the first ever register of approved complementary therapists.

-snip-

The Foundation’s Medical Director Dr Michael Dixon said:

'Millions of people every year use one or more complementary therapies, often alongside conventional treatment. Yet there has been nowhere that the public could check the qualifications and standards of most complementary healthcare practitioners. That is not good for patient safety.

http://www.fih.org.uk/media_centre/protecting_patients.html

For more from Michael Dixon see this link:

Devon GP Michael Dixon argues the case for an integrated health service: “I don’t think that the complementary therapies I suggest to my patients are placebos, but I don’t know.….Recent research on aromatherapy suggests that it could improve mental ability but only if the patient believed it would. That would not stop me referring ’believers’ for aromatherapy. Indeed, I would interpret the research as showing that I should.”

http://www.guardian.co.uk/society/2001/jul/22/health.life

And this one:

Presentation 1: Dr Michael Dixon, Chair, NHS Alliance – CAM in the Context of Primary Care

Dr Dixon ended his presentation with some reminiscences about his father, who was a Swordfish pilot during World War ll. These pilots set out to bomb the Bismarck. Visibility was very poor and the waves very high. They set off in a machine that looked like something from World War 1, to attack a ship with the most modern technology in history. He likened CAM practitioners to those Swordfish pilots, making their way through the fog. They have ancient skills, but lack the evidence base that orthodox clinicians think appropriate; the doctors, on the other hand, have the modern technology and the NICE appraisals to back their work up. His father was given orders to return to base and not to proceed. He disobeyed and so succeeded in his task. ‘I’m not advocating mass civil disobedience, but if you are going to win the game, you have to not always play be the rules of other people. We are going to have to invent our own set of rules and not accept anything as a given.’ he concluded.

Developing Clinical Governance for Complementary and Alternative Medicine in Primary Care, Seminar 1: Building consensus on the evaluation of CAM in primary care, Kings Fund, London
http://www.wmin.ac.uk/sih/pdf/1st seminar report - CGCAMN.pdf

[My bold]

And this article about his brand new surgery, which is currently being promoted on the FIH website, is worth a read too:

The first sign that this is a slightly unusual surgery are the raised organic growing beds in the middle of the car park…..

The surgery also has big plans to educate patients about food. Simon Mills, resident herbalist, has been leading the development of the herb garden, which is in the shape of a body. Herbs are grown on the parts of the body that they affect: echinacea for lungs, chaste tree for gynaecological problems. Mills plans to sell herbs to patients next year….

Michael Dixon says “'I got into the integrated approach for purely selfish reasons. I used to dread appointments with patients with conditions from back pain to allergies, where modern medicine has little to offer. Now I'm able to steer people towards approaches that help them to get better.”

http://www.fih.org.uk/integrated_health/integrated_general_practice/integrated_health_at.html

You can't help but think that Professor David Colquhoun is going to be in for a really tough time on the CNHC's Conduct and Competence committee:

25 September 2008. Surprise! The Complementary and Natural Healthcare Council advertised jobs on its Conduct and Competence committee. So I applied because I was interested to see what excuses they would use to turn me down. They didn’t, so now I am a member of that committee. It should be interesting. And I shall no longer be able to refer to the CNHC as “OfQuack“.

http://dcscience.net/?page_id=237#latest (scroll to end of link)

The very, very, best of luck to him.

 

[Soapy Sam]

For some time I have been convinced that the only form of CAM which has positive results is hairdressing.

The psychological effects of this are largely due to placebo, plus it's nice having someone brush your hair while gossiping- but hey, who cares?

I'm increasingly coming to the view that if people are silly enough to spend their money on SCAM, then hell mend them. My concern is with the waste of my money (insofar as anyone in Britain actually has money now) when someone demands SCAM on the NHS.

 

[Blue Wode]

A snippet from a Comment is Free piece written by Edzard Ernst in yesterday’s Guardian:

Is all this then just a farce, a waste of money and an exercise to please Prince Charles? No, I'm afraid it is worse than that.

-snip-

…their "Code of conduct, performance and ethics" was a closely guarded secret. When it was finally released [on 20th January], I was keen to find out what it says about evidence. The only statement I could find was the following: "You should only provide the treatment or advice if you believe this is appropriate".

So now it is official: evidence for conventional practitioners, while belief suffices for the alternative brigade. The MP Evan Harris was even less impressed with the new CNHC: "This register is an attempt to give legitimacy to a business model founded on deceiving the public with pseudo-scientific and misleading health claims".

More...
http://www.guardian.co.uk/commentisfree/2009/jan/21/complementary-natural-heathcare-council

CNHC’s Code of conduct, performance and ethics:
http://www.cnhc.org.uk/pages/index.cfm?page_id=25

 

[Asolepius]

Thanks Blue Wode - where do you find the time for all this research? So Michael Dixon is chief quack for our king in waiting now? He who waves hands at patients? It's now clear as to the extent of his departure from anything resembling reason. Watch the next official honours list for another gong to add to his OBE. He has all the qualifications.

 

[rudeboy]

My feeling is that those who are attracted by the most extreme `practitioners' are the least likely to be concerned about using a regulated one.



Direct harm is not the point. Most of these `therapies' do nothing - neither harm nor good. You can bet your bottom dollar that any insurance policy is going to exclude consequential loss. Mine does (I am a freelance clinical science consultant). So a patient with say heart failure gives up their drugs and takes homeopathy. They then die faster that they would have. Is this covered by insurance? Would the policy cover them for negligence (which this is)? Actually you have raised an interesting piont which I will follow up with CNHC.

My concern is with the greater harm. This scheme puts the stamp of credibility on people who lie to sick patients. It gets people to believe the unbelievable, and we all know where that takes us.

I used TCM for Diabets with no results

 

[seantellis]

Petition online

I was so incensed by the lack of evidence required for "certification" that I set up a petition at the Number 10 website. (Since I'm new on the forums I am unable to post a link, but the petition name is "CNHCsafety" so a couple of seconds on Google should get you there.)

 

[Wudang]

Here you go

http://petitions.number10.gov.uk/CNHCsafety/

 

[seantellis]

Many thanks for posting the link, Wudang. Only 43 signatures so far, though. Any thoughts for promotion would be gratefully accepted.

 

[Blue Bubble]

Many thanks for posting the link, Wudang. Only 43 signatures so far, though. Any thoughts for promotion would be gratefully accepted.

Sean, I too am perplexed why so few signatories so far. I'm there, as are Wudang and Asolepius.

Consider this a *bump* so that more here will see this.

P.s. I'm sure you've already noticed the typo in the petition:

We the undersigned petition the Prime Minister to require evicence of basic efficacy and safety for licencing by the CNHC.

ETA: p.s. welcome to the forum.