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.The University of Central Lancashire (UCLAN) is the first place I asked to see teaching materials that were used on its homeopathy “BSc” course. The request was refused, and subsequent internal appeals were refused too, Clearly UCLAN had something to hide.

UClan-logo

An appeal to the information commissioner took almost two years to be judged, but the case was won. The eventual decision by the Information
Commissioner rejected all the grounds that UClan had used to evade the Freedom of Information Act.

UClan appealed against the judgement and I still haven’t got the stuff but that hardly matters now, because the course in question shut its doors. In any case, plenty of stuff from similar courses has leaked out already.

Meanwhile, in September 2008, UCLAN announced an internal review of all its courses in magic medicine, The review seemed to be genuine. For a start they asked me to give evidence to the review (something that no other university has done). They also asked Michael Eslea to give evidence. He is the UCLAN psychologist, whose magnificent open letter probably tipped the authorities into holding the review.

Just in case it is useful to anyone, here is a copy of the written evidence that I sent [download pdf],

Report of the Working Party on the Review of issues associated with Homeopathy, Acupuncture and Chinese Herbal Medicine

1. Introduction

As a consequence of concerns expressed by some colleagues within the University of Central Lancashire (UCLan) Dr Malcolm McVicar, Vice Chancellor appointed a working party to review the issues associated with the University offering courses in Homeopathy, Acupuncture and Chinese Herbal Medicine.

MEMBERSHIP:

Eileen Martin (Chair)                Pro-Vice Chancellor and Dean of Faculty of Health and Social Care 
Professor Gordon Bromage      Head of Centre for Astrophysics
Professor Malcolm Edmunds    Emeritus; Built and Natural Environment
Professor Doris Schroeder        Director of Centre for Professional Ethics
Elaine Austin                               Project Manager, Faculty of Health and Social Care


The report was the subject of a special meeting of UCLAN’s Academic Board on 9th July 2009. The following resolutions were passed.

Resolutions

R1    That further minor revisions be made to the report prior to publication on the University’s website;

R2   That the University refrain from offering any practitioner-qualifying courses in Homeopathy, Acupuncture and Chinese Herbal Medicine until such disciplines have achieved statutory regulation status;

R3    That the University consider offering a limited number of postgraduate research studentships (leading to Masters by Research of PhD) to suitably qualified UCLan students and staff in these disciplines. They should have interdisciplinary supervisory teams to facilitate development of a broad range of research skills and to contribute to the generation of knowledge in CAM;

R4   That the University consider how more interdisciplinary teaching can be achieved, where appropriate, within both undergraduate and postgraduate teaching to facilitate greater exposure to subject expertise and different paradigms.

Resolutions 1, 3 and 4 say very little. Resolution 4 sounds thoroughly relativist. We are talking about medicine, about treating sick patients. There is only one “paradigm”. That is to find treatments that are as effective and safe as possible. There aren’t two sorts of medicine, regular and alternative. There is just medicine that works and medicine that doesn’t work. It’s a good illustration of DC’s rule number 2, “never trust anyone who uses the word paradigm”.

Resolution 2 is the really interesting one, because none if the topics, Homeopathy, Acupuncture and Chinese Herbal Medicine, is subject to statutory regulation.

If taken literally, resolution 2 means that all the UCLan courses in alternative medicine will close their doors. Bafflingly, this inevitable conclusion is not stated explicitly.

At least resolution 2 means that homeopathy, already closed, will stay closed. It is never likely to get statutory regulation.

For practical purposes, we can ignore for the moment the obvious fact that statutory regulation of nonsense subjects results only in nonsense. The only forms of alternative medicine that have got “statutory regulation” at the moment are chiropractic and osteopathy. The public has not been safeguarded by the General Chiropractic Council (GCC). The GCC, on the contrary, has endangered the public by allowing false health claims to be made with impunity. Perhaps the members of the review committee had not noticed that the Simon SIngh affair has resulted in almost 600 complaints being made to the GCC? The faith of the review in statutory regulation is clearly misplaced.

