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There can be no doubt that the situation for women has improved hugely since I started at UCL, 50 years ago. At that time women were not allowed in the senior common room. It’s improved even more since the 1930s (read about the attitude of the great statistician, Ronald Fisher, to Florence Nightinglale David).

Recently Williams & Ceci published data that suggest that young women no longer face barriers in job selection in the USA (though it will take 20 years before that feeds through to professor level). But no sooner than one was feeling optimistic, along comes Tim Hunt who caused a media storm by advocating male-only labs. I’ll say a bit about that case below.

First some very preliminary concrete proposals.

The job of emancipation is not yet completed. I’ve recently become a member of the Royal Society diversity committee, chaired by Uta Frith. That’s made me think more seriously about the evidence concerning the progress of women and of black and minority ethnic (BME) people in science, and what can be done about it. Here are some preliminary thoughts. They are my opinions, not those of the committee.

I suspect that much of the problem for women and BME results from over-competitiveness and perverse incentives that are imposed on researchers. That’s got progressively worse, and it affects men too. In fact it corrupts the entire scientific process.

One of the best writers on these topics is Peter Lawrence. He’s an eminent biologist who worked at the famous Lab for Molecular Biology in Cambridge, until he ‘retired’.

Here are three things by him that everyone should read.

PL

The politics of publication (Nature, 2003) [pdf]

The mismeasurement of science (Current Biology, 2007) [pdf]

The heart of research is sick (Lab Times, 2011) [pdf]

From Lawrence (2003)

"Listen. All over the world scientists are fretting. It is night in London and Deborah Dormouse is unable to sleep. She can’t decide whether, after four weeks of anxious waiting, it would be counterproductive to call a Nature editor about her manuscript. In the sunlight in Sydney, Wayne Wombat is furious that his student’s article was rejected by Science and is taking revenge on similar work he is reviewing for Cell. In San Diego, Melissa Mariposa reads that her article submitted to Current Biology will be reconsidered, but only if it is cut in half. Against her better judgement, she steels herself to throw out some key data and oversimplify the conclusions— her postdoc needs this journal on his CV or he will lose a point in the Spanish league, and that job in Madrid will go instead to Mar Maradona."

and

"It is we older, well-established scientists who have to act to change things. We should make these points on committees for grants and jobs, and should not be so desperate to push our papers into the leading journals. We cannot expect younger scientists to endanger their future by making sacrifices for the common good, at least not before we do."

From Lawrence (2007)

“The struggle to survive in modern science, the open and public nature of that competition, and the advantages bestowed on those who are prepared to show off and to exploit others have acted against modest and gentle people of all kinds — yet there is no evidence, presumption or likelihood that less pushy people are less creative.  As less aggressive people are predominantly women [14,15] it should be no surprise that, in spite of an increased proportion of women entering biomedical research as students, there has been little, if any, increase in the representation of women at the top [16]. Gentle people of both sexes vote with their feet and leave a profession that they, correctly, perceive to discriminate against them [17]. Not only do we lose many original researchers, I think science would flourish more in an understanding and empathetic workplace.”

From Lawrence (2011).

"There’s a reward system for building up a large group, if you can, and it doesn’t really matter how many of your group fail, as long as one or two succeed. You can build your career on their success".

Part of this pressure comes from university rankings. They are statistically-illiterate and serve no useful purpose, apart from making money for their publishers and providing vice-chancellors with an excuse to bullying staff in the interests of institutional willy-waving.

And part of the pressure arises from the money that comes with the REF.  A recent survey gave rise to the comment

"Early career researchers overwhelmingly feel that the research excellence framework has created “a huge amount of pressure and anxiety, which impacts particularly on those at the bottom rung of the career ladder"

In fact the last REF was conducted quite sensibly (e.g. use of silly metrics was banned).  The problem was that universities didn’t believe that the rules would be followed.

For example, academics in the Department of Medicine at Imperial College London were told (in 2007) they are expected to

“publish three papers per annum, at least one in a prestigious journal with an impact factor of at least five”. 

And last year a 51-year-old academic with a good publication record was told that unless he raised £200,000 in grants in the next year, he’d be fired.  There can be little doubt that this “performance management” contributed to his decision to commit suicide.  And Imperial did nothing to remedy the policy after an internal investigation.

Several other universities have policies that are equally brutal. For example, Warwick, Queen Mary College London and Kings College London

Crude financial targets for grant income should be condemned as defrauding the taxpayer (you are compelled to make your work as expensive as possible)  As usual, women and BME suffer disproportionately from such bullying.

What can be done about this in practice?

I feel that some firm recommendations will be useful. 

One thing that could be done is to make sure that all universities sign, and adhere to, the San Francisco Declaration on Research Assessment (DORA), and adhere to the Athena Swan charter

The Royal Society has already signed DORA, but, shockingly, only three universities in the UK have done so (Sussex, UCL and Manchester).

Another well-meaning initiative is The Concordat to Support the Career Development of Researchers. It’s written very much from the HR point of view and I’d argue that that’s part of the problem, not part of the solution.
For example it says

“3. Research managers should be required to participate in active performance management, including career development guidance”

That statement is meaningless without any definition of how performance management should be done. It’s quite clear that “performance management”, in the form of crude targets, was a large contributor to Stefan Grimm’s suicide

The Concordat places great emphasis in training programmes, but ignores the fact that it’s doubtful whether diversity training works, and it may even have bad effects.

The Concordat is essentially meaningless in its present form.

My proposals

I propose that all fellowships and grants should be awarded only to universities who have signed DORA and Athena Swan.

I have little faith that signing DORA, or the Concordat, will have much effect on the shop floor, but they do set a standard, and eventually, as with changes in the law, improvements in behaviour are effected.

But, as a check, It should be announced at the start that fellows and employees paid by grants will be asked directly whether or not these agreements have been honoured in practice.

Crude financial targets are imposed at one in six universities. Those who do that should be excluded from getting fellowships or grants, on the grounds that the process gives bad value to the funders (and taxpayer) and that it endangers objectivity.

Some thoughts in the Hunt affair

It’s now 46 years since I and Brian Woledge managed to get UCL’s senior common room, the Housman room, opened to women. That was 1969, and since then, I don’t think that I’ve heard any public statement that was so openly sexist as Tim Hunt’s now notorious speech in Korea.

Listen to Hunt, Connie St Louis and Jenny Rohn on the Today programme (10 June, 2015). sl50

On the Today Programme, Hunt himself said "What I said was quite accurately reported" and "I just wanted to be honest", so there’s no doubt that those are his views. He confirmed that the account that was first tweeted by Connie St Louis was accurate

Inevitably, there was a backlash from libertarians and conservatives. That was fuelled by a piece in today’s Observer, in which Hunt seems to regard himself as being victimised. My comment on the Observer piece sums up my views.

I was pretty shaken when I heard what Tim Hunt had said, all the more because I have recently become a member of the Royal Society’s diversity committee. When he talked about the incident on the Today programme on 10 June, it certainly didn’t sound like a joke to me. It seems that he carried on for more than 5 minutes in they same vein.

Everyone appreciates Hunt’s scientific work, but the views that he expressed about women are from the dark ages. It seemed to me, and to Dorothy Bishop, and to many others, that with views like that. Hunt should not play any part in selection or policy matters. The Royal Society moved with admirable speed to do that.

The views that were expressed are so totally incompatible with UCL’s values, so it was right that UCL too acted quickly. His job at UCL was an honorary one: he is retired and he was not deprived of his lab and his living, as some people suggested.

Although the initial reaction, from men as well as from women, was predictably angry, it very soon turned to humour, with the flood of #distractinglysexy tweets.

It would be a mistake to think that these actions were the work of PR people. They were thought to be just by everyone, female or male, who wants to improve diversity in science.

The episode is sad and disappointing. But the right things were done quickly.

Now Hunt can be left in peace to enjoy his retirement.

Look at it this way. If you were a young woman, applying for a fellowship in competition with men. what would you think if Tim Hunt were on the selection panel?

After all this fuss, we need to laugh.

Here is a clip from the BBC News Quiz, in which actor, Rebecca Front, gives her take on the affair.sl50

Follow-up

Some great videos soon followed Hunt’s comments. Try these.
Nobel Scientist Tim Hunt Sparks a #Distractinglysexy Campaign
(via Jennifer Raff)

This video has some clips from an earlier one, from Suzi Gage “Science it’s a girl thing”.

15 June 2015

An update on what happened from UCL. From my knowledge of what happened, this is not PR spin. It’s true.

16 June 2015

There is an interview with Tim Hunt in Lab Times that’s rather revealing. This interview was published in April 2014, more than a year before the Korean speech. Right up to the penultimate paragraph we agree on just about everything, from the virtue of small groups to the iniquity of impact factors. But then right at the end we read this.

