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The questionable influence of HRH Prince Charles, The Prince of Wales, on the integration of complementary and alternative medicine (CAM) into the NHS.
“On Wednesday 4th July, London South Bank University, never the most reputable institution, in the Western hemisphere will further muddy its name by holding a conference on “Acupuncture for Integrated Pain Management” sponsored by the College of Medicine. [The College of Medicine] as I have previously discussed, is an alternative medicine lobby group in the UK that has been roundly criticised in the sane academic press for basically espousing Snake Oil in the name of the medical profession. The College is linked to Prince Charles…Having played it relatively safe quackery-wise since its inception, the College seems to have abandoned all pretense of being a medical organisation…In the evidence-based environment in which we find ourselves, acupuncture has failed miserably to demonstrate its effectiveness. The recent history of research into acupuncture can be easily summarised thusly: The better the study, the smaller the effects. Straws may be clutched at, yes-buts may be uttered and words may be weaseled, but acupuncture simply cannot claim to have any medical standing nowadays…South Bank University, already languishing at the bottom end of most academic rankings, might be doing its wallet a few favours by hosting conferences espousing the rolling out of spiritualist voodoo on the National Health Service, but it should look to its reputation before siding with the charlatans.” Site Unseen (27th June 2012)
“Dr Dixon took offence to a review [by David Aaronovitch] in The Times of Mark Henderson’s new book, The Geek Manifesto… This excellent review evidently upset Dr Dixon, because on 20th May, his letter appeared in The Times…This letter seemed remarkable to me. It is very close to being an admission that alternative medicine is largely placebo…We have been here before. Many people have discussed the dubious ethics of deceiving patients by giving placebos while pretending they are no such thing. There is wide agreement that it is not only unethical, but also unnecessary.” Professor David Colquhoun, DCScience (26th May 2012)
“The Prince’s Foundation for Integrated Health closed shop in 2010. Now the company that ran the foundation has officially closed. The foundation was a vanity project by Prince Charles, who had a soft spot for so-called alternative medicine and natural therapies. The foundation was established in 1993 and in the last 19 years has misinformed the public about CAM therapies, promoted nonsense like homeopathy, and has been an official royal seal of approval on the anti-science in medicine movement in the UK. In short the foundation was an excellent example of why political ideology should not interfere with the normal process of science.” Steven Novella, Science Based Medicine (16th May 2012)
“The College of Medicine is well known to be the reincarnation of the late unlamented Prince of Wales Foundation for Integrated Health…It seems to be morphing into a major operator in the destruction of the National Health Service through its close associations with the private health industry…According to their web site ‘a founder of the College of Medicine is Capita’. Still more amazingly, the CEO of the College of Medicine [Mark Ratnarajah] is actually an employee of Capita too…Capita is, of course, a company with a huge interest in the privatisation of health care. It also has a pretty appalling record for ripping off the taxpayer. Capita were responsible for of the multimillion pound failed/delayed IT project for the NHS and HMRC. They messed up on staff administration services at Leicester Hospitals NHS Trust and the BBC where staff details were lost. They failed to provide sufficient computing systems for the Criminal Records Bureau, which caused lengthy delays. Capita were also involved in the failure of the Individual Learning Accounts following a £60M over-spend. And most recently, they have caused the near collapse of court translation services after their acquisition of Applied Language Services…One would have thought that such a close association with a company with huge vested interests would not be compatible with charitable status. I’ve asked the Charity Commission about that. The Charity commission, sadly, makes no judgements about the worthiness of the objects of the charities it endorses.” Professor David Colquhoun, DC Science (3rd May 2012)
Follow-up 5 May 2012 “…I see that the Prince of Wales himself, gave a speech at the [3rd May 2012 College of Medicine] conference…The speech, as usual, contributes precisely nothing.”
