Tuesday, 13 November 2018

General Regulatory Council for Complementary Therapies

The General Regulatory Council for Complementary Therapies (GRCCT) is very strange and the guy behind it, Barry Tanner is somewhat of a mystery. The website does seem to have been updated in several years. It's not clear if the GRCCT is active in any meaningful way.

If were not for the GRCCT being mentioned by the Society of Homeopaths (SoH) in various board minutes, being referred to Freedom4Health (run by Scientologist Martin Weightman) and Tanner's involvement with Homeopathy International (HINT), this would be of little initial interest. But what investigation has revealed is something very bizarre indeed. Something that raises more questions than it answers.

What is the GRCCT?
It is difficult to be sure.

It claims to be a "federal" regulator. The theory is that many small trade associations are simply to small to deal with regulation. They have few members who probably don't make a lot of money, can't afford to employ many, if any, staff. Some trade associations are just one person looking after a membership list, collecting fees and sending out a newsletter. Much is made of "ethical standards" by some of the larger trade associations but they can afford permanent staff and so forth. The idea of a federal or umbrella regulator is that they can deal with this. There's also something about such a regulator being able to "get a seat at the table" when it comes to engagement with the authorities.

The GRCCT isn't the only organisation like this. The Complementary and Natural Healthcare Council (CNHC) which is accredited by the Professional Standards Authority  (PSA) works is roughly the same idea. There is some history involved which will be explained later.

Where the GRCCT varies from the CNHC is that it purports to "certify" advertising and in some places is presented as an alternative to the Advertising Standards Authority (ASA) although this seems only have been going on since 2014.

It has said on its website for quite some time that the intentional is set up a community interest company but no such company or charity exists but as per previous post on Homepathy International, it is possible that GRCCT is effectively a limited by another name or an incorporated association but...

Who are the GRCCT?
There is a staff list here but it is very curious. None of the mentioned trustees, lay panel leads or staff make mention of the GRCCT online. It is the kind of thing that people do put on the LinkedIn profile. The only person associated with GRCCT who gets any mention anywhere is Barry Tanner.

A lot of the organisation involved in attempts at introducing some sort of regulation of Complementary and Alternative Medicine (CAM) in the UK have disappeared and even when they have not, records going back to the late 1980's aren't available or organisations don't want to share them.

This article from the Federation of Nutritional Therapists is very interesting (and wrong in places) and to quote -
The first steps on the road to a robust regulatory process for complementary medicine were taken in 1987 with the formation of the British Complementary Medicine Association. This new association recognised the necessity for a ‘Therapy Council’ to act as a centralised knowledge base for each therapy with an overarching administrative process performing the regulatory role. This ground-breaking regulatory structure developed by Barry Tanner and Sir John Hopson was called the ‘Pyramid Structure’.
John Hopson is a name that been encountered during research. The only "Sir" John Hopson that can be found would appear to be associated with the infamous Medicina Alternativa diploma mill that operates out of Sri Lanka which was mentioned in a previous post.

The British Complementary Medicine Association (BCMA) still exists but unfortunately, the website doesn't tell us anything about its history. The BCMA is like the GRCCT an umbrella group for small trade associations.

The article mentions the NHS Alliance which has changed somewhat in the past few years. It has rebranded itself as the "New NHS Alliance" probably to distinguish itself from the previous Dr Mike Dixon influenced incarnation. Although consigned to history, one of the things did was foist a directory of CAM lay practitioners on GPs. Dixon is well known for his involvement with the disastrous Prince's Foundation for Integrated Health and its successor the College of Medicine.

It's known that Tanner did have various meetings with various people at which he positioned the concept of the GRCCT but it isn't clear whether he was ever taken seriously.

What came out of all of this was the formation of the CNHC with considerable funding (and government bailouts). The "adventures" of the CNHC (aka "OfQuack") are well documented elsewhere including at the Quackometer blog.

The article stops before the remit of the PSA was expanded to cover voluntary registers.

Who is Barry Tanner?
Well, he looks like this.

Image result for "barry Tanner" "grcct"

But difficult to say. It's likely that he is related to Renee Tanner (some sources say he is her son), author of a number of books of reflexology and chair of the International Federation of Reflexologists (IFR). The IFR has an interesting document mentioning the GRCCT. Some reflexologists mention being trained at a "world famous" Renbardou Institute by both Tanners and there is also mention of them being examiners for Morley College. There is no indication that Barry Tanner is a practicing reflexologist.

