Malta and Homeopathy

One of the reasons for writing this post is that there will be a homeopathic conference there in June 2017.  

Malta is part of the EU and publishes its laws in English as well as Maltese. Malta has a legal system that has many influences because of its complex history. It's a history that can be read about but it is best understood by actually visiting Malta.

Homeopathy is not popular in Malta. There is a Malta Association of Homeopaths (MAH) but it reveals very few members. Nor does it reveal a long standing tradition of homeopathy. Google searches reveal more lay homeopaths in Malta but, again, this does not reveal a long tradition of CAM in Malta.

Practice of Medicine
The legislation covering who can practice medicine is unclear in a few places. The Medical and Kindred Professions Ordinance 1901 (amended) has for the most part been superceded by more recent legislation. It makes no mention of homeopathy. However, it does state -

90A. (1) No person shall advertise or permit or suffer to be advertised in any manner whatsoever, any medical or health service or treatment, not being a service provided by Government, or any other service or treatment which is or is described as being of a medical, therapeutic or curative value or effect, or in any other way beneficial to health, without the approval of the Council of Health.(2) For the purposes of subarticle (1), "treatment" shall include any form of advice relating to the treatment or cure of maladies or ailments, or any advice relating to health.

It later goes on to state -

98. (1) No person shall use any premises as a hospital, clinic, maternity home, nursing home, home for the aged, medical diagnostic laboratory, X-ray department, or any other similarestablishment or institution, by whatever name called, unless there is in respect of such premises a valid licence for the purpose issued by the Minister responsible for public health, and no person may open or carry on any establishment or institution for any of the purposes aforesaid unless he is in possession of a valid licence for the purpose issued by the said Minister.

 The Healthcare Professions Act 2003 (amended) does make mention of "professions complementary to medicine". However, that does not mean "complementary medicine" in the usual meaning of the word. Rather -

PART V 

PROFESSIONS COMPLEMENTARY TO MEDICINE 

Conditions to practise a Profession Complementary to Medicine.25.(1) No  person  shall  practise  any  of  the  professions complementary to medicine unless his name is entered in the respective register kept by the Council for Professions Complementary to Medicine, in accordance with the provisions of this Act.(2) No person shall qualify to be so registered unless -(a) he is a citizen of Malta or of a Member State or isotherwise  legally  entitled  or  authorised  to  work  in Malta;(b) he is of good conduct; and(c) his  name  is  entered  in  one  of  the  registers  for  the professions complimentary to medicine referred to in article 28.

Article 28 refers onwards to Schedule 3 which lists - 

• Accupuncture
• Audiologists
• Dietetics
• Physiotherapy
• Dental Hygiene
• Chiropractic 
• Nutrition
• Optometry
• Orthoptics
• Osteopathy
• Speech Language Pathology
• Clinical Perfusion
• Podiatry
• Psychotherapy
• Radiography
• Environmental Health
• Dental Technology
• Occupational Therapy
• Medical Laboratory Science
• Medical Physicists
• Nutritional Therapists

No mention of homeopathy although it is an odd mix.

So what does this actually mean? There's nothing that explicitly forbids the practice of homeopathy although the law could be read in such a way that the advertising of homeopathic services by the non-medically qualified is illegal. Where they can practice is a moot point. 

Medicines Regulation
As Malta is a member of the EU, its medicines regulation has a lot in common with that for the UK, Ireland and Norway as previously discussed.

As far as can be determined, although Malta does have a scheme to register homeopathic medicines, none have been. It is unknown where lay homeopaths are obtaining their remedies from - whether they are personally importing products, obtaining them from a wholesaler in Malta or some other route. Anecdotally, homeopathic medicines are not found in pharmacies. Whilst some herbal products are found in healthfood stores, homeopathic medicines are not it would seem. It is not unreasonable to suspect that Maltese homeopaths are importing homeopathic medicines from elsewhere. 

The Maltese medicines regulator is the Malta Medicines Authority (MA). If has the same powers and functions that other EU member states. Reading Maltese regulations is a bit tricky as it is not one continuous document. The legislation that covers important of medicines is tricky to read but...

