An independent charity for science and integrity in healthcare

Read the latest HealthWatch newsletter:  Issue 106, Autumn 2017

15 AprilBristol, North Somerset and South Gloucestershire Clinical Commissioning Groups (CCGs) are consulting on proposals for homeopathy for a second time.

We reported on their first consultation last year. This overlapped with a consultation by NHS England and we understand some homeopaths had complained to the CCGs about the way their consultation had been run. This second consultation should finally decide the fate of homeopathy in the area.

After the Bristol Homeopathic Hospital closed in January 2013, homeopathy continued to be provided by a small clinic at the South Bristol Community Hospital. Just three years later, in October 2015, this too closed to be replaced by a private clinic, the Portland Centre for Integrative Medicine. That is not part of the NHS but is contracted by the CCGs to provide homeopathy services.

At the end of November 2017, NHS England announced recommendations that GPs should no longer prescribe homeopathic treatments or herbal remedies.

The CCGs give further details here and have published a summary document.

The aim of their proposal is to review the commissioning of homeopathy services and treatments and includes three options.

  • The homeopathy service should continue under the current policy where funding is granted if the patient meets the published criteria
  • The current policy should be amended to reduce access either by reducing the number of appointments routinely funded or by restricting the access criteria so the fewer patients will qualify for treatment
  • NHS funded homeopathy is only available in rare and exceptional circumstances and would need to be approved by the Individual Funding Request Panel (IFR)

The consultation closes on Sunday 15 April 2018 so plenty of time to submit your response online. This is little more than indicating how strongly you agree or disagree with each of the three proposed options, but you have the opportunity to provide further information if you so wish.

We encourage members to take a minute to submit their response.

The 2018 HealthWatch student prize competition for critical appraisal of clinical research protocols is now open.

There are two first prizes of £500 each, one for medical and dental students and one for students of nursing, midwifery and professions allied to medicine. Up to five runner-up prizes of £100 will be awarded in each class. Prize winners will be invited to attend the HealthWatch Annual General Meeting in October to receive their prizes.

The competition consists of four hypothetical research protocols: your task is to rank the protocols in order from that most likely to provide a reliable answer to the stated aims of the trial to that least likely to do so. You then have to explain your ranking in no more than 600 words.

Please pass on to any students, organisations, colleges, universities, etc you think might be interested.

Your entry must be submitted before midnight BST on Monday 30 April 2018. Entries received after that time will not be considered.

The terms and conditions can be read here.

Find out more here.

Free student membership

Whether you enter the competition or not, if you are a full-time student, please consider taking advantage of our offer of free Student Membership of HealthWatch.

The Autumn 2017 issue of the HealthWatch Newsletter is now online here!

The HealthWatch Newsletter is now free to read and download. HealthWatch members will shortly receive their personal printed copy of the newsletter if they have opted to do so.

Featured in this issue:

  • NEWS FEATURE British universities are not sharing the results of their research, resulting in wasted public money and danger to patients.
  • NEWS Consultations, awards, a new book, and how patience with homeopathy is running out.
  • TREATMENTS How a routine practice during childbirth could be putting newborn's lives at risk.
  • NUTRITION Can this best-selling "healthy" 21-day diet plan live up to its promises?
  • MEETING REPORT Worlds collide: an on-the-spot-report from an NHS Public Consultation event.
  • LETTER TO THE EDITOR "Regulatory agencies are like a car with only two speeds - too fast and too slow".
  • LAST WORD Another hair-raising story about cancer hits the headlines, but the truth will surprise you.

Join us by becoming a member of HealthWatch and a supporter of science and integrity in healthcare.

The Department of Health is seeking views on the regulation of medical associate professions (MAPs) in the UK.

Deadline for submissions

Friday 22 December 2017

Consultation description

Full details of the consultation can be found here.

Rising demands for medical treatment and advances in clinical care requires a co-ordinated approach and greater skill mix within NHS healthcare teams.

In recent years the health service has seen the emergence and increased use of new professional roles within multi-disciplinary teams as part of a continuing drive to provide safe, accessible and high-quality care for patients.

Four of these roles are:

  • physician associate (PA)
  • physicians’ assistant (anaesthesia) (PA(A))
  • surgical care practitioner (SCP)
  • advanced critical care practitioner (ACCP)
  • As these professionals become more widely employed, it is necessary to explore the options for professional regulation.

