Appeasing CAM in the NHS

The UK’s National Health Service has made some progress towards embedding evidence based clinical practice in its service delivery. But there is still some fence-sitting going on. My attention has just been drawn to current guidance on complementary and alternative medicine which is less than definitive.

The Bell Tolls for Quack Charities?

So after nearly five years of effort, I am rewarded with a response from the Charity Commission regarding charities which make misleading claims about the treatment of ill health. Is it what I wanted? The answer is “partly”, but it depends on how the Commission applies its new guidance.

The Charity Commission Consultation

Most readers should be aware that the Charity Commission has issued a consultation on the registration of complementary and alternative medicine (CAM) organisations as charities. This was after a five-year battle documented in other posts on this blog. In the interests of transparency I am posting my response here.

Making up Law on the Fly

I was going to apologise for yet another post about the Charity Commission, but on reflection why should I? This is a serious matter and whatever I do the Commission seems more determined to look silly. You’ll recall that they have accepted that their internal guidance on complementary and alternative medicine (CAM) contains major errors of fact and logic, but that they refuse to update it. They did say however that my own review of the guidance would be circulated internally, as case officers also have to take into account updated information as well as approved guidance when making decisions. So I decided to see whether that had had any effect.

The Charity Commission – so near and yet so far

Some things take time, and it’s rewarding to get even a tiny bit of progress. My effort to get the Charity Commission to introduce an evidence-based policy has at last reached the stage of a reasonably sensible dialogue, but not yet any meaningful action. To recap, there are several charities that make misleading health claims, homeopathy of course being a prime example. I have been asking the Commission why they granted charity status to these organisations, when they clearly fail the public benefit test. For the full back story read my posts here, here, here and here – in reverse order.

The Myth of Big Pharma

Forty years ago this year (god, can it be so long?), I joined the pharmaceutical industry. Its reputation then was little better then than it is now, various companies having weathered scandals in the previous two decades. In the 1950s Pfizer was top UK company by a long way, on the back of its tetracycline antibiotics. Oxytetracycline was promoted via golf weekends for doctors, and a dimpled ball emblazoned with the brand name Terramycin was famously brandished in the House of Commons in the late 1960s by Gwyneth Dunwoody MP. Not many years later I was working for Pfizer, and doctors still asked me for golf balls, I suspect only half in jest. In the 1960s Roche was forced to repay excessive profits from benzodiazepine anxiolytics, and of course the now long gone Distillers Company presided over the worst ever case of teratogenic damage from a drug.

More Cherry-Picked `Evidence’

Some of you will have seen an email that went out the other day to subscribers to the `What Doctors Don’t Tell You’ website. Here it is:

Would you like to be featured in a future issue of What Doctors Don’t Tell You (WDDTY) magazine?

Integrative medicine – cat herding for the uninitiated

I confess to having quite a bit of fun by writing letters to medical and scientific journals. The web of course has opened up huge opportunities for this – indeed it was originally designed for scientists to exchange information. One online journal I rather like is MedScape, edited by George Lundberg who previously edited the prestigious Journal of the American Medical Association (JAMA). MedScape has recently carried a number of articles about CAM, and seems to be scrupulously fair in giving all sides a crack of the whip. A recent topic has been `integrative medicine’, which triggered two letters which epitomised the intellectual gulf that exists between the evidence based approach and most CAM supporters. So I bashed in a letter highlighting this.

An interesting evening

I have a bit of catching up to do, so I am going to tell you about a presentation I was invited to give last October. This was a meeting of Café Scientifique, a network of local science clubs. We had over 100 attending, a full house. People sit around tables café style, with drinks from the bar, and the idea is to have debate and interaction on scientific topics. I was asked to talk about complementary and alternative medicine (CAM – I won’t define this term again in this blog as most readers will know what I mean).