In your opinion, why are women still under-represented in senior positions in academia and funding bodies?

Hunt:  I’m not sure there is really a problem, actually. People just look at the statistics. I dare, myself, think there is any discrimination, either for or against men or women. I think people are really good at selecting good scientists but I must admit the inequalities in the outcomes, especially at the higher end, are quite staggering. And I have no idea what the reasons are. One should start asking why women being under-represented in senior positions is such a big problem. Is this actually a bad thing? It is not immediately obvious for me… is this bad for women? Or bad for science? Or bad for society? I don’t know, it clearly upsets people a lot.

This suggests to me that the outburst on 8th June reflected opinions that Hunt has had for a while.

There has been quite a lot of discussion of Hunt’s track record. These tweets suggest it may not be blameless.

19 June 2015

Yesterday I was asked by the letters editor of the Times, Andrew Riley, to write a letter in response to a half-witted, anonymous, Times leading article. I dropped everything, and sent it. It was neither acknowledged nor published. Here it is [download pdf].

One of the few good outcomes of the sad affair of Tim Hunt is that it has brought to light the backwoodsmen who are eager to defend his actions, and to condemn UCL.  The anonymous Times leader of 16 June was as good an example as any.
Here are seven relevant considerations.

  1. Honorary jobs have no employment contract, so holders of them are not employees in the normal sense of the term.  Rather, they are eminent people who agree to act as ambassadors for the university,
  2. Hunt’s remarks were not a joke –they were his genuine views. He has stated them before and he confirmed them on the Today programme,
  3. He’s entitled to hold these views but he’s quite sensible enough to see that UCL would be criticised harshly if he were to remain in his ambassadorial role so he relinquished it before UCL was able to talk to him.
  4. All you have to do to see the problems is to imagine yourself as a young women, applying for a grant or fellowship, in competition with men, knowing that Hunt was one of her judges.  Would your leader have been so eager to defend a young Muslim who advocated men only labs?  Or someone who advocated Jew-free labs? The principle is the same.
  5. Advocacy of all male labs is not only plain silly, it’s also illegal under the Equalities Act (2010). 
  6. UCL’s decision to accept Hunt’s offer to relinquish his role was not the result of a twitter lynch mob. The comments there rapidly became good humoured  If there is a witch hunt, it is by your leader writer and the Daily Mail, eager to defend the indefensible and to condemn UCL and the Royal Society
  7. It has been suggested to me that it would have been better if Hunt had been brought before a disciplinary committee, so due process would have been observed.  I can imagine nothing that would have been more cruel to a distinguished colleague than to put him through such a miserable ordeal.

Some quotations from this letter were used by Tom Whipple in an article about Richard Dawkins surprising (to me) emergence as an unreconstructed backwoodsman.

18 June 2015

Adam Rutherford’s excellent Radio 4 programme, Inside Science, had an episode “Women Scientists on Sexism in Science". The last speaker was Uta Frith (who is chair of the Royal Society’s diversity committee). Her contribution started at about 23 min.

Listen to Uta Frith’s contribution. sl30

" . . this over-competitiveness, and this incredible rush to publish fast, and publish in quantity rather than in quality, has been extremely detrimental for science, and it has been disproportionately bad, I think, for under-represented groups who don’t quite fit in to this over-competitive climate. So I am proposing something I like to call slow science . . . why is this necessary, to do this extreme measurement-driven, quantitative judgement of output, rather than looking at the actual quality"

That, I need hardly say, is music to my ears. Why not, for example, restrict the number of papers that an be submitted with fellowship applications to four (just as the REF did)?

21 June 2015

I’ve received a handful of letters, some worded in a quite extreme way, telling me I’m wrong. It’s no surprise that 100% of them are from men. Most are from more-or-less elderly men. A few are from senior men who run large groups. I have no way to tell whether their motive is a genuine wish to have freedom of speech at any price. Or whether their motives are less worthy: perhaps some of them are against anything that prevents postdocs working for 16 hours a day, for the glory of the boss. I just don’t know.

I’ve had far more letters saying that UCL did the right thing when it accepted Tim Hunt’s offer to resign from his non job at UCL. These letters are predominantly from young people, men as well as women. Almost all of them ask not to be identified in public. They are, unsurprisingly, scared to argue with the eight Nobel prizewinners who have deplored UCL’s action (without bothering to ascertain the facts). The fact that they are scared to speak out is hardly surprising. It’s part of the problem.

What you can do, if you don’t want to put your head above the public parapet. is simply to email the top people at UCL, in private. to express your support. All these email addresses are open to the public in UCL’s admirably open email directory.

Michael Arthur (provost): michael.arthur@ucl.ac.uk

David Price (vice-provost research): d.price@ucl.ac.uk

Geraint Rees (Dean of the Faculty of Life Sciences): g.rees@ucl.ac.uk

All these people have an excellent record on women in science, as illustrated by the response to Daily Mail’s appalling behaviour towards UCL astrophysicist, Hiranya Pereis.

26 June 2015

The sad matter of Tim Hunt is over, at last. The provost of UCL, Michael Arthur has now made a statement himself. Provost’s View: Women in Science is an excellent reiteration of UCL’s principles.

By way of celebration, here is the picture of the quad, taken on 23 March, 2003. It was the start of the second great march to try to stop the war in Iraq. I use it to introduce talks, as a reminder that there are more serious consequences of believing things that aren’t true than a handful of people taking sugar pills.

ucl-quad-200303-500.jpg

11 October 2015

In which I agree with Mary Collins

Long after this unpleasant row died down, it was brought back to life yesterday when I heard that Colin Blakemore had resigned as honorary president of the Association of British Science Writers (ABSW), on the grounds that that organisation had not been sufficiently hard on Connie St Louis, whose tweet initiated the whole affair. I’m not a member of the ABSW and I have never met St Louis, but I know Blakemore well and like him. Nevertheless it seems to me to be quite disproportionate for a famous elderly white man to take such dramatic headline-grabbing action because a young black women had exaggerated bits of her CV. Of course she shouldn’t have done that, but it everyone were punished so severely for "burnishing" their CV there would be a large number of people in trouble.

Blakemore’s own statement also suggested that her reporting was inaccurate (though it appears that he didn’t submitted a complaint to ABSW). As I have said above, I don’t think that this is true to any important extent. The gist of it was said was verified by others, and, most importantly, Hunt himself said "What I said was quite accurately reported" and "I just wanted to be honest". As far as I know, he hasn’t said anything since that has contradicted that view, which he gave straight after the event. The only change that I know of is that the words that were quoted turned out to have been followed by "Now, seriously", which can be interpreted as meaning that the sexist comments were intended as a joke. If it were not for earlier comments along the same lines, that might have been an excuse.

Yesterday, on twitter, I was asked by Mary Collins, Hunt’s wife, whether I thought he was misogynist. I said no and I don’t believe that it is. It’s true that I had used that word in a single tweet, long since deleted, and that was wrong. I suspect that I felt at the time that it sounded like a less harsh word than sexist, but it was the wrong word and I apologised for using it.

So do I believe that Tim Hunt is sexist? No I don’t. But his remarks both in Korea and earlier were undoubtedly sexist. Nevertheless, I don’t believe that, as a person, he suffers from ingrained sexism. He’s too nice for that. My interpretation is that (a) he’s so obsessive about his work that he has little time to think about political matters, and (b) he’s naive about the public image that he presents, and about how people will react to them. That’s a combination that I’ve seen before among some very eminent scientists.

In fact I find myself in almost complete agreement with Mary Collins, Hunt’s wife, when she said (I quote the Observer)

“And he is certainly not an old dinosaur. He just says silly things now and again.” “Collins clutches her head as Hunt talks. “It was an unbelievably stupid thing to say,” she says. “You can see why it could be taken as offensive if you didn’t know Tim. But really it was just part of his upbringing. He went to a single-sex school in the 1960s.”

Nevertheless, I think it’s unreasonable to think that comments such as those made in Korea (and earlier) would not have consequences, "naive" or not, "joke" or not, "upbringing" or not,

It’s really not hard to see why there were consequences. All you have to do is to imagine yourself as a woman, applying for a grant or fellowship, and realising that you’d be judged by Hunt. And if you think that the reaction was too harsh, imagine the same words being spoken with "blacks", or "Jews" substituted for "women". Of course I’m not suggesting for a moment that he’d have done this, but if anybody did, I doubt whether many people would have thought it was a good joke.

