MHRA accused of “clothing naked quackery”

Cyberduck_icon (1)Last Wednesday, I gave a talk at the newly formed Coventry Skeptics in the Pub on the ‘Persistence of Delusion’ – why some alternative medicines appear to thrive.

One of the techniques that ensures a healthy quackery is to obtain official endorsement from statutory and regulatory organisations. Chiropractic and Osteopathy have benefited greatly in the UK by becoming a protected ‘health profession’. Homeopathy is also helped by some regulations that give them special privileges when it comes to medical licensing.

In the morning, I had been on BBC Radio Coventry to promote the new group and to explain what I would be talking about. Naturally, this adverting would reach more types of people than the ‘sceptic community’. And so, a few believers in superstitious forms of medicine did show up.

One believer left at the break and left behind a scribbled note telling me, basically, how short sighted I was. During questions, another asserted that the campaign against alternative medicine was all driven by the government to back their friends in pharmaceutical companies. I begged to differ.

One of the reasons I disagree is that, if true, the government is doing a very lousy job of it. If I was in charge of the Department of Big Pharma Shilling I would do a much better job.

A good example of how government agencies actually assist quackery rather than protect the public from it is the medicines regulator, the MHRA.

The MHRA is charged with regulating medicines and medical devices. Their ’mission statement’ is

The Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe.

This is all good. Except when it comes to superstitious and pseudoscientific forms of treatments, they casually drop the condition that providers should be able to demonstrate that they work.

The result is that absurd and unproven medical treatments are able to compete on pharmacy shelves with products that have proven benefit. For consumers, it is difficult to tell that one product has an evidence base and the other is fantasy. The MHRA appear to adopt labelling policies that deliberately obscure the nature of homeopathic remedies and give ‘approval marks’ to unproven herbal remedies.

When it comes to actually upholding what regulations exist, the MHRA appear to take a ‘see no evil’ approach. The blogger Warhelmet is doing an excellent job at the moment of showing how homeopathic manufacturers appear to operate regardless of regulations.

A group of medics and researchers (all members of Healthwatch) have written to the BMJ this week expressing their deepening concern that the MHRA are “clothing naked quackery and legitimising pseudoscience”.

What has initiated this letter is the recent advertisement for ‘experts’ to sit on a Advisory Board to consider the registration of homeopathic products. The job specification calls for homeopaths who are “recognised by their peers as eminent members of their profession”. The problem is obvious. If you believe nonsense, how can you be an expert? As I have written recently, when the regulator believes in fairies, who protects the public?

Here is their letter in full.

Good value for money?

  • Susan Bewley, Obstetric consultant
  • Nick Ross, Alain Braillon, Edzard Ernst, John Garrow, Les Rose, Diana Brahams, Michael Baum, Vincent Marks, Keith Isaacs, James May Kings Health Partners, SE1 7EH

At a time of austerity cuts, when treatments that work should be protected, it was depressing to see the Government’s Advisory Board on the Registration of Homeopathic Products advertising for four expert and “eminent members of their profession” who can “assimilate complex scientific information” to advise about the “safety and quality of homeopathic medicines” [1]. For this they will be paid £325/day.

Homeopathy has definitively and repeatedly been proven to work no better than placebo or nocebo. It is, in short, bogus. Professionals with faith-based (rather than evidence or science-based) beliefs in homeopathy may be recognised as eminent by their peers only in so far as those peers think likewise. Indeed, the job specification specifically precludes proper scientists and sceptical lay people since it requires applicants to take homeopathy seriously. In particular, why is a pharmacist expert in pharmacognosy (medicines derived from natural sources) required to advise about products that vanish after multiple dilutions? The appointment procedure begs several questions of public policy. The scientific community will be at best bemused and at worst outraged over this ill-conceived process.

What possible purpose does this Board serve – other than to clothe naked quackery and legitimise pseudoscience?

