SIMON SINGH will announce his decision whether to appeal.

Speakers so far confirmed include:

the leading journalist NICK COHEN
bestselling author and comedian DAVE GORMAN

as well as Simon himself.

Meeting will be chaired by Prof CHRIS FRENCH, editor of The Skeptic.

...Rose Shapiro's book, Suckers— How alternative medicine makes fools of us all...

It's on my list of "books I should read".

The General Chiropractic Council objected to a leaflet that stated "''David Stevens'' CHIROKINETIC THERAPY ''Let Nature be your teacher''". The leaflet, which explained the theory and procedure of the therapy, listed on its back page serious diseases and conditions including "ANAPHYLAXIA", "ANOREXIA", "DEPRESSION", "FERTILITY", "M.E [sic]" and "PALPITATIONS". The complainants challenged whether the advertiser could prove the efficacy of chirokinetic therapy in treating the serious medical conditions listed in the leaflet.

One complainant challenged:
1. whether the ad feature made sufficiently clear it was advertising material;
2. whether Robert Delgados testimonial was genuine; and
3. the claim "There are many scientific studies that show that spinal adjustments can actually improve your immune system by up to 200%".
4. Two complainants challenged whether the use of "Dr" and the claim that an osteomyologist had equal amounts of training as a regular medical doctor were misleading.
5. The ASA challenged the efficacy of the treatment for the listed conditions.

1.The General Chiropractic Council (GCC) noted Dr Paul Marshall was no longer listed on the GCC's Register of Chiropractors and that he did not appear on the GMC's List of Registered Medical Practitioners. They objected that ad misleadingly implied that Dr Marshall was a registered medical practitioner or a medically qualified specialist such as a chiropractor.
The ASA challenged whether the ad:
2. implied that Dr Marshall could treat serious medical conditions such as migraine; and
3. encouraged treatment of serious or prolonged medical conditions without suitable medical qualifications.

1. The General Chiropractic Council (GCC) noted Christian Farthing was currently suspended from the GCC's Register of Chiropractors and that he did not appear on the GMC's List of Registered Medical Practitioners. They objected that ad (a) misleadingly implied that Christian Farthing was a registered medical practitioner or chiropractor.

2. The ASA challenged whether ad (a) implied that the ISC could treat serious medical conditions such as migraine.

3. A member of the public challenged whether ad (b) encouraged treatment of serious or prolonged medical conditions by unqualified practitioners.

4. The same member of the public objected that it was misleading for ad (b) to offer a "Spine & Health check" as he believed this was not carried out by medically qualified staff.

1. The General Chiropractic Council (GCC) and a member of the public objected that Peter Olsson was not entitled to describe himself as "doctor". The GCC said Peter Olsson had taken voluntary removal from their Register of Chiropractors and he did not appear on the GMC's List of Registered Medical Practitioners.

The same member of the public challenged whether:

2. the description "spinal specialist" misleadingly implied that the advertiser was a medically-qualified specialist;

3. the claim "I'm so impressed with the other miracles I see" gave a misleading impression of the efficacy of the treatments offered;

4. the claim "over 90% of patients who saw a spinal specialist were satisfied with their results" was misleading and could be substantiated;

5. the claim "published, peer-reviewed research indicates that the immune system may be enhanced by spinal adjustments" was misleading and could be substantiated.

6. The ASA challenged whether the ad implied that chiropractic treatment could treat serious or prolonged medical conditions such as migraines, whiplash and chronic pain.

The General Chiropractic Council challenged whether the claim "The Gonstead System of Chiropractic ... remains the leader in Chiropractic techniques due to the lengthy training a Gonstead Doctor receives" was misleading and could be substantiated.

1. The Carlton Clinic challenged whether the ad misleadingly implied that the practitioners listed held general medical qualifications.

2. The ASA challenged whether the ad offered treatment for serious medical conditions without the supervision of a doctor or suitably qualified health professional, and

3. whether the treatment was proven to be effective for the serious medical conditions listed, as implied by the ad.

