This is an open letter to all homeopaths in the UK.
It has been a bit of a surprise to me to learn that the Society of Homeopaths is wanting to lobby the Health Professions Council to include homeopathy within its regulation remit. As such, you will receive protected title (only registered homeopaths will be able to call themselves that) and be held against a code of standards and ethics.
Why do you want to do this? I can guess some of the reasons.
Homeopathy has always battled to be recognised – both as a science and as a healing profession. Deep within the homeopathic mindset is a belief that you hold a valuable principle of healing, if not the fundamental theory of healing. Over two centuries you have battled to gain acceptance and validation against what you see as a hostile (even conspiratorial) medical profession. You call the medical profession allopaths and define yourselves in opposition to your own picture of them.
Undoubtedly, you see that statutory regulation will put yourself at least on a par with doctors. You will no longer legally be invisible in the healing professions. But there are other more economic reasons too. Being statutorily registered will make it easier to gain referrals from the huge source of cash that is the NHS. It will also make it easier to get payments from private health insurers. You won’t have to pay VAT, although I doubt many of you make enough to have to worry about that. Universities have recently said that they will not teach BSc courses to train homeopathic practitioners unless they achieve statutory regulation.
So, the prize appears to be huge. Recognition, financial gain and the secured future of your profession through accredited education. The Society of Homeopaths can free itself of the tedious burden of having to pretend to regulate you and instead become something like the BCA and concentrate more on trying to sue its critics.
But what of the cost? Such rewards will come at a price – and I am amazed that the Society of Homeopaths believes you will wish to pay that price.
First, before we look at what this might all mean for homeopathy, I would suggest that the path to Statutory regulation will not be easy. I am sure you are aware that there are many people who think such a step would be absurd, myself included. Homeopathy has failed in two hundred years to make any progression in showing that it is nothing other than a inert treatment based on pre-scientific and magical thinking. The basic science to show that your principles are true is not there. My own simple challenge to homeopaths to demonstrate their fundamental propositions has not been taken up in 85 weeks. More damningly, in the two hundred years since homeopathy was invented, our scientific understanding of medicine, chemistry and physics has moved on enormously and it clearly shows that homeopathy is not just implausible but is utterly contradicted by everything we know about the world. Homeopathy lies outside of reason and science. It is a pseudo-medicine and is just a placebo therapy. It is just not tenable to hold any other position.
To gain statutory regulation, you will have to demonstrate that it is indeed possible to have meaningful standards in education and training for a pseudoscientific subject. That is not impossible – the current government has on the whole failed to see the problem with regulating absurd treatments. It is funding Ofquack, the Prince Charles backed Complementary and Natural Healthcare Council, as a voluntary regulator for a rag bag of quack practitioners. The government does not appear to see that upholding such people to high degrees of training and competence is problematic when such people believe in absurdities. I would suggest though that the HPC may well be tougher judges than Prince Charles.
So, onto the costs. In order to appreciate what such regulation might mean for homeopaths it is worth looking at what it has done for other statutorily regulated alternative medicines. Chiropractic would be a good example.
The regulation of chiropractic was not without its controversy. The Society of Homeopaths claim that 65% of its members support the route to such regulation. The Society of Homeopaths only represents 65% of homeopaths, so we can only be sure that 42% of homeopaths support such a route. Even then, this survey was taken in 2006 and a lot has changed since then. I would be very surprised if this support has grown. Are the majority of you in favour of this move? Chiropractors were also split when the Chiropractic Act was brought in. Many saw it as an attempt to control their practice and restrict what they could do. Chiropractic philosophy appears to embrace a libertarian stance and many resented passing control of their work to people who may not share their beliefs and views. Some were worried that the move had conspiratorial overtones of the medical community trying to suppress an alternative to them. There were quite a few who refused to be registered and had to cease calling themselves chiropractors and instead called themselves simply spinal manipulators or even the grand sounding osteomyologists.
Over a decade later, the political infighting still continues. Many resent that the McTimoney Chiropractors were let into the exclusive regulated club. McTimoney is seen as a chiropractic heresy where bones are not cracked so violently and training takes place through part-time courses. It is not seen as being real chiropractic and the practitioners as being undertrained – through cheaper courses. It represents a threat to the chiropractors who will have invested well over £40,000 in fees for their training at one of the other two ‘real’ chiropractic colleges.
The General Chiropractic Council, the regulatory body, appears to be popularly despised by the ordinary chiropractor. It is seen as heavy handed in its regulation, costly and not in tune with chiropractors’ needs (to be left alone). It has no duty to promote chiropractic but only to protect the public and enforce its code of conduct. It is also increasingly dominated by lay representatives – chiropractors are getting a smaller voice in its running. Much of this resentment has been well documented on the chiropractic blog chiropracticlive.com.
When the British Chiropractic Association decided to sue Simon Singh for criticising the lack of evidence base for the treatments it was promoting, I doubt they understood the difficulty they would be putting their members in because of the very fact that they were statutory regulated. The ensuing debate has exposed the non existent foundations of much of chiropractic care and this has led to an unprecedented number of complaints being made to the GCC about chiropractors misleading the public on their websites for the effectiveness of the treatments they offered. There are now perhaps 20-30% of the entire chiropractic profession undergoing statutory complaints procedures which could result in the loss of their registration and their ability to practice.
