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Yesterday I was fired from the Conduct and Competence Committee of the CNHC. That is the organisation that was very quickly dubbed Ofquack in the blogosphere.  So now I am free to write what I like about about it.

cnhc logo

It has now become clear that voluntary self-regulation can not work. Recent events at the CNHC show how it has become a victim of its own rules [skip the background].

Background | Complaints | Why CNHC won’t work |

Background

The CNHC was the product of the late unlamented Prince of Wales’ Foundation for Integrated Health. The Prince’s Foundation was paid a large amount of taxpayers’ money, £900,000, by the Department of Health to come up with a scheme for voluntary self-regulation of various sorts of alternative medicine.

There is, as usual, an enormous amount of relevant information can be found on the ebm-first site.

I posted a bit about Ofquack just before I joined them.  There were two main points. One was to draw attention to the wonderful account of CNHC by Polly Toynbee, "Quackery and superstition – available soon on the NHS",   The other was to point out an obvious problem with the job they were supposed to do.

“What won’t work is to insist that homeopaths are “properly trained”. If one takes the view that medicines that contain no medicine can’t work, then years of being trained to say that they do work, and years spent memorizing the early 19th century mumbo-jumbo of homeopathy, does not protect the public, it imperils them.”

On 25 September 2008, someone sent me an advertisement for a job on the conduct and competence committee. The job description seemed to fit me quite well, so I applied. I presumed they wouldn’t take me, and then I could write a blog about it. But after a phone interview with co-chair Maggy Wallace, I was amazed to be offered the job.

Since joining them I haven’t actually done anything whatsoever, apart from offering a few general ideas, because no cases have actually reached the Conduct and Competence Committee.

This was the first time I had encountered a quango at first hand. Several of the members seemed to have no great interest in medicine, or even in alternative medicine. They were more interested in regulation per se, or at least the sort of pseudo-regulation that most of these bodies mostly seem to offer. They seem to suffer from the well-known delusion that you can manage/regulate something without knowing anything about it.  In cases such as this one, where what is being regulated is largely nonsense, there are bound to be problems.

There were two people, whom I did come to like particularly, Maggy Wallace and John Lant. They were both willing to talk and to listen.

The anonymous emails

The alternative medicine community took a surprisingly long time to notice my presence, but on 19 May 2010 a pretty vicious anonymous email arrived at the CNHC, complaining about me.  Here it is.

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X-OriginalArrivalTime: 19 May 2010 09:45:25.0002 (UTC) FILETIME=[019176A0:01CAF738]

Thread-Topic: CNHC and Colquhoun

From: “Sara McGlouglan” <colquhounalertcnhc@gmail.com>


Colquhoun and the CNHC

(Complementary and Natural Health Care Council)

What is the CNHC and why does it exist?

REFLEXOLOGY IS BOLLOCKS!

Nutritional therapy self-styled ‘nutritionists’; making untrue claims about diet in order to sell you unnecessary supplements.

Reiki: tea and sympathy, accompanied by arm-waving.

Shiatsu uh? It seems the teacher is already committed to placebo medicine.

[All the above quotes; and many more stated by David Colquhoun, CNHC Panel member]

Contents

1: Colquhoun and CNHC

2: More statements from Colquhoun

3: Want some more!!!

4: What to do

1. Colquhoun and CNHC

Colquhoun is a man who has steadfastly attacked, denigrated and taken all steps he can to undermine those involved in natural health. Yet Colquhoun is now (and has been for more than a year) a member of the CNHC’s Conduct and Competence Committee.

The role of CNHC is to regulate the professions of their members. But what is the rational behind allowing an avowed critic of natural medicine onto the Conduct and Competence Committee. Isn’t this like asking racist to be objective about the circumstances of racist crime?

Would you, as a practitioner having to answer to a complaint, be happy to have one of the panel members think your profession is ‘bollocks’ or that everything you practice is fraudulent from the start?

Latest moves from the government now aim at putting all Herbal Practitioners under the authority of CNHC.

Do you want your personal and confidential data, and that of your patient/client in the hands of Colquhoun? What might happen to it?

