MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The General Chiropractic Council (GCC) is the statutory body regulating all chiropractors in the UK. Their foremost aim, they claim, is to ensure the safety of patients undergoing chiropractic treatment. They also allege to be independent and say they want to protect the health and safety of the public by ensuring high standards of practice in the chiropractic profession.

That sounds good and (almost) convincing.

But is the GCC truly fit for purpose?

In a previous post, I found good reason to doubt it.

In a recent article, the GCC claimed that they started thinking about a new five-year strategy and began to shape four key strategic aims. So, let’s have a look. Here is the crucial passage:

 

A clear strategy is vital but, of course, implementation and getting things changed are where the real work lie. With that in mind, we have a specific business plan for 2019 – the first year of the new strategic plan. You can read it here. This means you’ll see some really important changes and benefits including:

  • Promote standards: review and improvements to CPD processes, supporting emerging new degree providers, a campaign to promote the public choosing a registered chiropractor
  • Develop the profession: supporting and enabling work with the professional bodies
  • Investigate and act: a full review of, and changes to, our Fitness to Practice processes to enable a more ‘right touch’ approach within our current legal framework, sharing more learning from the complaints we receive
  • Deliver value: a focus on communication and engagement, further work on our culture, a new website, an upgraded registration database for an improved user experience.

The changes being introduced, backed by the GCC’s Council, will have a positive effect. I know Nick, the new Chief Executive and Registrar and the staff team will make this a success. You as chiropractors also have an important role to play – keep engaging with us and take your own action to develop the profession, share your ideas and views as we transform the organisation, and work with us to ensure we maintain public confidence in the profession of chiropractic.

END OF QUOTE

Am I the only one who finds this more than a little naïve and unprofessional? More importantly, this statement hints at a strategy mainly aimed at promoting chiropractors regardless of whether they are doing more good than harm. This, it seems, is not in line with the GCC’s stated aims.

  • How can they already claim that the changes being introduced will have a positive effect?
  • Where in this strategy is the GCC’s alleged foremost aim, the protection of the public?
  • Where is any attempt to get chiropractic in line with the principles of EBM?
  • Where is an appeal to chiropractors to adopt the standards of medical ethics?
  • Where is an independent and continuous assessment of the effectiveness of chiropractic?
  • Where is a critical evaluation of its safety?
  • Where is an attempt to protect the public from the plethora of bogus claims made by UK chiropractors?

I feel that, given the recent history of UK chiropractic, these (and many other) points should be essential elements in any long-term strategy. I also feel that this new and potentially far-reaching statement provides little hope that the GCC is on the way towards getting fit for purpose.

11 Responses to A 5-year strategy for UK chiropractors: not fit for purpose

  • The GCC probably copied their statement from the GOC webpage or vice versa…
    https://www.osteopathy.org.uk/home/

    “… to promote patient safety by setting, maintaining and developing standards of osteopathic practice and conduct. …”
    (from GOC)

    next to visceral manipulation and craniosacral iatromechanic vitalism the Commonwealth osteopathic manipulators are using the same repertoire of HVLA manipulations of the spinal areas …

    so your comment fits for GCC and GOC as well. So please don’t forget to mention them.

  • This reminds me very strongly of the announcements of the German Central Association of Homeopathic Physicians, whose main task, according to its own statement, is to guarantee “patient safety”. Above all by awarding her “additional designation Homeopathy for physicians”.

    I have not yet received an answer to the question as to why they – consequently – do not speak out clearly against homeopathy for self-medication and OTC sales (four fifths of German homeopathic sales).

  • Professor Ernst wrote: “Where is any attempt to get chiropractic in line with the principles of EBM?”

    As long as the scope of practice of a [UK] chiropractor “is not defined either by law or in Standard of Proficiency”
    https://www.gcc-uk.org/UserFiles/Docs/Degree%20Recognition%20Criteria.pdf (p.5), I doubt we’ll ever see any standardisation of practice, or at least see chiropractic defined unambiguously.