There is some very clear guidance on the importation of unlicensed medicines into Malta, which would seem to confine it prescriptions issued by doctors and dentists and that MA approval is required. It is difficult to find a direct source, but it is known that importation for personal use is largely legal although customs may seize products. But supplying personally imported homeopathic medicines is a no-no.

Advertising of Homeopathic Medicines
As no homeopathic medicines are registered in Malta, they are classed as unlicensed medicines and marketing is forbidden. Medicinal Products (Advertising) Regulations states this pretty clearly (cutting and pasting from the document is problematic). The question of whether, as the per UK and Ireland it would be understood that advertising homeopathic services is restricted in terms of what is indications have been approved for registered products is moot as Maltese law seems to indicate that lay homeopaths should not advertise.

Consumer Protection
Malta does not seem to have self-regulation of advertising. It is a relatively small market in EU terms. Effectively, the Malta Competition and Consumer Affairs Agency (MCCAA) regulates advertising in general where not covered by specific legislation and another government agency.

The most import piece of legislation is the Consumer Affairs Act which can be found alongside other legislation here. Again, this is difficult to read but the First Schedule -"Commercial Practices which are ipso jure unfair" contains the following relevant items.

....9. Stating or otherwise creating the impression that a product can legally be sold when it cannot.....12. Making a materially inaccurate claim concerning the nature and extent of the risk to the personal safety or security of the consumer or his family if the consumer does not purchase the product.....17. Falsely claiming that a product is able to cure illnesses, dysfunction or malformations.....

Oh dear
Oh dear indeed. The irony of a homeopathy conference being held in a country where lay homeopathy is so constrained will be lost on the attendees almost certainly.

Homeopathy and Autism - Ireland - Part Two

The previous post outlined the legislation and regulations that limit the marketing claims that Irish lay homeopaths can make as well as highlighting issues regarding competence. It may be helpful to read this post that explains the various therapies used by UK lay homeopaths in their "treatment" of ASD.

As per what could be considered the "name and shame" post on UK lay homeopaths marketing "treatment", the fault not lies not so much with the individuals but rather a regulatory system that seems not to be functioning. The problem with regulation that is notionally non-permissive and a regulator that behaves in a permissive way is that the regulator can change its behaviour, especially if it put under scrutiny.

Irish Homeopaths who make claims about Autism
This is not an exhaustive list. 

Carmel O'Keeffe claims to be a CEASE therapist and whilst does not link to the CEASE therapy website makes many claims for it. O'Keeffe repeats the debunked theories of ASD causation and applies them more widely and also offers phone or Skype consultation. The testimonials page is problematic.

Sinéad Hurley claims to be a CEASE therapist and does link to the CEASE therapy website. Hurley makes metntion of Gardasil which is of concern in the current Irish climate. Bogus claims are made about all manner of issues. Something else of concern is placenta encapsulation. Whilst it may make some queasy, properly done it should pose no health risks but it also offers no health benefits. The idea that homeopathic placenta remedies offer any benefit is dubious to say the least. It is not clear what Irish legislation has to say about ingestion of placental products but it is unlikely to be permissive.

Carolina Manthei claims to be a CEASE therapist but does not link to the CEASE therapy website.

Paula Seth seems to run a clinic with her husband Gideon who is an osteopath. Seth has a MSc in Homeopathy from the University of Central Lancashire. This is a rarity. She also has qualifications in psychotherapy and has an interest in eating disorders. Seth claims to be a CEASE therapist and links to the CEASE therapy website. Her page on CEASE makes a number of claims that can not be substantiated as well as linking to dubious research and publications.

Geraldine Walsh offers Reiki and Shamanic therapy in addition to homeopathy. To be fair, the website feels, in some ways, very New Age/Pagan especially this. Walsh claims to offer CEASE therapy but does not link to the CEASE therapy website.

Maura Duignan offers CEASE therapy and links to the CEASE therapy website.

Elisabeth Cussen offers CEASE therapy and links to the CEASE therapy website. Cussen also lists the diseases that homeopathy can "help" with. There are items on fertility and cancer "support" that are also worrying. Cussen also suggests that homeopathy can treat erectile dysfunction.

Clare Adams claims to be a CEASE therapist but does not link to the CEASE therapy website.

