DIRTY MEDICINE
a book by Martin Walker MA
ISBN 0951964607
Orthodox medical practitioners, pharmaceutical companies and industrial scientists, have organised against alternative and complementary medicine in Europe and America, since the last century. Dirty Medicine traces the history of these campaigns, their proponents and institutions.
In 1987 the Wellcome Foundation one of Britain's largest multi-national drug companies, obtained a license for the drug Zidovudine, known as AZT. AZT was heralded by the media and marketed by Wellcome as if it was the answer to the AIDS epidemic. Packaged and promoted like any other commodity, public relations companies and advertising agencies hyped AZT from Romania to Uruguay. In 1992 the Foundation made nearly £200 million profit from the drug.
With the marketing of AZT, the campaign against alternative and complementary medicine was suddenly transformed from an academic dispute to a war. Dirty tricks, industrial sabotage and character assassination replaced normal business and scientific practice.
Dirty Medicine, is a frightening story of the free market, at war with the powerless. It exposes how, under the guise of government regulation, big business, science and medical orthodoxy defended their products and profits from competition.
Orthodox medical practitioners, pharmaceutical companies and industrial scientists, have organised against alternative and complementary medicine in Europe and America, since the last century. Dirty Medicine traces the history of these campaigns, their proponents and institutions.
In 1987 the Wellcome Foundation one of Britain's largest multi-national drug companies, obtained a license for the drug Zidovudine, known as AZT. AZT was heralded by the media and marketed by Wellcome as if it was the answer to the AIDS epidemic. Packaged and promoted like any other commodity, public relations companies and advertising agencies hyped AZT from Romania to Uruguay. In 1992 the Foundation made nearly £200 million profit from the drug.
With the marketing of AZT, the campaign against alternative and complementary medicine was suddenly transformed from an academic dispute to a war. Dirty tricks, industrial sabotage and character assassination replaced normal business and scientific practice.
Dirty Medicine, is a frightening story of the free market, at war with the powerless. It exposes how, under the guise of government regulation, big business, science and medical orthodoxy defended their products and profits from competition.
- [Chapter 7 extracts] Organising and Fighting Back by Martin Walker
- [Chapters 26 & 27] The Campaign Against Health Fraud by Martin Walker MA
- [Chapter 28] The Company Director: Dr Vincent Marks by Martin Walker MA
- [Chapter 30] Professor Michael Baum: The Trials of a Cancer Doctor by Martin Walker
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From Chapter 7, Dirty Medicine: The Handbook.
Organising and Fighting Back
The cases of Dr Sarah Myhill MB BS in Britain and Meryl Dorey in Australia have many things in common. The objective of the cases from the perspective of those who attacked them are, in Sarah Myhill’s case, to force vaccine and therapeutic hegemony on Britain’s doctors, and in Meryl Dorey’s case to enforce the use of vaccination on Australia’s parents. They have both been the subjects of originally anonymous complaints by Skeptics, and after bogus investigations, they were both ordered to take down or alter parts of their websites.
The censoring of health information about medicine on the Internet is something that corporations have been very concerned about over recent years. Both the complaints against Dr Myhill and Meryl Dorey were made by Skeptic fellow travellers, citing material, in Dr Myhill’s case, which alluded to vaccination and the treatment of ME (myalgic encephalomyelitis) and chronic fatigue syndrome (CFS), (END NOTE 52) and on the Australian Vaccination Network (AVN) site about the problems and adverse reactions to vaccination.
The Skeptical complainants in both cases, however, manifest a different reaction from the complaints they had made, in England to the GMC and in Australia first to the Health Care Complaints Commission (HCCC). The Australian complainant appeared publicly with the over–aggressive emphasis used by quackbusters to protect themselves on film and on the Internet. In England, the medical research worker who complained about the content of Dr Myhill’s site wanted to remain anonymous — as they often do. When, however, Stuart Jones’s name entered the public domain, he suddenly became contrite in a thoroughly English way.
Stuart Jones explained on the BadScience site how he came to make the complaint almost be accident; presenting himself in the most reasonable of lights: (53)
In private the real reasons that Jones struck out for anonymity became clear when he emailed Dr Myhill, miserably complaining that he hoped the matter of his identity could be tucked away. In this communication he showed that he was now considerably embarrassed and slightly fearful of being criticised for behaving like a common informer.
He shouldn’t, of course, have been emailing Dr Myhill personally under any circumstances. His first worry was for that angel of medicine Ben Goldacre. It was important, Jones said, that no one identified Goldacre with him and his complaint, as this would have been terribly unfair:
On 8 April 2010, Sarah received a letter from Rebecca Townsley, assistant registrar at the GMC, stating that there had been two complaints about her medical practice received by the GMC. The GMC considered that these complaints brought her fitness to practise into question and so instigated an Interim Orders Panel Hearing.
One complaint that was termed the ‘B12 Complaint’ came from a practice of eight GPs, Dr H L Moss and Partners, who complained about Sarah’s advice that they should prescribe vitamin B12 and magnesium sulphate injections to a patient at their practice who suffered from Batten’s disease.
The ‘Website Complaint’ concerned a complainant, described as a clinical scientist, who considered that Dr Myhill’s website represented a risk to public safety. As far as Sarah Myhill was concerned, the complainant was effectively anonymous, although he quickly became known as Stuart Jones.
These complaints were heard at an IOP Hearing held on 29th April 2010. Despite the fact that the GMC has frequently claimed that it does not control the practice of doctors, a major content of the complaint against Dr Myhill was evidently aimed at stopping her from taking various treatment courses. The complaints against Myhill arise from the belief that her treatments do not conform to National Guidelines, in the case of the website complaint, and that Sarah Myhill’s recommended treatments in the case of the B12 were off licence and therefore in some way not generally recommended. Both Neil Jinks, GMC assistant registrar in 2006, and the gynaecologist Wendy Savage in her book A Savage Enquiry(about her own struggle with the GMC, which became a cause célèbre), make the point that the GMC cannot get involved in treatment modalities, stating that:
One of the first principles of British, European and even world law has always been that the accused is allowed to face their accuser in the court, not simply so that the accuser’s demeanour and physical presence can be seen by a jury, but also, and most importantly, so that the accused can cross–examine the accuser.
