Challenging misleading healthcare claims


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Red Tape Challenge Survey deadline extended

herbalpillsWe've had a great response to our Red Tape Challenge Survey on the regulation of homeopathic and traditional herbal products, despite the initial technical hitch!

Thanks to all our supporters who have completed the survey and given us their views — they will help us formulate our response to the Government's Red Tape Challenge.

Although the deadline for the Government's Challenge ends on 12 April, there is still time for more of our supporters to complete our survey so we're keeping the survey open until midnight on Tuesday 10 April.

Unfortunately, these consultations are frequently a bit of a numbers game, with weight given to quantity rather than quality when decisions should clearly be made on the strength of the evidence and argument, so if you are one of our supporters, make sure your voice is heard by completing our survey now.

Individual responses

But we also need as many supporters as possible to submit their individual views. We know you are all capable of it, so why not take some time out this holiday weekend and tell the Government what you think of the regulation of homeopathic and traditional herbal products?

You can do this by responding on the web pages for homeopathic products or traditional herbal products, perhaps challenging some of the views expressed there.

Alternatively, you can submit your response directly to the Red Tape Challenge.

Thanks again for all your support.

Our Red Tape Challenge Survey has now closed.

Thanks to all our supporters who contributed.

Red Tape Challenge


We need your help!

We are canvassing the views of our supporters so we can respond to the Government's Red Tape Challenge — they are looking at a lot of regulations, but the current focus is on medicines' legislation. The public are being asked:

…which regulations are working and which are not; what should be scrapped, what should be saved and what should be simplified.

We're particularly interested in the regulations surrounding homeopathic and herbal products.

For homeopathy, the regulation by the medicines' regulator the MHRA confers a degree of legitimacy onto products that have no robust evidence of efficacy. So, do you, our supporters, think the current regulation is a good idea? Are the labelling requirements misleading? Could these regulations be simplified or scrapped altogether?

Herbal products are different because they do contain potentially pharmacologically active ingredients. A case can be made for good regulation of them so that at least some measure of protection is afforded to the public. But since no evidence of efficacy is required for MHRA registration of traditional herbal products, does this regulation mislead more than it protects? If they are pharmacologically active, should they be regulated in the same stringent ways that pharmaceutical products are regulated? Or does the two-tier system provide acceptable protection to the public? Is the regulation onerous or is it essential protection to the public?

More information about each of these is given in our short survey.

Because responses to the Government's Red Tape Challenge have to be in by Thursday 12 April, we need our supporters to take our survey by Thursday 5 April — please take a few minutes now to complete it to give us time to analyse the results and finalise our submission.

We also urge you to submit your own response, sending it directly to the Red Tape Challenge — it's important to ensure your views are heard and taken into account by the Government.

If you are one of our supporters, please complete our Red Tape Challenge Survey.

Our Red Tape Challenge Survey has now closed.

Thanks to all our supporters who contributed.

Campaign News: January 2012

Misleading reflexology claims still not removed

Happy New Year!

We begin with an update of the Tamsin Marshall reflexology website we reported on in a previous newsletter.

This was one of the three websites for our master complaint on reflexology to the ASA. Although the website changed before the ASA's adjudication was published — removing a reference to cancer — many of the misleading claims we complained about remained (see right).

We are pleased to see that this list of misleading claims has finally been removed.


However, it's disappointing to see many of these claims are still there (cached) in a slightly different form:

Do you suffer from insomnia or fatigue? Are you prone to recurrent infections, mild or chronic illnesses? Are you trying for a baby, or currently pregnant? Are you suffering from hormonal imbalances or thyroid problems? If so, Reflexology may be just what you and your body needs.

If you would like to discuss your treatment or make an appointment please email.

And here (cached):

Reflexology encourages and supports the body in its own healing process, as well as improving blood circulation, assisting in the removal of toxins, inducing relaxation and restoring balance to organs and glands.

It is widely acknowledged that Reflexology is effective not only in helping the body to heal, but also as a source of preventative health care and improved physical fitness. By supporting the mind and body, Reflexology encourages optimum health.

Since these are virtually identical to the claims the ASA ruled were misleading, it looks like this reflexologist still has a lot of changes to make to comply with the adjudication against her. We have informed the ASA.

Ensuring compliance

There can't be many people who believe there is no need for an advertising regulator. A quick glance through the ASA's adjudications gives an indication of what it might be like if there was a free-for-all. Should advertisers of double glazing, car insurance, washing powder, weight-loss diets or penis enlargements be free to claim whatever they like about their product or service? Are exaggerations, half-truths and downright lies acceptable?

