Now I should say firstly this post isn’t an ad hominem attack on the practitioner in question. Its a learning exercise to allow other homeopaths to understand how to respond to the Advertising Standards Authority, or perhaps more pertinently – how not to do it.
Steve Scrutton is a Homeopath and Alliance of Registered Homeopaths member. He has this website, which prompted a complaint* to the Advertising Standards Authority about some of the content. As a result of this the ASA wrote to him and challenged whether:
“1. the web page headed “Arthritis”, which made reference to randomised controlled trials on homeopathy, could discourage essential treatment for conditions for which medical supervision should be sought; and
2. the web page headed “Influenza” made claims that implied homeopathy was proven to be effective in the prevention of influenza.”
Now faced with a letter from the ASA asking for you to provide evidence most people would either i) pony up the mountains of evidence or ii) accept that they were wrong and amend their website to become compliant.
Steve Scrutton however had a cunning plan, and unlike the majority of Baldricks it didn’t involve a turnip. Steve decided that using his sophistry he would convincing the ASA that his website was simply providing editorial information to enable consumer health choices, and was therefore outside their remit. He would simply assert that he was qualified, claim Homeopathy treated pain and not arthritis (seems odd that he says that on his website then) and for an encore chuck in a few studies about influenza and arthritis. In short, his approach was mainly to channel Alec Guiness, wave his hand and tell the ASA that these weren’t the droids they were looking for.
To say things didn’t go quite to plan is a bit like saying that King Kong was “a bit of a handful”. The full ruling is here and it makes interesting reading. This is because it once more shows that Homeopaths are not good at answering direct questions, and that they want to move the goalposts and get on with business as usual. Firstly, with regards to the Arthritis claims the ASA destroyed any notion his website wasn’t marketing material:
“Homeopathy uses many remedies for people suffering from arthritis, and related illnesses” and “In my experience, I have certainly found homeopathy to be a safe and effective therapy”. We considered that, in the context of a website for homeopathic services, these statements meant the web page was marketing his
services as a homeopath in the treatment of arthritis….[…]….The web page contained contact information, and a link along the side to “Appointments & Fees”. We therefore considered the web page was marketing material, and was within the remit of the CAP Code.”
So saying you can treat something and providing a link to your service for doing this is consider by the ASA to be marketing. Who’d have thought it? The ASA weren’t finished:
“However, the CAP Code stated marketers must not discourage essential medical treatment for conditions for which medical supervision should be sought, and this included offering specific advice on the treatment for such conditions unless that advice or treatment was conducted under the supervision of a suitably qualified health professional…[…]…we did not consider that Steve Scrutton had demonstrated he was suitably qualified to offer, in a marketing communication, specific advice on, or treatment for, conditions for which medical supervision should be sought, including arthritis.”
That must hurt, perhaps they didnt get to see the certificate on his desk? The influenza claims also folded under only light scrutiny:
“We noted Steve Scrutton had provided an article regarding one study, and provided information about a second study, in which the efficacy of Oscillococcinum in treating influenza-like symptoms had been examined. However, the claims on the web page referred to the prevention of influenza, rather than treatment, so we did not consider the evidence provided to be relevant to the claim.”
Jesus wept. Well, I guess we all get ‘treat’ and ‘prevent’ mixed up from time to time. Easy mistake to make and very re-assuring for anyone who Steve gave a prophylactic to. By the time I’d read the whole ruling – which incidentally upheld both complaints – I felt almost sorry for poor Steve. That is until I noticed that he still claims homeopathy can treat pain arthritis on his website.
Now I mention this case because its so public. But he certainly isn’t alone in thinking that the ASA ‘problem’ can be wished away, beaten with a word salad, nullified by a disclaimer, or simply be moved ‘off piste’ from the ASAs remit. This ‘blog‘ contains some very outlandish claims. And, of course a pricelist. I idly wonder if Alan Freestone is mistakenly under the impression that this is exempt?
Another very vocal objector to what she sees as ASA censorship has been Lisa Chalmers. Her website includes the following claims:
“Homeopathy can help many kinds of ill health…[…]…I have had patients with Autistic Spectrum Disorder, Arthritis, Auto-immune syndromes and complex abdominal problems,”
Having previously taken down all specific conditions listed on her Homeopathy website under duress, she has apparently received the all clear to re-instate them. I was curious as to what this landmark ruling could be, and it turned out to be this. Now if at this point you are feeling confused as to why being able to state in a general manner on your website that gods love can heal would also enable homeopaths to make specific health claims again – don’t be embarrassed. I’ve looked at this ruling a number times and can’t fathom it.