9 November 2015

An impressively detailed account of the Hunt affair has appeared. The gist can be inferred from the title: "Saving Tim Hunt
The campaign to exonerate Tim Hunt for his sexist remarks in Seoul is built on myths, misinformation, and spin
". It was written by Dan Waddell (@danwaddell) and Paula Higgins (@justamusicprof). It is long and it’s impressively researched. it’s revealing to see the bits that Louise Mensch omitted from her quotations. I can’t disagree with its conclusion.

"In the end, the parable of Tim Hunt is indeed a simple one. He said something casually sexist, stupid and inappropriate which offended many of his audience. He then confirmed he said what he was reported to have said and apologised twice. The matter should have stopped there. Instead a concerted effort to save his name — which was not disgraced, nor his reputation as a scientist jeopardized — has rewritten history. Science is about truth. As this article has shown, we have seen very little of it from Hunt’s apologists — merely evasions, half-truths, distortions, errors and outright falsehoods.

"

Jump to follow-up

This week’s Times Higher Education carried a report of the death, at age 51, of Professor Stefan Grimm: Imperial College London to ‘review procedures’ after death of academic. He was professor of toxicology in the Faculty of Medicine at Imperial.

ic

 

Now Stefan Grimm is dead. Despite having a good publication record, he failed to do sufficiently expensive research, so he was fired (or at least threatened with being fired).

“Speaking to Times Higher Education on condition of anonymity, two academics who knew Professor Grimm, who was 51, said that he had complained of being placed under undue pressure by the university in the months leading up to his death, and that he had been placed on performance review.”

Having had cause to report before on bullying at Imperial’s Department of Medicine, I was curious to know more.

Martin Wilkins wrote to Grimm on 10 March 2014. The full text is on THE.

"I am of the opinion that you are struggling to fulfil the metrics of a Professorial post at Imperial College which include maintaining established funding in a programme of research with an attributable share of research spend of £200k p.a and must now start to give serious consideration as to whether you are performing at the expected level of a Professor at Imperial College."

"Please be aware that this constitutes the start of informal action in relation to your performance, however should you fail to meet the objective outlined, I will need to consider your performance in accordance with the formal College procedure for managing issues of poor performance (Ordinance ­D8) which can be found at the following link.
http://www3.imperial.ac.uk/secretariat/collegegovernance/provisions/ordinances/d8"

[The link to ordinances in this letter doesn’t work now. But you can still read them here (click on the + sign).]

It didn’t take long to get hold of an email from Grimm that has been widely circulated within Imperial. The mail is dated a month after his death. It isn’t known whether it was pre-set by Grimm himself or whether it was sent by someone else. It’s even possible that it wasn’t written by Grimm himself, though if it is an accurate description of what happened, that’s not crucial.

No doubt any Imperial staff member would be in great danger if they were to publish the mail. So, as a public service, I shall do so.

The email from Stefan Grimm, below, was prefaced by an explanation written by the person who forwarded it (I don’t know who that was).

Dear Colleagues,

You may have already heard about the tragic death of Professor Stefan Grimm a former member of the Faculty of Medicine at Imperial College. He died suddenly and unexpectedly in early October. As yet there is no report about the cause of his death. Some two weeks later a delayed email from him was received by many of the senior staff of the medical school, and other researchers worldwide. It has been forwarded to me by one of my research collaborators. From my reading of it I believe that Stefan wanted it circulated as widely as possible and for that reason I am sending it to you. It is appended below.

This email represents just one side of an acrimonious dispute, but it may be indicative of more deep seated problems.

best wishes


Begin forwarded message:

From: Stefan Grimm <professorstefangrimm@gmail.com>

Date: 21 October 2014 23:41:03 BST

To: <big-email-list>

Subject: How Professors are treated at Imperial College

Dear all,

If anyone is interested how Professors are treated at Imperial College: Here is my story.

On May 30th ’13 my boss, Prof Martin Wilkins, came into my office together with his PA and ask me what grants I had. After I enumerated them I was told that this was not enough and that I had to leave the College within one year – “max” as he said. He made it clear that he was acting on behalf of Prof Gavin Screaton, the then head of the Department of Medicine, and told me that I would have a meeting with him soon to be sacked. Without any further comment he left my office. It was only then that I realized that he did not even have the courtesy to close the door of my office when he delivered this message. When I turned around the corner I saw a student who seems to have overheard the conversation looking at me in utter horror.

Prof Wilkins had nothing better to do than immediately inform my colleagues in the Section that he had just sacked me.

Why does a Professor have to be treated like that?

All my grant writing stopped afterwards, as I was waiting for the meeting to get sacked by Prof Screaton. This meeting, however, never took place.

In March ’14 I then received the ultimatum email below. 200,000 pounds research income every year is required. Very interesting. I was never informed about this before and cannot remember that this is part of my contract with the College. Especially interesting is the fact that the required 200,000.- pounds could potentially also be covered by smaller grants but in my case a programme grant was expected.

Our 135,000.- pounds from the University of Dammam? Doesn’t count. I have to say that it was a lovely situation to submit grant applications for your own survival with such a deadline. We all know what a lottery grant applications are.

There was talk that the Department had accepted to be in dept for some time and would compensate this through more teaching. So I thought that I would survive. But the email below indicates otherwise. I got this after the student for whom I “have plans” received the official admission to the College as a PhD student. He waited so long to work in our group and I will never be able to tell him that this should now not happen. What these guys don’t know is that they destroy lives. Well, they certainly destroyed mine.

The reality is that these career scientists up in the hierarchy of this organization only look at figures to judge their colleagues, be it impact factors or grant income. After all, how can you convince your Department head that you are working on something exciting if he not even attends the regular Departmental seminars? The aim is only to keep up the finances of their Departments for their own career advancement.

These formidable leaders are playing an interesting game: They hire scientists from other countries to submit the work that they did abroad under completely different conditions for the Research Assessment that is supposed to gauge the performance of British universities. Afterwards they leave them alone to either perform with grants or being kicked out. Even if your work is submitted to this Research Assessment and brings in money for the university, you are targeted if your grant income is deemed insufficient. Those submitted to the research assessment hence support those colleagues who are unproductive but have grants. Grant income is all that counts here, not scientific output.

We had four papers with original data this year so far, in Cell Death and Differentiation, Oncogene, Journal of Cell Science and, as I informed Prof Wilkins this week, one accepted with the EMBO Journal. I was also the editor of a book and wrote two reviews. Doesn’t count.

This leads to a interesting spin to the old saying “publish or perish”. Here it is “publish and perish”.

Did I regret coming to this place? I enormously enjoyed interacting with my science colleagues here, but like many of them, I fell into the trap of confusing the reputation of science here with the present reality. This is not a university anymore but a business with very few up in the hierarchy, like our formidable duo, profiteering and the rest of us are milked for money, be it professors for their grant income or students who pay 100.- pounds just to extend their write-up status.

If anyone believes that I feel what my excellent coworkers and I have accomplished here over the years is inferior to other work, is wrong. With our apoptosis genes and the concept of Anticancer Genes we have developed something that is probably much more exciting than most other projects, including those that are heavily supported by grants.

Was I perhaps too lazy? My boss smugly told me that I was actually the one professor on the whole campus who had submitted the highest number of grant applications. Well, they were probably simply not good enough.

I am by far not the only one who is targeted by those formidable guys. These colleagues only keep quiet out of shame about their situation. Which is wrong. As we all know hitting the sweet spot in bioscience is simply a matter of luck, both for grant applications and publications.

Why does a Professor have to be treated like that?

One of my colleagues here at the College whom I told my story looked at me, there was a silence, and then said: “Yes, they treat us like sh*t”.

Best regards,

Stefan Grimm

 

There is now a way for staff to register their opinions of their employers.The entries for Imperial College on Glassdoor.com suggest that bullying there is widespread (on contrast, the grumbles about UCL are mostly about lack of space).

Googling ‘imperial college employment tribunal’ shows a history of bullying that is not publicised. In fact victims are often forced to sign gagging clauses. In fairness, AcademicFOI.com shows that the problems are not unique to Imperial. Over 3 years (it isn’t clear which years) , 810 university staff went to employment tribunals. And 5528 staff were gagged. Not a proud record

Imperial’s Department of Medicine web site says that one of its aims is to “build a strong and supportive academic community”. Imperial’s spokesman said “Stefan Grimm was a valued member of the Faculty of Medicine”.

The ability of large organisations to tell barefaced lies never ceases to amaze me.

I asked Martin Wilkins to comment on the email from Grimm. His response is the standard stuff that HR issues on such occasions. Not a word of apology, no admission of fault. It says “Imperial College London seeks to give every member of its community the opportunity to excel and to create a supportive environment in which their careers may flourish.”. Unless, that is, your research is insufficiently expensive, in which case we’ll throw you out on the street at 51. For completeness, you can download Wilkins’ mail.