The Pittilo report is critical for what happens next

Acupuncture and Chinese Herbal Medicine are not subject to statutory regulation at present, so one would suppose that these degrees will close their doors too. However the infamous Pittilo report has proposed that they should become regulated by the Health Professions Council (HPC). The many problems of the Pittilo report have been documented here, in “A very bad report: gamma minus for the vice-chancellor“. There was also a high-profile critique of the report in The Times (and on this blog).

The HPC has, as one of its criteria for regulation, “evidence-based practice”. Disgracefully, the HPC has already shown its willingness to ignore its own rules and to act as statutory regulator for Acupuncture and Chinese Herbal medicine. This rather disgraceful behaviour is documented in “Health Professions Council ignores its own rules: the result is nonsense“.

The UCLAN report seems to assume that the recommendations of the Pittilo report will be accepted. But the long-awaited consultation has still not opened. We can be sure that when it does, the opposition to it will be very strong indeed.

The report in full

Here are a few comments on the report itself.    Download the full report (as of July 15th).

i have to say that when I visited Preston to give evidence, my views seem to be treated seriously, even sympathetically, so it was a great disappointment to see the outcome. So what’s wrong? The major disaster is declared early in the report.

Section 2, Context

The debate is centred on a number of key themes which relate to:-

1. The quality of and/or absence of an evidence base to support claims of the efficacy and benefits of such treatments, linked to issues of public safety/protection and professional regulation.

Sounds good. What matters about any sort of medicine is whether or not it works and whether it is safe. It therefore verges on the incredible that we read in section 4.1

“conclusions from research into the efficacy of the various CAM’s are outside the remit of this report.”

The whole point about CAM is that there is very little evidence that any of it works. So the review committee decided to ignore the most important problem of the lot.  I can’t see how any rational decision can be made without first deciding whether the treatment is better than placebo.  That, surely, is the main question, and it was dodged.

UCLAN has failed to grasp the nettle, just as the Department of Health has also consistently failed to do so.

Section 4,1  Efficacy   This section repeats the assertion, absurd to my mind, that it is possible to judge CAM courses while declining to assess whether they work or not.

Section 4.2 Role of Universities in Society.

There is universal agreement that critical thinking is crucial to the idea of a university, but the judgement of whether CAM teaches critical thinking is simply fudged. Again the report fails to grasp the nettle.

“Disagreements about critical thinking within CAMs arises because some will argue that such substantiation and assessment can occur within the discipline, whilst others will argue that the methodology for substantiation, that is evidence provision, is universal. As a result, the latter will demand that evidence is provided using methods from one field (e.g. randomised controlled trials) for use in another.”

Sadly, the report dodged the crucial judgement once again. The most obvious characteristic of every form of alternative medicine is their total lack of critical self-appraisal. It is very sad that the review committee could not bring itself to say so.

Section 4.4   Nomenclature of degrees

Recommendation
The nomenclature of courses, leading to a professional as well as an academic award, should reflect the professional route; for example Bachelor with Honours in Complementary Medicine, B Comp. Med.(Hons) or B Acupuncture (Hons).

This sounds to me like another truly pathetic fudge. What on earth is solved by changing the name of the degree? You’d still be teaching students the same load of gobbledygook and then letting them loose on sick people, whether you call it a Bachelor of Science, a Bachelor of Arts, or, as is recommended here, a Bachelor of nothing whatsoever.

Well, I suppose there is a (doubtless unintended) irony in calling CAM degrees “Bachelor of nothing whatsoever”.

Section 4.4   Ethical, non-harm and economic considerations

This section list a lot of reasons why teaching alternative medicine should be unethical. but nevertheless manages to conclude that

” . . . it is not unethical to offer courses in Homeopathy, Acupuncture and Chinese Herbal Medicine at a university.”

I find the logic by which this bizarre conclusion was reached quite impossible to follow. Like much of the rest of the report this conclusion seems to stem from a reluctance to grapple with the really important questions, like ‘does it work or not?’.