This consultation seeks your views on the following proposals:

  • To introduce statutory regulation for PAs
  • To seek further evidence on the most proportionate level of regulation for PA(A)s
  • To seek views on the position that statutory regulation of the SCP and ACCP roles is not proportionate, and whether alternative options for professional assurance should be considered

A consultation document and a risk assessment profile from Health Education England (HEE) are published alongside this consultation.

Responses

We will be considering whether to submit a formal HealthWatch response and we encourage our members to think about their own personal response.

Responses can be submitted here.

Questions

Do you feel that HealthWatch should respond to this consultation?

Do you have any suggestions about what we should say in our response?

Could you help us coordinate or write our response, particularly if you have expertise in this area?

If you submit your own personal response, could you send us a copy to help us formulate our response?

Contact

If you are able to help us, or require any further information, please contact our consultations coordinator, Roger Fisken.

HealthWatch has responded to the Government's consultation on research integrity with a practical proposal to address the issue of incomplete and inaccurate reporting of clinical trials.

The proposal, submitted jointly with Universities Allied for Essential Medicines UK, TranspariMED, and Dr Simon Kolstoe, calls for a national clinical trial audit system that would substantially strengthen research integrity by monitoring the registration, summary results posting and academic publication of every trial conducted in the UK. It refers to a pilot trial of such a scheme that was conducted over 2010–11 at the University of Portsmouth by Simon Kolstoe, senior lecturer in research design and ethics there. The pilot used documents already held by research ethics committees to monitor retrospectively whether trials have been registered, post summary results within 12 months, and publish accurate results. It found that such an audit was effective and could be implemented at minimal cost.

The House of Commons' Science and Technology Committee's Inquiry into Research Integrity was launched initially in January this year to look at trends and developments in fraud, misconduct and mistakes in research and the publication of research results, and the so-called 'crisis in reproducibility' of research. It had begun to take evidence but was closed on trhe dissolution of parliament for the general election, and there were fears that valuable evidence already submitted might not be heard (see Spring/Summer 2017 issue of the HealthWatch Newsletter, p3). The inquiry was re-opened on 13th September and closed on 5th October with nearly 100 submissions received from experts and concerned groups.

Written submissions from HealthWatch and by other parties will soon be accessible online at the House of Commons' Science and Technology Committee's webpage for the Research Integrity Inquiry.

The submission of which HealthWatch was a joint signatory was prepared by Dr Till Bruckner, of TranspariMED, a UK-based initiative that develops and promotes policy solutions to the problem of evidence distortion in medical research.

1280px Lettsom House 2011Date: Tuesday 17 October 2017

Time: 18.30 pm (drinks reception from 18.00 pm — see below for full agenda)

Location: The Medical Society of London, Lettsom House, 11 Chandos Street, Cavendish Square, LONDON W1G 9EB (see map)

HealthWatch Award 2017: Deborah Cohen
The 2017 HealthWatch Award will be presented to the BMJ Investigations Editor Deborah Cohen, in recognition of her courageous reporting of medical issues in the face of attack from vested interests.

She has written about drug and medical device regulation, access to clinical data, cost of medicines, research integrity and conflicts of interest, as well as collaborating on documentaries with the BBC Panorama and Newsnight, Channel 4 News and Dispatches. Her recent BBC Panorama investigation, Inside Britain’s Fertility Business, exposed private fertility clinics selling costly “add-on” drugs, tests and treatments of questionable efficacy.

Agenda

18:00 Reception for the AGM and Award ceremony.

18:30 Annual General meeting of HealthWatch (only members of HealthWatch may vote, but non-members are welcome to attend).

18:50 Presentation of awards to the winners of the 2017 Student Prize competition for critical analysis of clinical research protocols.

19:00 Presentation of the 2017 HealthWatch Award to Deborah Cohen (see above).

20:00 Buffet dinner (£45.00 per person). To order your buffet dinner, please complete the form here.

Nominations for Committee

Nominations for officers and members of the committee must be submitted not less than 28 days before the AGM. There is currently one vacancy on the committee. Any member of HealthWatch can nominate an officer or ordinary member for the committee. Nominations should be seconded by another member, accompanied by a letter from the person nominated to state s/he accepts, and sent to the Secretary, Prof David Bender or by post to 8 Eagle Close, AMERSHAM HP6 6TD before September 30th.

The deadline for the Autumn issue of the HealthWatch Newsletter is coming up and we'd love to have articles and letters from our members, friends, supporters and interested readers.