This process has only recently been forfeited in some terrorist trials or those involving informers to whom harm might later fall. Even then, in such cases, the witness has to arrive at the court and, though their voice might be disguised and though they may sit behind a screen, they are bound to answer questions from the defence that go to the heart of their accusation.
The GMC, in line with organisations like the RSPCA and RSPCC and other lower tribunals, now allow complainants to keep their anonymity. In the 1990s, when the pharmaceutical companies desired to bring their own cases before the GMC against doctors who worked against their interests, the Association of the British Pharmaceutical Industry's (ABPI) own private investigation agency MEDICOLEGAL INVESTIGATIONS LIMITED worked with the journalists to bring a number of cases before the GMC. (57) It seems to have been the case that, at that time, the GMC was unprepared to act unethically bringing charges without complainants to the hearings.
A decade and a half later, however, in the case of Dr. Andy Wakefield, the GMC appeared happy to ditch all pretence of due process. Brian Deer, a journalist for The Sunday Times, ‘uncovered’ the story of Dr Wakefield’s wrongdoings and then, after consorting with MLI and its appearance in The Sunday Times, sent his ‘evidence’ to the GMC, who caught it and ran with it. The prosecution case never reached further than Deer’s improbable ‘exposé’. Deer was never asked to give evidence and it seems more than likely that the GMC felt Deer would have been a poor and perhaps volatile witness, unable to cope under cross–examination.
In the case of Dr Myhill, the GMC excelled itself, flying in the face of hundreds of years of jurisprudence. Despite there being two sets of original complainants, the GMC refused to bring any of them to give evidence or be cross–examined. Just how, a person would be able to prove their innocence without tackling the accuser is beyond reason. However, the GMC seems to sidestep such minor issues.
None of the partners of one complaint including Dr Y, a partner from the practice who had complained against Dr Myhill, was brought to any hearings. Neither was Professor Bouloux, the expert witness who tendered a flawed expert witness report. Of course, in relation to the second set of charges, Stuart Jones was not present for cross–examination. Keen to cross–examine all these parties, the defence asked to subpoena the practice partner, only to be told that only the GMC could subpoena witnesses. How does the GMC get away with this?
The website complaint against Dr Myhill was perhaps far more complex than either she or her lawyers understood. For the past 10 years, the FDA especially, but also all the corporate interest organisations and the UK regulatory agencies have tried hard to bring ‘health freedom’ websites under control. It’s the same old story: while pharmaceutical companies sell off their produce to agents who sell them over the Internet with no care about buyers’ medical status or full explanations of adverse reactions, alternative medicine practitioners or campaigners are increasingly coming under attack for explaining their therapies or criticising pharmaceutical medicine.
In Dr Myhill’s case, the website complaint from Stuart Jones was based on a personal belief system, which bore little relation to any objective reality. The complainant seemed to believe that NICE guidelines were in some way mandatory, and that doctors who do not abide by them should be investigated for malpractice. This is not the case. (58)
The website complaint brought up the issues of due process, perhaps more than any complaints made in Dr Myhill’s case. The GMC seems to have reassured the complaining medical research worker of his anonymity and the lack of need for him to attend the hearing. How, then, was his completely unreferenced complaint to be pursued? He had, for instance, objected to a claim on Dr Myhill’s website that women should not always attend for breast screening. And yet, the concept of regular mass breast screening it is now often criticised, as this reference in the Belfast Telegraph makes clear:
In October 2010, Dr Myhill was called before another hearing the outcome of which was that she was banned from acting as a doctor for a period of six months.
Finally, for the moment at least, on 6th January 2011 the Interim Orders Panel, GMC, made the decision to lift the suspension of her GMC registration and to restore her licence to practise medicine. The Panel again placed a small number of procedural conditions on Dr Myhill’s registration, reversing its fitness to practice order while substituting a whole list of conditions. Supporters of Dr Myhill promote this change as a win and suggest that the prescribed conditions are largely cosmetic and procedural. Dr Myhill herself suggests that this climb–down will enable her ‘to carry out about 95% of her normal work’. However, reading the new terms and condition of practice, one is struck by just how arrogant and partisan the GMC is as they continue to protect their backs, principally concerned about being taken to a real court.
In the book there is a section about Meryl Dorey that you will have to buy the book to read. It then continues ...
Fighting Back
The objective of the Myhill and Dorey cases from the perspective of those who attacked them, are, in Sarah Myhill’s case, to force therapeutic hegemony on Britain’s doctors, and, in Meryl Dorey’s case, to enforce the use of allopathic pharmaceuticals, specifically vaccines on Australia’s parents. To these ends, they were both the subjects of originally anonymous complaints by those sympathetic to the Skeptics, and they were both ordered, after a bogus investigation, to take down or alter parts of their websites.
The censuring of health information about medicine on the Internet is something that corporations have been very concerned about and committed to over recent years. This is interesting when one considers that these same people and these same organisations get hysterical about China and other countries interfering with the communications laws and regulations of other countries.
The complaints against Dr Myhill and Meryl Dorey were made by Skeptic fellow travellers, citing material, in Dr Myhill’s case, that alluded to vaccination and the treatment of ME (chronic fatigue syndrome) (64) and on the Australian Vaccination Network about the problems with adverse reactions to vaccination. This has involved concerted attacks on those who put forward such views. The contemporary vaccine wars have been waged at an escalating rate in Britain since the sixties and industry–protective organisations have worked hard to censor alternative views to mass vaccination and herd immunity.