What the internet turns up on Tanner is mostly him going to meetings with trade associations (the photo is from such a meeting). There are no photos of any other person from the GRCCT.

A puff piece from a trade association conference flyer -
Project Director GRCCT. Broadcaster & lecturer. Campaigner on Rights Of Complementary Medicine. Former NHS Project Manager, Teacher, Examiner, University External Verifier, Professions Rep, Parliamentarian, Participant Of Prince’s Foundation Federal Regulatory Group. Talking ‘From his years of experience as Over 30 years as a complementary therapist and over 25 years experience in regulatory processes as diverse as the London Stock Exchange, the employment sector, and education, as well as orthodox and complementary medicine.’
Similar claims can be found here. Parliamentarian? In the UK that means MP and Tanner has never been an MP. University external verifier? Unlikely. Claims that he was a paramedic have also been seen but in the UK paramedics are regulated and the title is protected and can be searched for here. The history of paramedics in the UK is discussed here.

Regulation and registration of complementary therapists in the UK is voluntary self-regulation. This means that there are no laws in place to protect the public from unqualified or incompetent therapists. For the past ten years and in accordance with recent government recommendations, the various professional associations in each therapy have been working together to agree standards and requirements for each type of complementary therapy. 
When these criteria had been set the next stage was to put in place an overarching independent regulator to establish a national register and protect the public by validating the status of all registered therapists. This is a role of the General Regulatory Council for Complementary Therapies (GRCCT).
OK. Clear enough, in some ways but in reality, how does the GRCCT validate the status of therapists? By membership of a trade association? This list of therapy organisations whose members are eligible for membership makes for dismal reading (the healing one is worse). GRCCT makes mention of National Occupational Standards (NOS). NOS for homeopathy were discussed here and the point was made only lip service is paid to them. NOS do not exist for the majority of therapies covered. And even where they exist, the trade associations do not necessarily require members to demonstrate that they meet them.

It is further undermined by -
Registration Fee £35 for initial therapy plus £5 for each subsequent therapy
That suggests that if an applicant belongs to a particular trade association they can "bolt on" almost anything without need for any validation.

How does a trade association sign up with GRCCT? This gives some clues (as well as providing another insight into history) but it isn't entirely clear what criteria the GRCCT assess any approach. But it looks as if some of the trade associations never applied to GRCCT and that GRCCT just decided to accept members from them if this newsletter from the British Association for Applied Nutrition & Nutritional Therapy (BANT) is correct. This from 2008 doesn't take a favourable view of the GRCCT.
There are two bones of contention, firstly, this organisation is neither recognised nor sanctioned or has any connection with the Dept. of Health or its funded body The Foundation for Integrated Health despite clever wording implying a connection. Secondly and more concerning is that this organisation has used the name of the LCSP Register in its information, as it has other Societies, without permission or consultation. We have written to the GRCCT asking for our name to be withdrawn from their information with immediate effect.
Some of the trade associations don't seem to exist (online) either or have become part of something else.

There's also possible for those not on any list to apply for registration but there is apparently a verification process and it costs extra. 

Certified Advertising
As mentioned before this seems to have started to be offered in 2014.
Advertising Certification is a formal procedure by which the UK Federal Regulator for Complementary Therapies – The General Regulatory Council for Complementary Therapies (GRCCT) assesses and verifies advertising in the sector of Complementary and Alternative Medicine. 
Advertising which is seen to meet stringent industry and legal requirements of the profession and applicable UK law is issued with a GRCCT Unique Certification Mark. Certification is valid for a period of one year and is subject to random audit.
This is obviously not the case as even cursory examination of some of the advertising reveals multiple breaches of consumer protection law and in some cases medicines regulations.
Each submission is considered by a panel composed of:
  • Legal expertise
  • Profession expertise (for each discipline appearing)
  • Regulatory expertise
  • Academic expertise (Research)
  • Lay representation
Details of how the decision-making process is structured are available here: The Certification Process

The certification process is just a flow chart. The GRCCT also helpfully tells us about "relevant" legislation and fails to mention medicines regulation or the role of the ASA.
The Profession Support Guarantee is applied to any advertisement displaying a valid GRCCT Advertising Certification Unique Identification Mark. 
The Guarantee undertakes that GRCCT will supply free of charge and without limit expert report and expert witness in defence of any legal claim on the validity of the advertisement.
There is a problem with this statement - "expert". The GRCCT does not obviously demonstrate any expertise in the area of consumer protection and advertising law and offering an "expert witness" is all they offer. If an advertiser finds themself in court, they will have to bear the rest of their legal costs and their lawyers may well advise against using GRCCT's expert witness. Even if they don't, the Court may well choose to disregard the expert witness.
To summarise, an expert witness is an also an expert, but one whose specialist knowledge supports considered opinions which may be placed before a court (or other judicial or quasi-judicial body – for example, a tribunal or arbitration).

