MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Yesterday, BBC NEWS published the following interesting text about a BBC4 broadcast entitled ‘THE ROYAL ACTIVIST’ aired on the same day:

Prince Charles has been a well-known supporter of complementary medicine. According to a… former Labour cabinet minister, Peter Hain, it was a topic they shared an interest in.

“He had been constantly frustrated at his inability to persuade any health ministers anywhere that that was a good idea, and so he, as he once described it to me, found me unique from this point of view, in being somebody that actually agreed with him on this, and might want to deliver it.”
Mr Hain added: “When I was Secretary of State for Northern Ireland in 2005-7, he was delighted when I told him that since I was running the place I could more or less do what I wanted to do.***
“I was able to introduce a trial for complementary medicine on the NHS, and it had spectacularly good results, that people’s well-being and health was vastly improved.

“And when he learnt about this he was really enthusiastic and tried to persuade the Welsh government to do the same thing and the government in Whitehall to do the same thing for England, but not successfully,” added Mr Hain.

*** obviously there is no homeopathic remedy for megalomania (but that’s a different story)

Oh really?

A TRIAL?

SPECTACULARLY GOOD RESULTS?

NO KIDDING?

Let’s have a look at the ‘trial’ and its results. An easily accessible report provides the following details about it:

From February 2007 to February 2008, Get Well UK ran the UK’s first government-backed complementary therapy pilot. Sixteen practitioners provided treatments including acupuncture, osteopathy and aromatherapy, to more than 700 patients at two GP practices in Belfast and Derry.   

The BBC made an hour long documentary following our trials and tribulations, which was broadcast on BBC1 NI on 5 May 2008.

Following the successful completion of the pilot, the results were analysed by Social and Market Research and recommendations were made to the Health Minister

Aims and Objectives 

The aim of the project was to pilot services integrating complementary medicine into existing primary care services in Northern Ireland. Get Well UK provided this pilot project for the Department for Health, Social Services and Public Safety (DHSSPS) during 2007.

The objectives were:

  • To measure the health outcomes of the service and monitor health improvements.
  • To redress inequalities in access to complementary medicine by providing therapies through the NHS, allowing access regardless of income.
  • To contribute to best practise in the field of delivering complementary therapies through primary care.
  • To provide work for suitably skilled and qualified practitioners.
  • To increase patient satisfaction with quick access to expert care.
  • To help patients learn skills to improve and retain their health.
  • To free up GP time to work with other patients.
  • To deliver the programme for 700 patients.

Results 

The results of the pilot were analysed by Social and Market Research, who produced this report.

The findings can be summarised as follows: 

Following the pilot, 80% of patients reported an improvement in their symptoms, 64% took less time off work and 55% reduced their use of painkillers.

In the pilot, 713 patients with a range of ages and demographic backgrounds and either physical or mental health conditions were referred to various complementary and alternative medicine (CAM) therapies via nine GP practices in Belfast and Londonderry. Patients assessed their own health and wellbeing pre and post therapy and GPs and CAM practitioners also rated patients’ responses to treatment and the overall effectiveness of the scheme.

Health improvement
• 81% of patients reported an improvement in their physical health
• 79% reported an improvement in their mental health
• 84% of patients linked an improvement in their health and wellbeing directly to their CAM treatment
• In 65% of patient cases, GPs documented a health improvement, correlating closely to patient-reported improvements
• 94% of patients said they would recommend CAM to another patient with their condition
• 87% of patient indicated a desire to continue with their CAM treatment

Painkillers and medication
• Half of GPs reported prescribing less medication and all reported that patients had indicated to them that they needed less
• 62% of patients reported suffering from less pain
• 55% reported using less painkillers following treatment
• Patients using medication reduced from 75% before treatment to 61% after treatment
• 44% of those taking medication before treatment had reduced their use afterwards

Health service and social benefits
• 24% of patients who used health services prior to treatment (i.e. primary and secondary care, accident and emergency) reported using the services less after treatment
• 65% of GPs reported seeing the patient less following the CAM referral
• Half of GPs said the scheme had reduced their workload and 17% reported a financial saving for their practice
• Half of GPs said their patients were using secondary care services less.