The Skeptical complainants in both cases, however, manifest a different reaction to the complaints they had made, in England to the GMC and in Australia to the HCCC. The Australian complainant appeared publicly, with the over–aggressive emphasis used by quackbusters to protect themselves, on film and on the Internet. Collegiate organisations, and tipped–off regulatory organisations, rounded on Meryl, upping the stakes as days went by, name–calling and using vile threats on Twitters and other email facilities, while using every conceivable form of complaint to regulatory and oversight organisations.
In both cases the complaints were made by men against women; in both cases, the victims have fought back in a collective and exemplary manner. Both victims sought advice from radical academics and campaigners, and placed this advice on a similar parallel to the advice from lawyers. (65)
The way in which both organisations fought back and clearly survived, without massive public success but with an enhanced reputation amongst those who believe in freedom and democracy, shows that people are learning clear lessons about resistance. The lessons can be summarised in this way:
• Both groups framed their fight–back in political terms, with an emphasis on freedom of speech and civil and constitutional rights.
• In varying degrees, each organisation and both of the individuals involved understood from the beginning that they were being attacked, and that those who were attacking them were out to destroy their work and their published views.
• Both groups immediately publicised a message that answered and rebutted the accusations. There were no apologies, nor linguistic compromise.
• Both groups published contemporary information telling all their supporters what was going on.
• Both groups developed their websites, rather than curtailed them.
• The British group was immediately supported by patients who demonstrated outside the GMC.
• When Skeptics and their fellow travellers became involved in violent Internet threats against Meryl Dorey, she and her colleagues went straight to the police, publicised the threats, and demanded they record the incidents.
• Both groups learned very quickly that, on the whole, journalists are a waste of space because their newspapers and other media outlets are deeply tied to corporate interests.
In both these cases the whole point of the complaints was to censor the voices of pharmaceutical and chemical victims. It is very important that we understand the simple message exposed by both these complaints. In the Brave New World of science dictocrats, there is to be only one medical view, the official view, the pharmaceutical view. Anyone, whether a doctor or a layperson, who expresses any other view is first to be censored and then punished. Parents, for example, will not be allowed access to information about vaccination that is contrary in any respect to the orthodox view. Only one view is allowed: ‘four legs good, two legs bad’. Medically, politically and socially, this is totalitarianism engineered and provoked by powerful governments and corporations.
But perhaps even more frightening in this new world is the fact that it will ultimately not be intelligent four–legged animals making the decisions, but corporate science groupies, individuals whose cultural and intellectual acumen often ranks lower than a snake’s belly.
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END NOTES
51 (Cont.) is now in the parliamentary record, questioning the remit based on the people who had been invited to give oral submissions to the hearing. She also petitioned her MP and wrote a further two emails that were circulated to members accusing the Committee of obvious bias. She addressed the homeopathic community asking them to petition their MPs about this bias. However, there was no official statement on the issue and it proved impossible to get one on the table.
52 There has been a thirty–year campaign by psychiatric interests to prove that there are no environmental factors involved in ME.
53 Bad Science, posted on Thursday April 15th at 2.20.
54 Uber: an outstanding or supreme example of a particular kind of person or thing. He accuses Dr Myhill of being a supreme quack!
55 03 May 2010 10:12 to Sarah Myhill and subject titled: False accusations at Badscience/Ben Goldacre.
56 Mon, May 3, 2010 at 6:04 PM Jones to Myhill.
57 In the mid 1990s they worked with Duncan Campbell, the New Statesman’s journalist who joined the Campaign Against Health Fraud.
58 Dr Myhill’s legal brief.
59 Belfast Telegraph on 4 August 2010:
http://www.belfasttelegraph.co.uk/news/health/ breast-screening-harms-as-many-as-it-saves-report-14897265.html
60 http://hjhop.blogspot.com/2010/12/meryl-dorey-fucking-microphones-how-do.html
61 http://blogs.discovermagazine.com/badastronomy/2009/12/02/australian-skeptics-jeer-meryl-dorey/
62 An understanding of this organisation gives us a clear indication of what herbalists, homeopaths and nutritionists will be faced with when complaints are brought to the Health Professions Council (HPC), in the new regulatory system outlined at the beginning of this chapter.
64 (From previous page) Walker, J Martin. SKEWED: Psychiatric hegemony and the manufacture of mental illness, in Multiple Chemical Sensitivity, Gulf War Syndrome, Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. Slingshot Publications. London 2003.
65 Jayne Bryant and One Click helped organise support for Dr Sarah Myhill, while Brian Martin, the exceptional Professor of Science, Technology, and Society at the University of Wollongong, and I both helped Meryl Dorey, although with nothing she wasn’t capable of organising herself!
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The Campaign Against Health Fraud
by Martin Walker MA
[Chapters 26, 27, 31 DIRTY MEDICINE by Martin Walker. 1993]
1. Background and Beginnings
Organisations like the Economic League were set up to gather intelligence on trade unionists. In the mid-seventies, the National Association for Freedom, sponsored by big business and organised by individuals with backgrounds in the intelligence community, campaigned first to get Margaret Thatcher to lead the Conservative Party and then for monetarist policies.
The pharmaceutical industry, intimately related to the great oil and chemical conglomerates, has often been at the forefront of covert industrial subterfuge and propaganda. Those who controlled oil have often also been close to the centres of foreign policy.
Gulf Oil, founded by the Mellon family, was before the Second World War part of one of the largest chemical cartels in the history of modern capitalism. It was dominated by LG. Farben, a group of German chemical companies. 2 In the 1960s, the London offices of Gulf Oil, now known as Chevron, were based in an unobtrusive high-rise office building called Gulf House, just off Oxford Street. From that building in 1967, the Queen Anne Press produced Medicine at Risk: The High Price of Cheap Drugs, by F. H. Happold.3 The only acknowledgment the author gives in the book's foreword is to the Association of the British Pharmaceutical Industry (APBI).