Kelly CS Johnson offers telephone consultations but much more alarmingly offers homeoprophylaxis. The Irish Society of Homeopaths (ISoH) do not seem to have a position on vaccination. It is clear that Johnson is anti-vaccination and has been seen to promote the VAXXED film in various places.

Sinead Prendergast claims to be a CEASE therapist but does not link to the CEASE therapy website. The claim to treat ASD is clearly made.

Niki Taylor and Sarah Jane Hewitt both claim to be CEASE therapists. Hewitt offers Skype and telephone consultation.

Eileen Scullion claims to be a CEASE therapist but does not link to the CEASE therapy website.

Next?

The ISoH should probably consider issuing a position statement on vaccination. Most would regard advising parents not to vaccinate as unethical and that would also apply to providing unbalanced information.

In light of the landmark ruling by the Advertising Standards Authority for Ireland (ASAI), the ISoH would be well advised to issue marketing guidance to members. The ruling has caught the attention of the media and it is possible that some will be inspired to make more complaints to the ASAI.

UPDATE
The ASAI recently ruled about promotion by Almond Homeopathy that appeared on Facebook. Whilst the offending text/link may have been removed, it is clear that the Facebook page is in multiple breach of ASAI regulations and Irish consumer protection law. The original complaint was -

The complainant objected to the claim that the advertiser could alleviate the symptoms of Autism. The complainant noted that the blog linked to from the post contained a case history of a patient but there was no mention of the advertiser being authorised to do so. The complainant considered that the advertiser was not professionally qualified to treat such a condition.

Whilst making a very specific complaint does allow the ASAI to easily adjudicate, it does not ensure overall compliance. The response by the advertiser is interesting in some ways -

The advertiser stated that she was a qualified homeopath and was registered with the Irish Society of Homeopaths. 

She said that she did not diagnose conditions, nor did she claim to do so as this was not what she was trained to do. She said that people come to her with a set of symptoms and she uses the symptoms to determine what remedy may help them best. She said that she treats the person not their condition or disease and that she did not claim to be able to cure anything or anyone. She said that she used previous cases to illustrate what symptoms and struggles can be helped. 

In regards to the cases on her blog, she said that she has permission for every one she shares and that she changes the name for each case. Finally she said that when advertising on Facebook she sets the target audience to over 18’s and she does not advertise to young people.

These could be taken as "weasel words". "set of symptoms" vs "treats the person" for one thing. Claims of improvement? The ASAI's conclusion was - 

Complaint Upheld 

The Complaints Committee considered the detail of the complaint and the advertisers’ response. The Committee, whilst noting the advertisers’ comments that she was a qualified and licensed homeopath and that she was registered with the Irish Society of Homeopaths, were aware from a previous case (26082) that the Department of Health had confirmed that there was no statutory regulation of complementary therapists. 

The Committee also noted the advertiser’s response that she was ‘treating’ the person and not the condition, however, they considered that the wording of her post and the heading of the blog post would give readers the impression that she could treat the symptoms of Autism. 

In the light of the above the Committee considered that the advertising was in breach of Sections 11.1, 11.9 and 11.10 of the Code. 

ACTION REQUIRED: The advertising must not reappear in its current format again.

Unfortunately, there is still much content that could be understood as giving the impression of treating ASD.

The identity of the complainant is unknown. Which is not a problem but it would be interesting to know if the complainant also contacted the ISoH. In theory, complaints should be made first to the ISoH before the ASAI.  

Homeopathy and Autism - Ireland - Part One

There are a surprising number of homeopaths in Ireland who offer CEASE therapy. CEASE therapy is equally as problematic there as it is the UK. Also, Ireland seems to be suffering more than the UK from the activities of anti-vaccination groups. Some members of these groups engage in dubious tactics. As the arguments are largely the same as for the UK, reading previous posts will be of help.

Medicines Regulation
Medicines regulation in Ireland was covered in a previous post. As in the UK, there are questions about the legal supply of unregistered homeopathic medicines to lay homeopaths and supply by them to clients.

Irish Society of Homeopaths
They say -

We are the voice of homeopathy in Ireland, with a specially trained media team and spokespeople who deal with the media on our behalf. Also, as CAM therapies are self-regulating, the Irish Society of Homeopaths is the regulating body for homeopaths in Ireland.