After reading this post, Martin Wilkins wrote again to me (12.21 on 2nd December), He said

“You will appreciate that I am unable to engage in any further discussion – not because of any institutional policy but because there is an ongoing inquest into the circumstances of his death. What I can say is that there was no ongoing correspondence. We met from time to time to discuss science and general matters. These meetings were always cordial. My last meeting with him was to congratulate him on his recent paper, accepted by EMBOL "

The emails now revealed show that the relationship could hardly have been less “cordial”. Martin Wilkins appears to be less than frank about what happened.

If anyone has more correspondence which ought to be known, please send it to me. I don’t reveal sources (if you prefer, use my non-College email david.colquhoun72 (at) gmail.com).

The problem is by no means limited to Imperial. Neither is it universal at Imperial: some departments are quite happy about how they are run. Kings College London, Warwick University and Queen Mary College London have been just as brutal as Imperial. But in these places nobody has died. Not yet.

Follow-up

Here are a few of the tweets that appeared soon after this post appeared.

3 December 2014

The day after this post went public, I wrote to the vice-chancellor of Imperial College, thus.

To: alice.gast@imperial.ac.uk

cc: w.j.stirling@imperial.ac.uk, s.johal@imperial.ac.uk. d.humphris@imperial.ac.uk


Dear Professor Gast

You may be aware that last night, at 18.30, I published Stefan Grimm’s last email, see http://www.dcscience.net/?p=6834 

In the 12 hours that it’s been public it’s had at least 10,000 views. At the moment, 230 people. from all round the world, are reading it. It seems to be going viral.

I appreciate that you are new to the job of rector, so you may not realise that this sort of behaviour has been going on for years at Imperial (especially in Medicine) -I last wrote about the dimwitted methods being used to assess people in Medicine on 2007 -see http://www.dcscience.net/?p=182

Now it seems likely that the policy has actually killed someone (itwas quite predictable that this would happen, sooner or later).

I hope that your your humanity will ensure a change of policy in your approach to “performance management”.

Failing that, the bad publicity that you’re getting may be enough to persuade you to do so.

Best regards

David Colquhoun

__________________________________
D. Colquhoun FRS
Professor of Pharmacology
NPP, University College London
Gower Street

Today I updated the numbers: 44,000 hits after 36 hours.

I tried to put it politely, but I have not yet had a reply.

4 December 2014

More than one source at Imperial has sent me a copy of an email sent to staff by the dean of the Faculty of Medicine. It’s dated 03 December 2014 16:44. It was sent almost 24 hours after my post. It is, I suppose, just possible that Kelleher was unaware of my post. But he must surely have seen the internally-circulated version of Grimm’s letter. It isn’t mentioned: that makes the weasel words and crocodile tears in the email even more revolting than they otherwise would be. Both his account and Wilkins’ account contradict directly the account in Grimm’s mail.

Somebody is not telling the truth.

Download Kelleher’s email.

This post has broken all records (for this blog). It has been viewed over 50,000 times in 48 hours. It is still getting 35-40 visitors per minute, as it has for the last 2 days. How much longer will managers at Imperial be able to pretend that the cat hasn’t escaped from the bag?

5 December 2014

Late last night. Imperial made, at last. a public comment on the death of Stefan Grimm: Statement on Professor Stefan Grimm by Caroline Davis (Communications and Public Affairs). This bit of shameless public relations appears under a tasteful picture of lilies.

ICL lilies

It says “Members of Imperial’s community may be aware of media reports of the tragic loss of Stefan Grimm, professor of toxicology in the Faculty of Medicine”. They could hardly have missed the reports. As of 07.25 this morning, this post alone has been viewed 97,626 times, from all over the world. The statement is a masterpiece of weasel words, crocodile tears and straw man arguments. “Contrary to claims appearing on the internet, Professor Grimm’s work was not under formal review nor had he been given any notice of dismissal”. I saw no allegations that he had actually been fired. He was undoubtedly threatened with being fired. That’s entirely obvious from the email sent by Martin Wilkins to Stefan Grimm. on 10 March. The full text of that mail was published yesterday in Times Higher Education.

It’s worth reproducing the full text of that mail. To write like that to a successful professor, aged 51, is simply cruel. It is obviously incompatible with the PR guff that was issued yesterday. It seems to me to be very silly of Imperial College to try to deny the obvious.

I don’t know how people like Martin Wilkins and Caroline Davis manage to sleep at night.

Date: 10 March 2014

Dear Stefan

I am writing following our recent meetings in which we discussed your current grant support and the prospects for the immediate future. The last was our discussion around your PRDP, which I have attached. 

As we discussed, any significant external funding you had has now ended. I know that you have been seeking further funding support with Charities such as CRUK and the EU commission but my concern is that despite submitting many grants, you have been unsuccessful in persuading peer-review panels that you have a competitive application. Your dedication to seek funding is not in doubt but as time goes by, this can risk becoming a difficult situation from which to extricate oneself. In other words, grant committees can become fatigued from seeing a series of unsuccessful applications from the same applicant.

I am of the opinion that you are struggling to fulfil the metrics of a Professorial post at Imperial College which include maintaining established funding in a programme of research with an attributable share of research spend of £200k p.a and must now start to give serious consideration as to whether you are performing at the expected level of a Professor at Imperial College.

Over the course of the next 12 months I expect you to apply and be awarded a programme grant as lead PI. This is the objective that you will need to achieve in order for your performance to be considered at an acceptable standard. I am committed to doing what I can to help you succeed and will meet with you monthly to discuss your progression and success in achieving the objective outlined.  You have previously initiated discussions in our meetings regarding opportunities outside of Imperial College and I know you have been exploring opportunities elsewhere. Should this be the direction you wish to pursue, then I will do what I can to help you succeed.

Please be aware that this constitutes the start of informal action in relation to your performance, however should you fail to meet the objective outlined, I will need to consider your performance in accordance with the formal College procedure for managing issues of poor performance (Ordinance ­D8) which can be found at the following link.
http://www3.imperial.ac.uk/secretariat/collegegovernance/provisions/ordinances/d8

Should you have any questions on the above, please do get in touch.

Best wishes

Martin

These fixed performance targets are simply absurd. It’s called "research" because you don’t know how ir will come out. I’m told that if you apply for an Academic Clinical Fellowship at Imperial you are told

“Objectives and targets: The goal would be to impart sufficient training in the chosen subspecialty, as to enable the candidate to enter a MD/PhD programme at the end of the fellowship. During the entire academic training programme, the candidate is expected to publish at least five research articles in peer-reviewed journals of impact factor greater than 4.”

That’s a recipe for short term, unoriginal research. It’s an incentive to cut corners. Knowing that a paper has been written under that sort of pressure makes me less inclined to believe that the work has been done thoroughly. It is a prostitution of science.

Later on 5 December. This post has now had 100,000 views in a bit less that four days. At 13.30, I was at Kings College London, to talk to medical students about quackery etc. They were a smart lot, but all the questions were about Stefan Grimm.

The national press have begun to notice the tragedy. The Daily Mail, of all "newspapers" has a fair account of the death. It quotes Professor James Stirling, Provost of Imperial College London, as intoning the standard mantra:

“Imperial seeks to give every member of its community the opportunity to excel and to create a supportive environment in which their careers may flourish. Where we become aware that the College is falling short of this standard of support to its members, we will act”.

In my opinion the email above shows this is simply untrue. This sort of absurd and counterproductive pressure has been the rule in the Department of Medicine for years. I can’t believe that James Stirling didn’t now about it. If he did know, he should be fired for not anticipating the inevitable tragic consequences of his policies. If he didn’t know what was going on, he should be fired for not knowing. .

It is simply absurd for Imperial to allow (In)human resources to investigate itself. Nobody will believe the result.

An independent external inquiry is needed. Soon.

Stefan Grimm’s death is, ultimately, the fault of the use of silly metrics to mismeasure people. If there were no impact factors, no REF, no absurd university rankings, and no ill-educated senior academics and HR people who take them seriously, he’d probably still be alive.

8 December 2014

After one week, I wrote again to the senior management at Imperial (despite the fact that my earlier letters had been ignored). This time I had one simple suggestion. If Imperial want genuinely to set things right they should get an independent external inquiry. Their present proposal that the people who let things go so far should investigate themselves has been greeted with the scepticism that it so richly deserves. I still live in hope that someone will be sufficiently courteous to answer this time.

To: alice.gast@imperial.ac.uk

cc: w.j.stirling@imperial.ac.uk, s.johal@imperial.ac.uk. d.humphris@imperial.ac.uk, d.kelleher@imperial.ac.uk


Dear Professor Gast

My post of Stefan Grimm’s email last Monday evening, has been viewed 130,000 times from at least 175 different countries.  Your failure to respond to my letters is public knowledge.  When you finally posted a statement about Grimm on Thursday it so obviously contradicted the emails which I, and Times Higher Education had already published, that it must have done your reputation more harm than good.