The mistake the government and chiropractors made in accepting statutory regulation was allowing it to go ahead before chiropractors could demonstrate that they were not simply a vestigial remnant of Victorian back cracking quackery. Now, chiropractors find themselves being held to the highest forms of professionalism and practice without an evidence base for pretty much anything they do. It is now possible that chiropractic in the UK will not survive the current onslaught of professional complaints and trading standards investigations being pursued against them. What will come out the other side is pretty much anyone’s guess, but I am pretty sure it is not a situation that the majority of chiropractors would have wished for in their quest for recognition.
And this is what I find extraordinary about the attempt by homeopaths to join the HPC. At present, the nightmare that is happening to chiropractors cannot happen to homeopaths. Despite what you say, you have had the freedom of living without any form of genuine regulation. The Society of Homeopaths has never ruled against a homeopath for the way they practice when when faced with clear breaches of the code of ethics. Homeopaths have been free to indulge in whatever delusions they fancy without fear of sanction. You have claimed to treat malaria and AIDS and have done so without a single voice of censure from within the lay homeopathic trade. You have no idea what it is like to be regulated and to be subject to a real code of ethics and practice. I suggest you pop along to your nearest chiropractor to find out what it is like.
And I must say that chiropractors have it fairly easy. Their treatments (at least for lower back pain) have an air of plausibility and some evidence for effectiveness. Homeopaths lack these luxuries of plausibility and reliable evidence for anything. What makes your situation worse is that your belief set is acutely in conflict with those who will become your statutory medical colleagues. You regularly undermine public healthcare messages about childhood inoculation and believe your sugar pills are an alternative. You show no sense of boundaries for what you can reasonably hope to achieve and make claims to be a superior treatment for everything from asthma and swine flu to autism and cancer. Do you really believe you could continue with your alternative beliefs in a statutory world? And they are alternative. Whilst you denounce the side effects of real medicine as being avoidable by homeopathy you pitch yourself against the medical world. And I doubt that a regulated profession could last long with such rhetoric.
Homeopaths. You have never had it so good. And you do not realise it. You are pretty much free from any constraint on what you say and do. You may moan about the continuous criticism you get from people like me – but that is the worst you have to suffer at the moment – criticism. If by some fluke you do manage to achieve full regulation, expect your cosy world to come crashing down very fast. Your quest for regulatory recognition will be hubris. It took over fifteen years for the chiropractors to realise they had been practising on borrowed time. Your regulatory nemesis will come much quicker.
"You show no sense of boundaries for what you can reasonable hope to achieve"
I don't want my professional status with HPC accreditation eroded by inclusion of practitioners who practice non-science.
I doubt that the 6000 UK RDs would want inclusion, either
Or members of the other 12 disciplines currently regulated by HPC
I can just imagine the sheer numbers of bloggers ready, waiting for the gates to open if the Homeopaths got their own regulatory council.
*Rubs hands together in gleeful anticipation*
I wonder how much this can be seen as a power grab by the SoH? By seizing control of the professions debate about regulation and unilaterally applying for HPC membership they have neutered any voice the other professions have in this process. By sheer volume of numbers the SoH will be able to overide anything they don't approve of but the other organisations want. Members of the ARH, MRCH, etc might as well join the SoH if they want any say in the registration process.
If this is true, gimpy, then it is a high risk game. If SoH fail in their lobbying (which they stand a high risk of doing) then what little credibility they have will be shot. This will the third attempt by them to form a regulatory body (CORH, then single register, then HPA) that would have come to nothing.
The non SoH homeopaths are not members for a reason – a lot to do with the dislike of a large overseeing body and a non-homeopath being in charge. I cannot see them flocking into SoH just to have 'a say'.
Frankly, I think SoH are just still a little too enamoured by the pat on the head they got from the House of Lords ten years ago about being a good regulator. The malaria scandal, the AIDS conferences and their failure to reign in the excesses of their members (and even directors) has shattered any credibility they might have had as a professional organisation.
Well, whether or not the homeopaths like it, the SoH are the most credible lay organisation (the ARH's Steve Scrutton has been doing a fabulous job maintaining homeopathy's tolerance of absurdity) and best placed to steer the lay profession into the future. If other organisations want to play a role then they will have to collaborate with the SoH, if their members want to have a say then they will have to demand their leadership negotiate with the SoH or join the SoH themselves.
Incidentally, I've noticed that one of the SoH's intellectual powerhouses, Lionel Milgrom, is no longer using RSHom in the prodigious titular arrangements following his name when sharing his 'wisdom' on the BMJ rabid response section. I wonder if he had a falling out?
An excellent analysis.
I tend to think that the SoH's actions will cause more division in the homeopathic community and will strengthen the dislike of the SoH amongst some homeopaths.
I understand the desire for statutory regulation, but like you, I don't think that homeopaths understand the implications. One of the implications that I've not quite got my head round is what the SoH would become if registration and regulation are the purview of another body. The SoH seem very keen for this to happen – it must have some benefits for them beyond recognition of homeopathy? But what?
I think there will be a bloodbath.
Another fascinating post.
I like the idea of the SoH creating an amusing paradox:
TO practice as a homoeopath you must be registered with the HPC. IF you practice as a homoeopath you will struck off the HPC register.
The SoH would effectively checkmate themselves and ban homoeopathy in the UK.
The GCC "has no duty to promote chiropractic" but it is still paying for 1/2 page ad's in the British Journal of General Practice
This may be misuse of funds, but I don't know what the law says about this sort of thing.
I agree with you that the SoH achieving statutory regulation would be disastrous for its members, but perhaps it is a way of avoiding criticism over refusing to join the CNHC. By engaging in protracted and ultimately unsuccessful negotiations with the HPC, they can delay the criticism for years.
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