In checking some legals regarding Mannion I came across this:
"Findings of fact made by a competent body are findings of fact made in proceedings before one of the following bodies or any of its committees—
(g) the General Osteopathic Council;
(h) the General Chiropractic Council;"
This is from: http://www.publications.parliament.u...079.37-43.html
which is the Safeguarding Vulnerable Groups Bill
Be interesting to see if Simon Singh wins his case whether any legal recognistion of Chiropractors such as this is removed!?
Why would a libel court case have any impact on a statutory body?Originally Posted by Dubious Dick
On the basis that if the case shows Chiropractors up to be less than entirely plausible then their credibility as a statutory body ought to be called into question.
I thought it interesting that Chiropractry has any statutory recognition at all. Does it deserve it?
All the legislation does is to make it illegal for anyone to practice as a chiropractor if they aren't registered with the GCC. The plausibility of chiropractic doesn't affect this.
Of course, if practitioners don't wish to be regulated, they can just call themselves osteomyologists instead.
But statutory regulation in the uk exists to protect patients. And those that choose to join the registers are agreeing to be bound by the codes and statutes of those organisations.
As I understand it, the general councils for chiropractic and osteopathy are set up by primary legislation through parliament and overseen by the CHRE and the privy council. That surely makes it very diffcult to get them closed down?
What would replace them? My guess (sorry, no evidence to present), is that all these bone crackers would go underground and become spinal therapists or bone setters http://unifiedbonesetter.com/ without any form of supervision or standards.
Point of information: The organisation suing Simon Singh is the BCA, which is a separate body from the statutory GCC. I understand there is a legal precedent whereby a statutory body can not sue over criticism of its competence, but the BCA, being a separate trade association, can at least claim to have a case that its credibility has been defamed.
Thanks Trinoc, that is why I asked the earlier question.... why would the outcome of the BCA v Singh have any impact on the totally separate statutory regulator?
So true. Indeed, John Jackson wrote an excellent piece on chiropractic, including the problems caused by chiropractors gaining statutory regulation:
http://www.skeptics.org.uk/article.php?dir=articles&article=chiropractic.php
In the UK, Chiropractors are regulated by the General Chiropractic Council (GCC). It is illegal to practise as a Chiropractor in the UK without being registered with the GCC. This form of regulation is important as it sets standards, has a complaints procedure and has regulatory powers which will hopefully repel the more unscrupulous types who are attracted by the moneymaking potential of alternative medicine.
The main drawback with this type of regulation is that it does not question the validity of that which it is designed to regulate. For example, a Chiropractor who manipulates a baby's spine, who routinely advises against immunisation, or who x-rays children in the search for a subluxation, is not breaking the basic tenets of Chiropractic, and will not be considered to have done wrong by the regulatory body.
Qualification and regulation is welcome and should offer some consumer protection; however, they do nothing to prove that Chiropractic is a useful treatment.
The following questions should be considered: How can you be qualified in something that can't be shown to work? How can truly effective regulation be achieved in a pseudoscience, by proponents of that pseudoscience?
Conclusion.
Chiropractic is a pseudoscientific approach to health care. The thinking behind it has no basis in fact, and even after more than a century, its core belief, the subluxation, cannot be shown to exist; even though it is a scientifically testable theory.
Some of the beliefs, such as the anti-vaccination stance, actually go against scientific evidence, medical opinion and government policy. Opposing germ theory exposes the 19th century thinking that Chiropractic is based upon.
Chiropractic is not one technique that can treat one class of illness or disease. It is promoted as a panacea and an all-encompassing preventative measure to be used from the moment we are born onwards.
A healing system that is based on a mystical life-force that gets blocked by imaginary subluxations, and that relies on anecdotal evidence; special pleading; the placebo effect; and subjective diagnoses is clearly an irrational concept: no matter how much credence is given to it with qualifications and self-regulation.
the actual techniques (interventions or scope of practice) are outside the remit of the GCC as stated in the Code of Conduct and Standard of Proficiency.
"The law does not define the scope of practice for any healthcare profession. Nor is it the purpose of the Standard of Proficiency to define the scope of chiropractic. The Standard of Proficiency sets out standards for the competent and safe practice of chiropractic." http://www.gcc-uk.org/files/link_file/COPSOP_8Dec05.pdf page 2
To include or exclude any form of treatment for specific groups of people or ailments would require a change in the legislation for all regulators.