The book was published at a particularly sensitive time. The British Trades Union Congress was raising social and political questions about the pharmaceutical industry and in America the Kefauver hearings had recently enquired about price and monopoly practices. Only six years before, the international effects of thalidomide had dealt the image of the pharmaceutical industry its most devastating post-war blow.
The themes of Medicine at Risk are the themes of propaganda for the next two decades: themes which were to surface with a vengeance in the late 1980s.
Books like Medicine at Risk were foisted upon a relatively unsophisticated audience in the fifties and sixties. Its arguments are transparent but useful to explain the marketing strategies of the pharmaceutical companies in relation to alternative and complementary medicine. Twenty years after the inauguration of the NHS, Medicine at Risk supports the cosy relationships which socialised medicine introduced between general practitioners and the pharmaceutical industry.
Another important symbolic battlefield is the medical press. This too exists in a perfect world concerned only with disseminating biasfree information about the most appropriate treatments.
The arguments put forward by Happold show that even in the mid-sixties, it was difficult to separate doctors from the pharmaceutically-orientated infrastructure, which had grown up, densely, around them.
The Contemporary Scene
It was evident, in the early years of the nineteen eighties, that there was a growth of interest in alternative and complementary medicine. It was an interest about which pharmaceutical companies were becoming increasingly concerned.
In 1981, the Threshold Foundation, a body primarily interested in complementary healing, published the results of a survey into the status of complementary medicine in the United Kingdom. 10 The survey, thoroughly researched, was a major contribution to the understanding of the status and social position of a wide range of complementary treatments in Britain.
Some results of the Threshold Foundation study gave the pharmaceutical companies serious reason to be concerned. Findings showed that increasing numbers of patients were turning to non-orthodox practitioners and that in the year 1980 to 1981, the numbers of such practitioners were increasing annually by around 11 %. The number of lay homoeopaths registered with a professional association, for instance, had risen from 25 in 1978 to 120 in 1981. The number of practising acupuncturists had doubled during the same period, rising from 250 in 1978 to 500 in 1981.
Such figures had a relevance far beyond their simple arithmetic. The growing number of complementary practitioners would not be prescribing or advising the use of drugs. Perhaps more startling to the pharmaceutical companies, as each discipline set up its own training programme, the education of 'healers' and specialists would begin to change. The survey showed that already, by 1981, the rate of increase in complementary practitioners was nearly six times that of the annual increase in the number of doctors in the UK. 11
In July 1983, the BMJ 12 carried an editorial which warned doctors to remain sceptical about alternative treatments until they had passed the supreme scientific test of the 'controlled trial'. More should be done, the editorial suggested, to carry out rigorous clinical trials for alternative treatments: 'Stricter standards should be required, however, by a doctor proposing himself (sic) to use alternative treatments. If the treatment he (sic) proposes using has not been validated by a clinical trial then he (sic) is in just the same position as a clinical pharmacologist with a new drug.'
In 1984, the Royal College of Physicians and the British Nutrition Foundation published Food Intolerance and Food Aversion, which brushed over alternative treatments in relation to allergy. In 1986 the Board of Science and Education of the BMA published a report on Alternative Therapy, 13 which was clearly the profession's answer to the Threshold report.
Alternative Therapy argues the case for the allopathic doctor against the alternatives. The report was overseen by Sir Douglas Black at a time when he was President of the BMA. The first thirty six pages discuss the history of medicine from the birth of man, very useful for first-form secondary school pupils, but not so useful for those interested in alternative therapies. The description of the alternative therapies themselves is twenty five pages long. A short historical description of each practice - homoeopathy gets three pages, herbalism gets one page, acupuncture two pages - is followed by eighteen pages of discussion and analysis.
These eighteen pages represent the tablets of stone upon which later and more acerbic critics of alternative medicine, campaigning in the late eighties, came to base their case. The discussion begins with a short discourse in praise of science and from that point onwards a fog of cynicism emanates from the pages.
The authors of Alternative Therapy considered it important to make clear not only that many alternative treatments were in their opinion non-scientific but also to point out the fact that a number of alternative therapies are propagated by 'cults'. By discussing medicine within this context, the report begins the process of the 'criminalisation' of alternative practitioners, which the Campaign Against Health Fraud was to take up in 1989.
Another idea which enters the public domain with this report, is that many alternative therapies are actually bad for you. Never is the information about health damage caused by alternative medicine compared to the dangers implicit in pharmacological treatment, or surgical intervention. Rarely are references given for claims and never are these claims the result of scientific studies.
The campaigns against allergy medicine in particular, and clinical ecology generally, had perhaps been strongest during the previous decade in the north of England. The pragmatism of industrial Protestantism is seemingly unwilling to accept ideas about the delicate interleaving of the mind and body, and the hard commercial instinct remains unconvinced by alien notions of industry being bad for the health.
In the mid-eighties, after going to work with Wellcome, Caroline Richmond consolidated her friendships with a variety of natural allies, most especially orthodox doctors working in the field of immunology. Her most enduring contacts were made with doctors and activists in the Manchester area, the city which was to become host to the UK Skeptics. Two doctors in particular, Dr Tim David and Dr David Pearson, joined Richmond in her campaign against the alternative treatment of allergy.
In 1982, Dr David Pearson returned from the United States, where he had been working in an occupational illness centre funded by the US public health department. His first stop was Manchester University where he had previously received his PhD. Now his area of research was classical food allergy. Dr Tim David also became prominent in the early eighties working as a paediatrician, with an interest in allergy, at Booth Hall Hospital in Manchester. Dr David's interest in allergy developed in the late seventies and grew from his work with the National Eczema Society, a group which even then was patronised by the oil and pharmaceutical companies.
