Saturday, March 21, 2009

MHRA force Duchy Originals to remove claims of efficacy

Duchy Originals, Royal Quackpot Prince Charles' company, has been censured for putting claims on their website that their pretend-medicines work.

The Medicines and Healthcare Products Agency (MHRA) received a complaint regarding Duchy Herbals Echina-Relief Tincture and Duchy Herbals Hyperi-Lift Tincture, which had been advertised on the Duchy Originals website as having been assessed for efficacy. The MHRA agreed with the complainant and said their website was was misleading. Personally, I would use a word considerably stronger than 'misleading' - how about 'bullshit'?

The two products had been registered with the MHRA as Traditional Herbal Medicines which means the MHRA do not assess evidence of efficacy. Although the report was only published this week, the action was agreed with Dodgy Originals back in January 09. Not that such a trivial thing would stop Dodgy Originals from claiming their potions work - I wrote during the week (before coming across the MHRA report) about Dodgy Originals' response to Professor Edzard Ernst's broadside on Duchy quackery. Part of the Duchy response from Andrew Baker included the following, with my comment below:
Our Duchy Herbals Echina-Relief Tincture and Duchy Herbals Hyperi-lift Tincture have both been approved and licensed as traditional herbal medicines by the UK regulatory authorities, the Medicines and Healthcare Products Regulatory Agency (MHRA).

Come on, 'fess up, Mr Baker. You and I both know that MHRA approval does not give any indication as to effectiveness. The MHRA never make any claims as to a [Traditional Herbal Medicine's] efficacy, just that it is safe to use and has been well manufactured and won't kill you. But you wouldn't be trying to hide that fact, would you?

I think the answer to that question is now obvious. It seems that Dodgy Originals had already been censured for claiming the MHRA registration demonstrated efficacy two months before writing the above.


Thursday, March 19, 2009

Responding to criticism - The Alternative Way

Responding to criticism is a tricky business.

Let's face it, nobody likes to be criticised, but a robust response addressing the points made, providing evidence to back up your position and accepting mistakes if appropriate can put you in a stronger position than you previously were.

It's already very clear the Complementary and Alternative Medicine (CAM) Industry do not like criticism and do not respond well to it. The first line is often a legal chill - silence dissent by threatening libel. The list grows almost daily with Jeni Barnett, Matthias Rath, Society of Homeopaths, Ann Walker, British Chiropractic Association, and Derek Draper using draconian British libel laws to avoid having to answer their critics. In the majority of cases, The Streisand Effect has ensured that thousands more people were made aware of the criticism than would ever had heard about had the person not gone running to mummy.

Perhaps it's a sign of the times, perhaps the Quackery (CAM) industry has realised that legal threats are counterproductive. This week had two examples of an alternative Alternative response, which were suitably hand-wavy and free of substance, much like the pills and tinctures they purvey.

Firstly, the Society of Homeopaths woke from a daze - they haven't put out a press release since last November (no doubt their members are thrilled the fees have been put to such hard work). In response to a piece in Private Eye about Jeremy Sherr, they have put all of their talents together, diluted & succussed them to 30c and produced this. For anybody who wants to know the full Jeremy "I'm trying to cure AIDS with homeopathy" Sherr story, enjoy the ride at Gimpy's Blog. He has also blogged a tremendous fisk of the SoH response to the Private Eye note here. For the purposes of this blogpost, the salient points are that the SoH made a statement that contained untruths, disingenuous statements and weasel words - the evidence of this is clear in Gimpy's Post.

The second similar statement came from business arm of our Royal Quackpot, Prince Charles' Duchy Originals in response to criticism from Professor Edzard Ernst from the Peninsula Medical School. This isn't the first time that Charlie and Eddy have had a set-to. Prof Ernst has spoken out about the Prince's quackery before, which resulted in Clarence House complaining to the Vice-Chancellor, seemingly suggesting it might be suitable to sack the Prof. How very sporting, what, what?