No, there needs to be effective regulation that protects the public from the excesses of the marketing machine.

There are several possible models for regulation including one set up under legislation with legal powers to ensure and enforce compliance. However, the ASA is set up as a non-statutory regulator:

We are independent of both the Government and the advertising industry…

They are, of course, funded by a levy on advertisers. How else could they be funded? Who else would be willing to pay for the essential work they do?

Advertisers can choose to pay this levy, but they cannot choose to comply with the Advertising Codes or the ASA's rulings — compliance is mandatory.

However, finance is raised by arm's-length boards (one for broadcast and one for non-broadcast) so that those who investigate and adjudicate on advertising are completely unaware of who has provided the funding.

That separation gives them the necessary independence and authority.

Their job is to:

…make sure all advertisements are legal, decent, honest and truthful.

Very simple requirements; and ones that the public has a right to expect in all advertising, regardless of what it's for or where it appears.

But even though the ASA is a non-statutory body, it has considerable weight — a point that would appear to need highlighting to some CAM advertisers, some of whom have even proclaimed that there is no need to comply with the ASA's CAP Code and advise others to ignore any letter from the ASA. Some have even involved their lawyers.

The ASA outlines the strong basis for their authority:

Interaction with the law

Across the European Union (EU) there is a unified piece of consumer protection legislation to prevent the use of misleading or unfair trading practices. This law, called the Unfair Commercial Practices Directive, has been translated into UK law to make sure that we have the same rules as all the other countries in the EU.

The ASA works within this legal framework to make sure that UK advertising is not misleading or unfair. The ASA is able to refer advertisers who refuse to work with us and persistently make misleading claims to the Office of Fair Trading (OFT) for legal action. The OFT is able to act under the Consumer Protection from Unfair Trading Regulations 2008, which governs how businesses interact with consumers and the Business Protection from Misleading Marketing Regulations 2008, which govern how businesses advertise to each other.

The ASA is considered the ‘established means’ for gaining compliance with both these pieces of legislation. This means that the law itself is not usually enforced formally through the courts; instead the ASA is first allowed to tackle any problems under the Advertising Codes. This approach works well in the overwhelming majority of cases. The ASA is able to take action quickly and this avoids clogging up our court system.

Referral is rarely necessary, as most advertisers prefer to work with the self-regulatory system. Since 2000 around thirty advertisers have been referred to the OFT; in the same period the ASA has dealt with around 200,000 complaints.

In a nutshell: the vast majority of advertisers are responsible and work with the ASA, but the ASA have the option and authority to take strong action should that prove necessary.

Alternative regulation?

The Alliance for Natural Healthcare (a pressure group of herbal and supplement manufacturers, retailers and supporters) recently pronounced:

…the CAM community don’t regard the dissemination of information that relates to their practice as ‘marketing’ in the way interpreted by the ASA.


That so many CAM practitioners have responded positively to complaints would suggest there are many in the CAM 'community' who would disagree with this generalisation and who realise that to be socially and ethically responsible, they have to abide by the ASA's rules.

However, other CAM practitioners demand that they be considered a special case; that they shouldn't be regulated to the same set of rules as everyone else.

To accept a lower hurdle for CAM would put the public in even more danger of being misled. Indeed, because of the possible effects on our health and wellbeing, a case could be made for a higher level for healthcare claims.

Responsible advertising

The ASA only demands that claims about CAM meet the same evidential requirements as all other advertisers. No special pleading is allowed because they think they work in some alternative paradigm.

It's clear that there are many CAM practitioners who agree that advertising should be legal, decent, honest and truthful and that advertising rules must be applied equally and fairly to all adverts — whatever they are for.

That is all the Nightingale Collaboration is seeking.


In addition to their existing sanctions, on-line advertisers who have failed to abide by the ASA's adjudications can be listed on their Non-compliant online advertisers page. However, they also have other sanctions available to them including:

  • Removal of paid-for search advertising — ads that link to the page hosting the non-compliant marketing communication may be removed with the agreement of the search engines.
  • ASA paid-for search advertisements — the ASA could place advertisements online highlighting an advertiser's continued non-compliance.

Since the ASA's agreements with search engines include Google, advertisers should not underestimate the effect these might have on visitors to their website.