1. Both complainants thought the ad misleadingly implied that "Dr. Michael" held general medical qualifications.

2. One of the complainants challenged the efficacy of the treatment for the listed ailments, particularly migraine and whiplash, which were serious medical conditions.

3. The ASA challenged whether the ad was irresponsible, because it encouraged treatment of serious medical conditions without the supervision of a doctor or suitably qualified health professional, and discouraged the use of conventional medicine and medical supervision for such conditions.

4. The ASA challenged whether the claim "Dr. Michael Mathews, MAO ... is a registered Osteomylogist [sic]" misleadingly suggested Michael Mathews was registered with a medical or statutory body.

The Carlton Clinic challenged whether the claim "doctors of chiropractic" misleadingly implied that the practitioners held general medical qualifications.

A reader believed the ad was misleading because:

1. it claimed that strengthening your spine and nervous system would improve the immune system and the body's ability to fight disease and

2. it claimed that disease originated in the body and outside influences, such as germs, were not significant.

The ASA challenged:

3. whether the ad discouraged people from seeking essential treatment for illnesses from a suitably qualified medical professional.

If your doctor has taught you that germs can be caught, your doctor should be the sickest person in the world. The question is, can germs be spread? ... If the germ theory of disease was correct, there would be no one living today to talk about it! Although germs are certainly a factor involved in the diseases of man, the germ alone is not the cause of disease...

A chartered physiotherapist challenged whether:

1. the claim "Chiropractic is quite simply the best way to treat most spinal problems causing neck and back pain" could be substantiated;

2. the claim "Only a Doctor of Chiropractic is trained and qualified to give an adjustment" could be substantiated; and

3. the references to "Doctors" and "Dr" implied that the chiropractors were medically qualified.

The ASA challenged whether:

4. the testimonials misleadingly implied chiropractic had been proven to be effective for treating whiplash and chronic pain.

We noted CAP Code clause 14.3 stated that testimonials alone did not constitute substantiation and the opinions in them must be supported, where necessary, with independent evidence of their accuracy. We did not consider that the evidence sent by WFCC, which consisted of a page from a claims solicitors website and a reference to an article in an orthopaedic medicine journal, were sufficiently robust to substantiate the claims made in the testimonials that chiropractic had been proven to be effective for treating whiplash and chronic pain. Because we had not seen evidence to support the claims made in the testimonials, we concluded that the testimonials gave a misleading impression of the likely efficacy of chiropractic treatment for those conditions and could discourage people from seeking advice from a general medical practitioner.

Monitoring staff challenged whether:

1. the ad gave the impression of professional medical advice;

2. the ad made medical and therapeutic claims for treatments and referred to specific ailments.

3. Monitoring staff challenged the acceptability of broadcasting the ad after two previous upheld adjudications against another homeopathic practice advertised on Channel S Television Group channels.

Hi

One of my local chiropractors is referred to as 'Dr Connell Dorrian MSc D.C.' on his website. His GCC registration number is 01359.

I believe there are rules about how a chiropractor uses the title 'Dr' and I wondered if you could tell me the details of this and whether Connell Dorrian is within those rules?

Thanks.

Dear Sir

Thank you for your enquiry. The relevant part of the Code of Practice for chiropractors states that

“Chiropractors must not use any title or qualification in such a way that the public may be misled as to its mean or significance. In particular, chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear they are registered chiropractors and not registered medical practitioners.”

Do please let me know if from your perspective the information provided on Connell Dorrian’s website is sufficiently clear. If not, I will draw to his attention any issues that you are able to identify, with a view to remedying any problem.

Yours sincerely

Margaret Coats

Chief Executive & Registrar

Chiropractic is not readily available on the National Health Service in the United Kingdom

although some chiropractors do have contracts with PCT’s (Primary Care Trusts) which administer the funding of healthcare provision in a designated community.