Both David and Pearson felt particularly offended by the work and life style of Dr Keith Mumby. His practice, in the early eighties in Stockport then later in Stretford, on the edge of Manchester, used the 'provocation neutralisation' technique to diagnose and then treat allergies. Mumby, a writer as well as a doctor, had come late to environmental medicine, and when he did get involved, it was with great enthusiasm. He travelled frequently to America to train with Dr Joe Miller, the 'father' of provocation-neutralisation. By the mid-eighties Dr Mumby was at the centre of a small northern contingent of environmental practitioners.
Another doctor who had been attracted to environmental medicine and especially to food allergy treatment was Dr David Freed, at that time based in Prestwich near Manchester. Despite being a classically trained allergist and immunologist, Freed turned away from orthodox medicine and towards clinical ecology in the late seventies. He is a large, bearded man, whose avuncular nature disguises a clear, disciplined mind. It was during his postgraduate training at Manchester University that Dr Freed first met Dr Pearson. In the mid-eighties, Dr Freed was working with an allergy therapist and dietician, Anna Foster.
From the early eighties onwards, these northern practitioners were to become the subjects of a propaganda assault organised by Caroline Richmond and her two close friends.
While at Manchester University, Pearson carried out an investigation into people who said they suffered from food allergy; he later published the study.2 Pearson and his psychiatrically trained colleagues took a small group of individuals who either maintained that they suffered from allergy, or had been diagnosed as so suffering. Each patient was challenged with capsules of food additives and chemicals. Only 5 out of the 35 patients produced reproducible symptoms in a double blind test. The researchers concluded that the remaining 30 patients were suffering from psychiatric complaints.
This single piece of research by Pearson was to form the basis for the next decade of campaigning against doctors working in the field of allergy. The singular work was also to form the basis of Caroline Richmond's later contentions that people who complained of allergic responses or chemical sensitivity were in fact psychologically ill.
By the mid-eighties, both Pearson and David had got themselves quoted in the papers denouncing 'private allergy clinics'. 3 Dr Freed, who was working with Anna Foster in one of the few private allergy clinics near Manchester, 'The North West Allergy Clinic', inevitably felt that such attacks by Pearson and David were personal attacks on him.
Even in those early days of the campaign against clinical ecology, the vested interests supporting orthodox allergy work were beginning to show. Tim David denounced Dr Freed to the General Medical Council, after his name appeared on a list of doctors supporting the Hyperactive Children’s' Support Group, which had begun campaigning against chemical food additives.
In November 1986, a large two-day conference of classical allergists and immunologists was held in London. The proceedings were to be published as a book on food allergy. 4 The conference was sponsored by a leading nutrition company, Wyeth Nutrition, and held at Regents College. About twelve doctors attended a critical seminar prior to the conference at the Royal College of Physicians, at which each paper and potential chapter was discussed.
Following the seminar, the doctors gave a series of talks to the full conference. The audience was an invited audience consisting mainly of paediatricians and GPs. One of those present who was not a clinician of any kind was Caroline Richmond. When Dr David Freed went up to the podium to read his paper on 'provocation neutralisation', Richmond came bustling from the audience with a tape recorder.
In the mid-eighties, Richmond was already developing the tactics and gathering the intelligence, which were to form the basis of her work for the Campaign Against Health Fraud. A year after the Swiss Cottage conference, in Autumn 1987, while working at the North West Allergy Clinic, David Freed received a phone call from Caroline Richmond. She introduced herself as a journalist and asked for his comments on an article which she had written about the clinic.
After it had been read to him, Freed thought Richmond's article:
By the end of 1987, Dr Freed had a very clear idea that he was considered by Caroline Richmond and her small group of campaigners to be in the enemy camp. In 1988, after Anna Foster had set up a new organisation in Bolton called 'Nutritional Medicine', she received another call from Richmond. Richmond said she was working for the Observer on an article about allergy. When it became apparent that Anna Foster was not going to take part in an interview, Richmond used tactics which were to become common in later campaigns. She rang Foster frequently. The continual calls, as late as midnight, became so annoying that Foster was forced to refer the matter to the Press Council.
The Beginning of the Campaign Against Health Fraud
The major players in the British health-fraud movement, Caroline Richmond, Dr David Pearson, Dr Vincent Marks, Professor Michael Baum and Dr Nick Beard, had been coming together since 1985. They were all heavily involved in the defence of scientific medicine and most of them had a connection, however tenuous, with the Wellcome Foundation.† Each founder member also had contacts who would be drawn into the campaign and help in reporting information and publicising cases. One 'quackbuster', whose role in the organisation was to be shrouded in misinformation, was Duncan Campbell. Campbell was later to claim on a number of occasions that he had never been a member. There are, however, a number of references from the early days of the organisation which show clearly that he was involved. ††
† As well as working in the Wellcome Institute, and receiving a Wellcome bursary, Richmond acquired 250 Wellcome shares in December 1986. She held these shares until they were sold in 1990.
†† The Autumn 1989 CAHF Newsletter quotes a letter sent by Campbell to Hospital Doctor. 'I enthusiastically welcome the recent launch of CAHF. In the few weeks since they launched, I and others have already benefited immensely from their assistance in working to expose the many (other) charlatans who are preying on the vulnerable for commercial gain'. 7 Around the time that the Campaign was launched, Campbell had meetings with Caroline Richmond and Nick Beard. He was cited in the Campaign's newsletter as a member and attended ordinary Campaign meetings and closed Annual General Meetings at the Ciba Foundation and St Bartholemew's Hospital.8 At around the same time that it became public that the Campaign was funded by the Wellcome Foundation, Campbell began to distance himself from the organising core of the Campaign, and later claimed that he had never been a member. For the purposes of this book, Duncan Campbell has been considered as an associate member of the Campaign Against Health Fraud. He added a great deal of authority to the Campaign's strategy and was instrumental in many of its critical attacks. He used information supplied to the Campaign and was happy to use its founder members as a rich source of quotes for his articles, without questioning their vested interests. From the first 1989 issue of the UK Skeptic, Caroline Richmond and Nicholas Beard had the space to outline the strategies and attacks organised by the CAHF. In the February 1989 issue, Nick Beard contributed an article about the need to put natural or alternative remedies through clinical trials. He used the article to consolidate the attack on Jacques Benveniste carried out the year before, by CSICOP member James Randi.