Certainly every practitioner has to be responsible for their actions and practice but since when has it been standard practice to weigh the scales against you rather than be assessed by a panel of independent peers?

2. More statements by Colquhoun ‘ nonsense, untrue, unnecessary, rectal obsession, mystic barmpot, fraud, theatrical placebo

In his "Patients’ guide to Magic medicine” [https://www.dcscience.net/?page_id=733]

Colquhoun summarizes many of the CNHC members’ professional activities (and other professions too) as follows:

* Reflexology: plain old foot massage, overlaid with utter nonsense about non-existent connections between your feet and your thyroid gland.

* Nutritional therapy: self-styled ‘nutritionists’ making untrue claims about diet in order to sell you unnecessary supplements.

* Spiritual healing: tea and sympathy, accompanied by arm-waving.

* Reiki: ditto.

* Angelic Reiki. The same but with added Angels, Ascended Masters and Galactic Healers. Excellent for advanced fantasists.

* Colonic irrigation: a rectal obsession that fails to rid you of toxins which you didn’t have in the first place.

* Anthroposophical medicine: followers of the mystic barmpot, Rudolf Steiner, for whom nothing whatsoever seems to strain credulity

* Alternative diagnosis: kinesiology, iridology, vega test etc, various forms of fraud, designed to sell you cures that don’t work; for problems you haven’t got.

* Homeopathy: giving patients medicines that contain no medicine whatsoever.

* Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety.

* Acupuncture: a rather theatrical placebo, with no real therapeutic benefit in most if not all cases.

So what kind of organisation is CNHC and why have they put him on to their Conduct and Competence panel? Being a CNHC member seems to be like inflicting pain on yourself.

CNHC also received funding from the Prince’s Foundation for Integrated Health (FIH). Yet Colquhoun regularly lambasts the FIH and Prince Charles himself categorizing him as a ‘champion of endarkenment’ [https://www.dcscience.net/?p=2544] and calling the FIH the Foundation Fellows of the Prince of Wales Foundation for Magic Medicine, an organisation that is at the forefront of spreading medical misinformation. [https://www.dcscience.net/?p=2131]

Of course, no one expects that because an organisation provides funding it should be exempt from criticism but surely, if you are working for an organisation whose purpose is to represent standards in a certain field, why would you have someone on your management team who fires out carping criticism at the supporting organisation, its practitioners and its practices unless perhaps, it is your purpose to spread discord and cut the funding.

No wonder the CNHC has problems. Their business plan (contingent on funding) was initially to have more than 10,000 enrolled members. This has been revised down to 2,000 and by all counts they have not even made this. Not surprising if the practitioners whom you represent don’t have any trust in the organisation that is supposed to represent the standards of your profession.

3. Want some more!!! fantasists, wrong and dangerous, largely quackery, lies, mumbo-jumbo, made-up fantasies, placebo medicine

On nutritional therapy

It is interesting to compare the high standards of the Nutrition Society with the quite different standards of BANT (the British Association for Applied Nutrition and Nutritional Therapy).& They bill themselves as the “Professional Body for Nutritional Therapists”. Nutritional therapists are those fantasists who believe you can cure any ill by buying some supplement pills. [https://www.dcscience.net/?p=1391]

[On quotes taken from Nutritional Therapy text] That must be about as close as you can get to claiming you can prevent cancer by taking vitamin pills. It is wrong and t is dangerous,

Sigh. What century are we living in? [https://www.dcscience.net/?p=555]

Everyone is for good nutrition of course, but ‘nutritional medicine’, or ‘nutritional therapy’ pretends to be able to cure all sorts of diseases by changes in diet or by buying expensive nutritional supplement pills. It has no perceptible relationship to the very important subjects of ‘nutrition’ or ‘dietetics’.. ‘Nutritional therapy’ is very firmly part of alternative medicine, in other words it is largely quackery. If you don’t believe that, read on. https://www.dcscience.net/?p=260

On Reflexology

As usual, not many seemed to care very much about the secondary consequences of employing a ‘reflexologist’, namely that some poor kid has to memorise a bunch of lies to get the piece of paper demanded by HR (and the taxpayer has to fund it). https://www.dcscience.net/?page_id=237

What is the evidence about ‘spiritual healing’ ? Very little it seems.