[1] https://www.appointments.org.uk/JobDetails.aspx/1559/Advisory_Board_on_the_Registration_of_Homeopathic_Products_4_Members?Lang=1 (accessed 5th September 2011)

Competing interests: All the authors belong to Healthwatch-UK (a charity which promotes evidence-based treatment http://www.healthwatch-uk.org/). NR is the President of HealthWatch and a trustee of Sense About Science (which promotes, well… sense about science)

16 comments for “MHRA accused of “clothing naked quackery”

  1. Danny Chapman
    September 23, 2011 at 4:42 pm

    “The job specification calls for homeopaths”.

    Actually, only one of the posts “Community pharmacist and homeopath” calls for this (which is, of course, one too many). The other three posts should, according to the advert, be open to pharmicists, consultant and general physicians who think homeopathy is pure quackery.

  2. September 23, 2011 at 9:59 pm

    Another of the posts is for “A general physician (with a special interest in homeopathy)”, but it doesn’t say that that ‘special interest’ is a firm believer in magic sugar pills. Any skeptical GPs out there with some spare time?

  3. September 24, 2011 at 12:12 am

    It is worth taking a look at the minutes of the Board http://www.mhra.gov.uk/Committees/Medicinesadvisorybodies/AdvisoryBoardontheRegistrationofHomoeopathicProducts/Minutes/index.htm Not that they say very much.

    It is curious that some of minutes mention applications for registration under the National Rules scheme yet there is still only one product so registered.

  4. Dr Richard Rawlins
    September 24, 2011 at 9:17 am

    I have presented a number of briefing documents to the BMA’s Board of Science on Homeopathy, Reiki, The difference between ‘Efficacy’ and ‘Efectiveness’ (no difference, but some camists think there is) and ‘Integrated Medicine’.

    No serious interest has been taken. These issues are too far down the agenda I’m afraid. And doctors want to please patients, not simply conduct a rigouously scientific practice.

    So the issues to tease out will be those of intellectual honesty, abuse (by mal use) of scarce resources on paying for such a non-sensical advisory body, and the government’s endorsement of pseudo-science.

    My MP is a GP, but she is also in the camp which says “Well, patients say they benefit”.

    My question is – is there ANY MP who appreciates the harm endorsement of non-sense causes? Who is prepared to raise this issue in the House?

    Homeopathic products consist of no active ingredient. They do not need regulating. And certainly do not need an Advisory Board to advise on how to regulate nothing of any value.

    A constructive therapeutic relationship with a caring homeopath may provide benefit, but that is not a product.

    I am putting all this as a letter to the editor of the BMJ.

    • Mojo
      September 24, 2011 at 11:22 am

      My MP is a GP, but she is also in the camp which says “Well, patients say they benefit”.

      I suspect that mine (not a GP) is in the “voters say they benefit” camp.

      My question is – is there ANY MP who appreciates the harm endorsement of non-sense causes? Who is prepared to raise this issue in the House?

      Julian Huppert?

      • pv
        October 1, 2011 at 11:40 pm

        I benefit from free whiskey. Not the homeopathic variety, obviously.

  5. September 24, 2011 at 10:37 am

    Richard said:

    Homeopathic products consist of no active ingredient. They do not need regulating. And certainly do not need an Advisory Board to advise on how to regulate nothing of any value.
    Quite. The problem arises from the MHRA having to enforce existing legislation. I’m sure many in the MHRA know full well they are asked to regulate nonsense, but they have to do as they are told and get on with it. It will take some time to have the law changed to stop the wasteful and misleading regulation of magic sugar pills. Until then we need to make sure that the MHRA properly enforces the law that is already there and makes homeopaths and manufacturers of homeopathic ‘medicines’ well aware of what the legislation allows, and does not allow, them to do. We’re working on this. ;-)

    • Dr Richard Rawlins
      September 24, 2011 at 5:18 pm

      Alan – who are “we”?

      More strength to your arms!

      Can I lobby all folks of good will to reply to the BMJ letter.

