Yet more on the Charity Commission

Are you bored with this? I am. Because with the Charity Commission it’s just the same old same old. Some of you might have seen a piece in The Sunday Times in March, which was quite hard-hitting. For example a professor of clinical epidemiology castigated a charity called The Vaccine Awareness Network, which just recycles all the anti-vaccination tropes. Nothing new there, but the Charity Commission did say that “holistic methods”:

must be able to demonstrate that they are capable of promoting health, otherwise they will not be for the public benefit.

I could not have put it better myself, except for the woolly term “holistic methods”. They also said in the article that they were assessing whether the cases I have brought to their attention warrant “further regulatory involvement”, and that these charities

were all registered more than 10 years ago with the evidence and information available at the time.

Hmm, some things to follow up, so I did. I wrote to the Commission to ask when this evidence based policy would be implemented The opening paragraph of their reply is interesting:

I can confirm that an organisation applying to register as a charity which is set up with purposes to advance health by means of complementary or alternative medicine must be able to demonstrate that the purpose satisfies the benefit aspect of the public benefit requirement. To do that, the organisation must be able to show (and provide evidence if necessary) that the complementary or alternative medicine in question is capable of advancing health. This has always been the case.

Always been the case? Well at the same time I sent a Freedom of Information request for the evidence that was submitted when 28 charities were registered. Here they are, with their charity numbers:

Homeopathy In Africa

Homeopathy Action Trust

Homeopathy: Medicine For The 21st Century

Reflexology Outreach International

Milton Keynes Reiki Cancer Support Group

Vaccine Awareness Network

The Maun Homeopathy Project

Friends of the RLHIM

Harrogate Christian Spiritual Healing Church

Gentle Touch Healing

Homoeopathy For All

The Association Of Systematic Kinesiology

The Keys College Of Radionics

Bi-Aura Foundation

The Craniosacral Therapy Association Of The United Kingdom

Gerson Support Group

Northcote Homeopathy Trust (N.H.T.)

Travelling Homoeopaths Collective

Yes to Life

Cancer Active

Reflexology Outreach International

Fenwick Health and Wellbeing Centre – part of The League Of Hospital And Community Friends (Fenwick Hospital Lyndhurst)

Gambia Wellness Foundation

British Homeopathic Dental Association

The British Homeopathic Association

National Homeopathic Service

The Association Of Systematic Kinesiology

McTimoney Trust

I did get a reply, albeit one day past the deadline. The most shocking revelation was that:

The Commission’s records retention policy is to destroy those over 5 years old unless they are considered ‘key documents’. This means that we no longer hold copies of Registration documents for most of the charities listed.

Firstly, in what way are applications for registration not `key documents’? Secondly, is destruction of records after only five years what we expect of a public body? How can it possibly be answerable to government if it has no records on the vast majority of its registrants? So I only got records for:

Homeopathy In Africa

Homoeopathy For All

The Craniosacral Therapy Association Of The United Kingdom

Gambia Wellness Foundation

Homeopathy: Medicine For The 21st Century

The only applicant for which the Commission requested evidence was The Craniosacral Therapy Association, who provided a list of references to published studies. To be fair, although craniosacral therapy is widely recognised as quackery, I would not expect the Commission to know the difference between robust evidence and the poor studies beloved of quacks. I might though expect the Commission to refer to outside experts to answer that, exactly as the Advertising Standards Authority does. More significantly, all the other charities here happen to be promoting homeopathy, and not one of them was asked for evidence. Clearly it has not always been the case that charities have had to provide evidence of benefit. My full list goes back to 1964, but the Commission can’t support this claim because they don’t have records further back than five years. The reason they didn’t put the homeopaths on the spot is telling. Here is what they said to Homeopathy for All:

The Commissioners (sic) approach to Complementary and Alternative Medicines (CAMs) is based on a House of Lords Report which can be accessed by clicking on the link below:
This report divided CAM therapies into three groups based on public risk analysis as follows,

Group 1 — the principal disciplines of osteopathy, chiropractic, acupuncture, herbal medicine and homeopathy.

Group 2 — therapies which are most often used to complement conventional medical treatment and do not purport to embrace diagnostic skills.

Group 3 — the disciplines which purport to offer diagnostic information as well as treatment and which favour a philosophical approach and are indifferent to the scientific principles of conventional medicine.

For the purposes of charitable status, we are usually content to accept the provision of Group 1 therapies without proof of efficacy and we also take a similar approach to Group 2 therapies, where these are complementary.

Actually the cited House of Lords report has moved, and is now here. Why the Commission has based its policy on this report is beyond comprehension, as their Lordships were at pains to clarify that

…the question of efficacy was not included in our initial terms of reference…

Nevertheless the report has a quite detailed discussion of the state of the evidence base for CAM, and most certainly does not say that group 1 therapies have evidence established. Group 1 comprises simply the best organised and regulated practices (which is not saying much). The Charity Commission has based its policy on a disastrous misreading of the report, and has ignored all other relevant information.

I took up the Commission’s claim that a requirement to prove public benefit with evidence has “always been the case”. I pointed out that the charities at issue go back to 1964. The response was that they simply don’t know what evidence was required at the time. Yet again, and this is getting very very boring, they relied on the House of Lords Report on CAM:

I cannot comment on how charities advancing health using homeopathy have been assessed by the Commission as far back as 1964 I’m afraid. However, in more recent years, our Operational Guidance to staff on this (on which we have previously corresponded) did place some reliance upon the House of Lords report which included homeopathy in its Group 1 list of therapies. As you know, that Operational Guidance says, “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 trustees’ claims for it are in line with its recognised benefits.

How many times do we have to point out that the House of Lords report did not have evidence for efficacy in its terms of reference? Or that putting a therapy in Group 1 has nothing at all to do with evidence of efficacy? What does “so long as trustees’ claims for it are in line with its recognised benefits” actually mean? If there is no evidence of efficacy, there can be no benefits, and if there are no benefits then the trustees’ claims can’t possibly be in line. How hard is that to grasp? But the real reason for this intransigence emerges from this:

With regard to our assessment of risk and priorities, I am not making any assumptions about the benefits or possible harm of complementary or alternative medicine. I am merely recognising the limited resources which the Commission has to undertake generalised reviews of any sorts of charities. Any need for this must be weighed against the many other types of cases (involving fraud or financial abuse or mismanagement, safeguarding issues etc) which we must also assess and prioritise. As compared with those other priorities, a general review of charities advancing complementary or alternative therapies is not currently a priority. However, if you have specific concerns regarding individual charities, particularly if you believe there is a significant risk of harm to beneficiaries for example, then you can of course follow our complaints procedures:

They won’t do it because they don’t think it is important. But isn’t it rather insulting to refer me to the complaints procedure,  which has been 100% useless so far? What do they think I have been doing for the last two years?


One Response

  1. Unbelievable. Another pseudo regulator that represents itself as protecting the public yet patently does no such thing.

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