“A common symptom of quackery is big promises that don’t stand up to closer examination. A bit like this statement on the College of Medicine’s website: “There is a new force in medicine. A force that brings patients, doctors, nurses and other health professionals together, instead of separating them into tribes. A force that combines scientific knowledge, clinical expertise and the patient’s own perspective. A force that will re-define what good medicine means...” Charming isn’t it? Just the sort of College we would all want to be part of...Supporters claim the CoM will help GPs to stand up against the kind of BigPharma driven ‘Eminence Based Medicine’ that sees GPs paid to put 85 year olds on statins and penalises us for keeping their blood pressure up so they don’t fall over…Backed into a corner and feeling de-professionalised, some GPs may feel there is no alternative…In asking my colleagues to stop their ears to the siren call of ‘integrated and holistic’ quackery, I am asking them to up their game and ask difficult questions of every service they commission and – crucially – every service they provide themselves…Stopping your ears and shouting la-la-la-la is just not an option.” Terri Eynon MD, Freelance GP blog (25th February 2012)
CLARENCE HOUSE: The Prince of Wales, President, The Prince's Trust, this afternoon gave a Tea at Clarence House…The Prince of Wales later held a Dinner at Clarence House for the College of Medicine, preceded by a Reception which The Duchess of Cornwall attended. [Google's cache of The British Monarch on FaceBook. A snapshot of the page as it appeared on 28 Jan 2012 02:41:50 GMT.]
“Clarence House insists that Charles has nothing to do with it. Yet the stated aims are strikingly similar to those of the Foundation for Integrated Health and in May 2011 Charles also attended a dinner at St James' Palace for the College…” Professor Edzard Ernst, The Guardian (10th January 2012)
“Prince Charles is a big supporter of “natural” medicine, which in practice means unscientific and ineffective medicine. He has no particular expertise in this area, and there is absolutely no legitimate reason why he should have any influence over the practice of medicine in the UK. But he is the Prince of Wales, and he has chosen to use that celebrity to promote CAM…I would argue that being in an influential position, like the Prince of Wales, and actually using that influence to advocate for a certain position, comes with it the responsibility for due diligence – to make sure that the position you are supporting is valid...The Prince is not just an advocate for CAM in the UK, he appears to actively and effectively lobby for its promotion, or at least removal of science-based standards that would stand in the way of abject quackery.” Steven Novella, Science Based Medicine (23rd November 2011)
“The heir to the throne will not accept that treatments such as homeopathy, acupuncture and chiropractic therapy do not work in the vast majority of cases…Singh said that hundreds of scientific studies had concluded that alternative medicine is ineffective. Yet despite this, the Prince of Wales continues to believe the therapies can help patients because of his ideological commitment to the natural world, Singh said. ‘He only wants scientific evidence if it backs up his view of the natural treatment of health conditions,’ he said…Singh blames the growing alternative medicine industry partially on celebrity endorsements, including the Prince…Singh is campaigning for alternative medicines to be more fully labelled so that patients can be properly informed about their limited benefits…Last year Singh won a court battle with the British Chiropractic Association, who sued him after he accused them of misleading patients over the range of conditions they could treat. He is now campaigning for a reform of the libel laws and warned yesterday that free debate on scientific issues is being stifled by the fear of legal action.” The Telegraph (19th November 2011)
“It is dogma in the face of evidence that riles him [Ernst], and that is one of the key motivators for his recent snipe at Prince Charles… Arguably, it is a parting shot in revenge for what Ernst believes to be the prince’s contribution to Ernst losing his job…Ernst is vague on the details — he is in the process of writing a book about that episode — but says his resignation was a precondition for [his] unit continuing to exist.” David Cohen, freelance journalist, BMJ 2011;343:d4937 doi: 10.1136/bmj.d4937 (August 2011) [FULL TEXT - pdf]