      Simply go to the link Mr Quack provides and do the necessary. You do not have to be a member of the BMA, nor a doctor, but the more mail that comes in on a given subject, the farther up the agenda the isue arises.

      Do it now. Do it often!

  6. September 24, 2011 at 6:29 pm

    Richard said:

    Alan – who are “we”?

    The Nightingale Collaboration and others…

    I hope everyone is following the dissection of the regulations that relate to homeopathic ‘medicines’ by Warhelmet? His latest post today is particularly interesting: The Supply of Unregistered Homeopathic Medicines, but also see his previous posts on the same subject.

  7. Rob
    September 26, 2011 at 4:22 pm

    I’ll be on holiday in the UK within the week. A Boots establishment will be a stop form me, to be sure. Playing as a stupid American tourist, what would be some fun questions about homeopathic preparations to ask a pharmacist?

  8. Amadan
    September 26, 2011 at 11:16 pm

    “Miss, what are the ingredients of this medicine?”

    “Do you have a stronger version of this? It’s a really bad [cold/headache/dose of the . . .]. Oh, how do they make it stronger?”

  9. pv
    October 1, 2011 at 11:39 pm

    Just posted this on the good Dr Kaplan’s blog…
    I don’t think he’ll be testing homeopathy on himself any time soon.

    There are no cases of non-self-limiting diseases being cured by homeopathic “remedy”. Not a single one. After 200 years there should be millions upon millions if what homeopaths say is true. But all we have in reality are anecdotes, and most of those on the anecdotalist’s and homeopth’s favourite modern medium, the Internet. The reason for this that homeopathy is, quite demonstrably, medical fraud.

    A good test of this would be for Dr Kaplan to infect himself with meningitis, or typhoid, or malaria, and treat himself exclusively with homeopathic remedies. But you, good Dr Kaplan, won’t do this because you know what the outcome would be. You would die, just as anyone else doing the same pointless exercise. If you dispute this then I challenge you to do it. Think of the boost it would give to homeopathy worldwide, and Big Pharma killed at a stroke.
    But as I said, you won’t do it.

    Homeopathy is good business but it is nevertheless a despicable fraud, promoted and perpetrated mostly by despicable, second rate people. Who but a bunch of charlatans would claim a client satisfaction survey to be evidence of the medical efficacy of homeopathy? This is the real level of any debate about the place of fraudulent medicine in a civilised society – client satisfaction surveys as evidence.

    Claims for the medical efficacy of homeopathy are as demonstrably ridiculous as insisting the Earth is flat and the moon made of cheese. Unfortunately claims for homeopathy can have rather more catastrophic consequences that the other two.
    I will go so far as to say that there are only two types of homeopath – the utterly deluded, and the utterly dishonest. And not one willing to put their money where their mouth is and demonstrate it on themselves.
    Typhoid, Dr Kaplan. Meningitis, Dr Kaplan. You could do them. Malaria, Dr Kaplan… you could test the homeopathic prophylactic there, if your confidence in your quackery were actually real.
    In fact I suggest a Homeopath group demonstration. It would do so much more to convince idiots like me that your “remedies” are worth more than water and sugar. But you and I know you won’t. And we know why don’t we.

  10. October 3, 2011 at 12:45 am

    Rob

    In Boots homeopathic remedies are not sold by the pharmacist. They are out on the shelves to be picked up and taken straight to a cashier. It would be very interesting to know what response you’d get if you took one of those remedies to the pharmacist and asked what it could be used for or which would be best for your insomnia/constipation/whatever.

  11. October 25, 2011 at 11:11 pm

    It looks like the MHRA wants to downgrade this Advisory Body to a mere committee in their just-announced consultation:

    Accordingly, there is no provision for the continued establishment of HMAC [Herbal Medicines Advisory Committee] or the ABRHP [Advisory Board on the Registration of Homeopathic Products] in the draft consolidated regulations. However, the MHRA has concluded that the functions carried out by these bodies are still necessary, and that they should continue as expert committees appointed by the licensing authority.

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