Despite this the recommendation is perhaps the most interesting of all.

Recommendation
• The University refrains from offering any CAM courses until such disciplines have achieved statutory regulation status.”

This recommendation was accepted, and passed as a resolution at Academic Board. If it is implemented now, than there will be no more alternative medicine degrees next year at the University of Central Lancashire. If and when this happens, the University must be congratulated on its return to rational medicine.

Follow-up

Michael Eslea, UCLAN’s hero in resisting nonsense from the inside, has posted on this topic.

17 July 2009. It seemed odd that that no announcement was made about the future if the remaining CAM courses at UCLAN. So I asked deputy Vice-Chancellor Patrick McGhee for clarification. After a couple of days, I got this response.

From: CTheobald@uclan.ac.uk

To: d.colquhoun@ucl.ac.uk
Subject: uclan clarification

Hi David,

I have been asked to respond to your question below on the running of acupuncture and Chinese herbal medicine at UCLan. It is correct to assume that UCLan will not be taking any new entrants onto these programmes until further notice.

Best Wishes

Chris

Chris Theobald
Corporate Communications
University of Central Lancashire

So the report may have been disappointing, but it has done the job. As several people have pointed out in comments, it would be asking too much to expect a university to say “sorry we just noticed that we have been running junk-science courses for years”. But they have done the right thing anyway.

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28 Responses to University of Central Lancashire stops its alternative medicine degrees (or does it?). Yes, it does!

  • This is insane. Truly.

    If I were an optimist I would hope that this is the first step in kicking nonsense degrees completely off the prospectus without completely f**king over the poor naive sods who have just embarked on their PhD’s in Homeopathy or similar nonsense.

    And I am an optimist. Usually. But perhaps not in this case. It does smack of a complete lack of courage – probably due to the CAM industry’s total dependence of heavy-handed legal action, they’re now terrified of being on the receiving end of a hefty lawsuit from a bunch of young graduates who’ve just been told that “Err… sorry… that degree you’ve just been working on for the past three years? Total rubbish. Whoops.”

  • G’day David,

    In your post about the announcement of the review you said “the whole investigation will (or should) turn on the assessment of evidence” but the committee has decided that only woosters can review evidence for woo – a classic denial of an objective reality.

    My reading of Mike Eslea is that the temporary ban on courses is about protecting patients from “lack of professional regulation”, and will be lifted as soon as there is a pretend regulator for this quackery.

  • Homeopathy is the pons asinorum of alternative medicine. If this academic review failed to come to a straightforward conclusion that it is pseudoscientific nonsense, then there is no hope for them objectively assessing the slightly more tricky acupuncture, and definitely not the superficially plausible trade of Chinese Herbal Medicine.

    It is an indictment of the nature of academic thought in this establishment that it cannot come to straightforward objective assessments of the science of such practices.

    What this report looks like is a rather political fudge. There may well have been sensible voices there that have manoeuvred the report towards the right conclusion (for now) without upsetting too greatly the fantasies of the staff involved.

  • michaelgrayer, I think you can safely be (cautiously) optimistic. The cttee were caught in a difficult dilemma, because the University has obligations to its staff and students so they could never just say “it’s bollocks”. There will also be a legal dimension in relation to the partner colleges: remember that the acupuncture and TCM courses are actually being taught by the Northern Acupuncture College in York (& I have just discovered there is also a foundation degree in CAM at Kendal College which UCLAN validates). It will be interesting to see exactly how UCLAN extricates itself from these contracts…

  • michaelgrayer:
    “they’re now terrified of being on the receiving end of a hefty lawsuit from a bunch of young graduates who’ve just been told that “Err… sorry… that degree you’ve just been working on for the past three years? Total rubbish. Whoops.”

    Now I think the BCA’s action against Simon is a cowardly attempt to silence critics but action by students might be more justified.

