SOME CHALLENGES FOR CAM PRACTITIONERS AND ORGANISATIONS:
Like any professional, a practitioner of complementary or alternative medicine (CAM) will, from time to time, have their practice specialism questioned or challenged. Similarly, an organisation using or promoting CAM will also be subjected to scrutiny.
(Note to readers regarding extracts from the documents referred to below: the italics and bolding have been added by me).
This happened on the 5th June last year with regard to some treatments and remedies promoted by certain charities. Eleven medical professionals and academics published a letter in The Sunday Times newspaper (Tackle health charities) which, as the newspaper captioned, ‘claimed the Charity Commission has failed to confront groups promoting alternative remedies that are alleged to be of dubious benefit to the public’. The letter referred to an investigation by a clinical scientist that, according to the letter and amongst other things, ‘highlighted a number of charities that encourage homeopathic remedies for serious conditions and promote energy healing’. The letter added that ‘such organisations do not operate to benefit the public and should have their charitable status revoked’.
The Charities Act 2011 defines charitable purposes as including “the advancement of health or the saving of lives”, “the relief of those in need because of youth, age, ill-health, disability, financial hardship or other disadvantage” and “the advancement of education”.
See the Guidance (paragraphs 2, 4, 6 & 12) published by the Charity Commission on 16th September 2013, which states as follows:
‘…The advancement of health includes the prevention or relief of sickness, disease or human suffering, as well as the promotion of health. It includes conventional methods as well as complementary, alternative or holistic methods which are concerned with healing mind, body and spirit in the alleviation of symptoms and the cure of illness. To be charitable there needs to be sufficient evidence of the efficacy of the method to be used. Assessing the efficacy of different therapies will depend upon what benefits are claimed for it (ie whether it is diagnostic, curative, therapeutic and/or palliative) and whether it is offered as a complement to conventional medicine or as an alternative. Each case is considered on its merits but the House of Lords Report on complementary and alternative medicine provides a useful guide…’
To assist in deciding whether a charitable purpose is for the benefit of the public, the Government has issued the following guidance (new format February 2017) at page 14:
‘…60. When applying the rule that, to be charitable, a purpose must be for the benefit of the public in general or a sufficient section of the public, it is first necessary to identify the class of individuals whom the purpose primarily benefits. Where the purpose primarily benefits the public in general, the rule is satisfied. Where the purpose primarily benefits individuals of a particular description, the question to be asked is whether the potential beneficiaries are a sufficient section of the public. If they are, the purpose satisfies the ‘public’ aspect of the requirement that, to be charitable, a purpose must be for the public benefit…’
More information about “public benefit” may be found here (new format January 2017).
Relevant CAM charitable organisations, their practitioners, trainers, continuing professional development providers and other educators should be aware of the proposal contained in the letter to the Sunday Times. They, like readers of this blog, will no doubt have already decided whether or not the treatments and therapies referred to in the letter advance the health and education, etc, for the benefit of the public in general or for a sufficient section of the public. Even so, if the proposal is progressed by the Charity Commission, then practitioners and CAM charities may want to seek legal advice (readers will already be aware that it is not the purpose or intention of this blog to give legal or other professional advice).
The Charity Commission Consultation:
In the meantime and relevant to the above, on the 13th March this year the Charity Commission published a Consultation document titled The use and promotion of complementary and alternative medicine: making decisions about charitable status. The document is about the Commission’s approach to deciding whether an organisation which uses or promotes CAM therapies is a charity. It relates to organisations whose purposes involve the use or promotion of CAM therapies and (amongst other things) it gives guidance about the types of evidence the Commission can currently rely on (page 3) and the issues on which the Commission is now seeking views (pages 3 & 4), in relation to which it raises 6 Questions (pages 3 to 5) that apply specifically to CAM organisations.
After the end of the Consultation period, the Commission will decide whether its approach to CAM should be changed and, if so, what changes should be made (page 6). Once the Commission has completed its review of its policy in this area, it will consider whether it is necessary to review the registration of any particular charity (my italics: see page 5, paragraph 2).
Practitioners, organisations and charities involved in the use or promotion of CAM therapies together with CAM regulators and all other interested parties can respond to this consultation and, specifically, to the 6 Consultation Questions, by using one of the ‘How to respond’ methods explained on pages 5 & 6 of the document (web link provided above). The deadline for responses is 11.59 pm on Friday 19th May 2017.
Further information about the Consultation may be found here (Press release) and here.
The Advertising Standards Authority Ltd (ASA)
The Advertising Standards Authority (ASA), despite what its name seems to imply, is not a part of the Government or of the wider public sector, although it operates with Government approval. It has no statutory powers in its own right. For example, it performs a public enforcement role in the broadcast advertising sector to the extent that it has contracted to do so with OFCOM. It is a private self-regulatory agency set up and funded by the advertising industry and is, together with its related Companies, registered at the Companies Registry as a private, limited Company.