No doubt, mumbo-jumbo can make some people feel better, and to that extent it is justified. But it can and should done be honestly (for example, foot massage is fine, ‘reflexology’ isn’t). Lies to patients should be minimised and universities should not be tempted to hand out certificates in mumbo jumbo. https://www.dcscience.net/?p=34

Michael McIntyre has the first of several long speeches, advocating more research. There was an advertisement for his web site “promotes best practice” (allegedly). He talks quite seriously about “reflexology” and so on, as though it were real subject (it isn’t; its “principles” are made-up fantasies). https://www.dcscience.net/?p=2813

Much of what they do at the Christie is straightforward massage, but they also promote the nonsensical principles of ‘reflexology’ and acupuncture. https://www.dcscience.net/?p=1466

The hilarious Radio 4 programme, The News Quiz had a good joke. Jeremy Hardy was asked which patients are hoping for a more robust constitution?. This referred to the £1m PR exercise mounted by the NHS to launch the NHS constitution. Hardy said that in the week when Barack Obama was inaugurated, and the word constitution have a whole different sort of gravitas in a week like that.

"I think the constitution should open with the words “We hold these truths to be self-evident REFLEXOLOGY IS BOLLOCKS" https://www.dcscience.net/?page_id=237

On Shiatsu

Shiatsu uh? It seems the teacher is already committed to placebo medicine. https://www.dcscience.net/?p=454

4. What to do

Why join an association that condones the above? Many have never joined CNHC because of this and other issues whilst existing CNHC members do not want to remain members.

1. Contact your professional association and insist that they do not join CNHC.

2. If your association is already a member then make a complaint and insist that your personal details are not supplied to CNHC.

3. There are other associations in existence that have the same purpose as CNHC. Find out about them. You (or your professional association) have the option to join them and
be represented by/answerable to them. CNHC is not the only option and one should wonder why they were chosen in the first place.

4. Please pass on this information to anyone else that you know. It is important that we are represented honestly and with integrity. The actions of CNHC do not add up.

ooOOoo

Nobody seems to know the real name of Sara Glougan (aka Sam McGlougan.  The letter is, I suppose, fair enough. I did say most of those things.  What’s objectionable is that the anonymous writer seems to think that my opinions disqualify me from judging dispassionately a Conduct and Competence case.  What this letter really says is that "we don’t want anyone who cares about the truth of claims to have any power over us".  They just don’t want to be regulated in any effective way.  The co-chair, Maggy Wallace, is a bit more sensible than that.  The reason that I was appointed by her was because of my knowledge about how to assess evidence. But that isn’t a topic that interests alternative medicine advocates.

The fact of the matter is that the CNHC has been signing up people at a far slower rate than it hoped originally.  It is in dire financial trouble (see, for example, Will the government bail out Ofquack?>, and CNHC’s report to the Department of Health in June 2009, obtained under the Freedom of Information Act.. The last thing they can afford is anything like this letter, which might reduce the registration rate still further. So it was inevitable that they had to get rid of me. Initially I was invited to resign on grounds of bad health. I didn’t, so on 10 August 2010 I was asked to appear before the board to be fired (in the nicest possible way). The CNHC now has nobody with any statistical expertise. Needless to say I’m not heartbroken about it. It was a waste of time for me, but it did provide a valuable insight into how voluntary self-regulation works, or rather fails to work.

The complaints against reflexologists

[skip the complaints.]

The CNHC has a complaints procedure, though its operation is somewhat tortuous.. As soon as they started to register reflexologists, several complaints were sent by the indefatigable Simon Perry (read his account)

“The ad suggests that reflexology is suitable for treating babies with colic, IBS and arthritis. She also claims to have experience in treating fertility issues. There is no reliable evidence to suggest that reflexology is capable of treating [these] issues.”