Fundamentally, the role of the expert witness is to provide technical analysis and opinion which will assist the court in reaching its decision. The opinion evidence put forward by the expert witness is based on evidence of fact.
And the GRCCT will charge a variable annual fee for certification between £55 and £285. What the GRCCT would do if that annual fee is not paid and their symbol still used is unknown. Would they pursue through the courts? Ditto with those mentioning GRCCT registration after it lapses?

It is worth pointing out that the Committees of Advertising Practice (CAP) do provide lots of guidance, some therapy specific. They also offer free copy advice as well as an express (four hours) paid for service.

The ASA ruled against Elle Fox trading as Bubbling Life. Interestingly, her advertising purports to be certified by the GRCCT. Whilst it is possible that Fox did not request help from the GRCCT, there would seem little point in her paying for certification if this is the case. Fox has not complied and it is likely that there will be a referral to Trading Standards (ASA are alarmed by CEASE therapy).

Taking a look at a few websites that have have GRCCT "certification" -

Medical Thermal Imaging was subject to a very clear and damning ASA ruling in July 2015. Archived versions of the website reveal that GRCCT "certification" happen between June 2015 and October 2015.

Spherical Living is extremely strange and makes mention of Universal Medicine. It it offers among other things "esoteric breast massage".

Wendy Hooper and Bushey Colonic Hydrotherapy are enema providers. The International Association and Register of Integrative Colon Therapists and Trainers (RICTAT) is a trade association of enema providers. CAP has provided very clear guidance on colonic hydrotherapy.

The irony of an organisation that claims both regulatory and legal expertise having a website that is non-compliant with consumer protection legislation is probably lost on those who have signed up the GRCCT.
Practitioners who hold current registration with the GRCCT will be seen to meet the NHS National Cancer Action Team criteria in relation to Patient Safety.

‘We are happy to be working with, and guided by, the lead bodies in CAM for the benefit of patient care and safety.’ – Acting National Coordinator, Cancer Peer Review, Ruth Bridgeman
There is also a "press release" that has turned up in a number of other places. It is not the case. For one thing, although there is guidance (which suggests CAM practitioners who belong to PSA accredited registers) it is down to individual NHS Trusts to decide what is safe. There is a lot more to this but readers are unlikely to be terribly interested in NHS workforce policies.
The Federal Regulatory Council (FRC) is central to the operation of GRCCT and makes all regulatory decisions. In the same manner as the statutory Health Professions Council (HPC), the FRC is composed of a practitioner from each of the regulated professions and an equal number of lay members. The Council is chaired by a Lay Chair rendering it majority lay.
Really? From the only FRC minutes (15/09/2015) that are available -
Chair: Barry Tanner (BT) 
Ian McDougal (IM) Colonic Hydrotherapy 
Michael Lingard (ML) Buteyko Breathing 
Sue Knight (SK) Healers 
Sheila Hicks Balgobin (SHB) Essence Therapy 
Barbara Reeves (BR) Classical Manipulation 
Ann Whittle (AW) Upledger Cranio Sacral Therapy 
Robert Jefford (RJ) Reiki 
Nina Barbora (NB) Hirudotherapy 
Frances Smith-Williams Kinesiology 
Muddassar Raja (MR) Hijama 
Jacqui Footman (JF) EFT 
Geof Evans (GF) Orthopathy