Nevertheless, the ASA is a powerful organisation that performs a public regulatory function with regard to the content of broadcast (e.g. website, LinkedIn, Facebook & social media) and non-broadcast (e.g. leaflets & printed-materials) advertising. Failure to comply with ASA requirements can result in it posting a critical online ruling (‘adjudication’) which could have an adverse or even terminal effect on a CAM practice. In view of this, Practitioners may think it is prudent to review their advertising and to seek guidance from their professional organisations and regulators. For example, guidance and, in some cases, “Advertising Certification” is available from:
The General Regulatory Council for Complementary Therapies & advertising certification;
The Complementary & Natural Healthcare Council & advertising certification (paragraph 6);
The Federation of Holistic Therapists.
Enquire about what, if any, assistance you may expect to receive from your professional organisation or regulator in the event that you find your practice under investigation by the ASA. Also, check whether your professional indemnity insurance policy covers the cost of any dispute with the ASA.
The governance of the ASA has attracted critical parliamentary scrutiny in both the House of Lords and the House of Commons.
Some implications of this scrutiny are explored in my article published on Positive Health Online which can be read here. With regard to the ASA and the practise of homeopathy, The Society of Homeopaths (a professional body accredited by The Professional Standards Authority) has sought legal advice on behalf of its members.
My written submission (06.10.16: BRE0004) to the House of Commons Health Committee on Brexit and Health and Social Care, in which my “written evidence” is listed and hyperlinked as item 12 (at the time of writing this blog) and date ordered to be published on 22.11.16, can be found here.
EVALUATING OUTCOMES OF CAM TREATMENTS QUESTIONAIRE (MYCAW):
Work carried out by a multidisciplinary research group at The Centre for Academic Primary Care, The University of Bristol will assist Practitioners to evaluate the outcome of their treatments. The group has designed an individualized, patient-generated questionnaire for evaluating complementary therapies in cancer support which, it says, may be suitable in other settings too. The questionnaire is described as Measure Yourself Concerns and Wellbeing (MYCAW). Further information and templates can be viewed here.
FAREWELL CAMEXPO AND THANK YOU:
Many CAM practitioners and their patients will be saddened by the announcement, on 11th October last year, that, after 14 years, the 2016 CAMEXPO event will be the last. According to Mr Carsten Holm, Managing Director of Diversified UK (organisers of the event), following consultation with its leading supporters and exhibitors it was agreed that a decline in the audience attending the show over the past few years was unsustainable, making it difficult to justify the cost of an event on the scale of CAMEXPO. Mr Holm concluded:
“ Whilst this unfortunately marks the end of camexpo, the work done by all the amazing practitioners in the complementary and alternative medicine sector is more important than ever. There’s a big job to do out there, so please keep up the incredible work. And thankfully there are other great learning and networking events out there, including the successful CAM Summits”.
CAM practitioners, their professional organisations and regulators will, I am sure, treat the demise of CAMEXPO as a warning and respond positively to these words.
THE BREXIT NEGOTIATIONS AND THE NEED TO BE VIGILANT:
The debate continues about Brexit and how this could: ‘…offer an unparalleled opportunity to create a dynamic, diverse hub of integrated healthcare products and services that not only transform patient choices, but would dramatically reduce the burden on an overwhelmed National Health Service (NHS)…’ (More information: Alliance for Natural Health Press Release of 07.12.16).
The Brexit negotiations present an opportunity to secure the future of CAM and integrated medicine within the United Kingdom. Even so, Practitioners and their representative organisations must be vigilant and pro-active, as those lobbying against the practise and promotion of CAM will also take this opportunity to advance their cause and to restrict or end the freedom of Practitioners and their patients respectively to give and to receive CAM treatments.
SOME CAM EVENTS AND RESEARCH INITIATIVES:
The National Institute for Health Research (NIHR) Research for Benefit Programme (RfPB) is described here as:
“…a national, response-mode programme inspired by patients and practice to generate high-quality research for the benefit of users of the NHS in England. Its main purpose is to realize, through evidence, the huge potential for improving, expanding and strengthening the way that healthcare is delivered for patients, the public and the NHS. Around 600 applied research projects in health services and social care have been derived through our Regional Advisory Panels.”
Researchers of complementary and alternative medicine can contribute to this programme, perhaps with the aim of furthering research into the provision and cost-effectiveness of integrated medicine and healthcare in the NHS to the benefit of NHS patients.
Many congratulations to Member and Federation of Holistic Therapists (FHT) Excellence Award winner Angela Green and her colleague Dr Anne Johnson who were invited to give a presentation about the complementary therapy service at Cardiff’s Velindre Cancer Centre at a meeting of the All-party Parliamentary Group for Integrated Healthcare. Amongst many other things, the therapy team help to ensure that challenging medical treatments are successfully completed, creating cost and time efficiencies within the NHS, a topic which was the subject of my February 2017 blog.
Finally, I remind practitioners and complementary medicine researchers
about this year’s CAMSTRAND Conference (6th to 7th June in Southampton) details of which can be found on the Research Council for Complementary Medicine website here. Also, the Federation of Holistic Therapists (FHT) will be holding its Training Congress at the Holistic Health Show during the 21st to 22nd May at the Birmingham NEC, featuring 32 sessions over the two-day event and The Homeopathy Research Institute’s 3rd International Homeopathy Research Conference will take place in Malta from the 8th to 11th June.
RICHARD EATON 20th March 2017