The point of all this is simple.
Lay homeopaths are in a very tight spot. They claim that word of mouth from their successes gets them new patients and homeopathy is on the up. But this seems at odds with the evidence that some will risk prosecution to cling to a few words on a website, their unwillingness to engage with the ASA, and their willingness to advertise their ability to treat medical conditions that the ASA thinks should be under the medical supervision of someone properly qualified.
They are in a battle that they simply cannot win. Even if they are not ultimately prosecuted, the ASA rulings and the very public fallout like those above only further exposes the already weak arguments, the wooly attempts to redefine things to suit their own purposes, and importantly the general lack of evidence for their fantastical claims. It demonstrates that they are so entrenched in their dogma and so bloody minded that they don’t want to play by the rules everyone else has to. The damage then, is already done.
*NOTE: I was not involved in any ASA complaints about any of the above practitioners and I won’t be submitting any new complaints about these practitioners.
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Update 20/8/12
I did contact Steve so he could have his right to reply to what are legitimate concerns about his advertising and breaches of the CAP Code.
He didn’t reply. Although I note he did find the time to tweet a series of messages to his followers about such pressing matters as “#Roger Daltry say’s #Homeopathy saved his son’s life”, “The treatment of colds with #Homeopathy” and “#Homeopathy saving lives in Ghana”.
Its matters closer to home that are important. I’ll be writing about this and the ARH again in the future.
The Exit Door Leads In.... 
You say this is a battle the homeopaths simply cannot win, but I’m not so sure. What if, as Scrutton appears to be doing, a homeopath decides simply to ignore an ASA ruling? It’s not at all clear to me that they have sufficient powers to take any further action.
The central point I am making is that if Homeopaths continue to defy the ASA they cannot ‘win’ this battle in any real sense. Whether anyone is ultimately prosecuted or not, isn’t really the point.
While the Homeopaths may scoff at the ASA, I think these types of adjudication are extremely damaging. Every case solidifies the view that they operate without evidence, are advertising in a misleading manner and happy to work outside their competency. If a SOH member does this (it’s a requirement of their code of conduct to comply with the CAP Codes), it adds to the argument that they are incapable of self-regulation. Not that regulating it is the answer.
Lay homeopaths are under a lot of pressures at the moment the ASA, the MHRA review etc – it just one of many. I cannot see how small practitioners like Lisa Chalmers can find the resources, or the stamina to operate in such a way which leaves you with the constant possibility – no matter how remote – that you may be prosecuted.
Every case played out in public damages Homeopathy and they cannot, or will not see that fact. For these reasons they would be better to keep their heads down, comply, and attempt to work out just where lay homeopaths can operate. They are in a hole but continue to dig.
Well, I’d love to believe you’re right about this. To be clear, I’m not for a minute arguing that homeopaths should be allowed to advertise their magic potions as if they were actually capable of treating real diseases.
But I do wonder whether defying an ASA ruling might actually be good for their business. Marketing for homeopathy relies on many things, but one central plank of it is the “big pharma conspiracy” gambit: that big pharma is part of a conspiracy to shut them down, and homeopaths are the brave underdogs battling against the system.
It seems to me that there is a risk that unfavourable ASA adjudictions will only serve to reinforce that conspiracy theory. I’m just worried that for the ASA to make rulings that they have no powers to enforce may turn out to come back and bite them in the bum.
I’m sure they would attempt to spin it that way, and say that the ASA are not fit to adjudicate on such ‘complex’ matters. But the above breaches of the CAP Code are very obvious:- ‘treat’ vs ‘ prevent’, whether Steve is suitably qualified as a health professional etc. These are obvious to anyone objective with half a brain.
I would also ask this – is it good for any organisaton to set a standard which they themselves recognise as good practice and then openly breach that standard?
Take a look at The Alliance of Registered Homeopaths (ARH) Code of Ethics http://www.a-r-h.org/AboutUs/ARHCodeofEthics.pdf. By their own admission they recognised that the British Codes of Advertising Practice is good practice and a requirement for members (see point 36).
Steve is the Director (Media & Communications) of the ARH. He shouldn’t need telling this, or that specific medical conditions shouldn’t be mentioned etc. This is just more evidence of poor self regulation.
Yes, it’s excellent evidence that self-regulation for homeopaths is about as effective as a chocolate fireguard. I can see that, and you can see that.