    Those young people who have completed these courses have suffered a considerable loss both in fees and time that might have been spent on more worth while endeavours. They might have been nieve in trusting a university to offer courses only in real subjects but I think that trust is understandable in people in their late teens.

    The only honourable course is repayment of fees, compensation for lost time and offers of meaningful education free of charge.

  • “The only honourable course is repayment of fees, compensation for lost time and offers of meaningful education free of charge.”

    Hmm. An interesting thought.

    Here is an analogous suggestion. Many of the courses in question did contain some “conventional” science elements, taught by the mainstream UCLan bioscientists, especially in years 1 and 2. Though there was rather less than UCLan and other “B.Sc.CAM” Univs tended to state publicly there was.

    Anyway, since these degrees are undoubtedly based on “accruing credits”, one might take the view that the students had accumulated XX% of the credits for a “real” B.Sc.

    It might, consequently be possible for them to do something like go back, do just the final year of a different and less silly degree course, and then be credited with a real B.Sc. degree in a real science subject.

    Perhaps UCLan might consider offering that as a subsidised / discounted option to any discontented ex-student who thought they were getting an actual science degree?

    I suspect, actually, that most of the students were there wanting to end up as “accredited” (I use the word loosely) CAM practitioners, which they are and will remain, as far as the accreditation is worth anything. /arched eyebrow

    Of course, as the recession continues to bite, I imagine earning a living as a CAM practitioner is going to get harder and harder. At which point the ex-students might well be wanting to fall back on the job-getting power of a “”B.Sc”.

    Whoops.

  • Statutory regulation of TCM (& other forms of herbal med) and Acupuncture depends on the following report (published a couple of days ago): http://www.dh.gov.uk/en/Managingyourorganisation/Humanresourcesandtraining/Modernisingprofessionalregulation/ProfessionalRegulationandPatientSafetyProgramme/ExtendingProfessionalRegulation/DH_078555

  • Thanks very much for the reference,A nti-D. I remenber you telling us that herbalists themselves were not universally in favour of statutory regulation on my original post about the Pittilo report.

    The Department of Health told me that the consultation was awaiting the publication of the report on Extending Professional and Occupational Regulation, so thanks for spotting it. I notice that the report says that “The Working Group understands that a public consultation on the issues raised by the Steering Group [Pittilo] is imminent”.

  • The membership of the working group that produced the report Anti-D and DC mention can also be found on the DH website. It is mostly healthcare bureaucrats of various stripes (as far as I can infer from the organisations they work for), though I note it includes Mike Pittilo, of the eponymous report on CAM.

    Talking of regulating herbalistas and their ilk, if anyone needs (yet another) example of the kind of evidence-free nonsense that you can apparently sign up to having completed a “Degree in naturopathy”, then AP Gaylard provides a jaw-dropping one here..

  • Talking of herbalists, I stumbled on a fascinating new blog from a herbalist who has no time for woo. The Phytobabble blog points out that the course leader for herbalism at UCLan is (was?) an astrologer! There is also a good post on some loony stuff in the magazine of the National Institute of Medical Herbalists.

  • The comments from the astrological herbalist course leader at UCLAN are priceless.
    “At the end I asked her if I could cast her horoscope. She threw up her hands and said, ‘I knew this would happen if I came to an alternative practitioner!’. Needless to say I didn’t see her again, but that was well-indicated in the decumbiture chart (the chart for that consultation). I think the ruler of the ascendant was applying to Uranus in the ninth house, which was very pertinent”.

    Pertinent, indeed. And just when I thought that UCLAN was in danger of losing its Wooniversity status. You didn’t meet him when you were there, did you, David?

  • Gordon Bloomin’ Bennett, that astrology stuff takes some beating!

    Just when I thought that Galen’s humours had been discredited:
    ‘…. research interests lie in the history of medicine and herbal medicine and the re-evaluation of traditional, holistic approaches to therapeutics, particularly humoral medicine’.
    What the hell is decumbiture? (from the mondofacto dictionary: decumbiture =
    1. Confinement to a sick bed, or time of taking to one’s bed from sickness.
    2. Aspect of the heavens at the time of taking to one’s sick bed, by which the prognostics of recovery or death were made). [Note the past tense here]

    But good to know that we are safe.