This is a different situation from the UK the UK SoH is one of a number of trade bodies whilst the ISoH would appear to be the only one in Ireland. The ISoH has a Code of Ethics but what is interesting is the statement that "We take our Code of Ethics very seriously and every member signs a contract to abide by the Code at all times." In terms of elements of the Code that are of particular interest...

1.15 Practise only within the boundaries of their own competence 

1.16 Respond promptly and constructively to concerns, criticisms and complaints  

1.17 Respect the skills of other health care professionals and where possible work in co-operation with them  

1.18 Never disparage or speak disrespectfully of fellow Homeopaths, either in public or to patients  

1.19 Comply with current legislation of the country.  

1.20 Practice in accordance with this code and any other codes or documents as agreed by the committee of the ISH  

1.21 Advise the Professional Conduct Officer if a situation arises that may result in a complaint being made against them

As CEASE therapy etc often involve nutritional supplements -

2.6.1 Where members offer other complementary therapies, they must inform the patient prior to treatment about the other therapy and indicate their relevant qualifications, registration with the relevant registering body and adherence to a separate Code of Conduct. They should be very clear that this therapy is not Homeopathy. 

2.6.2 They must receive permission from the patient to perform this other treatment on the patient and record such consent in the patient notes

In theory, this would require ISoH to also be registered with the Nutritional Therapists of Ireland. 

3.1.1 Members are required to comply with the criminal and relevant civil law of the country, state or territory where they are practising  

3.1.2 Members must observe and keep up to date with all legislation and regulations relating directly or indirectly to the practice of homeopathy  

3.1.3 References to any legislation or regulations throughout this code shall include any amendments or other alterations, repeals or replacements made in law since the date they came into force. Any reference to the singular shall include the plural and references to the feminine shall include the masculine.

 This would include consumer protection legislation as well as medicines regulation.

2.14.1 Homeopaths who do not have full conventional medical training are not qualified to make a medical diagnosis 

2.14.2 Members will be aware of the limits of their professional competence and where appropriate will refer to other practitioners or health care professionals where: 

a) The case is beyond their clinical competence b) Where a patient would benefit from another form of treatment c) The patient exhibits symptoms that suggests an underlying condition which requires further investigation and medical diagnosis

Would the prohibit on making a diagnosis include making claims about the "underlying causes" of ASD? Would it include making statements about "vaccine damage"? Lay homeopaths in many countries seem to have problems with identifying the limits of their competence.

3.4.1 Members should ensure that they do not allow misleading advertising and information about their practice. Advertising should be ‘legal, decent, honest and truthful’ as defined by the Advertising Standards Authority for Ireland  

3.4.2 Professional advertising and marketing communications: 

a) Must be factual and not seek to mislead or deceive or make unrealistic or extravagant claims b) May indicate special interests but must not make claims of superiority or disparage professional colleagues or other professionals c) Make no promise of cure, either implicit or explicit, of any named disease d) All research should be presented clearly honestly and without distortion; all speculative theories will be stated as such and clearly distinguished 

3.4.3. Advertising content and the way it is distributed must not put prospective patients under pressure to consult or seek treatment from a member

Speculative theories will be clearly distinguished? CEASE therapy etc are not just based on speculative theories, they are based on discredited theories. The very phrase "Complete Elimination of Autism Spectrum Expression" is an implied cure. Anti-vaccination discussion often involves disparagement of professionals.

Advertising Standards Authority for Ireland
The ASAI are the advertising self-regulator. As the per the UK ASA, its function is partly one of dealing with problematic advertising without the need for expensive and time consuming legal action. Whilst the ASAI do not enforce consumer protection law, their Code can be understood as an accepted interpretation of consumer protection law and other industry specific law that affects advertising.

The particularly relevant parts of the Code include -

(h) A claim can be direct or implied, written, verbal or visual. The name of a product can constitute a claim.

This is particularly important in the case of CEASE therapy.

Legality 

3.14
Advertisers have primary responsibility for ensuring that their marketing communications are in conformity with the law. A marketing communication should not contain anything that breaks the law or incites anyone to break it, nor omit anything that the law requires. The determination as to whether or not a marketing communication is legal is a matter for the courts or other appropriate regulatory authorities.