Also, as I understand it, chiropractors should not be x raying people in search of a subluxation. Chiropractors and Osteopaths use static and motion palpation (or using the hand to feel the bones and joints) to discover places where the spine is out of line. Xrays are diagnostic tools to investigate the reasons for, and impact of, any serious pathology. For example, if orthopedic and neurological testing shows spinal stenosis (pinching of the spinal cord by slipped disc, tumour, bone fragments/ spurs, vertebrae that have travelled forward or backward (?would this be a subluxation, by any chance?), then an xray or other imaging would show the extent of the problem and enable any GP, chiropractor, surgeon, physiotherapist or osteopath to make an informed descision about treatment options for the patient. It also informs the prognosis or possible outcome of treatment or non treatment.
I am not sure that statutory regulation as currently operating in the UK would be at all affected by the outcome of the libel case (BCA v Singh). Are UK skeptics in a position to take up a campaign to change the legislation?
Last edited by dizzyblonde; 14th December 2008 at 09:58 AM. Reason: spelling
So do you think it is acceptable that the GCC requires that,
and that section A2.3 of its Standard of Proficiency requires that,“all chiropractors must ensure that all the information they provide, or authorise others to provide on their behalf is factual and verifiable, is not misleading or inaccurate in any way, does not abuse the trust of members of the public in any way, nor exploit their lack of experience or knowledge about either health or chiropractic matters”, and “does not put pressure on people to use chiropractic, for example by arousing ill-founded fear for their future health or suggesting that chiropractic can cure serious disease”.
See page 7 here…
http://www.gcc-uk.org/files/page_fil...OR_WEBSITE.pdf
…but then it appears to (intentionally?) confuse the public by failing to make clear on its website - and elsewhere - the essential differences between scientific manual therapy and chiropractic subluxation-based philosophy (woo)?“chiropractors’ provision of care must be evidence-based”...
http://www.gcc-uk.org/files/link_file/COPSOP_8Dec05.pdf
For example, here’s the GCC’s FAQs page:
http://www.gcc-uk.org/page.cfm?page_id=6
Since it makes no attempt to specify the common chiropractic techniques and practices which it does not consider legitimate, how would a chiropractic patient know what was “factual and verifiable”?
It’s an unresolved problem which was recently highlighted by Professor Edzard Ernst:
‘The ethics of chiropractic’
http://dcscience.net/nzmj-ernst-reply-050908.pdf
I do not judge the GCC or any other regulator for that matter. I asked a very specific question about the ability, resources and resolve of UK skeptics to pressurise the government into changing the law. Everyone who has answered is trying to mix all the strands up and provide a distraction from my question.
In simple terms: The GCC has no remit to include or exclude any form of intervention a chiropractor may choose to use. To include this would require a change in the law. Will UK skeptics take up the long term challenge of getting the law changed or just keep going round in circles saying 'ooooh its terrible wot those chiros get up to' .
Two years ago, I wrote at length to the (then) Health Minister, Caroline Flint, about the GCC's less-than-optimal effectiveness and asked what the government intended doing about tightening things up. What was the reply? An apparent abdication of responsibility through giving me the address details of the GCC to whom, she said, I should address my concerns!
UK-Skeptics doesn't have a team of people or the resources to do that.
.
Thank you both for direct and simple answers to my question.
My reading of the papers for all the health care regulators (yes I really did that) shows that the scope of practice is not regulated by any of them. Hence any doctor in private practice outside the NHS can use treatments that have not been approved by NICE . Dentists can give botox injections and GPs can use acupuncture. No one can tell them not to if they are outside the NHS.
and even inside the NHS, unproven drugs or interventions can be used if NICE agrees - eg thalidomide in myoloma even tho the cancerbackup admits that no-one knows how it works and can only hope for certain results from its use.
If skeptics think that health regulation should include limiting the scope of practice for chiropractors, then the same rule must apply across the board to all 7 statutory regulatory bodies.
Given that the UK skeptics do not have the resources to change the law for 7 statutory bodies, what action can be taken?
Last edited by dizzyblonde; 14th December 2008 at 12:06 PM.