  • Lindy
    As a former astrologer, I can confirm what she was saying is total bollocks. In effect she has said you have a mass of purple and your temperature is 2 furlongs per litre.

  • Hmm I see that you folks are not taking astrology at all seriously. Remember that Astrology and Health Psychology was the subject of a Ph.D. thesis in no less a place than the University of Southampton (in the Sociology department, not in the department of the inimitable George Lewith). Its authot, Pat Harris, says

    “A small case study series at a National Health Service hospital in the UK explored the effect of astrological counseling on chronic pain management, stress reduction, and quality-of-life improvements.”

    Although the study has not, as far as I know, been published, that doesn’t stop its author from selling you astrological advice about getting pregnant

    “. . .that can increase your likelihood of successful conception through assisted reproductive technology by as much as 21%.”

    She will also sell you astrological advice about what dress to wear.

  • @Nash
    Once I’d stopped laughing, your comment reminded me of the story of a Physics profeesor who, in despair about the inability of his stuends to convert units, made them express all velocities in furlongs per fortnight (I make it 10 kilofurlongs per fortnight – 3.72 miles per hour).

  • David

    Although astrology has to be the nonsensical drivel par excellence I could see astrological advice on getting pregnant as being vaguely plausible.

    I guess all you would need to do is take some readily available advice on the best time in the menstrual cycle to get pregnant, tie this into a load of old rubbish about Saturn in the ascendant and suggest a bit of horizontal jogging on the most propitious dates. Should work nicely and that’s £200 thank you very much.

    In order to fly the flag for EBM and science in general I am prepared to offer free advice and assistance on getting pregnant to suitable female candidates.

    My approach is wholly scientific and eschews all forms of mumbo jumbo and quackery. It is based on a short introduction to the scientifically validated theory of reproduction followed by a demonstration and extensive practicals.

    Clinically proven by doctors to work every time. Would appropriate candidates please form an orderly queue outside my house (when Mrs JH is at work).

  • I remember an advert for a ‘test’ predicting the sex of your unborn child. It was £300. “And your money fully refunded if we are wrong”. Genius.

  • Thanks a bunch AVP.

    That’s my retirement fund just gone down the khazi.

    I do agree that that is an absolute stroke of genius though.

    Unfortunately common sense all too often goes out the window in connection with difficulties getting pregnant and all matters relating to childbirth.

    It can be a time of great expense (IVF etc) and desperation (bio-clock running out, IVF tries running out etc). I had to actively dissuade two friends from trying acupuncture as there was apparently “evidence” that it faciitated getting pregnant (they had a child through IVF in the end).

    I wonder what sort of “evidence” that needling research was based on.

  • Given the major purpose of the UCLAN report was to defend CAM, it was hardly surprising that, as you and others have observed, it was a weak brew of rambling verbiage laced with complementary doses of unsupported assertions and non sequiturs. What was a little surprising, however, was that the authors seemed very forgiving in relation to the fact that many (most?) CAM procedures and claims, including those of the flagship, homeopathy, are based on groundless, often supernatural, assumptions.

    Consider the first two sentences of the section on efficacy (p2):
    “The debate on the efficacy and benefits of the various CAM disciplines and what constitutes an ‘acceptable’ evidence base for CAM treatments can be viewed as a dichotomy between two differing ways of knowing’, linked to the principles of ‘supposed holism’ and ‘reductionism in medicine’ (Rosenberg, 1998). It is also important to note that such debate is framed by country-specific socio-political circumstances.”

    Although these sentences are so vague that they seem empty of real content, they are nevertheless hinting at something telling, namely that CAM has its own special ‘way of knowing’, and because this way and the way in which conventional science ‘knows’ are incommensurable, CAM is entitled to claim a place in the sun without reference to the latter.