3.15
Advertisers should not state or imply that a product can legally be sold if it cannot. It is not a matter, however, for the ASAI to determine whether a product can or cannot be legally sold in Ireland.

Medicines regulations make the sale of certain products illegal, well, outside of limited situations.

Fear and Distress 

3.23A marketing communication should not cause fear or distress without good reason, such as for example, the encouragement of prudent behaviour or the discouragement of dangerous or ill-advised actions. In such cases, the fear aroused should not be disproportionate to the risk.

The anti-vaccination messages that go along with CEASE therapy etc could well fall foul of this provision.

Truthfulness 

4.1
A marketing communication should not mislead, or be likely to mislead, by inaccuracy, ambiguity, exaggeration, omission or otherwise.

4.2
Obvious untruths, exaggeration (“puffery”) or deliberate hyperbole that are unlikely to mislead, incidental minor inaccuracies and unorthodox spellings are not necessarily in conflict with the Code provided they do not affect the accuracy or perception of the marketing communication in any material way.

4.3
Claims such as “up to” and “from” should not exaggerate the value or the range of benefits likely to be achieved in practice by consumers. 

Honesty
4.4
Advertisers should not exploit the credulity, inexperience or lack of knowledge of consumers.

4.5
The design and presentation of marketing communications should allow them to be easily and clearly understood.

4.6
Disclaimers, asterisked, footnoted or “small print” information should not contradict more prominent aspects of the message. Such information should be of sufficient size and/or prominence and be located and presented in such a manner as to be clearly and easily legible and/or audible; where appropriate such information should be linked to the relevant part of the main copy.

4.7
Whether the presentation of information is insufficient or likely to mislead depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the advertiser takes to make that information available to the consumer by other reasonably accessible means. 

Matters of Opinion 

4.8
Advertisers may state an opinion about the quality or desirability of a product provided that it is clear that what they are expressing is their own opinion rather than a matter of fact and there is no likelihood of consumers being misled about any matter that is capable of objective assessment. Assertions or comparisons that go beyond subjective opinions should be capable of substantiation. 

Substantiation 

4.9
A marketing communication should not contain claims – whether direct or indirect, expressed or implied – which a consumer would be likely to regard as being objectively true unless the objective truth of the claims canbe substantiated.

4.10
Before offering a marketing communication for publication, advertisers should satisfy themselves that they will be able to provide documentary evidence to substantiate all claims that consumers are likely to regard as objective. Relevant evidence should be sent without delay if requested by the ASAI and should be adequate to support both detailed claims and the overall impression created by the marketing communication.

4.11
If there is a significant division of informed opinion about any claim made in a marketing communication, the claim should not be portrayed as universally accepted.

4.12
Marketing communications should not present statistics in such a way as to exaggerate the validity of an advertising claim nor give the unjustified impression that there is validity to the claim.

4.13
Marketing communications should not:(a) misuse, mischaracterise or misleadingly cite any technical data, e.g. research results or quotations from technical and scientific publications;or(b) use scientific terminology or vocabulary in such a way as to suggest falsely or misleadingly that an advertising claim has scientific validity.

4.14
Marketing communications should not exaggerate the value, accuracy or usefulness of claims contained in books, tapes, videos, DVDs and the like that have not been independently substantiated.

This is all very clear. Claims for CEASE therapy etc would fall foul of them.

The section on Health and Beauty is too long to reproduce in full but is worth reading in full. The key issues are those of substantiation, discouragement of medical treatment, claims to cure and also the professional status of a practitioner. Interestingly,

11.17Marketing communications for medicinal products should not contain any offer to diagnose, advise, prescribe or treat by correspondence (correspondence includes by phone, post, internet, email and fax).

prohibits the offer to "treat" in any other than a face-to-face context. It is certainly the case that many homeopaths offer things like Skype consultations in their marketing.

How the ASAI interpret the Code can be seen through their adjudications. Firstly, there is one against the Irish Society of Homeopaths. A key findings is -

HPRA advised the ASAI that currently under this scheme (NRS) there is only one licensed product for the treatment of colds and flu like symptoms. All other homeopathic products currently licensed in Ireland are under the Simplified Registration Scheme, with no indications.