“…it was a complaint from Prince Charles's principal private secretary five years ago that nearly cost Ernst his job [see further down this page]. The letter, sent by Sir Michael Peat in his capacity as chair of the Prince's Foundation for Integrated Health, accused Ernst of violating a confidentiality agreement in relation to the publication of a report. Prince Charles denies having anything to do with the letter personally, and Ernst was cleared by a subsequent inquiry. But Ernst believes the power of the royal family has distorted public policy in relation to complementary medicine, and does not plan to let the subject drop.…When in 2005 he was asked to comment on a report on the economic benefits of complementary medicine – commissioned by Prince Charles's complementary health foundation, written by economist Christopher Smallwood and due to be delivered to government ministers – Ernst let rip [see further down this page]. Sir Michael Peat's letter of complaint was the result, and the investigation of his conduct which dragged on for 13 months…But his feud with Prince Charles goes on. He believes there is a "conflict of interest" for Prince Charles in using his public and charitable activities to promote complementary medicine, and making money from the "Duchy Herbals" range of remedies (Ernst calls them "Dodgy Originals") The Foundation for Integrated Health was shut last year and its finance director jailed for theft. "I think it's an abuse of power. It's not his job to do that. He's not a politician. He's the king to be, and that is a very defined role, and it's not to mingle in health, politics or anything else…Ernst points to a recent select committee report – to which he gave evidence – that concluded homeopathy is a placebo and shouldn't be funded on the NHS, and suggests that the Royal London Hospital for Integrated Medicine (which changed its name from the Royal London Homeopathic Hospital in 2007) enjoys "strong protection" from the royal family.” The Guardian (30th July 2011)
“Edzard Ernst, who was Britain's first professor of complementary medicine, said the prince's support for homeopathy and other alternative medicines earns him the title. In a briefing with reporters at the Science Media Centre in London, Ernst warned that "snake oil salesmen are ubiquitous and dangerous", and named the prince as "one of the most outspoken proponents of homeopathy". He later told the Guardian: "There are no official criteria for a snake oil salesman, but if they existed, I think Charles would fulfil them."…In a briefing that coincided with his stepping down, Ernst blamed earlier confrontations with Clarence House for the threatened closure of his department and his early exit as head of the unit…Clarence House said it would not respond to Ernst's latest comments, and added that the prince was unaware of Sir Michael's complaint in 2005.” The Guardian (25th July 2011)
NB. The complaint was written on Clarence House notepaper by Sir Michael Peat, partly in his capacity as the Prince of Wales’ Principal Private Secretary and can be viewed from 4:52 to 5:46 mins in this video link.
“As I described recently, The College of Medicine appears to have perfected the art of ‘bait and switch’. Despite its up front aims to ‘redefine good medicine’ and ‘renew the traditional values of service, commitment and compassion and creating a more holistic, patient-centred, preventative approach to healthcare’ it appears to be doing nothing but promote disproven and superstitious treatments… Despite a recent denial on the pages of the BMJ web site from the colleges prime sponsors that the College is not promoting quackery but “is calling for a more compassionate NHS, where practice based on good evidence”, the bankrolling by the Sunflower Trust would appear to contradict that view. The Sunflower Trust, the organisation behind Superjam, are quite explicit in their aims to see spiritual healers within the NHS…Another worry about the real nature of the College of Medicine is that they have been keen to distance themselves from the Prince of Wales, a notorious supporter of quackery. But, according to a tweet from the Superjam, Charles will be attending a reception for the musicians and guests before the main show. The College, with many of the same staff and supporters, can be little more than a resurrection of Prince Charles’ discredited charity, the Foundation of Integrated Health, that closed last year after arrests were made for corruption and fraud.” Quackometer blogspot (8th July 2011)
Replies to Jane Cassidy’s 15th June 2011 observations in the British Medical Journal. (Replies published on 22nd June 2011.)
Professor Edzard Ernst, Peninsula Medical School: “Jane Cassidy mentions that the new 'College of Medicine' singles out projects for praise. I had a closer look at the initiatives which were listed on the College's website. The information indicates that these projects offer a wide range of treatments, including homeopathy, qigong, reflexology and aromatherapy which, according to an evidence-based assessment, must be categorized as unproven or even disproven. In one case, a therapeutic claim was made (homeopathy is useful for asthma and eczema) which is clearly not supported by evidence. Quackery can be defined as the promotion of unproven or fraudulent medical practices. Based on this definition, there can be little doubt, I think, that the new College is a college of quackery. “
Michael Baum, Professor emeritus of Surgery, University College London: “The new College of Medicine promotes itself by claiming that modern medicine has lost its way and only they retain sufficient supply of the milk of human kindness to sustain the born again doctor of the future. Well if what Professor Ernst says is correct then the College of Medicine is in fact leading the way backwards to the dark ages of Galenic dogma and the new age doctor will be practising "new age" mumbo jumbo. A great leap forward into the past.”