May I suggest that the best chance to salvage your reputation would be to arrange for an independent external inquiry into the policies that contributed to Grimm’s death.  You must surely realise that your announcement that HR will investigate its own policies has been greeted with universal scepticism. Rightly or wrongly, its conclusions will simply not be believed.  I believe that an external inquiry would show Imperial is genuine in wishing to find out how to improve the way it treats the academics who are responsible for its reputation.

Best regards

David Colquhoun

__________________________________
D. Colquhoun FRS
Professor of Pharmacology
NPP, University College London
Gower Street

Here is a map of the location of 200 hits on 4 December (one of 20 such maps in a 4 hour period).

hitmap 4 dec

10 December 2014

Eventually I got a reply, of sorts, from Dermot Kelleher. It’s in the style of the true apparatchik "shut up and go away".

Dear Dr Colquhoun
Many thanks for your enquiry. Can I just say that College will liaise with the Coroner as required on this issue. In light of this, I do not believe that further correspondence will be helpful at present.
Best wishes
Dermot

Nobody could have been more surprised than I when I found myself nominated as an academic role model at UCL. I had to answer a few questions. It is not obvious to me what the object of the stunt is, but the person who asked me to do it seemed to find the answers amusing, so I’ll reproduce here what I said. I apologise for the temporary lapse into narcissism.

The final version has now been printed [download a copy]. Sadly the printed edition was “corrected” by someone who replaced “whom I asked to submit the first theoretical paper by Hawkes and me to the Royal Society” (as written below), with “paper by Hawkes and I”. Aaargh.

DC 2013

Your nomination – Why you were nominated as an Academic Role Model?

"David Colquhoun has made major contributions to our understanding of how ion channels (proteins which allow charged ions to pass across cell membranes) function to mediate electrical signalling in nerve and muscle cells. This work elegantly combines experimental and theoretical aspects, and resulted in David being made a Fellow of the Royal Society. David Colquhoun played a key role in resisting the notion that UCL should merge with Imperial College in 2002, by running a website opposed to the merger. He thus facilitated the continued existence of an independent UCL. He is also well-known for his principled opposition to therapies that are not based on scientific evidence, and for his blog which comments on this issue as well as on university bureaucracy and politics."

Role models’ questions

1.  What is your response to being nominated?

Astounded.

We are interested in giving people a very brief ‘snapshot’ description of their career trajectory, to help a broad range of people see how you got to where you are:

2.   What has your career path been?

My first job (in 1950s) was as an apprentice pharmacist in Timothy Whites & Taylors (Homeopathic Chemists) in Grange Road, Birkenhead.  You can’t get a more humble start than that.  But it got me interested in drugs, and thanks to my schoolmaster father, I got to the University of Leeds. 

pa 1955
My father (1907 – 2001), in 1955

One of the courses involved some statistics, and that interested me.  I think I made a semi-conscious decision that it would be sensible to be good at something that others were bad at, so I learned quite a lot of statistics and mathematics. I recall buying a Methuen’s Monograph on Determinants and Matrices in my final year, and, with the help of an Argentinian PhD student in physical chemistry (not my lecturers) I began to make sense of it. 

aitken

I purposely went into my final viva with it sticking out of my pocket. The examiner was Walter Perry, then professor of Pharmacology in Edinburgh (he later did a great job setting up the Open University).  That’s how I came to be a PhD student in Edinburgh. 

Although Perry was one of my supervisors, the only time I saw him was when he came into my lab between committee meetings for a cigarette.  But he did make me an honorary lecturer so I could join the Staff Club, where I made many friends, including a young physics lecturer called Peter Higgs. The  staff club exists no longer, having been destroyed in one of those acts of short-sighted academic vandalism that vice-chancellors seem so fond of.

The great university expansion in the 1960s made it easy to get a job.  The most famous pharmacology department in the world was at UCL so I asked someone to introduce me to its then head, Heinz Schild, and asked him if he had a job.  While interned during WW2 he had written a paper on the statistics of biological assay and wanted someone to teach it to students, so I got a job (in 1964), and have been at UCL ever since apart from 9 years.  Between 1964 and 1970 I published little, but learned a great deal by writing a textbook on statistics.

That sort of statistics is now thought too difficult for undergraduates, and the famous department that attracted me was itself destroyed in another act of academic vandalism, in 2007.

I have spent my life doing things that I enjoy.  Such success as I’ve had, I attribute to a liking for spending time with people cleverer than I am, and wasting time drinking coffee.  I found a very clever statistician, Alan Hawkes, in the Housman Room in the late 1960s, and we began to collaborate on the theory of single ion channel analysis in a series of papers that still isn’t quite finished.  He did the hard mathematics, but I knew enough about it to write it up in a more or less comprehensible form and to write computer programs to evaluate the algebra.  When I got stuck, I would often ask Hyman Kestelman (co-author of the famous mathematics textbook, Massie & Kestelman) to explain, usually in what was then the Joint Staff Common Room at lunch time (it is now the Haldane room, the common room having been confiscated by unenlightened management).  Before leaving for the USA in 1970, I, in league with the then professor of French, Brian Woledge, eventually got through a motion that allowed women into the Housman room.

I’d also talk as much as I could to Bernard Katz, whom I asked to submit the first theoretical paper by Hawkes and me to the Royal Society. His comments on the first draft led to the published version making a prediction about single ion channel behaviour before channels could be observed. 

The next step was sheer luck.  As this was going on, two young Germans, Neher & Sakmann, succeeded in observing the tiny currents that flow through single ion channel molecules, so it became possible to test the theory.  In series of visits to Göttingen, Sakmann and I did experiments late into the night.  Neher & Sakmann got a well-deserved Nobel Prize in 1991, and I expect I benefitted from a bit of reflected glory

The work that I have done is nothing if not basic.  It doesn’t fit in with the current vogue for translational research (most of which will fail), although I would regard it as laying the basis for rational drug design. My only regret is that rational drug design has proved to be so difficult that it won’t be achieved in my lifetime (please don’t believe the hype).

We’d also like you to take a slightly more personal view:

3.  What have been the highs (and the lows?) of your career so far?

The highs have been the chance to work with brilliant people and write a handful of papers that have a chance of having a lasting influence.  Because I have been able to take my time on those projects there haven’t been too many lows, apart from observing the continuous loss of academic integrity caused by the intense pressure to publish or perish, and the progressive decline in collegiality in universities caused by that pressure combined with the rise in power of managerialism.  Luckily the advent of blogs has allowed me to do a little about that. 

I’m saddened by the fact that the innumeracy of biologists that I noticed as an undergraduate has not really improved at all (though I don’t believe it is worse).  Most biologists still have difficulty with even the simplest equations.  Worse still, they don’t know enough maths to communicate their problem to a mathematician, so only too often one sees collaborations with mathematicians produce useless results.

The only real failure I’ve had was when, in a fit of vanity, I applied for the chair of Pharmacology in Oxford, in 1984, and failed to get it.  But in retrospect that was really a success too.  I would have hated the flummery of Oxford, and as head of department (an increasingly unattractive job) I would have spent my time on pushing paper, not ion channels.  In retrospect, it was a lucky escape.  UCL is my sort of place (most of the time).

We would like to hear what our role models have to say about the next generation:

4.  What advice would you give to people finishing off their PhD?  

My career course would be almost impossible now.  In fact it is very likely that I would have been fired before I got going in the present climate.  There were quite long periods when I didn’t publish much.  I was learning the tools of my trade, both mathematical and experimental.  Now there is no time to do that.  You are under pressure to publish a paper a week (for the glory of your PI and your university) and probably rarely find time to leave the lab to talk to inspiring people. If you are given any courses they’ll probably be in some inane HR nonsense, not in algebra.  That is one reason we started our summer workshop, though bizarrely that has now been dropped by the graduate school in favour of Advanced Powerpoint.

The plight of recent PhDs is dire.  Too many are taken on (for the benefit of the university, not of the student) and there aren’t many academic jobs.  If you want to stay in academia, all I can suggest is that you get good at doing something that other people can’t do, and to resist the pressure to publish dozens of trivial papers. 

Try to maintain some academic integrity despite the many pressures to do the opposite that are imposed on you by your elders (but not always betters).  That may or may not be enough to get you the job that you want, but at least you’ll be able to hold your head high. 