This complaint never came to to the Conduct and Competence Committee. It didn’t get past the preliminary Investigating Committee (chaired by John Lant), the job of which is to see if there is a case to answer. They decided that the advertisements in question did indeed breach paragraph 15 of the CNHC’s Code of Conduct, Performance and Ethics (see below). All 14 of Simon Perry’s complaints were upheld. However the Investigating Committee Panel’s report went on to say, apparently on the advice of the ‘Profession specific boards’ that

“The ICP found that the registrants’ Fitness to Practise was not impaired, because they did not deliberately seek to mislead their clients or to exaggerate the benefits of the therapy which they described in good faith. However they found that the registrants had made claims about the therapy offered which appeared to imply more efficacy than evidence necessarily provides.”

That, presumably, is why the complaints never reached the Conduct and Competence Committee. There was no case to answer.

One must admire Maggy Wallace’s statement that she “place on formal record their thanks to Simon Perry for bringing this matter to their attention.”.   Never the less the problem is glaringly obvious and it shouldn’t have need a complaint.

Why ofquack can never work

The complaint episode is fascinating. The CNHC has clearly painted itself into a corner. It has brought to the fore all the contradictions that are inherent in what they are trying to do.

They have decided that reflexologists make false claims about what they can achieve.

But they decided it wasn’t the fault of the reflexologists because that is what they had been taught

Therefore the CNHC has judged that fitness of reflexologists to practise is not affected by the fact that they make false health claims.

That means that the CNHC judges that the public safety is not affected by whether their members make false health claims. That seems ludicrous enough, but it goes further

In the initial publicity it was often said that the job of the CNHC was safety -their job to protect the public, not to judge whether treatments worked or not. That sort of statement is contradicted directly by paragraph 15 of their Code of Conduct, Performance and Ethics, which reads thus.

15. You must follow CNHC guidelines in relation to advertising your services

Any advertising you undertake in relation to your professional activities must be accurate. Advertisements must not be misleading, false, unfair or exaggerated. You must not claim that your personal skills, equipment or facilities are better than anyone else’s.

If you are involved in advertising or promoting any other product or service, you must make sure that you use your knowledge, healthcare skills, qualifications and experience in an accurate and professionally responsible way. You must not make or support unjustifiable statements relating to particular products or services. Any potential financial rewards to you should be made explicit and play no part at all in your advice or recommendations of products and services that you give to patients, clients and users.

This paragraph places on the CNHC the responsibility for judging whether or not a treatment does what’s claimed for it. With my departure, there is really nobody left who is well-qualified to do that,
but nonetheless, their judgement on claims made by reflexologists was quite right.

The assertion by the CNHC that the false claims were OK because that is what reflexologists are taught is a direct admission that the courses that ‘train’ reflexologists are teaching them to say things that are not true. Of course the rest of the world knew that already, but to have it admitted by the CNHC is amazing.

Part of the job of the CNHC is to judge whether registrants are properly trained. But they have just decided that courses for reflexologists teach them to say things that aren’t true, That leaves the CNHC it an impossible position. By accepting reflexologists, they are saying that it doesn’t really matter that they are taught to make false claims, The criteria for entry include

“Have undertaken a programme of education and training which meets, as a minimum, the National Occupational Standards for that profession/discipline”

This shifts the responsibility for deciding what’s acceptable to National Occupational Standards and Skills for Health. Neither of these quangos is in the least concerned about what’s true and what isn’t. That’s not surprising when you realise who drafted all the HR style nonsense to be found at Skills for Health? None other than the late Prince of Wales’ Foundation. The stuff produced by them isn’t worth the paper it’s written on. There is something about Skills for Health in the post where I recount a phone call with them, When I asked whether they would produce standards for talking to trees, I was referred, in all seriousness, to LANTRA, the Land based skills council. You couldn’t make it up.

The National Occupational Standards (NOS) directory leads to the NOS for reflexology.  The preamble says

Reflexology is the study and practice of treating reflex points and areas in the feet and hands that relate to corresponding parts of the body. Using precise hand and finger techniques a reflexologist can improve circulation, induce relaxation and enable homeostasis. These three outcomes can activate the body’s own healing systems to heal and prevent ill health. 