James May, General Practitioner, London: “Is it possible that the new college is being deliberately ambiguous about the term integrative health? I would be interested to meet any doctor who would not support the underlying 'philosophy of taking into account patients' beliefs and personal circumstances and helping patients look after their own health.' Of course this fundamental principle of good medicine needs nurturing and encouraging at every opportunity. The college, however, seems to interpret this 'philosophy' to mean the promotion of unproven complementary therapies. These are very different agendas and should not be confused. All good doctors should support the first and reject the second. If this college appears to be an attempt to smuggle in the second under the guise of the first then good doctors should be very wary indeed.”
“The Indian system of medicine is increasingly attracting doctors from abroad, this time from the United Kingdom. The Prince’s Foundation for Integrated Health will soon collaborate with institutes practising and promoting alternative and integrated systems of medicine…Michael Dixon, the foundation’s medical director and adviser to Prince Charles: ”Due to fear of opposition from allopathy doctors, 50% of patients undergoing integrated treatment don’t reveal it and this is leading to problems. Realizing the need to educate and create better understanding, the foundation is setting up a college of integrated health by September.” Times of India (13th February 2010)
“…the College of Medicine, launched in October in a blaze of pomp and circumstance, is neither a college, nor a place particularly associated with the practice of medicine (as we understand it). Rather it seems to simply be the same alternative medicine lobbying organisation that brought such disrepute to Prince Charles earlier this year, except this time, his name isn’t quite so prominently attached to it…where is the Prince in all this? Charles’ support for alternative medicine is widely documented. In the recent past the Prince has dirtied his hands personally lobbying the relevant ministers and writing secret letters to the MHRA. But the Prince has clearly learned caution after the fall of his Foundation. When asked about the College by alternative medicine campaigner Prof. David Colquhoun, the Office of Their Royal Highnesses the Prince of Wales and The Duchess of Cornwall declined to make any comment referring him only to College director Dr. Michael Dixon. However, there are reasons to suspect the Prince is heavily involved…” Craig Aaen Stockdale , Republic (18th January 2011)
"Our future head of state wants alternative medical diagnostic techniques, using tongues, irises and the pulse to become more prominent on the NHS". Article by Andy Lewis, The Quackometer, (19th December 2010)
According to its home page, this college, which was launched on 29th October 2010, is “A force that brings patients, doctors, nurses and other health professionals together, instead of separating them into tribes. A force that combines scientific knowledge, clinical expertise and the patient’s own perspective. A force that will re-define what good medicine means...”
“The Prince of Wales’ Foundation for Integrated Health shut down amidst scandal in April 2010. In July, we heard that a new “College of Medicine” was to arise from its ashes. It seemed clear from the people involved that the name “College of Medicine” would be deceptive. Now the College of Medicine has materialised, and it is clear that one’s worst fears were well justified…It hides an agenda that could do much harm. It is, quite simply, the Prince of Wales by stealth." Professor David Colquhoun, DC Science (29th October 2010)
A Freedom of Information appeal hearing seeking the release of Prince Charles's correspondence with ministers so that the extent of his behind-the-scenes lobbying may be publicly assessed has been adjourned until next year for reasons the panel cannot 'go into'. Guardian (16th September 2010)
UPDATE: "This autumn a seven-year campaign by the Guardian to expose some of Charles's letters to ministers in seven Whitehall departments enters its final stages. The government is resisting the application, which will be decided by a freedom of information tribunal.” The Guardian (31st August 2012)
UPDATE (2): Prince Charles's letters to ministers should be disclosed, judges rule. "The government has for the first time been ordered to disclose copies of confidential letters that Prince Charles wrote to ministers after a freedom of information tribunal said that the public has right to know how the prince seeks to influence government policy." The Guardian (18th September 2012)
UPDATE (3): Seven government departments launch a last-ditch legal attempt to block disclosure of portions of the prince's confidential letters (also known as 'black spider memos'). The Guardian (12th October 2012)
UPDATE (4): "Republic accuses government of royal cover-up after it agreed to veto a Freedom of Information request for access to Prince Charles’s lobbying. In his statement, the Attorney General Dominic Grieve admitted that the letters were ‘particularly frank’ – expressing Charles’s ‘most deeply held personal views and beliefs’ – and would be ‘seriously damaging to his role as future monarch’. Republic has said that clearly Prince Charles has something to hide and that ministers have colluded and conspired with him to keep his secrets under wraps…[so] we’re announcing a new campaign for changes to the Freedom of Information Act that will allow the royals to be held accountable for their interference."