    Meanwhile, the General Chiropractic Council (GCC) seems content to NOT be protecting patients from the financial and physical harms of quackery such as craniosacral therapy and applied kinesiology, which it claims falls within its ‘definition of evidence-based care’. See https://jdc325.files.wordpress.com/2009/06/gcc-ak.pdf

    Further, one of the GCC’s expert witnesses recently brushed off my complaint about a raw milk related article in the national press (a chiropractor was the main point of reference) with “it’s consistent with a body of reasonable chiropractic opinion”. See https://edzardernst.com/2017/10/chiropractic-is-safe-oh-really/#comment-104210

    In addition to that, this dubious dossier
    http://cdn2.perfectpatients.com/static/uploads/3/2011/11/VSC_Position_Statment_AUKC.pdf
    apparently caused the GCC to amend its statement on the Vertebral Subluxation Complex to make it more friendly towards subluxationist UK chiropractors. See:
    https://skepticbarista.wordpress.com/2010/10/17/subluxations-still-no-evidence/
    Also see here: https://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1827-alliance-of-uk-chiropractors-october-2010-newsletter.html

    I note, also, that the GCC say that they are supporting emerging new degree providers. See p. 35 (5) here:
    https://www.gcc-uk.org/UserFiles/Docs/Council%20Meetings/2017/December%202017%20papers.pdf

    Indeed, recently the GCC announced that it was “continuing to support the emerging programmes in Scotland”:
    https://www.gcc-uk.org/UserFiles/Docs/Council%20Meetings/2018/Dec%202018%20open%20papers.pdf
    p14 (6)
    and that “Discussions and meetings have continued regarding the proposed new programme in Scotland. It is understood that discussions are ongoing regarding a suitable University to validate this course.” (pp.158 -9)

    What is appalling is that the forthcoming Scotland College of Chiropractic (due to open in 2020) has declared itself to be vitalistic/subluxationist. See http://scotlandcollegechiro.co.uk/eblasts/ Background here: https://www.zenosblog.com/2016/02/the-scotland-college-of-chiropractic-out-of-kilter-with-science/

    In view of the above, I think it’s high time that we had a chiropractor regulatory body that is impartial and scientifically literate.

    • @Blue

      “I think it’s high time that we had a chiropractor regulatory body that is impartial and scientifically literate.” Agreed in principle, but isn’t it a fact that most regulatory bodies comprise practitioners marking their own homework? Doctors (GMC, BMA), lawyers (Law Society, Bar Council), house agents (Association of Residential Letting Agents) and very many more professional organizations work in this way. Even astrologers have The Astrological Association — admittedly not a regulatory body, and clearly not in any way scientifically literate, but an organization that is inevitably partly aimed at inspiring public confidence in the authenticity and competence of its members.

      I guess the theory is that regulatory bodies should involve, mainly or exclusively, experts in their profession. If you formulate laws stipulating a proportion of executive committees should be lay members, you risk getting only supporters standing. And, anyway, government and MPs would regard becoming involved in this kind of regulation as an unwanted incursion on their time with zero electoral advantages.

      • @ Frank

        So what do you propose could make a difference? If the GCC did get chiropractic in line with the principles of EBM, saw chiropractors adopting the standards of medical ethics, implemented an independent and continuous assessment of the effectiveness of chiropractic, critically evaluated its safety, and truly protected the public from the plethora of bogus claims made by UK chiropractors, it would likely destroy the profession and itself (and probably knows that). So where do we go from here?

        • Sadly, Blue, I fear the future is going to be no different from the present. Concerned individuals like you bothering to complain to the Advertising Standards Authority on the more egregious claims, individuals like yourself and Prof Ernst running blogs as you do, organizations such as Healthwatch bringing together concerned individuals to make concerted approaches to appropriate official medical bodies.

          You can no more stamp out SCAM than you can stamp out religions and the rest of the panoply of faith-based, personal experience-fed weird beliefs that humans come up with in the depths of their irrationality.

          Julian Money-Kyrle recently said in a comment on this blog: “I’m getting rather fed up with commentating on this thread – it is like playing Whack-a-Mole.” That’s very similar to Randi’s ‘unsinkable rubber ducks’ characterization of believers in preposterous things.

          • sure!
            but without doing our best to counter-balance, there would be more and more harm would be done.
            we do not aim at eradication, we aim at minimisation.

        • BW…”it would likely destroy the profession and itself (and probably knows that).”

          It would certainly change the profession…what some of us are working towards.

  • Frank Odds wrote: “You can no more stamp out SCAM than you can stamp out religions and the rest of the panoply of faith-based, personal experience-fed weird beliefs that humans come up with in the depths of their irrationality.”

    @ Frank

    I’m a bit more optimistic than you given that, in the U.S., osteopaths (D.O.s) evolved into fully licensed medical doctors, and that here in the UK we are seeing homeopathy on the decline (especially on the NHS). Also, in the UK, 41.5% of the population now have no religion.

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