Effectively, Irish lay homeopaths are limited to claiming to be able to treat colds and flu like symptoms.

However, that seems to be the only adjudication that relates specifically to homeopathy.

Consumer Protection
The Competition and Consumer Protection Commission (CCPC) enforces consumer protection legislation. One of the fundamental differences between the UK and Ireland is that consumer protection in the UK is devolved to local authorities whilst in Ireland it is centralised. It would appear that the CCPC has sweeping powers.

The most important piece of legislation is the Consumer Protection Act 2007 but there are others. A lot of is very dull reading and involves the setting up of a statutory body. Section 3 is were the important information starts. The below covers the most important aspects re CEASE therapy etc marketing.

Chapter 4 
Prohibited Commercial Practices 

55.—(1) A trader shall not engage in any of the following commercial practices: 

(a) a representation that the trader has an approval, authorisation or endorsement that the trader does not have, or making such a representation when the trader is not in compliance with that approval, authorisation or endorsement;
(b) a representation that the trader is signatory to a code of practice, if the trader is not;
....
(d) a representation that a product has an approval, authorisation or endorsement that it does not have, or making such a representation when the trader is not in compliance with that approval, authorisation or endorsement;
....
(f) a representation that supply of a product is legal, if it is not, or creating such an impression;
(g) a representation that a product is able to cure an illness, dysfunction or malformation, if it cannot;

Whilst the rest of the Act does make for interesting reading, the above provides sufficient information for the purposes of this post and the following one.

Next post?
The next post will look at the claims of individual Irish lay homeopaths has regards to homeopathy and autism.

Homeopathy and Autism - Part Three

The potential implications of the accreditation of the Society of Homeopaths (SoH) as a voluntary register by the Professional Standards Authority (PSA) were discussed in a previous post. As discussed in the last post, the Advertising Standards Authority (ASA) did rule against Teddington Homeopathy's promotion of CEASE Therapy. Teddington Homeopathy chose not to comply.

This ruling does set a precedent and one that the SoH would do well to take notice of. As another previous post pointed out some members of the SoH do have a problem with the ASA. The SoH deleted the news item that it was associated with but it can be found here. The reason for its deletion is unknown.

Mark Taylor, Chief Executive of the SoH has made some bullish remarks whilst not quite understanding the PSA requirements for a voluntary register.

ASA Ruling on Teddington Homeopathy
It is worth examining the ruling in some detail.

The complainant challenged whether:
1. the claims that CEASE therapy could treat autism were misleading and could be substantiated; and
2. the ad discouraged essential treatment for autism, a condition for which medical supervision should be sought.

The ASA tend to consider only a few number of items in a complaint. It must be understood that it does not necessarily mean that the rest of the advertising is compliant. Generally only the most serious items are considered.

Teddington Homeopathy stated that the page correctly referenced the clinical work of a medical doctor and contained no claims. They stated that in clinical practice Dr Smits found CEASE to be of benefit to individuals suffering from autism and other conditions on the autistic spectrum, and that this was substantiated by his patient records. They stated that the text was not an advertisement or form of marketing, but was intended to provide the general public with correct information about different healthcare options. They removed the testimonial and the section regarding removal of toxins.

There is a failure to understand that text forms part of a website that is designed to promote goods and services is de facto marketing. The anecdotes of Smits do not constitute substantiation. As shown in the last post, there are serious reasons to believe that information on CEASE therapy is not correct.

1. & 2. Upheld 

The ASA acknowledged that the web page included information about the history of CEASE therapy. However, we noted that the advertiser provided the therapy in question and considered that the page constituted marketing for the purposes of the CAP Code. The page also contained references to Tinus Smits' experiences with "helping" patients with autism as well as other references to the benefits of CEASE therapy for autism, including material within the testimonial. We considered that visitors to the website would understand the claims in the testimonial as factual, regardless of the disclaimer, and that the claims within the testimonial would therefore be understood as relating to the objective benefits of CEASE therapy. We therefore considered that the ad made claims for the efficacy of CEASE therapy in treating autism. 