Note, no lay members. And those minutes reveal some interesting things.
3.1. Registrations – BT reported that registrations currently stand at 17,780 individuals which represents one of the slowest periods of growth for GRCCT since inception. Previous meetings had discussed a probable ceiling for significant registration rise at about 24,000 to 28,000 registrants depending largely on what happens with the 4,000 to 5,000 CNHC registrants.  
3.2. Growth for the next 36 to 48 months is predicted to be slow in comparison to previous years. With a prediction of hitting 20,000 registrants around 36 months.
BT confirmed that GRCCT currently list between 5,000 and 6,000 practitioners or Reflexology on the National Register and that the extent of input by a regulator into an award consultation would usually be limited to the requirements for employment.
Compare this to -
The Complementary Therapies regulated by GRCCT are practised by in excess of 50,000 practitioners in the UK
Is that a misleading statement? It is difficult to determine the exact number of registrants from the website (the search facility is shockingly bad) but research suggests 200. There would appeal to have been a massive decline in numbers which would suggest a massive decline in income too. 
4.5. The management team of GRCCT are of the view that we have lost traction in practitioner marketplace over the last twelve to eighteen months. GRCCT has been enormously successful in recruiting registrants and profession bodies. Whilst retention remains strong market awareness has diminished. We feel we have relied too heavily on the numbers and the profession association communication route.4.6. Several major sites and a number of less major sites have dropped GRCCT referral as they are not ‘seeing GRCCT’. The Admin Team is now chasing hard on all of which we are aware. Please tell us of any sites of which you become aware that are not listing GRCCT.
Market awareness?
Financial report – Year to date is £736K income v £674 outgoings representing an annualised increase in turnover of approaching 18%. 
3.15. The two primary impacts on these are figures. The annual registration fee was increased at the end of last year. We targeted to cover 750K over three years so to hit 736K within twelve months is very positive. 
3.16. Advertising Certification is now coming online very well and will be reported more accurately at the next meeting.
That is an awful lot of money and the absence of an obvious limited company is troubling. At that level of income VAT registration is required. No mention is made of it but it is not necessary to display it on a website - only on invoices.
3.21. Since the last meeting senior teams have met or been in specific communication with: 
3.21.1. The GMC to discuss changes in advice to GPs 3.21.2. The BMA to discuss issues around insurance relating to the advice given to GPs3.21.3. Skills for Health to discuss awarding body status and development of new framework awards. 3.21.4. HCPC in relation to instruction from Privy Council 3.21.5. Delegation from Hong Kong in connection with ongoing discussion for the regulation and education of CAM practitioners in the China 3.21.6. Delegation from Kingdom of Saudi Arabia.3.21.7. The Irish Department of Health and Children on implementation of regulation and insurance.3.21.8. QCF re government proposals to amend framework level descriptors to more closely match European levels. It was noted that the majority of awards in the CAM sector are not on the framework. 3.21.9. Dept. of Health procurement team to facilitate understanding of requirement
"Specific communication"? That might mean the GRCCT sent an email. Most of the bodies mentioned would be extremely unlikely to engage because the CNHC exists etc. QCF stands for Qualifications and Credit Framework which is looked after by OfQual in England.
3.22. AGORED – Welsh awarding body who are seeking award consultation in Reflexology. The usual route for consultation on a framework award is for the proposer to demonstrate industry consultation. Often they will come to the regulator seeking a list of profession bodies. A Level 5 award was proposed by AGORED; the consultation for which would usually be directed by GRCCT to the LB (in this case the Reflexology Forum) and the proposer also supplied with a list of any know profession bodies outside of the regulatory process. In this case AGORED had mistakenly approached CNHC and ended up with a consultation panel including only discipline representation from the proposing education provider, the CNHC Profession Specific Body rep and Margaret Coats from CNHC. GRCCT was able to step in and administer the correct procedure to ensure that the submission would receive a proper consultation. 

Because of the nature of some of the claims, a complaint has been made to the ASA. It seems very unlikely that the GRCCT will respond.

Also from the minutes -
7. Advertising Standards Authority  
7.1. Legal actions – The meeting discussed the legal defence process and considered how GRCCT provides the Profession Guarantee to cover witness and profession report.  
7.2. There are currently two certified sites initiating legal action against ASA. The cost of libel action in the UK is very high but so are the awards for successful outcome. 
7.3. Advertising Certification – The advertising Certification process is now fully functional for all disciplines. 
7.4. BT provided the meeting with a history of ASA communication and overview of the types of applications being received. 
7.5. The FRC instructed that GRCCT continue to communicate with ASA with a view to having appropriate expertise consider complaints against practitioners. 
7.6. Another invitation to appear before the FRC is to be issued. 
7.7. RJ queried the term co-regulation as quoted by ASA.  
7.8. BT advised that in in 30 years of work in regulation he had never before encountered the term co-regulation in this context and could not provide an interpretation as to how co-regulation would function. Regulation in healthcare is either Statutory or Voluntary, the two cannot be mixed. 
7.9. SHB asked if there was specific advice available. She was directed to the discipline advertising descriptors on the GRCCT website.
Legal action against the ASA could take one of two forms. The serving of an injunction (average cost £500, but would be very difficult to obtain, see this case involving Matthias Rath) to prevent publication of an adjudication or post-publication libel action. Pursuing the ASA for libel would be unlikely to succeed given i) the number of legitimate defences and ii) breach of CAP Codes is also likely to be a breach of  consumer protection law and in some cases medicines regulation.