As of this year the HealthWatch Newsletter in pdf format is openly accessible online immediately on publication so that our contributors can benefit from as wide an audience as possible, and may share their work freely.

For our Autumn issue we are looking for topical and thought-provoking material from new contributors. Opinions, book reviews, letters commenting on current issues of interest are all welcomed for consideration.

Please send your articles by Monday 18th September for target publication date during October/November. For more information and details of how to submit please see our Information for Authors page.

Bristol, North Somerset and South Gloucestershire Clinical Commissioning Groups (CCGs) are consulting on their proposal to decommission all NHS-funded homeopathy.

After the Bristol Homeopathic Hospital closed in January 2013, homeopathy continued to be provided by a small clinic at the South Bristol Community Hospital. Just three years later, in October 2015, this too closed to be replaced by a private clinic, the Portland Centre for Integrative Medicine. That is not part of the NHS but is contracted by the CCGs to provide homeopathy services.

Now the group of CCGs wants to end all homeopathy referrals to that clinic.

The consultation consists essentially of just two simple questions:

  • Do you understand the reasons for our proposal to stop NHS funding for homeopathy treatment? Yes|No
  • Do you agree or disagree with our proposal to cease NHS funding for homeopathy? Agree|Disagree

…with the opportunity to explain your answers and provide further information.

The consultation closes next Tuesday, 15 August 2017 so plenty of time to submit your response, but don't leave it too late!

The Spring/Summer 2017 issue of the HealthWatch Newsletter is now online! The HealthWatch Newsletter is now free to read and download.

Featured in this issue

  • NEWS FEATURE Criminologist Mike Sutton calls for an urgent study into the public health impact of the US president's promotion of the idea that vaccines cause autism
  • NEWS Deborah Cohen, BMJ investigative journalist, to receive this year's HealthWatch Award; whistleblower Peter Wilmshurst calls for the Science and Technology Committee to resume its inquiry into research integrity; and more…
  • CONSUMER PROTECTION Getting bad science claims off the internet, one website at a time 
  • NUTRITION Lowering blood cholesterol saves lives — or does it?
  • DENTISTRY Want to have straight teeth by Christmas? An expert view of the 6-month smile promise
  • BOOK REVIEW sex, lies and brain scans — can an MRI scan read your mind? 

Join us by becoming a member of HealthWatch and a supporter of science and integrity in healthcare. HealthWatch members will continue to receive their personal printed copy of the newsletter if they have opted to do so.

Please respond to the Charity Commission's consultation on CAM charities

Many charities promote or provide what is frequently referred to as 'complementary and alternative medicine', or CAM for short. This isn't an accurate term because the practices they promote or provide aren't always medicines, but it CAM can be a convenient term. What many do have in common is the lack of robust evidence for their efficacy and this sets them apart from conventional treatments.

But should such charities have the advantages and prestige of being registered charities? In the UK, charities are regulated by the Charity Commission and they have to meet certain requirements and standards, particularly with respect to 'public benefit'. There are many CAM charities that have already been granted charitable status but should they have been given this status in the first place and how should the Charity Commission decide whether any particular CAM charity establish that an organisation would have the beneficial impact necessary? How should the Charity Commission consider conflicting or inconsistent evidence?

These and other questions are part of the Charity Commission's current consultation: The use and promotion of complementary and alternative medicine: making decisions about charitable status.

This consultation was the prompted by the work done by HealthWatch Trustee Les Rose. He has written extensively on his blog about his battle with the Charity Commission and his posts there are well worth reading. Les's own response to the consultation is also published on his blog.

We know that several homeopathy trade bodies and other CAM proponents (eg 4Homeopathy, an umbrella organisation for UK homeopaths) are encouraging their members and supporters to respond to the consultation with their own particular view of what constitutes good evidence. Our members who share concerns about evidence in healthcare may like to submit their own responses.

The closing date is this Friday, 19 May 2017 and responses can be sent to This email address is being protected from spambots. You need JavaScript enabled to view it..

Today's Guardian carries an article by Michael Marshall of Good ThinkingShould complementary and alternative medicine charities lose their charitable status? This gives some background and further details and their own response is available on their website: Our submission to the Charity Commission’s CAM charities review

With that, Les's submission, a page on notes he's drawn up for members and the consultation document itself, we know that many of you will be able to submit a thoughtful and robust response.