There is, if course, not a shred of reason to think that “areas in the feet and hands that relate to corresponding parts of the body”. This statement alone would fail the CNHC’s code of conduct. National Occupational Standards in this area are simply a farce.

What will the CNHC do about these paradoxes? The complaint report said

“The ICP have asked Maggie Dunn, the CNHC Registrar, to initiate, as a matter of priority, discussions with the CNHC’s Profession Specific Boards and the Professional Fora to agree advice to registrants in relation to paragraph 15.”

I was told that this might take between 3 and 5 years to do. But I have a strong feeling that it will never be done in any effective way. If the CNHC prevented training courses from teaching students to make claims that aren’t justified by evidence, just about every course would close and the CNHC would crumble to dust. The result would be the ultimate irony. Alternative medicine would be abolished, not by skeptics, but by the CNHC.

That follows inevitably from the complaint judgement combined with paragraph 15 of the code of conduct.

It will be fascinating to see how the CNHC tries to escape from the grave that it has dug for itself.

If the CNHC implements properly its own code of conduct, few people will sign up and CNHC will die. If it fails to implement its own code of conduct it would be shown to be a dishonest sham.

Follow-up

Interview for Pod Delusion on the CNHC case

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24 Responses to Why the Complementary and Natural Healthcare Council (CNHC) can’t succeed (in which DC gets fired)

  • […] This post was mentioned on Twitter by David Colquhoun, gimpy, Liz Ditz, Liz Ditz, Dr*T and others. Dr*T said: RT @EvidenceMatters: .@david_colquhoun reveals why he was fired from Complementary & Natural Healthcare Council http://bit.ly/9tTNCd &l … […]

  • twaza says:

    Wonderful!

    Thanks ++++

  • zeno says:

    What I don’t understand is what you’ve done to warrant being fired.

    Yes, you have views on AtlMed (based on the scientific evidence) that you are not afraid to voice, but are you expected to say nothing or be neutral? Are all other committee members neutral or are they AltMed supporters? If they fired you for having and expressing a view on AltMed, then they need to be firing anyone else who has expressed a view – positive or negative. Or do they only want fauning supporters?

    Your views may or may not have been known to OfQuack when they offered you the job, but they (Maggie and Maggy at least) have known for some time.

    So, the question is, why does it appear that this email precipitated your firing? (If OfQuack were interested in preserving any reputation they thought they had, they should be pursuing the writer of that email.)

    But, as in any employment case, it depends on exactly what your employment contract says and whether they have correctly followed their disciplinary procedures.

    Any deviation here and no amount of reflexology will give them a leg to stand on before an employment tribunal.

  • pberry says:

    Just fascinating.

    One question remains: if the CNHC were to investigate itself, would it disappear in a puff of smoke?

  • Andrew McLean says:

    Well the government are looking to save some money and quangos, in particular, are under scruitiny. How about writing up the case against CNHC, and circulating it? I can’t imagine there is anyone better qualified.

  • gimpy says:

    Andrew, it is tempting to suggest the CNHC as a quango to be quashed however I don’t think this is likely. It represents, after considerable lobbying by the heir to the throne, the only semi-official attempt to regulate quackery. Without this statutory regulators such as the HPC might be expected to take up the slack, and the statutory regulation of quacks, with all the benefits to credibility that implies, is a bad thing. Just look at how chiropractors were seen before they drew attention to themselves through the BCA’s libel claim against Simon Singh.

    I’m not sure if there are any solutions to this regulatory mess though.

  • […] Why the Complementary and Natural Healthcare Council (CNHC) can’t succeed (in which DC gets fired) If the CNHC prevented training courses from teaching students to make claims that aren’t justified by evidence, just about every course would close and the CNHC would crumble to dust. The result would be the ultimate irony. Alternative medicine would be abolished, not by skeptics, but by the CNHC. (tags: quacks uk medicine bad.science) […]

  • Margaret says:

    “But they decided it wasn’t the fault of the reflexologists because that is what they had been taught”

    So I had been taught that 2 + 2 = 7

    Then presumably it wouldn’t be my fault for getting my sums wrong down at that job in the pizza place so I can’t be fired…..