It was first decided to call the Campaign, the Council Against Health Fraud. 6 This is a clear indication that the British Campaign had links with the American Council.† In November 1988, Caroline Richmond organised the first steering committee meeting for what was to become the Campaign. The meeting was advertised in the newsletter of the Medical Journalists Association (MJA). The MJA, of which Richmond is a long-standing member, is supported by Ciba Geigy and a number of other pharmaceutical companies. Companies use the Association's newsletter to advertise meetings and conferences and 'freebies' at which they promote their drugs to journalists.
†The Campaign Against Health Fraud was listed in the Newsletter of the American Council as an associate organisation. 9
Following the meeting, Caroline Richmond sent round a circular to the press and interested parties. 'At a meeting on 1st November 1988, a group including doctors, journalists and a barrister decided to form the Council Against Health Fraud, an information and action service against the growing tide of quackery.' At the bottom of this short advertisement Richmond gave her address, for contact purposes, as The Wellcome Institute, 183 Euston Road.† 10
† Richmond later claimed that she was not influenced by her employers and that the Campaign was not supported by Wellcome. She told a number of people that she had almost lost her job as a consequence of using the Wellcome address at the bottom of the leaflet. In an attempt to correct the blunder she later replaced the Wellcome address with a box number and her home telephone number.
Between the first meeting and the official launch of the Campaign in May 1989, the steering committee met at the Ciba Foundation, 11 the academic front for the drug company Ciba Geigy. The Ciba Foundation has an information service, the Media Resources Service (MRS), which was to some extent already doing the kind of work, in defence of science, health and the pharmaceutical and chemical industries, that CAHF planned. The MRS put scientists and sympathetic journalists in touch with each other.
At least two patrons of the Service were known to Caroline Richmond. Professor Sir Hermann Bondi was influential within the British Humanist Association, and Sir Alastair Pilkington was at that time one of the principal directors of the Wellcome Foundation. Amongst MRS Steering Committee members were two people with whom Richmond had closer links, Sir Walter Bodmer † and Dr Bernard Dixon. Dixon was both a founder member of the Campaign Against Health Fraud and a member of CSICP, the British branch of CSICOP.
† For Caroline Richmond's links with Sir Walter Bodmer in the British Association for the Advancement of Science see Chapter 22, The Pollution of Science.
The Ciba Foundation also plays host to a number of other organisations with which Caroline Richmond and Sir Walter Bodmer are associated. These include the Wellcome-administered Association of Medical Research Charities and the Association of British Science Writers. The British Association for the Advancement of Science holds meetings there for its Media Fellows, as does the Medical Research Council.
During the gestation period of the Campaign Against Health Fraud, Caroline Richmond was involved with the magazine UK Skeptic †, which had been set up in 1987 with money from CSICP. 12 On its inauguration, CAHF was advertised as a co-member of the UK Skeptics in the first page of their magazine UK Skeptic. The British branch of the CAHF had the same relationship to UK Skeptics, as the American Council Against Health Fraud had to CSICOP. The health fraud campaign was, as it were, the armed wing, while CSICOP and CSICP were made up of theorists.
† See Chapter 18.
From the first 1989 issue of the UK Skeptic, Caroline Richmond and Nicholas Beard had the space to outline the strategies and attacks organised by the CAHF. In the February 1989 issue, Nick Beard contributed an article about the need to put natural or alternative remedies through clinical trials. He used the article to consolidate the attack on Jacques Benveniste carried out the year before, by CSICOP member James Randi.
† In the 1991 January/February edition of UK Skeptic, there is a biased account of the flawed Lancet paper on Bristol Cancer Help Centre, and a one-sided account of the CAHF-engineered attack upon Dr Jean Monro.
The Campaign proper finally got off the ground at a press conference held on May 8th 1989, at the Royal Society of Medicine. The invitation briefly stated that the campaign organisers were 'worried about the growth of quackery, and false, pseudo-scientific claims'. 15 Coincidental with the launch of the CAHF was a CSICOP European conference also held in May near Munich, West Germany. The launch of CAHF was discussed, as was the general subject of 'fringe medicine'.
The press conference was chaired by Caroline Richmond and attended by 20 or so journalists, who were treated to speeches from Professor John Garrow, the TV and radio presenter Nick Ross and Professor Michael Baum. The 'Today' programme reported the Campaign's concern about 'private food allergy clinics' and hair analysis, while Vincent Marks managed to get himself on LBC, attacking 'worthless cancer treatments' which deterred people from having surgery.
The CAHF launch got publicity in the BMJ and was reported with some seriousness in some daily papers, particularly The Times.
Reports of the launch of CAHF by Thompson Prentice, published in The Times, made little attempt to disguise links between CAHF and Wellcome. The article in which news of the launch appeared was an unadorned advertisement for AZT. Headed 'AIDS RESEARCH', the sub-heading 'Drugs May Protect Carriers' stretched across three columns. The news content of the article simply reiterated basic information about the Concorde trials. Set in the centre of this article in bolder type was a single paragraph article about the launch of CAHF.
For a self-styled independent organisation, the proximity of these articles, their intimacy even, was a little embarrassing. On the following day, Thompson Prentice went to town in promoting CAHF, when The Times ran a four by three inch column article bannered 'ANTI-FRAUD CAMPAIGN', as if the newspaper had adopted the campaign. Even in this article, which described the new organisation and its launch, Thompson Prentice could not resist placing information from Wellcome in close proximity.