We welcomed Teddington Homeopathy's decision to remove the testimonial and other material from the page, but considered that the information about Tinus Smits and the URLs still implied a benefit for homeopathy and CEASE therapy for autism, and that the intention of CEASE therapy was to treat autism. Although advertisers may provide information about the history of a therapy, care should be taken not to make unsupported claims for the treatment when describing this background. The Code also stated that marketers must not discourage essential treatment for conditions for which medical supervision should be sought, and that this included offering specific advice on, or treatment for, such conditions unless that advice or treatment was conducted under the supervision of a suitably qualified health professional. We considered that autism was a condition for which medical supervision should be sought. In the absence of evidence to demonstrate that CEASE therapy could treat autism and that any treatment was carried out by a suitably qualified healthcare professional, we concluded that the ad was misleading and breached the Code.

The concept that linked to websites can be considered to create an implication for marketing purposes is important. The ASA do not recognise UK lay homeopaths as suitably qualified health professionals despite what some might think. That is because UK law does not.

Blue Guide
The Blue Guide is produced by the Medicines and Healthcare product Regulatory Agency (MHRA). It is a guide to advertising of medicines and, to a degree, medical services. It represents an understanding of medicines legislation and regulations. The SoH Code of Ethics now includes Blue Guide compliance as a requirement for members in addition to the CAP Codes. Bear in mind that whilst the ASA may refer non-compliant advertisers to Trading Standards on the basis of the provision in consumer law that it is illegal to -

17. Falsely claiming that a product is able to cure illnesses, dysfunction or malformations.

The MHRA don't have to. They can mount prosecutions themselves. The Blue Guide states -

5. Advertising homeopathy services Homeopathic practitioners may promote the service they provide for the public, e.g. the availability of a homeopathic consultation service. Details of products in any advertising must be limited to those licensed by the MHRA and must comply with the requirements set out in section 4 above.  

These restrictions apply equally to advertising on the internet. Product information, including sales material and any online purchase facility, may only be provided for licensed products. 

Mention of unlicensed products is problematic to say the least.

Society of Homeopaths Position Statement
The SoH made a statement about vaccination, if couched in weasel words but the core of it is -

Currently there is no homeopathic alternative to vaccination or anti-malarial drugs which has been proven beyond doubt to be clinically effective. It is therefore unethical for a homeopath to advise a patient against the use of conventional vaccines or anti-malarial drugs.

As the CEASE Therapy website states that "Autistic children should never again be vaccinated!" and the question of linkage was established above, the SoH should at least be aware of the implications of linkage if nothing else. Linking to anti-vaccination websites could be considered advice. Pretending a false balance that the risks of vaccination are somehow equivalent to the risk of death or harm from preventable diseases is a distortion.

Competence
No UK lay homeopath has the competence to treat ASD. They can treat people with ASD for minor self-limited conditions but beyond that, nothing. The CEASE therapy training course, given its concentration on debunked theories about the causes of ASD does not make a lay homeopath competent. Nor is anyone who uses it.

Society of Homeopaths Members "treating" ASD
This is by no means an exhaustive list. Examining each website in forensic detail for breaches of legislation and regulations would be time consuming and result in a massive document hence only a few aspects of each website will be examined. Also, depending on when this is read, the websites may have been amended. 

Mike Andrews was mentioned in the last post. It makes many dubious claims. Most unfortunate of all, the blog on his website states - 

This has been a delightful case and profound changes have taken place over the last four months, what other therapy for Autism Spectrum Disorder could achieve so much in such a short time.

As the blog is part of his website promoting his services, it is considered advertising.

Jonathan Stallick does not say anything specific about autism but this from his website is problematic. 

Len Marlow seems to get about. Practises in Greenwich and the Midlands and is a "clinical" supervisor for the College of Practical Homeopathy. Here he talks about DPT vaccination as a cause of autism. The SoH position on vaccination applies.

Ursula Kraus-Harper makes the statement on her website -

Please note that because I treat many children who are on the autism spectrum and talk about vaccination, I am constantly under attack from some people who will have to consult their own conscience as to why they do this. On the Internet you will find several links to articles about me, claiming all manner of things. If you have any concerns or doubts, please phone me.

Kraus-Harper is one of those homeopaths who inspired the SoH to seek legal advice on the domain of the ASA which the SoH removed as a news item as seen above. The page on her website that relates to vaccination could be interpreted, in terms of linkage and false balance as in breach of the SoH statement above.

