The Charity Commission is not fit for purpose

Last year I was pleasantly surprised when the Charity Commission advised a charity to stop making unsubstantiated claims, after I complained. I am now much less impressed. Encouraged by my initial success, I started looking at more charities that seem to mislead the public. Remember that charities are legally obliged to operate for public benefit, and there are many that do not. Several promote homeopathy, in some cases to vulnerable people in poor countries, which can’t possibly benefit them, and could do much harm.

The first stage in the Commission’s process for dealing with problem charities is that you have to complain directly to the charity. You can imagine how far this got me. Most didn’t reply, and the rest simply repudiated any challenge. This was in June 2014. I therefore wrote to the Commission on 27th July setting out my concerns, using their web form for raising concerns about charities. I pointed out that homeopathy has been comprehensively shown to be ineffective, and hence promoting it must not be for public benefit. Now the Commission has a rather odd policy for responding to messages. Here is their auto-reply:

We will consider your request within 15 working days.
Your enquiry will now be assessed. If we feel that the issues do not fall within our regulatory remit you may not receive a response from us. Please do not send us a paper version unless we have specifically requested this.
Please do not contact us again inside the 15 working day period.

So they are basically saying that they can decide not to do anything about it, and not to tell you they doing nothing. Hardly professional for a public body. Well you know me, and I persisted. Here is their response to my email:

Your e-mail will now be assessed however please note that currently we are experiencing high volumes of work. Please do not send us a paper version unless we have specifically requested this.

If you do not receive a response from us within 25 working days you can assume that the issue raised does not fall within our regulatory remit and we will not be responding.

The period of silence seemed to be going up. Playing for time? Eventually I wrung out of them this reply dated 21st August:

Homeopathy: Medicine for the 21st Century

Thank you for your email dated 29 July 2014 raising your concerns about Homeopathy: Medicine For The 21st Century. Please accept our sincerest apologies for the delay in replying to you, this was caused by the current high volumes of correspondence at this office.

It might be useful if, at this point, if I clarify the role of the Charity Commission. The Commission is established by law as the regulator and registrar of charities in England and Wales. Our aim is to provide the best possible regulation of charities in England and Wales in order to increase charities’ efficiency and effectiveness and public confidence and trust. For the most part the day to day running of charities remains the responsibility of charity trustees. Where things go wrong our action will be evidence based and proportionate, taking into account the issue and the risk involved to the charity and its beneficiaries.

The Commission has an overall duty to maintain the integrity of the charitable sector. It has legal powers, which enable it to take regulatory action in what it perceives to be appropriate circumstance. In general, this is to be interpreted to mean where a charity is in imminent danger because of financial incompetence or dishonesty or where trustees clearly act outside of their powers under charity law. The Commission has wide discretion to decide whether to take regulatory action in any given case and, if so, the extent of that action. The Commission’s statutory authority does not however extend to interfering in the internal administration of a charity and it is unable to replace the judgement of trustees with its own.

Our publication CC47 (Complaints About Charities) sets out in more detail when we will, and when we will not, take up the issues reported to us. This can be accessed below:

http://www.charitycommission.gov.uk/detailed-guidance/protecting-your-charity/complaints-about-charities-cc47/

All charity trustees must run their charity according to the rules set down in the governing document. Our records show that Homeopathy: Medicine For The 21st Century is governed by a Constitution dated 05 September 2007. The charity’s objects are:

To advance the education of the public in the subject of homeopathy through:

(1) research into

(a) the extent of use of homeopathic treatment;

(b) the range of outcomes of use of homeopathic treatment;

(c) the level of public interest in the use of homeopathy

(2) publication of such research

(a) conducted by the charity;

(b) conducted by others

(3) campaigning for increased levels of research and use of homeopathy

There is currently no evidence to suggest the activities carried out by the charity are not in furtherance of the above objects. We are therefore unable to become involved in this matter.