But what worries me is whether the average person who might consider seeing a homeopath can see that, or even cares. Anyone who is taken in by conspiracy theories could see it all as rather attractive, reinforcing the “brave lone maverick” stereotype.
The ASA is a voluntary regulator and has no statutory powers. As far as medicines advertising goes, the MHRA has statutory powers to enforce regulations. The ASA can be very variable in dealing with complaints relating to homeopathy. Sometimes they will, sometimes they say it’s for the MHRA do deal with.
You’re right to point out that the ASA is self regulatory. It acts as a sort of buffer to give advice and the advertisers the opportunity to comply without stronger action being taken.
However, my understanding is that if advertisers break the CAP codes repeatedly or fail to engage with the ASA self regulatory approach, then they can be referred by CAP to the Office of Fair Trading who can use the Consumer Protection Regulations or the Business Protection Regulations to force them to remove misleading claims.
Although ASA is voluntary the OFT recognises them as the means for regulation of misleading advertising. On this basis it would seem unwise to not engage and at least attempt to comply with the ASA.
Perhaps ‘suffer sanctions’ is more accurate than ‘prosecute’, and yes I doubt Steve is top of their list.
Where is the evidence, exams, certificates or other evidence of those people in the ASA to demonstrate scientifically that they can scientifically determine the effects pharmaceutical drugs, placebo, nutrition, complementary/alternative treatments, psychological, spiritual effects on people who have a clinically proven disease? Can we have faith in their scientific judgment?
Madeline thanks for your comment, and a happy new year to you.
I’ll limit the scope of my reply to homeopathy if thats ok. Firstly, I think there is a misunderstanding about how the ASA operate. They are a self regulator and have finite resources and a very wide range of issues to look at. They expect any advertiser making a claim to hold the evidence to support this claim. The burden of proof is on the advertiser.
Of course the ASA do not have full time staff with the expertise in house to look at each and every issue as experts. Its therefore possible that the ASA may be asked to pass judgement on matters which are potentially contentious. In practice, in my expeirence, this doesnt seem to happen very often, since advertisers like Steve fail to provide any good evidence to back up their specific claims when challenged.
With regards to Homeopathy the sheer volume of complaints meant that the ASA had to adopt a more general position based on the best evidence available about claims of efficacy – see here http://www.asa.org.uk/~/media/Files/ASA/Misc/Letter%20to%20Homeopathy%20Adv.ashx
The House of Commons Science and Technology Committee: Evidence Check 2: Homeopathy was undertaken with submissions from Homeopaths and their professional bodies and is based on the best evidence and opinion. I dont think its unreasonable to require Homeopaths to not make claims of efficacy about specific medical conditions in the light of this best evidence that it is at best unproven.
Your suggestion that the ASA may not be ‘qualified’ to pass judgement on the claims of Homeopathy are a little hard to understand, since it is not a protected title and anyone practicing Homeopathy without an evidence base is, by any reasonable definition, incompetent themselves.
Ha all of you are making such a big deal about ASA. Who are they again? Oh yes they were set up by the advertising association and paid indirectly by them through ASBOF. They have no jurisdiction in any legal sense. Everyone at the top of the pile is strongly linked to the pharmaceutical industry and if they continue to act like they have the authority to understand CAM evidence they themselves are going to wind up in the hot seat. A number of MP’s to my knowledge are already becoming aware of the discrepancy between a company who openly state that they operate in the interests of advertisers (check out the Advertising Association and ASBOF who are the ASA ‘parliament’ and funders respectively. How long will it be before the ASA is discredited entirely. Just a brief peek at who’s at the top of the pile reveals the links to pharma. In fact one doesn’t even need to look that far, even ASA is blatant with their connections to the pharma industry. A headline from PR week reveals… Drugs giant AstraZeneca has appointed the Advertising Standards Authority’s comms chief to head up its worldwide media relations activities. Get real people. If you don’t think there are vested interests going on in the AA, ASBOF and ASA think again. If I could be bothered I could write at great and revealing length about who pays the piper…and in far far far worthier places than here.
But why bother…everyone knows that anyway. Homeopathy will continue as usual and deep down the skeptics know there is no actual way to prevent people from using or practicing it. All this latest campaign has done has revealed the corporate interests at work behind our healthcare. People are now as acutely aware of how they have been ripped off and lied to by pharma as people are about the same scenario from the banking industry. So bring it on-full transparency is welcomed and encouraged.
I am honoured that you have chosen to share your wisdom in my far far from worthy blog. Even though this post is well over 12 month old I suppose the polite thing is to reply to your comments.