Finally, we want to give a balanced impression of our role models because many were nominated for their ability to motivate others, and to balance life and work:

5.  How do you keep motivated?

Work-life balance is much talked about by HR, though they are one of the reasons why it is now almost impossible, In the past it wasn’t a great problem.  I’m fascinated by the problems that I’m trying to puzzle out.  I’ve had periods of a year or two when things haven’t gone well and I’ve felt as though I was a failure, but luckily they haven’t lasted too long, and they occurred in a time before some idiotic performance manager would harass you for failing to publish for a year or two.  The climate of “performance management” is doing a lot to kill innovation and creativity.

6.  What do you do when are not working in SLMS?                                                               

I’ve had various phases. For a while I carried on boxing (which had been compulsory at school). When I was first at UCL in 1964 I bought a 21 foot sloop (and as a consequence could barely afford to eat), and in 1970 (at Yale) I learned to fly. I had a lot of fun sailing right up to the early 1980s, when I found I could not afford a son as well as a boat. That was when running came into fashion and that could be done for the price of a pair of shoes.  I did marathons and half marathons for fun (the London in 1988 was great fun).  And that was supplanted by walking country trails in the early 2000s.  

There is never a clear division between work and play, especially with algebra. You can continue to struggle with a derivation on a boat, or even get a new angle on it while running.  That, of course, is why the transparency review is such total nonsense.

The main cause of stress has never been work for me. Stress comes mainly from the imposition of dim-witted managerialism and incompetent HR policies.  And that has become progressively worse.  I doubt that if I were a young academic now I’d have the time to spend the weekend sailing.

I’m not sure whether the blogging that has taken up something like half my time since my nominal retirement in 2004 counts as work or not.  It certainly depends on things that I have learned in my academic work.  And it’s fun to have effects in the real world after a life spent on problems that many would regard as esoteric. 

If you want a hobby that costs very little, and allows you to say what you want, start a blog.

Follow-up

Des Spence, a general practitioner in Glasgow, has revealed a memorandum that was allegedly leaked from the Department of Health. It was published in the Britsh Medical Journal (17 June 2009, doi:10.1136/bmj.b2466, BMJ 2009;338:b2466). It seemed to me to deserve wider publicity, so with the author’s permission, I reproduce it here. It may also provide a suitable introduction to a forthcoming analysis of a staff survey.

Re: The use of ‘note pads’ in the NHS and allied service based agencies.

Hi, all care providers, managers of care, care managers, professions allied to care providers, carers’ carers, and stakeholders whose care is in our care. (And a big shout to all those service users who know me.)

We report the findings from a quality based review, with a strong strategic overview, on the use of “note pads” across all service user interfaces. This involved extensive consultation with focus groups and key stakeholders at blue sky thinking events (previously erroneously known as brain storming). This quality assured activity has precipitated some heavy idea showers, allowing opinion leaders to generate a national framework of joined-up thinking. This will take this important quality agenda forward. A 1000 page report is available to cascade to all relevant stakeholders.

The concentric themes underpinning this review are of confidentiality. Notes have been found on the visual interface devices on computers and writing workstations throughout the NHS work space. Although no actual breach of confidentiality has been reported, the independent external consultants reported that note pads “present a clear and present danger” to the NHS, and therefore there is an overarching responsibility to protect service users from scribbled messages in felt tip pen. Accordingly all types of note pads will be phased out in the near time continuum. A validated algorithm is also attached to aid this process going forward.

This modernising framework must deliver a paradigm shift in the use of note pads. Care provider leaders must employ all their influencing and leverage talents to win the hearts and minds of the early adopter. A holistic cradle to grave approach is needed, with ownership being key, and with a 360 degree rethink of the old think. All remaining note pads must be handed over in the next four week ” note pad armistice” to be shredded by a facilitator (who is currently undergoing specialist training) and who will sign off and complete the audit trail.

(Please note that the NHS’s email system blocks all attachments, so glossy, sustainable, wood based hard copies will be sent directly to everyone’s waste recycling receptacles.)

Cite this as: BMJ 2009;338:b2466


Spence added a footnote, Note: The BMJ’s lawyers have insisted that I make it clear that this is a spoof, just in case you were wondering.

 

Here are a few more

There is an initiative underway to determine what we do as an organisation in the realms of drug discovery. The intention is to identify internal and appropriate external capabilities to foster a pipeline of competencies that enable some of our basic research outputs to better impact healthcare.

Follow-up

Jump to follow-up

The first post was NICE falls for Bait and Switch by acupuncturists and chiropractors: it has let down the public and itself.

That was followed by NICE fiasco, part 2. Rawlins should withdraw guidance and start again.

Since then, something of a maelstrom has engulfed NICE, so it’s time for an update.

It isn’t only those who are appalled that NHS should endorse voodoo medicine on the basis of very slim evidence who are asking NICE to rethink their guidance on low back pain. Pain specialists are up in arms too, and have even started a blog, ‘Not Nearly as NICE as you think …‘, to express their views. Equally adverse opinions are being expressed in the Britsh Medical Journal. A letter there is signed by over 50 specialists in pain medicine. It ends thus

“Because of these new guidelines patients will continue to experience unnecessary pain and suffering and their rights to appropriately individually tailored treatment have been removed on the basis of a flawed analysis of available evidence. We believe the guidelines do not reflect best practice, remove patient choice and are not in our patients’ best interests.”

In a contribution headed “NICE misguidance”. Dr Michel Vagg ends

It seems to me that this guideline has been used as a propaganda vehicle to allow cherry-picked evidence to be enshrined as doctrine. This is an abuse of the guideline development process . . . ”

I have to say, though, that it seems to me that some of these people are promoting their own interests as much as chiropractors and acupuncturists. The evidence that spinal injections produce worthwhile benefits seems to be as thin as the evidence that chiropractic and acupuncture produce worthwhile benefits. But no doubt the injections are good for the budgets of PCTs or private practice doctors.. Could it perhaps be the case that some of the clinicians’ anger is being generated by doctors who are rushing to defend their own favourite ineffective treatment?

Why, oh why, can’t either NICE or the pain consultants bring themselves to state the obvious, that nothing works very well. The only thing that can be said for most of the regular treatments is that although they may not be much more effective than acupuncture or chiropractic, at least they don’t come with the intellectually-offensive hokum that accompanies the latter. Very sensible attempts have been made to identify the cause of low back pain [reviewed here], Occasionally they succeed. Mostly they don’t.

One clinician’s letter deserves special attention because it goes into the evidence, and the costs, in some detail. Its conclusions are very different from those in the NICE guidance.

The letter, a Review of NICE guidance, is from Dr C.J.D. Wells [download the whole letter].   He is a pain relief consultant from Liverpool.

Let’s look at some highlights.

Wells points out the absurdity of the cost estimates

“In the pricing section, they estimate that this will require an increase of facilities so that 3,500 patients can be treated instead of 1,000 at present (again see comments on pricing). This is not many treatments for the 20 million sufferers, of whom we can estimate that at least 2 million will have significant long-term disability and psychological distress”

And that is without even costing all the secondary costs of miseducating a new generation of students in fables about “Qi”, meridians, energy flow, subluxations and innate intelligence.

“The abysmal ignorance of the committee is reflected in the poor overall advice. So if you have a committee with special interests in Exercise, Manipulation, PMP’s, and Surgery, and you call an expert on Acupuncture, you get advice to use Exercise, Manipulation, Acupuncture, PMP’s and Surgery. Amazing.”

Another pain consutant, Charles Guaci, says in a comment in the Daily Mail.

I am a Pain Consultant of 30 years experience, have published two books (one translated into different languages).

NICE never asked me for my opinion.

This is the most ridicuculous pseudo-scientific document I have ever seen.

The panel consisted of a surgeon, psychologist, osteopath, acupuncturist a physiotherapist and an academic; not one pain consultant! The conclusions are simply a means of increasing the employment of their friends!

All evidence submitted to NICE was ignored.

It is almost certain than unless NICE rethink their ideas that Pain Consultants will be seeking a judicial review as well as full disclosure of how the panel arrived at their bizarre findings under the Freedom of information act.

Patients should realise that they are being taken for a ride.

Despite the outcry from opponents of magic medicine and from pain specialists, the assessment by the normally excellent NHS Choices site was disappointing. It made no mention at all of the secondary consequences of recommending CAM and described the assertions of the guidance group quite uncritically.

The reputation of NICE

NICE has been criticised before, though usually unjustly. In the past I have often supported them. For example. when NICE said that treatment of dementia with anticholinesterase drugs like galantamine was ineffective, there was a great outcry, but NICE were quite right. There is little or no rationale for such treatments, and more importantly, very little evidence that they work. But patients, especially when they are desperate, have greater faith in drug treatments than most pharmacologists, They want to clutch at straws. A bit like the NICE guidance committee, faced with a bunch of treatments most of which are almost ineffective, clutched at the straws of acupuncture and chiropractic. But this time it isn’t only the patients who are cross. It is most of the medical and scientific world too.