In July 2006 the Department of Health published “The Musculo-Skeletal Services Framework : A Joint Responsibility : Doing It Differently”.

The UK is becoming more litigious...

Currently there are concerns about the cost of defending our members who have complaints made against them to the General Chiropractic Council and the consequent impact this has on the claims history of the BCA’s block insurance policy.

A recent review of statutory regulation by the Government has resulted in recommendations that all of the nine medically based statutory regulators should work towards standardisation in the management of their disciplinary processes. The BCA has been instrumental in putting forward a number of proposals to the GCC for change and it would appear that there is to be some movement in the way in which certain complaints against chiropractors are handled whereby the complaint would be considered by the Professional Conduct Committee without the need for a hearing. These discussions are at a very early stage and the BCA has taken action to ensure that its members have a professional indemnity insurance policy which is fit for purpose and which provides cover for £5m, £2m above the limit that is required by the GCC.

The majority of private medical insurance companies provide cover for chiropractic fees, if referred by an NHS Consultant. An increasing number accept GP referrals and a few companies permit open access by their clients up to agreed limits.

Where appropriate, chiropractors are able to refer a patient for blood testing and other laboratory based tests to the patient’s local hospital.

Currently there are about 180 x-ray installations operated by BCA members across the UK.

...a number of chiropractors now will refer patients to their local hospital or discreet imaging centres...

The films or scans are however normally read by a consultant radiologist practicing within the District General Hospital.

CHIROPRACTORS IN THE ASSOCIATION/COUNTRY WHO WORK IN HOSPITALS PART OR FULL TIME OR IN GOVERNMENTAL OFFICES
This question is very difficult to address, as there is no hard data across the profession which records those individuals who work in a hospital setting.

In 2005 the BCA, distributed a questionnaire to its practicing members and one of the questions which was asked of those members was whether or not the respondents wished to work within the National Health Service either in a hospital setting or primary care facility. 41% of the BCA’s members responded and of those who did respond 40% said they would wish to work within the National Health Service framework, 22% sought further information and 37% said they did not wish to.

EDUCATION
The GCC has responsibility for accrediting educational institutions in the UK. The Anglo European College of Chiropractic (AECC) currently runs a five year full time course leading to an MChiro in Chiropractic. The Welsh Institute of Chiropractic at the University of Glamorgan, offers a four year full time course leading to a BSc Hons in Chiropractic. Both of these institutions have full GCC and ECCE accreditation. The University of Surrey formerly offered a two-year post-graduate MSc course in chiropractic but the course had limited GCC accreditation and has now graduated its last students. The McTimoney College of Chiropractic in Abingdon has in place a BSc Hons five year course. As of June 2006, the General Chiropractic Council sought the approval of the Privy Council for recognition in respect of awards achieved during the period 1st December 2006 – 31st March 2009 by students currently in Years 3, 4 and 5 of the programme. As at September 2006, the GCC also sought the approval of the Privy Council for recognition of awards achieved by students currently in years 1 and 2 of the programme – this will be during the period 1st December 2009 – 31st March 2011. The General Chiropractic Council requires its education providers to provide an annual report to its Education Committee so that the GCC may be sure that the programme continues to meet their criteria and any conditions of recognition. If problems arise that cannot be rectified, then subject to the approval of the Privy Council, the GCC can remove recognition. The full recognition process is repeated every five years.

At the end of the cycle, which occurs on 31st August each year, the chiropractor is required to sign a self-certification declaration that they have completed the learning cycle and evidence may be sought by the GCC to support this.

The General Chiropractic Council, in common with the other medical statutory regulators in the UK is considering the requirement for re-validation which the Government is making a mandatory requirement for healthcare professionals in the UK within the next five years.

RESEARCH
In 2006, the BCA has set up a research budget of £50,000, under the chairmanship of Dr Neil Osborne. Thus far, two grants have been made for the fund and the funding will continue in 2008.