Impressed? Well, in case you are, please consider this:

  • there was no control group
  • therefore it is not possible to attribute any of the outcomes to the alternative therapies offered
  • they could have been due to placebo-effects
  • or to the natural history of the disease
  • or to regression towards the mean
  • or to social desirability
  • or to many other factors which are unrelated to the alternative treatments provided
  • most outcome measures were not objectively verified
  • the patients were self-selected
  • they would all have had conventional treatments in parallel
  • this ‘trial’ was of such poor quality that its findings were never published in a peer-reviewed journal
  • this was not a ‘trial’ but a ‘pilot study’
  • pilot studies are not normally for measuring outcomes but for testing the feasibility of a proper trial
  • the research expertise of the investigators was close to zero
  • the scientific community merely had pitiful smiles for this ‘trial’ when it was published
  • neither Northern Ireland nor any other region implemented the programme despite its “spectacularly good results”.

So, is the whole ‘trial’ story an utterly irrelevant old hat?

Certainly not! Its true significance does not lie in the fact that a few amateurs are trying to push bogus treatments into the NHS via the flimsiest pseudo-research of the century. The true significance, I think, is that it shows how Prince Charles, once again, oversteps the boundaries of his constitutional role.

16 Responses to How Prince Charles disrespects his constitutional role

  • With regard to the Northern Ireland project run by Get Well UK, it’s worth remembering that the founder of Get Well UK, Boo Armstrong – who was briefly CEO of the Prince of Wales’s Foundation for Integrated Health before it closed due to money laundering activities – died from breast cancer at the age of 37 in 2012. In the terminal stages of her illness, she admitted that she had become ‘more open’ to the options on offer from conventional medicine.

  • It’s truly hard to know how to start commenting where Prince Charles is concerned. You have posted previously about his baseless opinions and relentless advocacy of CAM. Charles’s noble accident of birth makes him feel entitled to behave as someone more important than the rest of the population. Sadly, it has never occurred to him that that feeling needs to be supported by something better than ignorance. He’s classical Dunning and Kruger material, but his position unreasonably commands undue respect.

    One can only hope that, should our king-in-waiting be unfortunate enough to suffer a real illness, he will be man enough to insist only on his preferred non-medical treatments.

  • I too heard this programme and was left screaming with fury at the uncritical manner in which this – and other issues – were treated. Far from being a critique of HRH and his misguided attitudes to serious issues, it turned out to be another programme produced in the BBC’s usual unscientific manner. In other words, for each slight criticism, however well justified, there was a load of ill informed junk from people who agree with him. They call this balance. I call it stupid.

    I applaud HRH’s interest in public matters, and do not mind him offering his views publicly, but am appalled that he should think it acceptable to manipulate behind the scenes, as it was admitted that he has been doing. I think my health is important and object to someone like him being able to secertly influence the sort of treatments I might be given.

  • EE, is it true that Prince Charles had something to do with you losing your early retirement from Exeter? Could this be colouring your perspective?

  • “EE, is it true that Prince Charles had something to do with you losing your early retirement from Exeter? Could this be colouring your perspective?”

    OK, Mojo. Don’t get your knickers in a knot. It is a legitimate question. I am sure this has occurred to others as well.

    But as I was reading EE’s list of why he doesn’t like the trial (and by extension, Bonny Prince Charles, son of his sovereign ruler), these jumped out at me:

    “there was no control group
    therefore it is not possible to attribute any of the outcomes to the alternative therapies offered
    they could have been due to placebo-effects
    or to the natural history of the disease”

    I realized that this could apply to many of the so-called “proven” “scientific” allopathic remedies. For example, each winter, there is always a huge drumbeat for every man, woman and child to get a flu shot. Hundreds of millions sold. OK, then, the question is: has there ever been a control group? You know, where you take, say, 100 people, split them into two groups, vaccinate one group, then expose both to the flu and scientifically measure who gets more flu. I don’t think so. Has this ever been done with any vaccine? I don’t think so. Of course it would be unethical. But going by EE’s reasoning, if there has never been a control group, then “therefore it is not possible to attribute any of the outcomes to the alternative (vaccines) therapies offered.” How do we know that the vaccine works?