    Hmmm.

  • mugsandmoney says:

    You don’t sound very upset about being fired.

    But it sounds as though you have excellent grounds for a trip to the employment tribunal; you should apply for reinstatement rather than compensation.

    Should tie them up in knots for a while.

  • Teige says:

    Colquhoun alert! They really do think you a bit of a threat..

    It’s such a shame, sorting out this mess needn’t be so difficult, there are enough people who clearly see what the problems are.

  • Teige says:

    ….But too many people educated in meaningless professions like management, who need the jobs, and who can’t tell a duck for a duck; maybe?

  • Dudeistan says:

    Isn’t much of managerial practice these days – albeit not all – a cult, not that dissimilar to Scientology?

  • […] sc_project=233721; sc_invisible=0; sc_partition=0; sc_security=""; ← Why the Complementary and Natural Healthcare Council (CNHC) can’t succeed (in which DC gets fi… […]

  • annie says:

    Is it perhaps time the UK seriously considered republicanism?

    That one of your Royal Family could significantly interfere in healthcare and its funding seems to me to be a complete outrage. Yes, he gives voice to nutters in the population, but he appears to have undue and improper influence at a high level.

    Public funding of quackery is enough of a problem here in New Zealand – naturopathy is funded by our Accident Compensation Corporation – but high-level commitment to the funding of faith healing seems to be out of control in your patch.

    Keep up the excellent work.

  • BadlyShavedMonkey says:

    Can I join the others in asking what were the grounds for your dismissal?

    I wonder whether you might find yourself protected by the rules that protect ‘whistleblowers’.

    You may not want to run rings around them at an employment tribunal, but those of us sitting in the stands and eating popcorn would certainly cheer you on.

  • HughWillRidmee says:

    Is that the entire email – basically a list of statements made by David with no attempt to produce evidence to counter them? Well – not evidence perhaps – but surely some whining BS could have been used. Presumably it was only meant to be seen by people whose critical faculties are moribund.

  • @HughWillRidmee
    Haha I love your nickname.

    Probably you are quite right. The purpose of the email, presumably, was to spread panic and stop people registering with CNHC. The pro- and anti-regulation lobbies seem to exist in every branch of alt med. Herbalist almost come to blows over it, It’s all very reminiscent of religious sectarian warfare.

  • James8855 says:

    The factionalism of alt med sometimes reminds me of the People’s Front of Judea/ Judean People’s Front/ etc. in the Life of Brian…

    Re. the possibility of an employment tribunal, obviously that would depend on whether you were an employee of CNHC. Did you receive anything like a contract from them when you joined?

    The Conduct and Competence Committee may have members rather than employees. if so, it may be entitled to dismiss them according to its or CNHC’s terms of reference, which I imagine would be far less rigorous than a process driven by employment law.

  • […] Natural Health Care Council (CNHC)do nothing to protect the public, They endanger the public (see Why the CNHC can’t succeed). Their excuse for rejecting complaints that members were making false claims was not to deny that […]

  • […] 3 of the 14 therapists were registered with the Complementary and Natural Healthcare Council (the CNHC, more commonly know as Ofquack). They are meant to be the official regulator, launched with a good chunk of taxpayers’ […]

  • […] makes it perfectly clear that DH regards the Prince’s Foundation, and the equally flaky Complementary and Natural Healthcare Council (CNHC: known on the web as Ofquack) as appropriate guides for public health policy. The fact of the matter is that regulation of magic […]

  • […] (CNHC) is widely know in the blogosphere as Ofquack. I know about them from the inside, having been a member of their Conduct and Competence Committee, It was set up with the help of a £900,000 grant from […]

  • […] of thousands of pounds by the health service to produce witchdoctor literature and set up the Complementary and Natural Healthcare Council. He wouldn’t get privileged access to the Health Secretary. His Prince’s Foundation for […]

  • […] astonishing £900,000 to prepare the ground for the setting up of the hapless self-regulator, the Complementary and Natural Healthcare Council (CNHC, also known as […]

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