Right now, the Charity Commission is in the middle of a public consultation, asking whether or not organisations that offer complementary and alternative therapies should continue to have charitable status. This review presents an unprecedented opportunity for the public to turn the tide, and to make it clear to the Charity Commission that it is not enough to make a medical claim, but that such claims have to be backed up by reliable evidence.
There are currently more than 167,000 charities registered with the Charity Commission, each of which must meet one of 13 pre-defined charitable purposes, as well as operating for the public benefit. One such purpose is “the advancement of health or the saving of lives”. It is this purpose that most complementary and alternative medicine (CAM) charities currently registered with the Charity Commission claim to have as an objective, arguing that the promotion of CAM treatments is a benefit to the public.
However, last year scientists and medical professionals, working alongside the Good Thinking Society (ourselves a registered charity – #1147404), wrote to the Charity Commission in a letter also published in The Times (paywall). The letter urged the Commission to reconsider whether organisations offering or promoting alternative therapies should qualify under this purpose, given the lack of evidence of efficacy for the overwhelming majority of alternative therapies. In September last year, the Commission agreed to the review, and plan to announce their conclusions by 1 July 2017. As part of that review, the Commission is currently inviting interested professional bodies and members of the public to share their thoughts.
Although there are exceptions, such as hypnotherapy for irritable bowel syndrome, in the majority of cases alternative therapies are unproven, disproven or – worst of all – actively harmful. This means that some alternative medicine charities not only fail the public benefit test, but may result in harm, especially if patients delay seeking effective, conventional medicine.
Take, for instance, Cancer Active (registered charity #1102413), who describe themselves as “the UK’s number 1 Complementary Cancer Charity” and whose charitable purpose is “to provide information from all published scientific sources around the world so that people wanting to beat cancer can make more informed choices.” The charity has written in praise of the highly dangerous and caustic black salve, a topical ointment which burns the skin, leaving many users with severe scarring.
Another example of advice that does not meet the standards of mainstream science was republished by Cancer Active in 2012, in a lengthy article from the magazine What doctors don’t tell you entitled Much more than placebo: Homeopathy reverses cancer, which claimed:
Several homeopathic remedies are as effective as powerful chemotherapy, according to clinical trials, and thousands of cancer cases are being reversed by homeopathy alone.
It is not hard to imagine that someone suffering from cancer could follow this advice, with potentially disastrous consequences. Although the Cancer Active has added a disclaimer, in the end, the piece has been republished and promoted by a registered medical charity, with all of the credibility and legitimacy charitable status confers. The charity may be offering some sound information, but it is also making disturbing claims about some alternative therapies.
Other organisations are also deeply concerning. The Maun Homeopathy Project (registered charity #1109958) is run by with the charitable purpose of “Providing a free homeopathic service for women, men and children living with HIV and AIDS and/or traumatised by rape in Maun, Botswana”. Given the lack of convincing evidence – and total absence of plausibility – that homeopathy is effective for any condition at all, it is in our opinion hard to see how the Maun Homeopathy Project’s work– aimed at some of the world’s most vulnerable people – can be said to offer any real public benefit.
There are financial issues with granting CAM organisations charitable status too: The Vaccination Awareness Network (registered charity #1072794) defines its goal as “ To advance the education of the public in all matters relating to vaccination and immunisation”. However, its website betrays a bias: its url is not vaccinationawareness.com, but vaccineriskawareness.com and the site’s banner slogan is the Latin quotation Qui medice vivit misere vivit – which translates as He who lives medically lives miserably.
There is little sign of this charity presenting balanced scientific information; instead, their efforts involve spreading anti-vaccine advice such as is contained in their article:
Vaccination – the act of artificially acquiring a disease so as to become immune to it – is flawed in a number of ways. Firstly, a vaccine contains many hazardous chemicals and not just the viruses to immunise against. These each have their own toxic affect [sic] on the body.
This anti-vaccination rhetoric in the Vaccination Awareness Network’s material can be very persuasive to parents of young children – as the current re-emergence of the anti-vaccination movement in the UK and elsewhere demonstrates. It raises the question of whether it is right, at a time when Public Health England is working hard to raise vaccination rates across the country, that an organisation which discourages vaccination by spreading misinformation should be given charitable status and afforded tax benefits. The organisation has a right to free speech, of course, but it does not have an automatic right to charitable status. It is hard to see how it can be convincingly argued that the government should, through tax breaks and eligibility for Gift Aid, be subsidising the spread of dangerous vaccine misinformation.
The review by the Charity Commission is long overdue, particularly as Commission’s existing policy already states that claims to offer public benefit should be backed by more than anecdotal evidence. The review needs to acknowledge this policy and emphasise the importance of applying it in order to protect the public and patients.
This is also an opportunity for the Commission to protect public confidence in the charity sector as a whole – after all, those people who are generous enough to make donations to charitable organisations need the reassurance that charities are acting for the public benefit, and in particular that health charities are promoting treatments that are based in evidence.
If the Commission actually implements its policy in relation to requiring evidence of public benefit, then it may mean that some organisations lose their charitable status. However, organisations which do not meet the criteria for charitable status will not be shut down, they simply will not be given the credibility and the financial benefits that come from being a registered charity. In some cases, it may mean that a charity stops its non-evidenced activities, and focuses on its projects that have a demonstrable public benefit.
In turn, the public will have more confidence that when they give their money to charities – especially health charities – those organisations will have shown their treatments offer a public benefit, which ultimately means more people will be helped more effectively, and fewer people will be harmed unnecessarily.
The Charity Commission’s CAM consultation closes on 19 May, and the public are invited to respond. As project director at the Good Thinking Society, I have submitted a response, which is available to read via our website. We know that supporters of alternative therapies will be responding to the review, so it is vital that doctors, nurses, scientists, those who care about evidence-based medicine and evidence-based philanthropy, as well as everyone who donates to charity, make their voices heard by taking part in the consultation.
In prompting and contributing to this review, we feel we are making a very fair and reasonable request, namely that those who want charitable status to promote or offer an alternative therapy should be able to present an appropriate level of evidence to show that they offer a public benefit, in accordance with the law. Is that too much to ask?