Kraus-Harper has a page where she discusses treating ASD which links to the CEASE therapy website. It is full of unsubstantiated claims and offers no evidence of competency to treat ASD. Quite the reverse. There is considerable irony in the above quote. 

Clare McGennon claims to be a CEASE therapist and links to the CEASE therapy website. Her list of conditions seen is also problematic but that might be due to not understanding SoH guidance.

Clare Allsop  claims to be a CEASE therapist and links to the CEASE therapy website.

Julia Lockwood claims to be "qualified to treat people with persistent and deep-rooted chronic conditions using CEASE" and links to the CEASE therapy website.

Gill Upham claims to be a CEASE therapist and links to the CEASE therapy website.

Merran Sell unlike most of the other homeopaths listed here has a background in special education and is a Special Educational Needs Co-ordinator. She states -

I have worked with autistic, Asperger’s, ADD and ADHD children for over 20 years as a special education needs teacher, in specialist schools and as a Special Education Needs Coordinator in a mainstream junior school. During this time I have also worked with these children in my homeopathic clinic.

Hopefully she does not see the same children in her clinic. There is a potential conflict of interest, especially if money is changing hands. 

Renata Wild claims to be a CEASE therapist but does not to the CEASE therapy website.

Gill Marshall does not make the wild claims that others do and has done voluntary work with autistic children. If it were not for the use of homeopathy this would seem quite sensible.

Emma McGuire's entry on Yell is unfortunate in that it contains a blank list of conditions. 

Lucinda Torabi  is another of the homeopaths who demanded the SoH take legal advice on the status of the ASA. Unsurprisingly, much of the content of her website would appear to be in breach of the CAP Codes and guidance on advertising. Her page on ASD links to the CEASE therapy website.

Donna Draper offers more than just homeopathy. SCENAR is basically a glorified TENS machine although all sorts of bonkers claims are made for it. The Asyra device is also bonkers and the claims made for it are extraordinary. The section on CEASE therapy is very problematic and links to the CEASE therapy website.

Penelope Harrington claims to be a CEASE therapist but does not link to the CEASE therapy website.

Cathryn Brooks claims to be a CEASE therapist but does not link to the CEASE therapy website.

Jennifer Hautman has had dealings with the ASA and has attracted the attention of other bloggers. It is very strange to read her blog post on the subject - it would appear to be a storm in a tea cup and the initial complaint is odd that it only focuses on one issue. Her website is not compliant with the CAP Codes in many areas but the SoH may not be aware of this. It would seem very likely from her pronouncements on her own website and other places that Hautman has no intention of complying.

The information on vaccination is likely in violation of the SoH position. It is not clear whether Hautman treats those with ASD but the information presented is problematic.

Jacquie Haylett claims to be a CEASE therapist but does not link to the CEASE therapy website.

Suzie Reye-Nichols claims to be a CEASE therapist and links to the CEASE therapy website.

Candice Francis Joyce doesn't make any claims but this item is interesting as it mentions homeopathic secretin.

Samantha Pereira claims to be a CEASE therapist but does not link to the CEASE therapy website.

Niki McGlynn claims to be a CEASE therapist and links to the CEASE therapy website.

Margaret Kincade claims to be a CEASE therapist but does not link to the CEASE therapy website.

Rebecca Maunder has this



on her website. Blank lists of conditions can be interpreted in several different ways.

Nick Cripps does mention any particular method but this testimonial is problematic.

Mary English makes a great deal out of Indigo Children. It is just plain odd. If you aren't familiar with the concept it is New Age nonsense.

Karenza Grant claims to have treated autism.

Elaine Watson claims to be a CEASE therapist but does not link to the CEASE therapy website.


Complaint?
There is little point in raising complaints with the SoH. Their complaints process allows them to dismiss "vexatious" complaints. Whilst they do have a poor history of responding to public (media) concerns about their members, placing concerns into the public domain is more likely to result in action than direct complaint.

All of the information above is in the public domain. There is nothing confidential about it. There are no privacy concerns. Pointing that this information exists can not be construed harassment or defamatory.

What others choose to do with this information is a moot point but is suggested the problems lie more with the SoH than the individuals named. Harassment of individuals is not condoned.