At last the Commission has provided what they describe as their “conclusion of stage one complaint process”. If you are new to this saga you’ll need to read my previous posts on the subject here, here and here. If you have done that, you will not be surprised to learn that the Commission still refuses to accept logical arguments about homeopathy charities. Here is what I received on 28th September last:
As I have previously outlined, the Commission is not an expert body in the efficacy of any non-traditional medical treatments. The Commission’s guidance on the charitable status of organisations which provide complementary or alternative medicine (Operational Guidance 304) was published in July 2013.
I was not sent this operational guidance (OG), so searched for it on the Commission website. There is a long list of OGs but guess what? Number 304 is not there. I had to phone to get it. It’s very long and repetitive, so I won’t critique it in this post, and for copyright reasons I don’t think I should post it in its entirety. But I’ll refer to the key sections which apparently govern what the Commission says about this complaint. Meanwhile back to their response……
Within that guidance, reference is made to the 2010 Parliamentary and media coverage which questioned the efficacy of homeopathy and raised concerns that there is no evidence that its benefits exceed a placebo effect.
However, there has been no subsequent Parliamentary or legislative determination which has changed recognition of its efficacy and our current position is still to regard homeopathy as a method for which we need little or no further supporting evidence of efficacy. (my bold)
I defy anyone to make sense of this sentence. Correct, the scientific consensus is that homeopathy does not work, so that has not changed since 2010. Indeed it was well established long before 2010. It is a change from what the Commission previously took (incorrectly) to be support from the House of Lords report. But they then say that their position has not changed, without saying why.
As I have previously explained, each case is determined on its merits and at the point of registration we would check that the trustees’ claims for the treatment are in line with its recognised benefits and that the public benefit test is satisfied in line with the guidance in section B of the Operational Guidance.
Section B of the OG is very long and it’s not at all clear to which part the Commission is referring here. But the OG does say:
All claims made for the efficacy of a method must be substantiated with evidence. We recognise that not all forms of alternative or complementary treatment may lend themselves to conventional research methods. However, the evidence must be evidence that a court can recognise.
Examples of suitable evidence include;
- peer-reviewed research (ie research scrutinised by fellow professionals) in recognised medical journals, for example The Lancet or BMJ
- recognition by the Department of Health or other governmental health regulatory or health provision body.
That mostly makes pretty good sense to me. Peer -reviewed research shows overwhelmingly that homeopathy is a placebo, and the Department of Health is at pains to state that it does not endorse any CAMs and leaves clinical decisions to clinicians. But “not all forms of alternative or complementary treatment may lend themselves to conventional research methods” is a standard CAM special pleading canard. The Commission should know better than to fall for this one – they seem to have got it from the House of Lords Report. Back to the response again…..
According to our records, there are currently 26 charities registered with us which have homeopathy as part of their charitable purposes. There is nothing in the information you have submitted to us to date to suggest that any of these charities are not operating in accordance with our published guidance. As I have previously explained many of the charities we have registered include a reference to homeopathy in the context of advancing education and research. Where they have a relief of sickness purpose, there is no evidence that they are operating irresponsibly or making claims which would put the public at risk. Homeopathy in Africa (1125981) for example make it clear on their website that they offer homeopathy as a therapy alongside traditional medicine and refer individuals to conventional medicines where they are suffering from a specific disease or condition such as malaria or HIV/Aids.
The Commission seems unable to grasp the principle of public benefit here. While risk is a significant issue, and one which is well known to attend homeopathic treatment, my point is that benefit must be demonstrated with evidence, and that homeopathy is unable to provide that evidence. The public benefit test is therefore failed. How hard is that?
If you have specific concerns about individual charities and you can provide evidence to support those concerns then we will consider those further in so far as the issues fall within our regulatory remit. This consideration will not extend to a more general look at our policy on homeopathy (which I have explained above) but if you have evidence that the charities concerned are not operating in accordance with the guidance we will consider this on a case by case basis.
To clarify, this concludes my consideration of the case and of your concerns regarding our guidance relating to homeopathy. If you are dissatisfied with the standard of service you have received, then please email the Business Assurance Team on or before 28 October at BusinessAssurance@charitycommission.gsi.gov.uk and a review of the way your complaint has been handled will be undertaken by a member of that team.
They are of course using the standard public body ploy here, of closing off all discussion, or trying to. It has taken about 14 months to get this response, which does nothing but repeat their original arguments without addressing any of mine. If I complain about the standard of service, how long should I expect a response to that to take? Meanwhile charities can carry on misleading vulnerable people and getting tax breaks for doing it.
I’ll conclude with a few comments about OG 304. Several sections talk at length about the need for CAM practitioners to be regulated. Nowhere does it mention that no CAM regulator requires evidence of efficacy. The Commission has confused regulation with evidence.
OG 304 is structured according to the House of Lords Report on CAM 2000. Bearing in mind that the OG is dated 2013, one wonders why this outdated (and widely criticised) report is still given any credence. There was a majority of CAM enthusiasts on the committee, and they never assessed evidence at all. The Commission’s stance is taken from this report, which places homeopathy in Group 1 as a therapy which “does not require further evidence of efficacy”. This was a gross error, not supported by the facts, and the Commission is disingenuous in clinging to it. But it’s convenient for them to do so.
Curiously, the very last clause of the OG homes in on homeopathy:
F7 Is homeopathy still accepted as being able to deliver benefits related to an aim of promotion of health or the relief of sickness?
Yes. The efficacy of homeopathy was called into question in 2010 when Parliamentary and media coverage suggested that the claimed health benefits are unfounded and that there is no evidence that its benefits exceed a placebo effect. However, there has been no subsequent Parliamentary or legislative determination which has changed recognition of its efficacy. Our current position is to regard homeopathy as a method for which we need little or no further supporting evidence of efficacy so long as the trustees’ claims for it are in line with its recognised benefits. See Group 1 of the ready reference table which sets out the information we need from organisations using homeopathy to deliver their purposes.
This seems to be the origin of the gobbledegook that the Commission has used in response to my complaints, and appears to have been tacked onto the end for a particular reason. Do they not realise that what matters here is not official policy but scientific evidence? What are “recognised benefits”? Recognised by whom? Presumably by the homeopaths. The “benefits” are certainly not recognised by any bona fide medical or scientific professional body. Does the Commission know that the UK medicines regulator the MHRA does not require homeopathic products to demonstrate any efficacy at all?
It is very easy to say “We are not experts in medical science, so we can’t regulate health claims”. That seems to be what the Commission is saying. They go to the trouble of writing a long procedure which sets out what sort of evidence they require, and then they do a 100% about turn and ignore the standard they have set. This is not what we citizens expect from a public body whose salaries we are paying.