This time, Prof Ernst has stated that the Duchy Herbals Detox Tincture which contains globe artichoke and dandelion has no efficacy in 'detoxing' (whatever the hell that word means) and is a pretty pill for the middle class worried well, who perhaps like to think that overindulgence can be cured that way. (Edit: See Cargo Cult Science for a similar takedown)

The response is brilliant in its hand-waving, untruths, disingenuous statements and weasel words (where have I heard that before?) - ah yes, three paragraphs ago.
Following recent press articles regarding our Duchy Herbals range, we are aware that some of our customers may be seeking reassurance about the range.

Our CEO, Andrew Baker, says:

'Together with our partners, Nelsons - leaders in the field of natural medicine, we spent many years researching and developing our first range of herbal tinctures. It is a range that we are truly proud of.

Well, they probably are seeking 'reassurance' - they don't really like being told that they are fools easily partable with their money. Even though they are. I have spent many years researching and developing a range of Dr*T's herbal tinctures. Like the Duchy's, they don't work.
Our Duchy Herbals Echina-Relief Tincture and Duchy Herbals Hyperi-lift Tincture have both been approved and licensed as traditional herbal medicines by the UK regulatory authorities, the Medicines and Healthcare Products Regulatory Agency (MHRA).

Come on, 'fess up, Mr Baker. You and I both know that MHRA approval does not give any indication as to effectiveness. The MHRA never make any claims as to a products efficacy, just that it is safe to use and has been well manufactured and won't kill you. But you wouldn't be trying to hide that fact, would you?

Our Duchy Herbals Detox Tincture, which is traded as a food supplement, has been produced to the highest quality standards and within the regulatory framework of both UK and European food law

Ah, a 'food supplement' - I am confused. Why are making medicine-like claims but you sell it as a 'food supplement'? Anything to do with trying your very best to imply it is a medicine, but not making any bold claims, because it doesn't work? I have no doubt it's extremely high quality snakeoil, but it remains snakeoil. (In any case, I still don't understand what "eliminating toxins" means, or indeed "aiding digestion".)
I do hope, therefore, that you are able to share our confidence in the compliance of the Duchy Herbals range to the very highest regulatory standards
Well, I do. This product is very high quality, well-made, and completely benign quackery. This sums up the Duchy's attempt to reassure their customer chumps - the criticism was to say that the product is make-believe nonsense, the response is not to deny that, but to assert that it is quality make-believe nonsense.

Outside of the statement, the Telegraph has quoted a Duchy Originals' (or Dodgy Originals as Prof E likes to call them) spokesperson as saying:
It is not – and has never been described as – a medicine, remedy or cure for any disease.
Compare with the Dodgy Originals Facebook page:
Each of our tinctures provides an alternative and natural way of treating common ailments such as colds and flu.

There is place on the Duchy's website to write a comment - despite a number of Bad Sciencers leaving their thoughts, the Duchy has not deemed it suitable to print them.

That does not deserve a response.

With thanks to Tristan and stvb2170 on Bad Science.


Thursday, March 12, 2009

Department of Health response to CNHC letter

After a month of patiently waiting for a response from Ben Bradshaw to a letter I wrote regarding the Complementary and Natural Healthcare Council (OfQuack), I received a letter from Laurent Vaic, Correspondence Officer for Department of Health.

My original letter can be found here. After some pleasantries, the letter begins in earnest:

In your letter you ask about the efficacy of treatments. I should explain that the CNHC does not promote the efficacy of the therapies it represents. The question of whether or not they work is for those who choose to use the therapies to decide. Professional regulation, whether statutory or in this case, voluntary, is about protecting the public, not about the efficacy of the therapies involved. Registration will mean that a practitioner has met certain entry standards (for instance, has an accredited qualification) and subscribes to a set of professional standards. In this way, the public will have the reassurance that any registered practitioner they choose meets these criteria and that practitioners would be subject to fitness to practise procedures should they behave inappropriately.

In my letter, I asked "How can the CNHC provide protection without knowledge of efficacy?". DoH is stating that it is up to the customer to decide whether the treatment works, and separates 'protecting the public' from 'treatment efficacy'. Remember that the mission of the CNHC is to "support the use of complementary and natural healthcare as a uniquely positive, safe and effective experience." Effective, but with no interest in efficacy. Yes, I know, I had to read again as well.