UPDATE (5): Comment from Hayley J. Hooper, Lecturer in Law at Trinity College, Oxford. Excerpt: “The decision in Evans v Information Commissioner  UKUT 313 (AAC) is something of a novelty in several respects. First, this is likely to be one of the last decisions of its kind because as of January 19, 2011 communications between public authorities and the Heir to the Throne are now the subject of an absolute exemption under the Freedom of Information Act 2000 due to an amendment made by the Constitutional Reform and Governance Act 2010. Secondly, the decision of the Upper Tribunal created the unusual situation whereby a judicial body had to adjudicate on the scope of several constitutional conventions as they related to the Heir to the Throne. Thirdly, it presents an opportunity to begin debating the proper conception of the public interest in knowing information about the activities of the Heir to the Throne in relation to his preparation for Kingship, and his role in public life generally.” UK Constitutional Law Group (16th October 2012)
UPDATE (6): Prince Charles letters: the attorney general's statement deciphered: The government has blocked the publication of 27 letters Prince Charles wrote to ministers. The Attorney General's justification for the ban turns out to reveal how disclosure of the letters could jeopardise Charles's chances of becoming king. Click on the yellow sections of text within this link for an explanation. The Guardian (17th October 2012)
UPDATE (7): Prince Charles's charity officials given access to Whitehall elite. Eighteen recent meetings with ministers and top officials raise further questions about prince's influence on politicians. The meetings took place over 13 months from the beginning of 2011 and include talks with four secretaries of state, the head of the civil service, the chief government scientist and the prime minister's key adviser on Europe and global issues.
UPDATE (8): Prince Charles and the curious case of the Black Spider Letters: "…this case – the case of the 'Black Spider Letters' – really is a fascinating one, involving an examination not just of the legislative provisions relating to the disclosure of information, but also a consideration of the existence and extent of constitutional conventions pertaining to the role of the monarchy in government…this intriguing story is not over. As well as responding to the Attorney General’s decision with a blistering editorial, the Guardian has indicated that it may seek to have the decision judicially reviewed in the High Court; the judiciary may yet have the last word." UK Human Rights Blog (23rd October 2012)
UPDATE (9): Prince Charles: 'black spider memos' to ministers could spark second veto: "Further secret lobbying letters could set cabinet against judiciary again if judges rule in favour of publication 'in public interest'. The prince is known to have strong views on subjects as diverse as architecture, farming and alternative medicine. For seven years, the government has been fighting to prevent the disclosure of the letters – dubbed "black spider memos" because of the heir's handwriting." The Guardian (26th December 2012)
UPDATE (10): Prince Charles held private meetings with eight ministers in 12 months: "Secrecy over the discussions with ministers has led to criticism that Charles, who has acknowledged his reputation as the "meddling prince", may be using the access to advance his own sometimes controversial views in areas of public life including health, the environment, agriculture and town planning, as well as education policy..." The Guardian (28th December 2012)
UPDATE (11): Minister accused of wrongly blocking publication of Prince Charles letters: "Decision by attorney general [Dominic Grieve] to veto disclosure of prince's letters to ministers was fundamentally flawed, high court told...Opening the two-day case at the high court, Dinah Rose, QC for the Guardian, said Grieve's use of the veto was fundamentally flawed and legally unjustified. The judicial review is the latest round in an eight-year battle by the newspaper to gain access to the prince's letters to politicians." The Guardian (9th May 2013)