The article was clever in its orientation: headlined 'Quacks risk women's lives', 17 it quoted mainly from Dr Michael Baum: 'A growing number of women are dying from breast cancer because they are putting themselves in the care of "quacks", rather than orthodox specialists. '
Baum went on to describe how women came to his surgery with little chance of survival after they have sought 'unproven alternative therapies ... I have a cluster of patients who have been convinced that homoeopathy and special diets will help them. In fact, their cancers go unchecked' .
Vincent Marks was quoted as stating: 'Bogus explanations for ill health bring the genuine concept of scientific medicine into disrepute.' CAHF was an organisation, the article said, 'of doctors and lay members who aim to protect the public from taking cures and untested medical treatments'.
Following the launch, Michael Baum gave an interview to the Journal of Alternative and Complementary Medicine. In this interview he at least made clear his views about alternative medicine. He did not believe, he said, 'that any system of alternative medicine had any basis in scientific fact'. 18
After the launch, Steering Committee meetings continued to be held at the Ciba Foundation, the first being on the 15th of May. 19
3. The Players and the Game, 1989-1991
The Players
Those who represented the core of the Campaign Against Health Fraud at its formation in 1989 remained involved over the next two years; others pulled in on the fringe soon drifted away. On April 3rd 1989 at a Steering Committee meeting held at the Ciba Foundation, two joint presidents were elected: Dr Michael O'Donnell, broadcaster and former GP, editor of GP magazine, and television and radio presenter Nick Ross.
At that time, soon after the press launch, the leading Campaign activists were Dr Nick Beard; Dr Christopher Bass, a psychiatrist and committee member of the British Association for the Advancement of Science; Dr Simon Wessely; Professor Michael Baum and his brother Professor Harold Baum, Professor of Biochemistry at King's College Hospital; Diana Brahams, barrister and journalist; John Walford; Mark Pownall; Dr lain Chalmers; Dr Vincent Marks and Duncan Campbell.
An initial statement from the Campaign about funding suggested that it was largely funded by individual subscriptions which stood at £12 per annum. The claim that individual members were paying for the Campaign was similar to that made by the American Council Against Health Fraud. It might strictly have been true, but as the majority of the early core activists had some financial connection with Wellcome, as well as other companies, or worked in projects funded by the pharmaceutical industry, the exact source of their corporate funds is relatively unimportant. †
† In 1992, the minutes of the CAHF Annual General Meeting disclosed that in the year 1991-1992 the Campaign received a grant from the Wellcome Foundation. Other granting bodies included medical insurance companies and other pharmaceutical companies.
Apart from Caroline Richmond's obvious connections with Wellcome, most other leading members also had links. Professor Michael Baum worked at the Royal Marsden Hospital which was joined to the Institute of Cancer Research where Dr Robin Weiss had developed testing kits with Wellcome. In 1990 at the same time as he took up a position at the Institute of Cancer Research, Michael Baum became clinical advisor to Breakthrough, a cancer charity which is raising money for a Breast Cancer Centre at the Royal Marsden Hospital. The Centre will be staffed by, amongst others, a team of eight Wellcome-funded scientists.2 Michael Baum also ran the Tamoxifen trials in Britain throughout the 1980s for ICI. Wellcome and ICI had a number of joint projects, not least between 1985 and 1990, when they jointly owned Coopers Animal Health. Professor Harold Baum with two other medical scientists received a large grant from Wellcome in 1985. Dr lain Chalmers was running the National Perinatal Epidemiology Unit, which was hugely subsidised by Wellcome. 3† John Walford was the Grants Officer for the Multiple Sclerosis Society of Great Britain and Northern Ireland; this Society is a member of the Association of Medical Research Charities, an organisation administered by Wellcome. 4 The MS Society research is funded by a number of industrial interests including pharmaceutical companies. 5 Vincent Marks, biochemist and entrepreneur, heads the Department of Biochemistry at Surrey University which received nearly half a million pounds from Wellcome between 1985 and 1990. 6
† In 1990, the Wellcome Foundation gave £186,182 and the Wellcome Trust gave £24,888, to the National Perinatal Epidemiology Unit.
Given that considerable emphasis was later to be placed upon the idea of supporting the National Health Service and the general practitioner, the above members and those who were to follow were an odd collection. Just as the Campaign did not have any representation from patients, there were few hard-working general practitioners or people with clinical experience of everyday illness. Even more interestingly, few of the active members obtained their salary from working as medics of any kind; a large percentage of them were journalists or scientists of one kind or another. Caroline Richmond describes herself as a medical journalist; the two Presidents, Dr Michael O'Donnell and Nick Ross, were both journalists. When Dr Nick Beard met up with Richmond he had just finished working for Coopers and Lybrand and was on a course at Imperial College while also doing some free-lance journalism. Bernard Dixon was a writer and journalist. Later, Andrew Herxheimer from the Drug and Therapeutics Bulletin was to join. James Le Fanu, who joined later, though working as a doctor was also a free-lance journalist. In various articles, Duncan Campbell was to make much of the idea that those he attacked were at the centre of private medicine, and yet those he was working with were often supported by private interests.
As the campaign began to gather members, others with a Wellcome connection joined. Dr Jeremy Powell-Tuck, for example, had been a Wellcome Fellow and Sir John Vane, who joined with his wife Daphne Vane, had recently been one of the most senior scientists at the Wellcome Laboratories. A number of those who were to join the Campaign soon after its launch were associated with the processed food industry. John Garrow and Arnold Bender, whose wife became the membership secretary in May 1990, had both previously been grant-aided by large processed food concerns. 7
By the time of the second Annual General Meeting in July 1990, at the Nutrition Department of St Bartholomew's Hospital, there were a few committed new members. One in particular, Professor Tim McElwain, must have seemed like a prestigious catch. McElwain was one of Britain's most renowned cancer doctors and a man who had been committed to orthodox cancer treatment for the whole of his working life. †
† See Chapter 36, for Professor McElwain's involvement in the survey of patients attending the Bristol Cancer Help Centre.
