I know I’m not the first to criticise Boots for its shameless exploitation of health fads and fancies, but I happened across what it calls its `Corporate Social Responsibility’ policy. With regard to `Our Marketplace’, they say that:
Central to the success of our Group is the trust in which Alliance Boots is held by our customers and wider stakeholders. We aim to reflect integrity and stewardship in everything we do.
How do these fine words sit with some of the products they are selling? I thought I would find out. Thus I marched into my local Boots store and homed in on the substantial `Alternative Therapies’ shelves. The conversation I had with the pharmacist in charge is detailed further down this post, so I won’t duplicate it here, but after that fruitless exchange I fired off an email to the Alliance Boots website, asking how the sale of homeopathy and Bach Flower Remedies could be called socially responsible. In fact that department never responded at all, and simply passed my email to Boots Customer Care, who replied thus:
Thank you for taking the time to contact us regarding your concerns over the retail of Homeopathic and Alternative remedies available in store.
At Boots we take our responsibilities as the leading Pharmacy led Health & Beauty retailer very seriously and as part of this we pride ourselves on being able to offer all of our customers a choice of products that support them in their day-to-day lives.
I’d like to reassure you that we take product quality and efficacy very seriously and every product is thoroughly reviewed by our team of Nutritionists, Legal, Pharmacy and Formulation experts before it can be stocked within our Stores.
Boots also stocks a number of proprietary branded items that are popular with our customers. Many of the products that we offer to our customers are an alternative to prescribed medication, some of which have side effects that are difficult to manage. Guidelines currently exist which mean that Boots, as well as all other retailers, are currently unable to make claims on our Homeopathic products.
We take the concerns of all of our customers very seriously here at Boots and we thank you for the time you have taken to give us this feedback. Please be assured that I have shared your comments with the teams here in Boots for future product ranges that we may consider.
Well they don’t take some things seriously enough to answer a direct question with a direct answer. I was not taking this lying down of course, so had another go. In among a number of specific questions, I highlighted homeopathy:
I need to update my previous question. Last week I found on the shelf of my local Boots store `Boots Homeopathic Insomnia Tablets’. This product bears, quite legally, a product licence of right (PLR). I had not seen this before. It is obvious to anyone buying the product that it is intended to treat insomnia, and is therefore a claim. Such licences were granted in 1971 when the Medicines Act 1968 came into force. There was no requirement to submit data to support any claims when those licences were granted. You are therefore wrong when you say that homeopathic products do not carry claims – many of them do. In addition, you seem to be unaware of the regulations which became law in September 2006, which allow homeopathic products to make claims for `mild, self-limiting conditions’ (ie those that get better anyway). Again there is no requirement for homeopathic products to submit data in support of claims of efficacy – a situation that has caused huge controversy.
Now my primary point is not whether Boots is operating within the law, but how you can reconcile these activities with what you claim is social responsibility. Let me take homeopathy as an example. I took the insomnia tablets to the counter and asked for advice from the pharmacist. I asked what assurances she could give as to whether they would work. She started talking about the `like cures like’ principle of homeopathy, noting that the product contains coffee (which it doesn’t of course because it is diluted out of existence). She could not give me any assurance that this principle was scientifically valid. She also had to accept that there was no evidence from clinical trials to support the claim on the label. I then asked what her professional code of practice says about advice given to customers. She said that advice had to be factual. I pointed out the conflict between that, and the claim of the product she (as the responsible pharmacist) was selling, as well as what she had told me about how it was supposed to work. She then called in the store manager, who refused to answer any questions and referred me to Boots Customer Care – ie yourselves.
I need to make it clear that I will be publishing my questions to Boots, and your replies. If you choose not to reply, I shall publish that fact as well. So the best thing is if you send me a clear reply, addressing each of my direct questions with direct answers. Please note this point very carefully: anecdotal reports from customers, or sales figures, or any information other than properly controlled scientific studies, do not constitute reliable evidence. If they did, we would not bother regulating conventional medicines. So please don’t tell me how popular these things are – I already know that.
The reply contained the following comments about homeopathy:
The continued supply of Homeopathy products in our stores is supported by close regulation of such products by the MHRA, which is then substantiated by a number of professional bodies as being viable alternatives that appeal to our customers.
Your comments have been fully understood by us and I trust that you understand we’ve taken your concerns seriously. I feel that there is little more assurance that we can give you on this matter and of course we understand that your opinion is important to you. Thank you for the feedback you have given us.
Another exercise in how not to answer a question, so I gace it one last try:
Thanks for taking the time to reply, but you still don’t address my questions. I really don’t think you have `fully understood’ my comments, or you would have given me a direct answer. I will re-state my original question.
Do you consider that it is socially responsible to promote in your stores products for which there is no evidence to support their claims of effectiveness? Please give me a direct answer. The regulation of homeopathy by the MHRA is not relevant, as the national rules scheme enacted in September 2006 specifically excludes any requirement to demonstrate efficacy. Thus the MHRA’s regulation process has nothing to do with claims of efficacy so has no bearing on my question. Please tell me which professional bodies `substantiate’ the supply of homeopathic products in your stores. What do you mean by `substantiate’? On what evidence do they say that they are a `viable alternative’ – and alternative to what? My guess is that you are referring to professional bodies of homeopaths. If so, do you think these are objective and unbiassed sources of advice? Do you seek advice from independent sources such as The Cochrane Collaboration, or the UK’s only professor of complementary medicine?
Well they got the last word, for what it’s worth:
Thank you for your further email of 29 July.
Your comments and feedback have been fully understood and we respect that your opinion is important to you.
I believe there is little more assurance or comment that we can offer you, or comment any further from the previous emails that I’ve sent to you, that will resolve this matter to your satisfaction, and we now consider this matter closed.
I wonder if Boots really understands how much information is conveyed in their steadfast attempts to tell me nothing? Their last reply indicates that they have not the slightest idea of the difference between fact and opinion – or they choose not to know. Firstly, I was not expressing an opinion, I was asking direct questions, which they refused to answer. Secondly, I was stating facts, eg about the regulation of homeopathy, about which they are signally ignorant. Indeed I was not particularly looking for `assurance’, I was hoping for a direct answer to a direct question.
What can we conclude? I think it is that Boots has not the slightest intention of being `socially responsible’, if that conflicts with the need to make money by misleading customers about health care. But I just want to make one thing clear. I am not surprised when a company is venal, self-serving and unscrupulous; that’s disappointing but not unexpected. What is very much worse is when a company publishes high-sounding words as a pretence that it has a conscience, and refuses to engage in any kind of dialogue when asked what it means by that.
You might well be thinking that there is no point in ranting on like this if Boots and the like are not going to take the slightest bit of notice. But there is a point. If you read my first post here you will remember that I hope the blog will be a tool kit for those who want to make a difference, and support truth against falsehood. There was a good example recently, when the BBC removed its whole complementary medicine section from its website, as a result of multiple complaints by people who support evidence-based medicine. Over the last few years I have been increasingly encouraged by the good sense of a growing proportion of the general public. Boots is accountable to its shareholders as any company is, but it’s a public company and the trading of its shares is a public matter. Ethical investment portfolios have grown very fast over the last 10 years, which is something Boots should consider if it wants its share price to hold up. Meanwhile, you can do what I do and ask your local Boots pharmacist why they attempt to defend the indefensible. They may not see sense as quickly as the BBC did, but it’s worth trying.