Named and shamed

Five out of the 14 advertisers currently highlighted on their Non-compliant online advertisers page fall into the alternative therapy category and include one advertising detox foot pads, two advertising reiki and one advertising liquid chlorophyll. The latest additions include Ionic Balance and an 'osteomyologist'.

Ionic Balance were advertising a plastic bracelet, promising all sorts of medical benefits, saying it produced 'negative ions, far infrared rays [heat] and alpha waves'. It would require a source of power to produce any of those and there is no evidence that, even if it did emit these, it had the benefits claimed for it.

The osteomyologist, Back Trouble UK, claimed they could treat:

whiplash and arthritis and be effective for migraine, headaches, period pains, behavioural problems in children, diabetes, stress, asthma, glue ear, colic in babies, sleep disturbance, strokes and other neurological problems

These bear more than a passing resemblance to the types of medical conditions that some chiropractors and osteopaths have claimed. Many chiropractors have removed lots of claims — although there are still far too many questionable claims — so perhaps it's time for the osteomyologists to fall in line and abide by the rules?

Legal aid

As part of our plans for the coming year, we could do with some legal help. We need a lawyer who either already knows all about the Consumer Protection from Unfair Trading Regulations 2008 or who is willing to become familiar with them.

If you can help or know someone who might be able to assist us, please contact us.

06 January 2012

Season's Greetings


We know from what our supporters tell us that there are more than a few pharmacists up and down the country who still either aren't sure what homeopathy is and even recommend it to some of their customers in the mistaken belief that it is a proven, efficacious alternative medicine.

We thought we'd seize the opportunity of this time of year to try to raise awareness among high street pharmacists and their staff about homeopathy.

We have sent greetings cards to the pharmacists and staff of nearly 2,000 Boots pharmacy stores up and down the country.

The front of the card is shown above and we included some information explaining the absurdity and lack of evidence for homeopathy. The complete card can be downloaded here (pdf).

We hope that pharmacists will use the card to help make sure staff are properly informed about homeopathic products when responding to queries about them from customers.

If you like this idea, please feel free to print the card out and drop it into your local pharmacy or health store.

Homeopathic advertising

While you're there, you might like to check if they have any advertising next to homeopathic products. You may remember that the medicines regulator (the MHRA) told Boots to stop making medical claims for pills with no active ingredient and we asked our supporters to check their local Boots to make sure this prohibited point-of-sale advertising had been removed.

After a supporter found that it had not been removed from their local Boots near Birmingham, he complained to the MHRA who took it up with Boots. The MHRA assured him that Boots had now put a process in place to ensure all the prohibited advertising was not only removed, but also destroyed — and their head office are actively checking that this has all been done.

Boots are to be congratulated on taking such firm and responsible action.

It's unfortunate that this prohibited advertising had been around so long unchallenged in the first place, but at least now, no member of the public can be misled by it.

But what about other shops and pharmacies?

Boots isn't the only shop to use this kind of advertising. Boots homeopathic products are made by Nelsons and they also supply many other high street pharmacies and health food shops — one of the best known is Holland and Barrett. Our local H&B sells Nelsons homeopathic products and had similar point-of-sale advertising to Boots, so we complained to the MHRA.

The MHRA upheld our complaint and the prohibited advertising materials are being withdrawn from Holland and Barrett stores.

Since the MHRA had contacted Nelsons over this, we now hope that Nelsons will respond positively and responsibly and withdraw all such advertising from all shops that have been supplied with it.

If you find a shop that is still using it, feel free to use our updated information sheet to inform the pharmacist or shop owner of the MHRA's rules.

The use of advertising for homeopathic products registered under the MHRA's Simplified Scheme that links medical conditions to those products is prohibited and such advertising should now be a thing of the past.

Season's greetings to those who are our supporters…and to those who aren't!

20 December 2011

The final reflexology ASA master complaint

feet2The Advertising Standards Authority (ASA) has published its adjudication on the third and final of our reflexology master complaints.

The website of Tamsin Marshall Reflexology was chosen as one of three reflexology websites for our master complaint because of the broad range of questionable claims being made. Two of the pages carried long lists of conditions under the claim that reflexology "can be used in the treatment and relief from" them.

Given that reflexology apparently involves nothing more than pressing different areas of the feet and hands, we challenged whether this therapy could actually help the conditions named and whether the claims on the website could have the consequence of discouraging people from seeking essential medical treatment.

The ASA additionally challenged whether the efficacy claims in the customer testimonials could be substantiated.