The ASAs legal position is noted above in the comments, including their ability to refer to the OFT. The question which remains though, is if the ASA have no real powers why people like Steve Scrutton and HMC21 engage with them at all? I mean if they have both the conviction in their belief and the cojones they should ignore them. But they don’t – they delay, play semantics, appeal. Que surprise.
Everyone at the top of what pile? You’ll need to be more specific if you wish your claims to be taken seriously.
Not sure what CAM evidence is and how that is different to well….evidence. Perhaps you would care to elaborate otherwise this looks a bit like special pleading? You know, asking that CAM should be subject to a lower standard of evidence than others.
Also, not really clear what the threat to the ASA is, who is going to put them in the hot seat and what the consequences of being in said seat are?
My MP is certainly aware. I wrote in support of the ASA and her aide was kind enough to invite me to parliament on the day of the HMC21 lobby to meet her. I like my MP. Not really clear what you mean about the ASBOF or why the AA are picked out of the many funders who collect the levy to, and fund the ASA? I think the ASA operate very much in the interest of advertisers which brings me nicely to your next point
Be careful what you wish for. One alternative to an ineffective self-regulator might be less tolerant statutory regulator who thinks people like Steve can go straight to court.
Ah, presume you mean the ASBOF? Don’t really see how they influence the ASA when they are independent of the adjudications on advertising and consist of a board of 20 individuals from a range of organisations. Have Big Pharma like bought off the whole board of ASBOF? Or is one evil member like Palpatine in Episode I manipulating them all with the force (the second option being more credible).
Did Astrazenica really give her this high powered job as a reward for attacks on CAM? Their HR department must be a nightmare to work in.
[Edit 22/10/13: A quick search finds that Esra Paler joined AstraZeneca in April 2011, a couple of months after the ASA extended their remit to digital marketing in Feb 2011. Although her ASA role included Director of Policy, its not clear to me how she could influence the ASA policy or adjudications made after her departure]
I don’t, and you haven’t provided any evidence to change that view.
So why don’t you? You know blow the whole thing wide open – name names, provide the money trail. It would be a massive scandal and would devastate the ASA. No need to denigrate your great work by posting here. Post it wherever you want and provide a link. I’d love to see it and, if the evidence is good I will be more than happy to support you.
Everyone would know if you told us specifically what was going on. Until then it remains what it is, a baseless slur aimed at deflecting attention away from the failure of CAM to provide decent evidence of efficacy.
Where have I said people should be prevented from using or practicing Homeopathy? This is a strawman to avoid the real issue, that like other sceptics I want those selling CAM to follow the same rules on evidence as everyone else.
Advertising. We are talking about advertising – inaccurate claims made by CAM practitioners to be specific.
Mainly through the work of sceptics I would note.
Transparency about what though? You have made above nothing but vague, unsupported assertion without a scrap of evidence.
My understanding is that ASA has referred 10 cases to the OFT in the last 30 years. I doubt very much that any of these 10 are anything to do with homeopathy. Apart from thinking that the general public is stupid, the skeptics seem to have the astounding audacity to think that ASA are stupid as well! They don’t want their ethical discrepencies brought to the fore in a court of law. Real life people-real life! It’s a pointless expenditure of your time but then there’s nothing new there.
Thanks for these further points about the OFT.
Which could be taken as evidence that the ASA are in fact doing their job as a self regulator. This is what you fail to understand – the ASA is a buffer to allow resolution of things without the need for prosecution of advertisers making false claims – its in the interest of advertisers to fund and co-operate with the ASA. As I said above, be careful what you wish for, the alternative to self regulation might be less palatable for CAM practitioners.
The lack of prosecutions tells us nothing about the legitimacy of Homeopaths claims.
I make no assumptions about who is stupid or not, its about evidence and a level playing field.
Who the ASA? Which ethical discrepancies – their understandable decision to rejects shaky evidence?
So it pitching up here and making a series of slurs, assertions and accusations without evidence, but it hasn’t stopped you! 😉
As several of the comments above show, many people – it happens all the time among altmeds – are incapable of understanding the logic of basic argument. For instance, the assertion that nobody who doesn’t have a medical/scientific/ homeopathic background has the right to comment on Steve Scrutton or similar. Talk about not being able to hit a cow’s arse with a shovel. The point of course is the general one -i.e. whether a claim is backed up by evidence, whether evidence has been cherry- picked or just completely made up, whether downright lies are being told, etc.It isn’t the ASA’s job to have expertise in absolutely every area of human life or commerce or medicine or science. Same with judges.