    A few lines later the cat was well and truly out of the bag when it was admitted that one of the [unresolved] issues on which the debate about efficacy focused was “Is it appropriate to examine CAM effects using the randomised controlled trial?” Why on earth should this be a matter for debate? How could it possibly be inappropriate to have a randomised double-blind trial to test whether or not, say, acupuncture in the ear-lobe (or ingested homeopathic or Chinese herbal preparations) reduced epileptic seizures or cigarette smoking? Their question shows that they are taking seriously the possibility that a CAM procedure can somehow remain genuinely superior to a placebo control while reliably failing to show it. This looks very much like ‘mystical’ thinking. Or, perhaps like (some of) the working party had taken refuge in the risible notion that homeopaths can claim some theoretical credit for their therapy by suggesting that its mode of action resides in the paradoxical twists and turns of the subatomic world. Like they’ve turned Schrodinger’s imaginary simultaneously dead and alive cat into flesh and bones. [But it seems that so far, at the point of decoherence, when the quantum world would have chosen either life or death for the cat it has chosen only death, that is to say, lack of efficacy, for homeopathy.]

    The theme that CAM is entitled to ask to be judged by its own standards and not by those of the natural sciences or conventional medical science was given a further sympathetic, but entirely uncritical, airing in a paragraph about the importance of critical thinking (at the top of p. 5 in the Report’s next section, The role of the Universities in Society). The theme was taken up again throughout p. 6. At the end of the second paragraph there was an reference to an article (Barry, 2006); the report noted, with apparent approval, that it implied “…that in order to understand the notions of evidence and efficacy that feature in informed work on CAM we must be prepared to step outside the scientific model of medicine and its purposes.” If all that Barry meant was that social, psychological, and economic factors should not be ignored, then there is nothing exceptional or exceptionable about that. Indeed, the double-blind randomised trials are the best, perhaps only, way of ensuring that these factors (which are known to influence the outcome of any treatment) are controlled. But that’s certainly not how it looks from either the general context or the way in which the Report represents Barry’s position; it looks like a naked plea to allow CAM practitioners to ignore scientific rules and procedures as and when they see fit.

    Finally, I wonder if anyone has a clear view of what lay behind, and what lies within, the following two-sentence paragraph (end of Page 6): “A criticism levelled against Chinese Herbal Medicine, Homeopathy and Acupuncture is the lack of a credible scientific explanatory theory. However, even though an explanatory theory is untenable a particular CAM may still have an unexplained beneficial effect”. If a CAM has an untenable theoretical basis and has not proved itself against a placebo control there can be no basis on which to suggest ‘it may have an unexplained beneficial effect’. Indeed, if a CAM is based on a whole string of hypotheses as stupendously implausible (and supernatural) as those of homeopathy there is really no point in testing it as the prior probability of its being efficacious is as near to zero as makes no difference. It would have been instructive if the Report had drawn readers’ attention to those CAMs that have been reliably shown to be efficacious AND for which there is no “tenable” explanation. Perhaps its failure to do so was inadvertently instructive; perhaps it’s an indication that, in fact, no CAM meets both criteria. And perhaps it’s time to call time on those CAMs that rest on supernatural assumptions.

  • @youcannotbeserious

    While I don’t disagree with most of what you say, I’m not at all sure thet the purpose of the report was to defend CAM. Some of the committee members could not be described as being sympathetic to CAM.

    It is actually rather difficult for universities to stop courses. After intake is stopped they still have to see through the students are already enrolled. It would be unreasonable to expect a university to announce that they’d just realised that they’d been teaching rubbish for the last 20 years so now we are going to stop. It just isn’t in the nature of university committees to call a spade a spade.

    I suspect the obscure wording of the report disguises radical differences of opinion between the people who wrote it.

    In fact the report could just as easily be interpreted as a bureaucratic device to get rid of CAM while saving as much face as possible. After all, that was the outcome.

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