The evidence submitted by the website owner in support of the claims on her website did not meet the standard required by the ASA and the complaint was upheld on all four points, identifying a total of 24 breaches of the CAP Code.

Making changes

We note that some amendments to the main text of the Tamsin Marshall Reflexology website have been made recently and that cancer has been removed from the list of conditions on the About Reflexology (cached) page. However, the website still carries the claim that reflexology can be used in the treatment of many serious conditions including asthma, "eye and ear disorders", endometriosis and polycystic ovary syndrome. It also still carries the customer testimonials that the ASA had objected to.

As it is now eight months since the ASA's remit was extended to include websites, some six months since this practitioner was notified of the complaints and a fortnight since she was notified of the adjudication, it is surprising that she has made little progress in making her website comply with the standards of truthfulness required by the ASA, so that we as consumers are better able to make an informed choice.

We are encouraged, however, to note that the first of the reflexology websites we challenged, Jackie Ginger Reflexology, which was adjudicated on two months ago, has now been amended accordingly, which shows it can be done. The other website we complained about, The Reflex Clinic, is still down at the time of writing.

The ASA continue to work with those responsible for the long list of other reflexology websites we supplied and with the relevant reflexologist trade bodies. This process will take time, but we are confident that the ASA will succeed in ensuring that these websites become legal, decent, honest and truthful — as they should be.


handsWe seem to be getting the credit for quite a lot of the complaints being made to the ASA about misleading websites, even if the complaints weren't submitted by us!

For example, we came across a blog called Reiki Medicine [sic] with the story of complaints made to the ASA about the website of a reiki practitioner in Newcastle. We are told that the complaints are believed by the practioner in question to have "originated with the Nightingale Collaboration" and that she "expressed concern about skeptic groups in effect dictating the work of the ASA because of personal beliefs rather than in the best interest of the general public".

We don't know whether the complaints about this particular website were inspired by the Nightingale Collaboration or if the complainant was assisted by the information on our website. What is clear is that there were a number of very questionable claims on this particular website, beginning with, "Reiki is believed to have many beneficial effects by: Treating the symptoms and causes of illness…" and that one or more members of the public objected enough to take the time to complain about them.

The result is that these claims have now been removed from that website, whose owner advises other practitioners receiving complaints:

…to not take it personally, and to view it as a challenge rather than as an attack… This is an opportunity to be clear about our own information and intention, and to demonstrate a professional and reasoned attitude to both complainants and the ASA… It is possible to play the game and remove taboo words, not list conditions, and be more creative with language.

Good advice, on the whole, though we are a bit dismayed to see promoting a healthcare therapy in a way that is honest and decent and unlikely to mislead people who may be ill and vulnerable being described as "a game".

No indications allowed: how you can help!

Boots Pharmacies had their knuckles rapped recently for listing medical conditions in their in-store, point-of-sale (POS) advertising of homeopathic products by the medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).

POSDisplayThe products — made for Boots by A Nelson & Co Ltd — are not licensed with therapeutic indications, ie they are not allowed to say what medical conditions the manufacturers think they can be used to treat.

This isn't because — as many homeopathists would have us believe — there is some big conspiracy against homeopathy, but because, for the homeopathic products registered with the MHRA, not one jot of scientific evidence of their efficacy is required as part of that registration. Advertising the products with therapeutic indications would therefore be misleading.

This advertising, found in many Boots stores, took the form of a booklet of next to a rack of homeopathic products. The booklet listed indications, symptoms and corresponding homeopathic products. Boots have now agreed to remove all such advertising from their stores.

But Boots aren't the only shops that sell homeopathic products and many others have similar POS advertising that lists medical conditions for those products: we've seen it in branches of high street 'health' food shops, particularly for Nelsons own-branded products.

How can you help?

We are sure that Boots will take their responsibilities seriously and remove all such advertising. But what if you find a store that hasn't? What do you do if you find a health food shop with a similar booklet?

You could politely ask to speak to the manager or the Superintendent Pharmacist and make them aware of the MHRA's decision against Boots and ask them if they will review their advertising.

But if you're not confident about doing that, we have produced an information sheet that you can download and print out (in black and white or colour) to help you.

We've made the sheet informative and non-confrontational: it simply gives details of the MHRA's decision and asks that the shop reviews its in-store advertising to make sure it complies with the MHRA requirements.

If you are successful in persuading a shop to remove these unlicensed indications, please let us know; if you find that the advertising hasn't been removed, please also let us know.




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