If you do submit a response, it would be good to have a copy of it for our files. Please send a copy to This email address is being protected from spambots. You need JavaScript enabled to view it..

New study finds trading standards close to breaking point trying to regulate misleading marketing claims on healthcare products

Ineffective and dangerous health products are being advertised to the public for serious medical conditions in breach of consumer protection regulations, while cash-strapped trading standards departments struggle to keep traders in line. A new study has confirmed that laws intended to protect vulnerable consumers against misleading health-related marketing claims are simply not being enforced.

The UK charity HealthWatch, which promotes integrity in healthcare, has just completed a two-year investigation[1] to learn what really happens when consumers blow the whistle on false claims about healthcare products. They found:

  • Pursuing a complaint is cumbersome and lengthy
  • Most complaints do not result in enforcement
  • Approaches to enforcement vary widely between trading standards offices

HealthWatch’s volunteer investigators submitted 38 complaints to trading standards via the Citizen’s Advice website about traders making misleading claims for their products online. Some were simply ineffective, such as copper bracelets for restless legs syndrome, and red jasper crystals to heal and prevent colds and flu. Others were potentially harmful – one ad was offering homeopathic remedies for deadly whooping cough or poisoning. It took up to 74 working days to get a reply – more usually around a month. Despite the volunteers pursuing their complaints for up for six months, enforcement action was ultimately only taken against two traders. In fact, the volunteers found the process so cumbersome and time-consuming that many of them withdrew from the study.

Annual funding for local trading standards services dropped from £213m in 2011 to £124m today, and the number of full-time officers has fallen by 56% over the last seven years, according to a recent report by the National Audit Office[2].

The HealthWatch investigation found that responses from trading standards were highly variable and this even extended to disagreeing as to whether an offence had been committed. Trading standards is the legal backstop to the Advertising Standards Authority[3] but, despite their statutory powers, seems not to be in a position to provide an effective regulatory function.

The complaints were made under the Consumer Protection from Unfair Trading Regulations 2008. All product claims complained about were clearly misleading, and had been widely marketed nationally.

The full report is available on the charity's website at https://www.healthwatch-uk.org/cpr2. The HealthWatch study is the subject of a major feature in Trading Standards Review[4].

- END -

Notes to editors

  • HealthWatch is the charity that has been promoting science and integrity in healthcare since 1991
  • Further information from www.healthwatch-uk.org
  • Media enquiries: our press office e-mail address is monitored continually, at This email address is being protected from spambots. You need JavaScript enabled to view it. or via the media contact form
  • HealthWatch has no connection with “Healthwatch England”

References

  1. Rose L et al. Testing the effectiveness of consumer legislation for health-related claims. April 2017. https://www.healthwatch-uk.org/cpr2
  2. National Audit Office. Protecting consumers from scams, unfair trading and unsafe goods. December 2016. ISBN: 9781786040923. https://www.nao.org.uk/report/protecting-consumers-from-scams-unfair-trading-and-unsafe-goods/
  3. Advertising Standards Authority. Trading Standards https://www.asa.org.uk/resource/trading-standards.html
  4. Bailey C. Mind the cracks. Trading Standards Review. April 2017. pp18-23.

The 2017 HealthWatch student prize competition for critical appraisal of clinical research protocols is now open.

There are two first prizes of £500 each, one for medical and dental students and one for students of nursing, midwifery and professions allied to medicine. Up to 5 runner-up prizes of £100 will be awarded in each class. Prize winners will be invited to attend the HealthWatch Annual General Meeting in October to receive their prizes.

The competition consists of four hypothetical research protocols: your task is to rank the protocols in order from that most likely to provide a reliable answer to the stated aims of the trial to that least likely to do so. You then have to explain your ranking in no more than 600 words.

Please pass on to any students, organisations, colleges, universities, etc you think might be interested.

Entries must be received by 30 June 2017.

Find out more here.

Members, friends, supporters and interested readers - the deadline for the Spring issue of the HealthWatch Newsletter will soon be here.

As of this year the HealthWatch Newsletter in pdf format is openly accessible online immediately on publication so that our contributors can benefit from as wide an audience as possible, and may share their work freely.

For our Spring issue it would be great to have material from some new contributors. Opinions, book reviews, an insider's take on a news story perhaps ...

Please send your articles by Monday 20th March for target publication date during April. For more information and details of how to submit please see our Information for Authors page.