Whilst we appreciate that some individuals or bodies may not support the promotion of homeopathy, we would advise that as far as the law is concerned it is charitable. When considering charities related to complimentary or alternative medicine, each case is considered on its merits but the House of Lords Report 1 on complimentary and alternative medicine provides a useful guide. The House of Lords Select Committee determined that Homeopathy is a ‘Group 1’ therapy. Charitable organisations that provide therapies that fall within the Group 1 category of ‘well known’ therapies do not generally need to provide further evidence of efficacy before we accept that these therapies are effacious in the relief of illness.

The House of Lords Select Committee report still remains relevant despite the date that it was published and the Commission can take account of its findings when considering new applications for registration as appropriate.

The Commission’s approach when considering whether or not a particular alternative or complimentary method is capable of promoting health or relieving sickness for public benefit is based on case law. The law requires a link between the benefit claimed and the purpose, and that the purpose is for the public benefit. The law also requires that benefit be demonstrated by evidence. For some treatments this evidence is already accepted by the law and case law and in those cases there is recognition that the particular method is capable or promoting health or relieving sickness. This is the current position in relation to homeopathy but each case is considered on its facts.

On the basis of the information you have provided we do not consider there to be sufficient evidence to justify any action on our part.

I hope that I have explained why the Charity Commission will not be taking any further action on this matter and thank you again for contacting us.

Yours sincerely

Jim Gerrard

Charity Commission – First Contact

It’s not hard to spot the errors in this. For a start, I had complained about the Homeopathy Action Trust which promotes quackery in Africa, not HMC:21, and they used the wrong heading in this reply. To be fair I did mistype the registration number, but they didn’t notice the difference. The Commission has a complaints procedure, which of course I then followed, with a detailed analysis. By 21st October there had been again no reply, so I sent the same text to the Commission’s CEO Paula Sussex:

Dear Ms Sussex

I am a retired clinical research consultant, and as it happens a trustee of the charity HealthWatch (1003392). I am greatly concerned that certain charities, all of which are obliged to operate for the public benefit, obviously do not do so. I wish to bring to your attention the example of homeopathy.

I have previously submitted complaints to the Charity Commission in respect of some of these charities. For illustration, I suggest that you visit the websites of the following:

Ghana Homeopathy Project http://ghanahomeopathy.org/

Maun Homeopathy Project http://www.homeopathybotswana.com/

Homeopathy Action Trust http://www.homeopathyactiontrust.org/

There are many more. My complaints have always been rejected, and responses from your team contain several logical fallacies and errors of fact, which I will now explain. I reproduce below the statements at issue, with my comments below each one.

“When considering charities related to complimentary (sic) or alternative medicine, each case is considered on its merits but the House of Lords Report on complimentary and alternative medicine provides a useful guide. The House of Lords Select Committee determined that Homeopathy is a ‘Group 1’ therapy. Charitable organisations that provide therapies that fall within the Group 1 category of ‘well known’ therapies do not generally need to provide further evidence of efficacy before we accept that these therapies are effacious (sic) in the relief of illness.”

This is incorrect. The House of Lords report categorised therapies on the basis of their popularity and history of use, not on their efficacy (as would be shown by properly conducted clinical trials). The report did not suggest that these therapies require no such evidence. Indeed, the report called for more research to test the claims made by practitioners.

“The House of Lords Select Committee report still remains relevant despite the date that it was published and the Commission can take account of its findings when considering new applications for registration as appropriate.”

This is also incorrect, and logically untenable. Fourteen years have elapsed since the report appeared, and during this time a great deal of further research has been published, which consistently fails to demonstrate any robust evidence that homeopathy has effects above those of a placebo. No justification is given for claiming that the report, misinterpreted as it is, remains `relevant’. Much more recently, the House of Commons Select Committee for Science and Technology reported that homeopathy is ineffective and public money should not be spent on it. Why does the Commission not rely on this report?