    To put it another way, if EE gets a flu shot and I don’t, and neither one of us gets the flu, then how would EE know that the flu vaccine prevented him from getting the flu? How would anyone know? It is impossible to prove that something didn’t happen.

    Seems to be to be a bogus therapy, this flu vaccine. If anyone here on this “blog” gets a yearly flu shot, I would love to hear your reasoning as to why you obediently roll up your sleeve. If anyone can enlighten me as to how it can be known that a flu vaccine, or any other vaccine can work when there has never been a control group to prove it works, I would be happy to entertain such an explanation and listen politely, something no one here seems capable of doing.

    OK, I have my raincoat on and I am ready for the barrage of hate-mail since I had the audacity to utter the sacred “V” word.

  • EE wrote:
    “SP: fine! we have all long understood that you have no clue about science and scientific methods – you don’t need to rub it in!”

    OK, then. Enlighten me. Do you get a flu shot? Likely yes. Then what you are saying is that, according to your rules, there is no proof that the flu shot works and it is a big waste of time and just a big money-maker for the doctors who give it and the pharma companies? So why do you get a flu shot?

    How about anything in psychiatry?

    • there are about 10 000 publications on this in pubmed. here is the conclusion of just one of them [http://www.ncbi.nlm.nih.gov/pubmed/21840359]:
      The inactivated influenza vaccine has been proven effective in preventing laboratory-confirmed influenza among healthy adults (16-65 years) and children (≥6 years) (GRADE A evidence). However, there is strikingly limited good-quality evidence (all GRADE B, C or not existing) of the effectiveness of influenza vaccination on complications such as pneumonia, hospitalisation and influenza-specific and overall mortality. Inconsistent results are found in studies among children younger than 6 years, individuals with COPD, institutionalised elderly (65 years or older), elderly with co-morbidities and healthcare workers in elderly homes, which can only be explained by bias of unknown origin. The vaccination of pregnant women might be beneficial for their newborns, and vaccination of children might be protective in non-recipients of the vaccine of all ages living in the same community (one RCT, Grade B evidence).
      PS
      I always suspected you were an anti-vaxer as well
      PPS
      not that it is any of your business but I never had a flue jab – not because I mistrust the evidence but because I never came round to it.

    • Or take a look at the many meta-analyses of these trials. The most recent I found in a 5-minute search was Demicheli et al. Vaccines to prevent influenza in healthy adults. Cochrane Database Syst Rev. 2014;3:CD001269. (Just google that last part to get the abstract).

      The 69 trials that have been done — in exactly the same way you claim (in your second post) they haven’t been — have involved more than 70,000 people. The results show that the flu vaccines have a mild but statistically unequivocal protective effect. You have to vaccinate 40 healthy adults to prevent 1 case of (laboratory confirmed) influenza. You’re welcome to argue that’s too small an effect to justify the annual push for vaccination, but remember these trials covered people of all ages. In the elderly the effects of ‘flu are far more profound than in the young. I don’t have the time to read all this work. I’m happy to accept the strongly expressed views of government organizations all over the world that people over 65 benefit from annual prophylactic ‘flu vaccination. If you seriously believe that “big pharma” can influence so many governments to spend money on pointless vaccination at a time of economic depression, you need to spend a bit of time in reflective contemplation.

      And, yes, if you want to claim that the language of published science is not always perfect, the abstract of this article does make the fascinating claim that “The target populations were healthy adults, including pregnant women and newborns.” Are neonates the new adults?!

  • Thought you might like to add this article to the Windsor file: more bumbling, ignorant interference in the professions – and in the lives of professionals, too, it seems:

    http://www.theguardian.com/artanddesign/2014/dec/27/prince-charles-10-principles-architecture-10-better-ones

Leave a Reply

Your email address will not be published. Required fields are marked *

Please answer the following: *

Gravityscan Badge

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted.


Click here for a comprehensive list of recent comments.

Categories