One interpretation of these bizarre events is that they represent a case of medical/scientific arrogance. Ben Goldacre wrote of another aspect of the same problem thus week, in Dodgy academic PR [download the paper on which this is based].

The first job of a scientist is to say openly when the answer to a question is not known. But scientists are under constant pressure to exaggerate the importance of their results. Last year we published an article which I feel may, if verified, turn out to be the second most important that I have ever been an author on. Because it happened to be published in Nature (not because of its quality), a press release was written (by an arts graduate!). It took some argument to prevent the distorted and exaggerated account being imposed on the public. This is typical of the sort of thing reported in Goldacre’s column. I reported a similar case a while ago, Why honey isn’t a wonder cough cure: more academic spin.

If NICE does not reconsider this guidance, it is hard to see how it can be taken seriously in the future. I hope that when NICE’s director, Professor Sir Michael Rawlins, returns from his trips abroad, he will find time to look at the case himself.

Indirectly, then, it can be argued that NICE’s bizarre guidance is just another manifestation of the management of science being passed from the hands of scientists into the hands of administrators and spin experts. It is yet another example of DC’s rule

Never trust anyone who uses the word ‘stakeholder’

Some bone-headed bureaucrat decides that any charlatan or quack is a ‘stakeholder’ in the provision of NHS care and gives them a quite disproportionate say in how taxpayers’ money is spent. The bureaucrats are so busy following processes and procedures, ticking boxes, and so deficient in scientific education, that they failed to notice that they’ve been caught out by the old trick of used car salesmen, bait and switch.

The consequences

The expected consequences have already started to materialise. The Prince of Wales’ Foundation for Magic Medicine is jubilant about having been endorsed by NICE. And I’m told that “The chiropractors have now just written letters to all health boards in Scotland asking for contracts for their services to deal with back pain”.

There could hardly have been a worse time for NICE to endorse chiropractic. We are in the middle of a storm about free speech because of the disgraceful action of the British Chiropractic Associaton in suing one of our best science writers, Simon Singh, for defamation because he had the temerity to express an opinion, Of course, even if the BCA wins in court, it will be the overall loser, because chiropractic claims are now being scrutinised as never before (just look at what they told me).

Follow-up

A much-cited paper. The paper that is most often cited by chiropractors who claim to be able to cure colic by spinal manipulation is Klougart N, Nilsson N and Jacobsen J (1989) Infantile Colic Treated by Chiropractors: A Prospective Study of 316 Cases, J Manip Physiol Ther,12:281-288. This is not easy to get hold of but Steve Vogel has sent me s scanned copy which you can download here. As evidence it is about as useless as the infamous Spence study so beloved of homeopaths. There was no control group at all. It simply follows 316 babies and found that most of them eventually got better. Well, they do, don’t they? It is a sign of the pathetic standard of reaearch in chiropractic that anyone should think this paper worth mentioning at all.

June 6 2009. More flak for NICE from the Royal College of Anaesthetists, and more adverse comment in the BMJ. And of course the blogs. for example, “If this is “evidence based medicine” I want my old job back“.

“Acupuncture on the NHS: a dangerous precedent”: a good analysis at counterknowledge.com.

June 6 2009, Comment sent to the BMJ. The comment was submitted, as below, early on Friday 5th June. The BMJ said it was a “sensitive issue” and for the next five days lawyers pondered over it.

Underwood and Littlejohns describe their guidance as being a “landmark”. I can only agree with that description. It is the first time that NICE has ever endorsed alternative medicine in the face of all the evidence. The guidance group could hardly have picked a worse moment to endorse chiropractic. Chiropractors find it so hard to find evidence for their practices that, when one of our finest science writers, Simon Singh, asked to see the evidence they sued him for defamation. I suggest that the guidance group should look at the formidable list of people who are supporting Singh, after his brave decision to appeal against this iniquitous persecution.

Of course I’m sure this bizarre decision has nothing to do with the presence on the guidance group of Peter Dixon, chair of the General Chiropractic Council. Nevertheless, I am curious to know why it is that when I telephoned two of the practices belonging to Peter Dixon Associates, I was told that they could probably treat infantile colic and asthma. Such claims have just been condemned by the Advertising Standards Authority.

The low back pain guidance stands a good chance of destroying NICE’s previously excellent reputation for dispassionate assessment of benefits and costs. Yes, that is indeed a landmark of sorts.

If NICE is ever to recover its reputation, I think that it will have to start again. Next time it will have to admit openly that none of the treatments work very well in most cases. And it will have to recognise properly the disastrous cultural consequences of giving endorsement to people who, when asked to produce evidence, resort to legal intimidation.

Eventually, on Wednesday 10 June the comment appeared in the BMJ, and it wasn’t greatly changed. Nevertheless if is yet another example of legal chill. This is the final version.

Underwood and Littlejohns describe their guidance as being a “landmark”. I can only agree with that description. It is the first time that NICE has ever endorsed alternative medicine in the face of all the evidence. The guidance group could hardly have picked a worse moment to endorse chiropractic. Chiropractors are so sensitive about criticisms of their practices that, when one of our finest science writers, Simon Singh, queried the evidence-base for their therapeutic claims they sued him for defamation. I suggest that the guidance group should look at the formidable list of people who are supporting Singh, after his brave decision to appeal against an illiberal court ruling in this iniquitous persecution.

One wonders whether this bizarre decision by NICE has anything to do with the presence on the guidance group of Peter Dixon, chair of the General Chiropractic Council. I am also curious to know why it is that when I telephoned two of the practices belonging to Peter Dixon Associates, I was told that chiropractic could be effective in the treatment of infantile colic and asthma. Similar claims about treating colic have just been condemned by the Advertising Standards Authority.

The low back pain guidance stands a good chance of destroying NICE’s previously excellent reputation for dispassionate assessment of benefits and costs. Yes, that is indeed a landmark of sorts.

If NICE is ever to recover its reputation, I think that it will have to start again. Next time it will have to admit openly that none of the treatments works very well in most cases. And it will have to recognise properly the disastrous cultural consequences of giving endorsement to people who, instead of engaging in scientific debate, resort to legal intimidation.

Bait and switch. Oh dear, oh dear. Just look at this. British Chiropractic Association tell their members to hide their sins from prying eyes.

Excellent round-up of the recent outburst of writing about “chiroquacktic” (Tut, tut, is there no respect?).

Dr Crippen writes “NICE recommends a cure for all known disease” [Ed some exaggeration, surely]

It is almost six months now since I posted Quackery creeps into good universities too -but through Human Resources. One example given there was the University of Leicester. This is an excellent university.  It does first class research and it was the alma mater of the incomparable David Attenborough who has done more than anyone to show us the true beauty and wonder of the natural world.

Nevertheless, their well-meaning occupational health department had a section about “complementary therapies” that contained a lot of statements that were demonstrably untrue. They even recommended the utterly outrageous SCENAR device. So I pointed this out to them, and I had a quick and sympathetic response from their HR director.

But three months later, nothing had changed. Every now and then, I’d send a polite reminder, but it seemed the occupational health staff were very wedded to their quackery.   The last reminder went on 6th February, but this time I copied it to Leicester’s vice-chancellor.  This time it worked. There is still a link to Complementary Therapies on the Wellbeing site, but if you click on it, this is what you see.

Complementary therapies

Some employees may have an interest in complementary therapies such as acupuncture, yoga, Indian head massage, Reiki, sports & remedial massage, reflexology and hypnotherapy. If you have an interest in any of these, Staff Counselling can happily provide details of practitioners in the local area. Some of these practitioners offer discounts from their normal rates for University of Leicester staff.

However, the University of Leicester cannot vouch for, or recommend any of these therapies to staff as being effective. We would urge members of staff who believe that such therapies might be effective to contact their GP prior to undertaking any of them. Further, the University of Leicester shall not be liable for any damage of any kind arising out of or related to the services of any complementary therapists or treatments listed here.

If you would like further information, please contact Chris Wilson at: staffcounsel&welfare@le.ac.uk or telephone 1702.

That’s not bad. Pity it doesn’t say alternative, rather than complementary though.   Euphemisms aren’t really helpful.

In fact I have a bit of a problem with “wellbeing” too. It is a harmless word that has been highjacked so that its use now makes one think of mud baths provided by expensive hotels for their rich and gullible customers.

Leicester’s HR director wrote

“Unfortunately an instruction I had given previously had not been fully complied with.  I spoke to the manager of the Staff Counselling team on Friday and gave clear instructions as to the content of this site.  I had been assured that the offending information had been removed, but found that it had not.

I have now checked the site for myself and can say, with confidence, that all claims for the efficacy of complimentary [sic] therapies have been removed including SCENAR.”