“The Commission’s approach when considering whether or not a particular alternative or complimentary method is capable of promoting health or relieving sickness for public benefit is based on case law. The law requires a link between the benefit claimed and the purpose, and that the purpose is for the public benefit. The law also requires that benefit be demonstrated by evidence. For some treatments this evidence is already accepted by the law and case law and in those cases there is recognition that the particular method is capable or promoting health or relieving sickness. This is the current position in relation to homeopathy but each case is considered on its facts.”

This is utterly bizarre and philosophically unsound. Which law is being cited here? The Commission applies a standard which is at odds with those of any major health care professional body. Anybody could create a `link between the benefit claimed and the purpose’, just by making it up – which is what the homeopaths actually do. Then, in a complete reversal of logic, a requirement for evidence is presented. But the Commission’s idea of evidence is a fantasy. What does `already accepted by the law and case law’ mean? Who accepted what `evidence’? If `each case is considered on its facts’, what facts are considered? The facts regarding homeopathy are very clear, it does not work.

This would be bad enough if it were simply the case that homeopathy is useless but harmless. The truth is different. Two of the charities I have listed here are promoting homeopathy to vulnerable people in Africa. Such communities have quite enough trouble with indigenous forms of fake health care, without their being exploited by European quackery. There are numerous documented cases of serious harm suffered by people who were distracted from effective medicine by homeopaths – see http://whatstheharm.net/homeopathy.html.

I hope I have demonstrated to you that charities which promote homeopathy are not operating for the benefit of the public. Please review the Commission’s policy on this issue.

I have sent this as a printed letter, instead of via email, because your people have stated that all dialogue on my complaints is closed and they will not respond further. I could not be sure that any email I sent for your attention would be passed on. Therefore please forgive this intrusion, but I felt it was the only way to make my case. By all means reply via email if you wish.

Yours sincerely

There has been no substantive response to this, other than an interim reply on 27th January after again I repeatedly chased them:

Thank you for your emails and letter regarding your concerns about the charitable status of charities involved in homeopathy.

I understand from your correspondence that your concerns with homeopathy is (sic) primarily where it is being promoted as a medical treatment for the purposes of the relieving sickness.

In our previous correspondence we have referred to the fact that the Commission has no power or expertise to determine the medical efficacy of any particular treatment and that in making our decision regarding an organisation’s charitable status we rely on expert evidence and guidance. However, I have considered your comments regarding the latest Select Committee report and I am going to refer the matter to our policy team to consider whether our published guidance and approach reflects the current government policy. This may take some time but I will write to you again once a decision has been made.

According to our records we currently have 30 charities on the register with the term “homeopathy” in their objects. Given the overall size of the register, this is a very small number but I do appreciate that we have a responsibility to ensure that all charities on the register are exclusively charitable. Of those 30 charities, not all have objects which fall within the purpose of the relief of sickness. A number have objects which fall under the advancement of education, which are primarily conducting research into homeopathy and other complementary medicines. The test of charitable status under the advancement of education is different and does not require evidence of the efficacy of the treatment being researched. The focus is on the subject matter being definable (which is it) and the way in which the research is conducted and the results shared.

Once I have received advice from our policy team I will then consider whether or not we need to examine the individual charities in more detail.

Yours Sincerely

Joanne Maguire

Senior Case Officer

I would not agree that “…the test of charitable status under the advancement of education is different and does not require evidence of the efficacy of the treatment…“. Teaching people nonsense is not a public benefit. But then, lots of charities do nothing but promote religion…..

By 16th February of course I had still heard nothing, and I warned the Commission thus:

Dear Ms Maguire

As I have not heard anything further from you on this matter, I will now proceed with my complaint to the Parliamentary and Health Services Ombudsman. I realise that you didn’t give me a time scale, but as I have said I’m not able to wait indefinitely. I asked for a review almost four months ago and I think that’s long enough to wait for a substantive reply.

Yours sincerely

Over two months elapsed, marked with the usual silence, so I tried phoning the Commission. This seemed to prompt another reply:

Thank you for your emails regarding Homeopathy charities. I apologise for the delay in getting back to you but I did not consider that you would expect a response when there is nothing to report as yet.