Professor Jenni Bolton and Dr Haymo Thiel also have the results of their study “Safety of Chiropractic Manipulation of the Cervical Spine – Prospective National Survey”, published in the October 2007 edition of Spine.

There were no reports of serious adverse events (defined as “referred to hospital A&E and/or severe onset/worsening of symptoms immediately after treatment and/or resulted in persistent of significant disability/incapacity”.

This is the largest study of its kind undertaken in the world and it is hoped that these results will provide the chiropractic profession with a more robust defence to its detractors. At the time of writing this report, discussions are underway on how to optimise the publicity with the results of this study in the UK.

On the 1st July 2007, the Journal of the Royal Society of Medicine published a research paper from Edzard Ernst, entitled “Adverse Effects of Spinal Manipulation : A Systematic Review”.

Fortunately this study did not receive very much media publicity and the results outlined by Ernst are at odds with the study undertaken by Dr Thiel and Professor Bolton. Robust responses were sent to the Journal of the Royal Society of Medicine by the BCA President and Dr Thiel and Professor Bolton and these are to be published in the October 2007 edition. It is also hoped that this correspondence will provide an opportunity for further engagement with the Royal Society of Medicine and its publications on this important issue.

Ongoing research into the chiropractic profession is vital as one of the key requirements to assist decision making within the National Health Service is the presence of evidence based research and cost effectiveness.

VAT is not chargeable by registered healthcare professionals.

GENERAL RULES
Principles
2.2 All marketing communications should be prepared with a sense of responsibility to consumers and to society.

Substantiation
3.1 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove all claims, whether direct or implied, that are capable of objective substantiation. Relevant evidence should be sent without delay if requested by the ASA or CAP. The adequacy of evidence will be judged on whether it supports both the detailed claims and the overall impression created by the marketing communication. The full name and geographical business address of marketers should be provided without delay if requested by the ASA or CAP.

3.2 If there is a significant division of informed opinion about any claims made in a marketing communication they should not be portrayed as generally agreed.

3.3 Claims for the content of non-fiction books, tapes, videos and the like that have not been independently substantiated should not exaggerate the value, accuracy, scientific validity or practical usefulness of the product.

3.4 Obvious untruths or exaggerations that are unlikely to mislead and incidental minor errors and unorthodox spellings are all allowed provided they do not affect the accuracy

Matters of opinion
8.1 Marketers may give a view about any matter, including the qualities or desirability of their products, provided it is clear that they are expressing their own opinion rather than stating a fact. Assertions that go beyond subjective opinions are subject to 3.1 above (also see 12.1 below).

Safety
10.1 Marketing communications should not condone or encourage unsafe practices. Particular care should be taken with marketing communications addressed to or depicting children (see section 47).

Testimonials and endorsements
14.3 Testimonials alone do not constitute substantiation and the opinions expressed in them must be supported, where necessary, with independent evidence of their accuracy. Any claims based on a testimonial must conform with the Code.

HEALTH & BEAUTY PRODUCTS AND THERAPIES
General
50.1 Medical and scientific claims made about beauty and health-related products should be backed by evidence, where appropriate consisting of trials conducted on people. Where relevant, the rules will also relate to claims for products for animals. Substantiation will be assessed by the ASA on the basis of the available scientific knowledge.

50.3 Marketers should not discourage essential treatment. They should not offer specific advice on, diagnosis of or treatment for serious or prolonged conditions unless it is conducted under the supervision of a doctor or other suitably qualified health professional (eg one subject to regulation by a statutory or recognised medical or health professional body). Accurate and responsible general information about such conditions may, however, be offered.

Substantiation will be assessed by the ASA on the basis of the available scientific knowledge.

The latest Jack of Kent's blog post...the one in which yours truly gets a mention!

As the truly excellent Alan Henness ("Zeno") of ThinkHumanism pointed out to me,