Personally, I would consider 'protecting the public' to cover stopping quacks from teaching that a urine-press placed on the neck is a suitable treatment for thyroid cancer, but apparently that's fine, providing they don't touch you up at the same time.

The question I posed hasn't been answered. Back to the letter.
You also mention the minutes of a meeting of the Federal Regulatory Board of the CNHC held on 20 November 2008. Officials have contacted the CNHC following your letter to gain an understanding of the statement in the that meeting to which you refer.
And indeed, I can only refer to it, as those (assumed) same officials removed the link from the CNHC webpage specifically for ... em ... putting the minutes on. Furthermore, it is my understanding that the Board meets once a quarter, so we are missing two sets of minutes. A quick quote from the CNHC Missions and Values page:
At all times CNHC will...lead clearly and responsibly, inspiring trust through integrity, transparency and equity.
Transparency is important, but seemingly not in Quackville.
I understand from the CNHC that a board member suggested the possibility of using digital stories as a means of illustrating the positive side of complementary and alternative medicine (CAM) professional regulation. The suggestion was that such stories could utilise people who use CAMs and who recognise the value of regulation, as well as CAM practitioners. The board member concerned told the board that digital stories could be used as part of reflective practice and, as such, may have a place in ongoing professional development. It was suggested that board members might want to look at the website of Pilgrim Projects since this company specialises in 'humanising healthcare' and that Pilgrim Projects' Patient Voices programme contains a selection of the stories the company has made in a variety of contexts.

Unfortunately, I don't speak bureacratese very well, so a chunk of the above paragraph left me slightly bewildered. Reflective practice, anyone? Digital stories? Do people really speak like that?
I understand that the intention was to present this advice in the context described so that the board would gain a better insight into the kind of work that has been done and to ascertain whether they thought this form of 'storytelling' was appropriate for the CNHC to use at some time in the future. I further understand that these were preliminary discussions only and that no decisions were either asked for or made. Unfortunately, the minutes of the board meeting of 20 November 2008 were placed on the CNHC's website without having been approved by the board. The CNHC recognises that potential inaccurate representations of the debate could do considerable damage to the reputation of the CNHC's Board member and that of Patient Voices, neither of which was its intention.

Mistakes have been made, and so minutes will be edited in future to ensure this doesn't happen again.

The last part of the letter provides contact information for CNHC should I require further clarification of the minutes. Actually, the actual minutes would be a start, but as I said above, they have disappeared from the website.

No response on why the CNHC regards its mission as "to support the use of complementary and natural healthcare as a uniquely positive, safe and effective experience".

What happens if someone complains? From the CNHC's own document on Complaints, the CNHC complaint process is not designed to be punitive, with the maximum power of the Complaints procedure being that a practitioner can be removed from the register. Bear in mind it is a voluntary register.

I've already shown above that they are not great at keeping to their own standards. In addition, they have already had a legal chill from the British Standards Institute for hijacking the 'kitemark', which they have had to remove from the CNHC website. Alan H at Think Humanism has also demonstrated a personal data conflict on the CNHC site; from the CNHC site on 'Your Privacy', it states:
The Published Register
CNHC will make part of your register entry available to any enquirer as part of the published register.

The public can inspect the following information on the online register:

* Your full name
* Your profession or practice discipline
* Your approximate work location
* Your registration number
* Any restrictions imposed on your registration

Your home address, contact details, date of birth and other data are not available to the public.
(My bold)

Compare that to this page, which is a search of quacktitioners whose surname is Harmer (unfortunate name for a 'health' practitioner, but no matter):
Search by name

You searched for harmer

Suzanne Harmer
44 Moneybrannon Road, Aghadowey, County Londonderry BT51 4AA Northern Ireland, United Kingdom
Telephone: 07799 471235 Telephone: 07799 471235

Disciplines Massage Therapy Status Registered until 17/02/2010

I'm pretty sure this isn't the last of my OfQuack squawking, although it is tempting to forget about the whole thing as a waste of time, but I *really* begrudge tax-money being used to fund what appears to be a complete waste of energy with no obvious benefits to quacks or punters.
If anyone else can help interpret the letter (and suggest suitable responses - I'll be formulating over the next few days), please feel free to leave your thoughts and ideas below.