I have explained previously the basis on which we register charities with homeopathy in their objects and explained that it is not the role of the Charity Commission to determine the efficacy or otherwise of specific treatments. Discussion with our Policy team may take some time and, to be honest, may not result in the outcome you appear to want. Even if we change our policy guidance to reflect the latest Select Committee report we will continue to make decisions based on individual applications and the evidence presented to us at the time. If you have evidence that individual charities are operating outside their objects then you should provide that to us for us to consider.

I understand that you have contacted the PHSO (the Ombudsman). Before the ombudsman can consider your complaint about the Commission, you first need to exhaust our internal complaints process. You can find more details of that process on our website: https://www.gov.uk/government/organisations/charity-commission/about/complaints-procedure

To which I replied:

Dear Ms Maguire

On the contrary, I expect as a matter of courtesy at least a short reply from you to say that you have read my email and that it is being actioned. Failing to respond for several weeks is not acceptable.

I think you can see that I have already followed your complaints procedure. I have set out in detail how the Commission is wrong in its original response, and have allowed a generous period for a substantive reply to that. These delaying tactics are a disgraceful way for a public body to behave.

Yours sincerely

Followed by:

Dear Ms Maguire

Further to my previous reply, I need to make it absolutely clear that I have already followed the complaints procedure that you mention below. The link you provided takes me to the following page:

https://www.gov.uk/government/organisations/charity-commission/about/complaints-procedure

Under the heading Complain about a service we’ve provided the only means of contacting the Commission to complain is a link which goes to this page:

http://forms.charitycommission.gov.uk/contact-us/general-enquiries/make-a-general-enquiry/contacting-us-online/contacting-us/

This is actually a general enquiries form and not specifically for complaints. Nevertheless this is what I used and to which you have eventually replied (after prompting by me). I also sent the same text as a letter to your chief executive, who failed to reply. Today I spoke to the Parliamentary Ombudsman’s office, which says that the matter is not within their remit. You have apparently told them that you are still dealing with my complaint. You will understand my confusion; are you progressing my complaint, or are you waiting for me to repeat the complaints process?

While so far my complaint has been about homeopathy charities in general, if you wish I am happy to submit separate complaints for each and every charity that in my view misleads the public. At this stage I am asking you to reassess in general your policy on evidence that underlies a charity’s aims. I have made it clear that your present policy is based on errors of fact and is illogical. I do not think it is difficult to verify what I have said, and I see no reason to continue to delay this process, which has been going on for over six months.

I fully appreciate that the Commission has a heavy responsibility in terms of the size of the charity sector, but this matter is simpler than you appear to think and could be quickly resolved. Please keep me informed as to progress.

Yours sincerely

I can’t say I have been blown away by the efficiency of the Parliamentary Ombudsman either. The complaint went to my MP in the post on 17th February this year. By 31st March I had heard nothing, so I emailed the Ombudsman’s office, requesting a read receipt. It was read, but nobody replied. On 6th May I phoned them, and learned that the case was put in process on 31st March – funny that. I was told that they had contacted the Charity Commission, who said they were still dealing with the complaint. So the Ombudsman won’t touch it until the Commission says they have finished their review. This is rather different from what the Commission told me, which as you can see from their reply above asks me to complete the complaints process. I had of course already done that.

I should make it clear that I am not criticising the Commission for struggling with inadequate resources in times of austerity. But they spent a lot of time writing a very long reply that was essentially rubbish. They would have been better off promptly acknowledging my complaints, looking up whether what I was saying was correct, and then referring the matter straight away to their policy team. Instead they have for the last nine months had to put up with me making a nuisance of myself, while delaying the process to the best of their ability.

The Ombudsman sets no time scale for a public body to respond to a complaint, and the Commission knows this. Removing charitable status opens a can of worms that they simply don’t want to open. So what do we do? Note that the Commission appears to invite complaints about specific charities regarding specific breaches. So far I have only given the Commission a few examples of quack charities. What if they were given more? Identifying quack charities is not of course hard. Over to you dear readers.