The similarity between quack treatments and religion is intriguing.  It seems that the devotion of the occupational health people to their baloney was so great that they wouldn’t take it down even when told to do so.  The more irrational the belief, the greater the fervour with which it is defended,

What’s the lesson from this minor saga?  It seems that most VCs and many HR people are too sensible to believe in alternative baloney, but that they are a bit too ready to tolerate it, perhaps on grounds of political correctness.  Tolerance is a virtue, but lies about health are not in the least virtuous. If you point out that people are saying things for which there isn’t the slightest evidence, they will often respond.  Just be prepared to send a few reminders.

It may also be useful to point out that some of the claims made are almost certainly illegal.  Even people who care little about evidence of efficacy are impressed by the idea that they might be prosecuted by Trading Standards officers.

Who needs mystical medicine when you have real wonders like these.

(Click the google video logo for a bigger version)

Or try the pitcher plant video, or the Bird of paradise, or the Bower Bird, or the giant Amazon lilies.

Follow-up

Jump to follow-up

We know all about the sixteen or so universities that run “BSc” degrees in hokum. They are all “post-1992” universities, which used to be polytechnics. That is one reason why it saddens me to see them destroying their own attempts to achieve parity with older universities by running courses that I would regard as plain dishonest.

Older universities do not run degree courses in such nonsense. Academics (insofar as they still have any influence) certainly would not put up with it if they tried. But nevertheless you can find quackery in some of the most respected universities, and it gets there not via academics but (guess what) via Human Resources.  It creeps in through two routes.  One is the “training courses” that research staff now have to do (the “Roberts agenda”).  The other route is through occupational health services.

Quackery in training courses

It isn’t easy to find out what happens elsewhere, but I was certainly surprised to find out that UCL’s own HR department was offering a course that promised to teach you the “core principles” of Brain Gym and  Neurolinguistic Programming, both totally discredited bits of psycho-babble, more appropriate to the lifestyle section of a downmarket.women’s magazine than a university.  I gather that HR’s reaction after I brought this to light was not to ask what was wrong with it, but just to get angry.

In a spirit of collegiality I offered to run a transferable skills course myself.  I even offered to do it for nothing (rather than the rumoured £700 per day charged by the life style consultants).  I proposed a course in ‘How to read critically’ (subtitle ‘How to detect bullshit’).  This seems to me to be the ultimate transferable skill. Bullshit occurs in every walk of life. My proposal was moderately worded and perfectly serious.

Guess what?  Despite several reminders, I have never had any response to my suggestion.  Well, I suppose that HR people now regard themselves as senior to mere professors and there is really no need to reply to their
letters.

Quackery in occupational health. Leicester sets a good example

If you work at a university, why not search the university’s web site for “complementary medicice” or complementary therapies”. If it is a real university, you won’t find any degrees in homeopathy, or in amethysts
that emit high yin energy
.  But some quite surprising places are found to be recommending magic medicine through their Occupational Health service, which usually seems to be part of HR.  In fact at one time even UCL was doing it, but no soon had somebody sent me the link than it disappeared. As a matter of historical record, you can see it here (it had all the usual junk, as well as harmless stuff like yoga and pilates).

While looking for something else I stumbled recently some other cases.  One was at the University of Leicester, a very good university (and alma mater to the great David Attenborough who must have done more to point out the beauty of science than just about anyone).  But we find on their staff wellbeing site, alongside some perfectly sensible stuff, a link to complementary therapies.

The list of ‘therapies’ includes not only the usual placebos, acupuncture, reiki, reflexology, but, even more exotically, a fraudulent Russian device called SCENAR therapy. They have a nice leaflet that explains all these things in words that run the whole gamut from meaningless gobbledygook to plain wrong.  Here are some examples from the leaflet.

Reflexology

“In the feet, there are reflex areas corresponding to all the parts of the body and these areas are arranged in such a way as to form a map of the body in the feet”

Reflexology has been shown to be effective for:

  • Back Pain
  • Migraine
  • Infertility
  • Arthritis

Well no, there are no such areas in your feet. That is sheer imagination.  And reflexology has not “been shown to be effective” for any of those conditions.  These claims for therapeutic efficacy are not only lies.  They are also illegal.

Reiki

Each hand position is held for a few minutes, and during this time healing energy will flow into you, balancing your energy system, releasing stress, soothing pain, and promoting your body’s natural ability to heal itself.”

This is sheer idiotic mumbo-jumbo. The “flow of healing energy” is totally imaginary. Such talk is offensive to anyone with half a brain. Insofar as they claim to heal anything, it is also illegal.  The comes SCENAR.

What is SCENAR?

SCENAR is an acronym for Self Controlled Energo- Neuro Adaptive Regulator. It is a reflex biofeedback device which when used by a qualified practitioner, can help to alleviate acute and chronic pain. It is licensed in the UK for pain relief but experience has shown that it is helpful in a wide variety of conditions.”

This is even more seriously nuts than the others.  The term “licensed” means merely that it is electrically safe. It certainly does not mean that it works.  Pubmed shows only three publications about the SCENAR device, all in Russian,

One sales site (apparently Russian) makes the following modest claim.

“A prime goal of the Russian Space Program was to provide space travelers with a portable  medical device that would become their “universal medical assistant” in space. So from the beginning, the SCENAR was designed to replace an entire medical hospital, with all its staff, diagnostic and treatment facilities, even the pharmacy. A universal, non-invasive, portable regulator of body functions (among other things) was envisaged.”

The SCENAR device (right) looks like a TV remote control (perhaps it IS a TV remote control -we aren’t anywhere told in comprehensible terms what’s in the box.  The Russian site sells also the rather baffling accessory on the right. The mind boggles.

SCENAR device

Remote rectal-vaginal electrode for SCENAR

How does this rubbish get onto the web site of a good university?

I presume that it is just another sign of what happens when universities come to be run by non-academics.  No doubt the occupational health people are well meaning and kind, but just scientifically illiterate. What about the HR person in charge of them?  They are not known for scientific literacy either (which would not matter if they stuck to their job).  But perhaps they just didn’t notice.  There is only one way to find out. Ask.  So I sent this letter.on 10th September.

Hello

I am a pharmacologist and I have a side interest in public understanding of science, alternative medicine.and medical fraud

I was quite surprised when Google led me unexpectedly to your complementary therapies page at http://www.le.ac.uk/staffwellbeing/complementary_therapy.html

There is, sad to say, a great deal of information on these pages that is simply not true. For example it has NOT been shown that reflexology has been shown to be effective in any of the conditions which you list, as far as I know
(please send me references if you think I’m wrong) “Reflexology has been shown to be effective for: Back Pain Migraine Infertility Arthritis Sleep disorders Hormonal imbalances Sports injuries Digestive disorders Stress-related condition ”

To take only one more example from this page, the SCENAR device is an even more extreme example. It is well known to be fraudulent. and has been investigated by the Washington State Attorney General.

This sort of thing is not what one would expect from a very respectable university, and it must be a great embarrassment to your excellent medical scientists.

Apart from the many scientific inaccuracies (which greatly impede the efforts of those of us who try to improve public understanding of science), you are, I hope, aware that there is a legal aspect.

Since May this year, new regulations have made it illegal to make claims for health benefits if evidence cannot be produced to show that the claims are justified.  I would like to put it to you that many of the claims made on this page are not only immoral, but also illegal.

I wondered whether you , or your HR department, would like to make any comments

Best regards

David Colquhoun


I got an immediate and very sympathetic response from the Director of HR and a week later, on17th September, he wrote

“Hi David,

I have discussed the matter with my manager of Staff Counselling and Welfare and have agreed that it is probably safest that we remove the references to ‘complimentary’[sic] therapies from the site entirely.

Thank you for your helpful input and the recommendations for reading matter.”

So there is a lesson here.  If you find this sort or stuff on your own institution’s web site, all that may be needed is a simple letter that points out what nonsense it is.  Admittedly the HR man seemed rather more worried about whether the claims were illegal than whether they were true, but either way, it worked.

Only one little snag.  As of 6 October the pages still have not been removed.

On the assumption that they eventually will be removed, I have kept copies of the Wellbeing page, of the Complementary Therapies page, and of the ‘explanatory leaflet’. They stand as part of a historical record that
shows, once again, what can happen when scientific matters get into the hands of HR. Fortunately Leicester University has an HR director who is willing to listen to advice.

Follow-up

Something seems to have gone seriously wrong. Despite the rapid response, virtually all the nonsense is still there on 13th October. It seems not to be so simple after all.

And despite several reminders, the advertisement for SCENAR ‘therapy’ is still on  the University web site on December 14th.  I know that no decision by HR can be made with fewer than 25 meetings and an awayday in Majorca, but this is getting ridiculous.