UPDATE (12): Prince Charles's letters to ministers to remain private, court rules: "Judges reject Guardian attempt to force publication of 'black spider memos' that would reveal efforts to influence government...Cabinet ministers conceded that the prince's private letters – dubbed "black spider memos" because of their scratchy handwriting – contained Charles' "most deeply held personal views and beliefs", which could undermine the perception of his political neutrality...the lord chief justice of England and Wales, Lord Judge, ruled that the attorney general, Dominic Grieve, had acted properly when he employed a rarely used veto to block publication of the letters. The lord chief justice, however, noted that the existence of the veto was troublesome and appeared to be "a constitutional aberration". The Guardian is intending to appeal." The Guardian (9th July 2013)
UPDATE (13): Guardian challenges ban on publication of Prince Charles's letters to ministers: "...Dinah Rose, the QC for the Guardian, opened the two-day appeal in front of the master of the rolls, Lord Dyson, and two other judges, Lord Justice Richards and Lord Justice Pitchford. She is arguing that [attorney general] Grieve's use of the veto, backed by an earlier court, is legally unjustified and should be quashed. She told the court that Grieve had acted unreasonably when he issued the veto in October 2012." The Guardian (24th February 2014)
UPDATE (14): Veto over Prince Charles letters based on value judgment, court told: "Government lawyers defend a decision by the attorney general, Dominic Grieve, to block the publication of letters written by Prince Charles to politicians. Jonathan Swift, the QC for the attorney general, told the court that Grieve "was entitled to take a different view on matters of public interest from the tribunal, without any requirement for fresh evidence or a material error of fact"....Meanwhile, the government has delayed disclosing how much money it has spent in legal costs to ensure the letters remain concealed from the public. In a further freedom of information request two months ago, the Guardian asked the attorney general's department and the Treasury solicitor's department how much money they had spent on barristers and lawyers to oppose the publication of the letters. The Freedom of Information Act requires government departments to respond within a month. Last week the two departments said they needed more time to decide whether to release the information." The Guardian (25th February 2014)
UPDATE (15): Prince Charles letters: Attorney general acted unlawfully, say senior judges: Today's ruling in the court of appeal backs Guardian campaign to have letters to ministers released under freedom of information law. Three senior judges ruled [read the full text of the judgment] that Dominic Grieve, the attorney general, acted unlawfully when he blocked the publication of letters written by Prince Charles to government ministers. The ruling, led by Lord Dyson, the head of the civil judiciary in England and Wales, paves the way for the release of the letters which reveal how the prince lobbied government ministers to change official policies...Grieve had refused access to the letters, arguing that they could cause constitutional problems. He had said their contents could "seriously damage" the prince's ability to perform his duties when he became king because they could cast doubt on his political neutrality... Dyson said the attorney general had been given permission to appeal the ruling at the supreme court. He also ordered the attorney general to pay the Guardian's legal costs, amounting to £96,000. Dyson, the master of the rolls, said Grieve "did not have reasonable grounds" for issuing the veto "merely because he disagrees with the decision" of the tribunal. Grieve "could point to no error of law or fact in the [tribunal's] decision, and the government departments concerned did not even seek permission to appeal it", he added...Dyson, along with Lord Justices Richards and Pitchford, said Grieve "had no good reason for overriding the meticulous decision" of the tribunal, which examined evidence from constitutional experts and arguments from barristers for the government and the Guardian. Dyson called the verdict from the tribunal – which was chaired by a high court judge – "an impressive piece of work". Dyson also ruled that the veto was unlawful under European commission law...A spokesman for the attorney general said: "We are very disappointed by the decision of the court. We will be pursuing an appeal to the supreme court in order to protect the important principles which are at stake in this case." The Guardian (12th March 2014)