Searches of legal databases reveal no court action against the ASA by registrants of the GRCCT or persons with "certified" advertising but this may be a case of omission.

GRCCT at one point had a limited company in Ireland which is now defunct. It also had a website which is archived. Obviously, the GRCCT's attempt to expand into Ireland was a failure.

Questions, questions
Short of seeing audited accounts, audited membership numbers, etc, to be certain of anything that they GRCCT has said. Research has made it clear that the GRCCT/Banny Tanner has consistently overstated the importance/role of the GRCCT.

Have the trade associations involved with GRCCT ever seen audited figures? In the light of some of the information above, would they wish to continue their association? What about registrants?

Are there any real links between Freedom4Health and GRCCT or are they just "fellower travellers"?

Surely the GRCCT is not financially tenable any more? Has the formation of HINT anything to do with this?

UPDATE 20/12/2018
Things get more murky. The GRCCT are currently claiming elsewhere to have 18,769 members. 

This webpage is from the Federation of Nutritional Therapy Practitioners website. It makes for extraordinary reading. 
Members of FNTP have been amongst many practitioners in various disciplines of Complementary and Alternative Medicine (CAM) who have been unjustly accused by a private Limited Company called the Advertising Standards Authority (ASA) of being in breach of UK law when adverting their services. With the help of the General Regulatory Council for Complementary Therapies (GRCCT) none of the accusations against FNTP members have been actioned by Trading Standards.
We are very pleased to join with organisations in a wide range of disciplines in support of The Road to Change proposal which will facilitate industry-informed voluntary regulation of advertising in our sector.
There is little evidence of any support. From an email on that page, purported sent by one Martin McClinton of the GRCCT.
The GRCCT Advertising Certification process has gained considerable traction in the past year and succeeded in stopping Google from accepting Sponsored advertising from ASA against GRCCT Certified sites. Following the limitation of this and other ASA ‘sanctions’ we pleased to advise that Lord Toby Harris, Chair of the National Trading Standards Board, has now confirmed that the arrangement between Trading Standards Camden and the ASA has been suspended. No further referrals will be accepted until the situation has been reviewed.
The veracity of the statement re Google advertising in unknown but National Trading Standards said in an email -
Legal Backstop, National Trading Standards and London Borough of Camden. On the rare occasions when the ASA is faced with advertisers who persistently break the Advertising Codesthey will refer these cases to Trading Standards. Prior to 2012 this legal backstop function was delivered by the Office of Fair Trading. Following Central Government changes in 2013, when the OFT was abolished, this function became the responsibility of National Trading Standards (NTS). NTS does not have its own legal powers. It delivers all its work by commissioning specialist trading standards teams throughout the country. NTS commissions the work to deliver the legal backstop for the ASA from the London Borough of Camden Trading Standards Service. Camden uses its own legal powers under the above regulations to assess, investigate and take action (where appropriate) on any matters the ASA refers to it. This arrangement has been in place since 2013/14 and is ongoing. It has not been suspended.
Correspondence with GRCCT There has been no correspondence between GRCCT and NTS. 

Oh dear. The webpage also contains a link to this documentIn essence, it details GRCCT's attempts to position itself as an alternative to the ASA - albeit one that is funded by advertisers at great individual cost compared to small levy on the advertising industry.
The proposal recognises that the General Regulatory Council for Complementary Therapies (GRCCT) Advertising Certification process is the only vehicle which, when appropriately supported, can currently meet the requirements of a Compliance Partner. It is anticipated that after a period of successful operation (between 5 years and 7 years) Advertising Certification will be self-funding and in possession of sufficient supporting resources to enable uncoupling from GRCCT and establishment as an independent body.
Well, the GRCCT would say that.

The Advertising Certification Process is non-profit and self-funding. Pump-priming funds to the value of £250,000 will be made available at inception from the GRCCT Disciplinary Reserve Fund to cover costs incurred during the first 30 months of operation. This availability will be in the form of £180,000 available during the first 18 months of operation and a further £70,000 will be made available for months 19 to 30 if required. 
This is interesting - where the GRCCT is getting that kind of money from is unknown, assuming the money actually exists.

The FNTP website is interesting in itself as it uses some software solutions in common with both the GRCCT and the HINT website. This doesn't mean that they are linked in anyway. It is very possible that FNTP has absolutely no idea about GRCCT's problems with facts.

It is likely that very few are mislead by the GRCCT. 

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