I’m not sure what action can be taken to rectify things, but hopefully the BCA/Simon Singh case will ultimately see a much wider and more influential audience publicly questioning the way in which chiropractic is currently regulated, i.e. it will become apparent that most of the other statutory bodies have a good amount of evidence to back up the scope of practice of their registrants whereas the evidence for chiropractic remains exceedingly slim.
Here’s what David Colquhoun recently had to say on the subject:
It’s also worth bearing in mind that one of the General Chiropractic Council’s main duties is to set standards of chiropractic education. However, as the Quackometer recently pointed out, in executing that duty it appears to be faced with a major conflict of interest:“Both the New Zealand and the UK governments have got themselves into an impossible position by giving official recognition to chiropractic before the evidence was in.
Since the conventional manipulative treatments are cheaper, and may well be safer, and because they involve no quasi-religious ideas like ‘subluxation’ or ‘innate intelligence’, the only reasonable conclusion is that there is no need for chiropractic to exist at all. They do nothing they do that would not be done as well by medical practitioners and physiotherapists.
What will governments do about that, I wonder?”
http://dcscience.net/?p=253
And yet the Council for Regulatory Healthcare Excellence seems to think that the General Chiropractic Council’s doing rather well…“One of the recurrent criticisms of chiropractic is that it is founded in mystical ideas and has a very poor evidence base for the efficacy of any of its treatments…..[The philosophy of McTimoney] looks like pretty fundamental chiropractic with their mysterious and unproven 'subluxations' being the cause of illness - and not just bad backs, but the health of all 'cells and organs'. The college appears to adopt this worldview.
-snip-
….the General Chiropractic Council is responsible by law for recognising courses as meeting its standards so that graduates can call themselves chiropractors, don their white coat, put their brass plaque up, and title themselves 'Dr'. The GCC makes inspection visits to colleges and issues reports as you can view on their web site. This must surely create a conflict of interest. As there are only three colleges that provide chiropractic degrees, there would be severe repercussions for the profession as a whole if one of them was found to be offering substandard education. This potential conflict of interest is exacerbated by the fact that the principle of the McTimoney Chiropractic college in Abingdon, Christina Cunliffe, is also a council member of the GCC. The GCC does ask its council members to declare interests, but questions can surely be asked about how independent the GCC can be in assessing the quality and appropriateness of education provided by the colleges.”
http://www.quackometer.net/blog/2008/08/role-of-uk-universities-in-chiropractic.html
…but perhaps it forgot to ask the GCC for “factual and verifiable” evidence regarding the findings of the most recent survey on the scope of practice of UK chiropractors:The GCC has met all the Council for
Healthcare Regulatory Excellence’s
(CHRE’s) performance standards.
CHRE’s Performance Review Report
was published in August 2008 and it
identified the GCC as
● being particularly strong in its
communications with registrants and
the public
● demonstrating a deep commitment to
informing the public about chiropractic
and the regulatory role of the GCC
● being noteworthy with regard to its
Code of Conduct for Council members
and effective procedures for their
assessment and appraisal
See page 7 here:
http://www.gcc-uk.org/files/page_file/GCCNews25_100_WEB.pdf
[My bold]Overall, mechanical conditions of the musculoskeletal system were felt to be treated effectively by chiropractic intervention and there was 100% agreement that it was beneficial in treating mechanical dysfunctions of the spine. Non-musculoskeletal conditions in adults, including asthma (64%), gastro-intestinal complaints (61%) and pre-menstrual syndrome (PMS) (70%), were considered conditions that can benefit from chiropractic management. Opinions on the treatment of osteoporosis (43%), obesity (26%), hypertension (42%) and infertility (30%) were less conclusive. Childhood musculoskeletal and muscular conditions, infantile colic, otitis media and asthma were perceived to benefit from chiropractic intervention by more than 50% of the respondents.
-snip-
Traditional chiropractic beliefs (chiropractic philosophy) were deemed important by 76% of the respondents and 63% considered subluxation to be central to chiropractic intervention.
Aranka Pollentier and Jennifer M. Langworthy, The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic, Volume 10, Issue 3, September 2007, pp147-155.
http://www.cam-research-group.co.uk/POI/The%20scope%20of%20chiropractic%20practice%20a%20s urvey%20of%20chiropractors%20in%20the%20uk%20-%20Aranke%20Pollentier%20-%20Clinical%20Chiropractic%202007%2010%203%20pg%20 147-155.pdf
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