As part of our vision for taking HealthWatch forward, we plan to concentrate our efforts on two or three projects or areas of investigation in depth. This could involve research, investigation, taking part in consultation ... anything that will forward HealthWatch's aims of promoting integrity in healthcare. Projects currently under way or completed have included the highlighting of concerns over Public Health England's age extension trial of mammography screening, the student experience of CAM teaching in medical schools1 and two investigations into the efficacy of the Consumer Protection Regulations as applied to health claims (one published2 and one in the final stages of data analysis).

Among HealthWatch members and committee there is a vast pool of skills, experience and enthusiasm. We know that we have many supporters who would like the opportunity to get more directly involved. So let's have your ideas! Please complete our very short Focus questionnaire to suggest areas that you think we should investigate. Just click here.

References

1. Ho D et al. Focus Altern Complement Ther 2013;18(4):176–81 http://onlinelibrary.wiley.com/doi/10.1111/fct.12059/abstract

2. Rose LB et al. Med Leg J 2012;80(1):13–8 http://dx.doi.org/10.1258/mlj.2011.011034 

The Winter 2016-17 issue of the HealthWatch Newsletter is now online - in full! The HealthWatch Newsletter is now free to read and download.

Features in this issue:

  • NEWS FEATURE Are the WHO guilty of woo? An out-of-date World Health Organization report is being widely cited as evidence for the efficacy of needling, and Australia’s award-winning Loretta Marron calls on the WHO to set the record straight for the sake of the poorest and most vulnerable.
  • HEALTHWATCH AWARD WINNER Peter Gotzsche is tired of being labelled controversial – the Cochrane scientist and author who compares big pharma to organized crime just wants to tell the truth about medicine. He pulls no punches in his talk to the HealthWatch AGM, reported here.
  • BOOK REVIEW broadcaster and journalist Nick Ross shares a taste of Edzard Ernst’s new book on homeopathy
  • plus Chairman's report from latest AGM, Student Prizewinners and news updates

Join us by becoming a member of HealthWatch and a supporter of science and integrity in healthcare. HealthWatch members will continue to receive their personal printed copy of the newsletter if they have opted to do so.

Notes to Editors:

HealthWatch is the charity that has been promoting science and integrity in healthcare since 1991.

Further information from: www.healthwatch-uk.org

Media enquiries: our press office is manned continually, at This email address is being protected from spambots. You need JavaScript enabled to view it. or via the media contact form online.

HealthWatch has no connection with “Healthwatch England”.

There could soon be an end to compulsory mammography screening of women in Uruguay, thanks to one woman’s battle.

A bill presented at the Congress on Thursday, 1st December aims to ensure that women are asked for their informed consent to undergo screening for breast cancer and are not penalised if they refuse the test.

The news is the latest in a long-running campaign by Ana Rosengurtt, a 55-year-old computer engineer. Earlier this year she won a 4-year legal battle for the right to be excluded from the compulsory test. A Montevideo court found that the government had neglected its obligation to obtain patients’ informed consent. But Ana’s victory this summer applied to her only. The new law, if adopted, will give the same freedom to all Uruguayan women.

Until the new law is passed, though, Uruguayan working women aged 50-69* will continue to be compelled by law to undergo mammography screening for breast cancer every 2 years, to qualify for the “carné de salud” (health card) that permits them to work, hold a driver’s licence, study at university. Women will still have to submit to compulsory PAP smear, blood and urine tests every two years. Uruguay has the highest cancer mortality in Latin America, and the 10th highest worldwide according to the WHO. Screening has been compulsory since 2006 and the policy is largely accepted, as awareness of the possible risks is low.

Ana says, "Thank you very much to all of you who had supported my fight all these years.

"Now the law will be discussed at the congress. I expect a swift approval as it is based on a ruling by the court. So, the ruling that initially applied only to me, will be a law for every woman soon. Not only justice, also congress will have endorsed my right."

Mammography screening for breast cancer has questionable benefits and considerable harms. HealthWatch believes it is unethical to impose screening without the woman’s informed consent.

*the age range changed this year, previously it was 40-59.

For more information:
 
BMJ, 8 Dec 2016

Montevideo Portal, 30 Nov 2016

The Congress website shows the registration of the bill (labelled “606/0”)

(For articles in Spanish - if using Chrome browser, right-click on the text to have the article translated into English)

Scientific American, 17 Oct 2015

BMJ, 21 Mar 2013

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