By the first months of 1990, the Campaign literature was quoting the names of those who although they had been associated with the campaign from the beginning had never been listed as members before: Dr David Pearson, the allergy specialist from Manchester, Duncan Campbell who had been involved from the beginning with Nick Beard, and a medical sociologist with a good reputation in the field of orthodox medicine, Dr Petr Skrabanek of Dublin University.
The Game
Within a couple of months of its launch, the Campaign Against Health Fraud had produced a newsletter. It was not as professional as its American counterpart 8 but it provided a good platform for the Campaign to promote attacks and debunking projects which it had initiated.
Caroline Richmond seemed most concerned that journalists got the proper view of health matters. To her, one of the principal aims of CAHF was to inform the media about treatments which did not reach an acceptable standard. 'The campaign will give journalists and everyone in the media concerned with health, access to an independent assessment of the many claims about health that are currently in circulation.' 9 Nick Ross, writing as the co-chairman, pursued a line common amongst American campaigners: that it is the elderly, the old and the ill who are exploited by health-fraud. Ross seemed to envisage the Campaign as an extension of the para-policing work which he did on the television programme 'Crimewatch', homing in on criminal fraud: 'it is a particularly offensive form of fraud when people pose as healers and exploit that desperate need for help by offering illusions of cure that can never be fulfilled.' 10
The newsletter provided Campaigners with a forum where they could criticise what they saw as 'unscientific' ideas about health in the media. In the first newsletter, Caroline Richmond complains about the absurdity of suggesting that electricity has anything to do with illness; John Garrow complains about an article in the Today newspaper which talks about apricot kernels in the context of nutrition and Nick Beard complains about an item on reflexology in the TV Times.
The strong American flavour of the Campaign showed clearly in their choice of books they reviewed. Nick Beard reviewed a book published by Paul Kurtz and CSICOP's publishing company Prometheus, while Caroline Richmond reviewed an American Medical Association bibliography of health fraud.
In June 1989, Michael Baum gave an interview to the Journal if Complementary and Alternative Medicine. The article was entitled: 'Why I Will Bust Quacks'. 11 From his first utterances about the Campaign, Michael Baum, like other members, was 'economical with the truth' about its objectives. 'What the campaign is not, I must emphasise, is a clique of doctors, ganging up against alternative medicine. Alternative and complementary therapists would be welcome to join the campaign as long as they agreed with its aims.' In fact, the CAHF had from the beginning a practice of restricting membership to those who endorsed the use of pharmaceuticals. The few natural medical practitioners who tried to join were usually turned down, without any reason being given.
CAHF was formed, Baum claimed, 'for the specific purpose of protecting the public by highlighting examples of fraudulent practice and providing a panel of experts to independently assess health claims. † Recent years have seen a flood of explanations and promised cures for illness whose validity has never been tested; vitamins to increase intelligence, hair analysis which reveals vital missing minerals, diets that promise to counteract childhood hyperactivity or prevent cancer.' 12
† From the beginning CARF was keen on 'assessing' claims for diagnostic techniques and treatments. As in the main they knew nothing about alternative and complementary medicine, and some like Caroline Richmond had no clinical experience, it is difficult to see from where they thought their authority in this judgemental capacity came.
In three lines of this interview, Baum gave away a good portion of the game plan which CAHF activists had been working on for the previous year. The vitamins to increase intelligence alluded to the work of Larkhall Natural Health and Cantassium products. Hair analysis related to the work of Biolab and Stephen Davies and diets which promise to counteract childhood hyperactivity alluded to the work of Belinda Barnes on child hyperactivity. In fact, in each of these cases there were mountains of referenced work and scientific papers, none of which were ever alluded to by the Campaign.
By the time the first newsletter was published, it was evident how the Campaign were to go about prosecuting their complaints against non-pharmaceutical treatments. Apart from sundry bodies like the Advertising Standards Authority, they were to rely upon the investigators at MAFF and the Medicines Commission, inside the DoH. The Campaign even made overtures to the Department of Health, asking if they might be formally recognised as a prosecutorial agency by them.
It is not surprising that they expected such official bodies to prosecute their complaints; both MAFF and the DoH generally have a cosy relationship with industry and what might be called an intimate relationship with the pharmaceutical and agri-chemical business. In the second newsletter, Mark Pownall, writing about a 'MAFF crackdown on misleading nutritional claims', points out germanium as being 'clearly dangerous', a product which 'should be subject to the Medicines Act' as should 'promotional claims of other health enhancing properties of "health food" products'. 13 Clearly the CAHF had powerful friends in high places, because germanium was not simply made subject to the Medicines Act; a short time after the newsletter was written it was banned. †
† For the story of how germanium was banned see Chapter 34.
At the Annual General Meeting of CAHF in 1990, members voiced concern that the organisation had been accused of being in the pay of the pharmaceutical industry (in particular the Wellcome Foundation). This was refuted and the minutes recorded that: 'There is no connection, nor has any money been received from any pharmaceutical company towards any of our activities.'
Some time was taken up at the Annual General Meeting discussing under what circumstances and from whom, the campaign might accept money. 'The Committee decided that money from any source, including the pharmaceutical industry, would be acceptable if it was given on a hands off basis and provided that no single interested party contributed more than 25% of CAHF's annual requirement.'
Nick Ross was apparently unhappy with the decision, believing that the pharmaceutical and food industries had the greatest interest in the survival of CAHF. He felt that such donations would be used against the Campaign. In the discussion which followed, Professor Vincent Marks, Professor John Garrow, Wally Bounds, Dr lain Chalmers and Dr Jeremy Powell-Tuck all agreed that money could be taken from any source. Sir John Vane pointed out naively that anyone contributing would do so because they had an interest and this need not influence the behaviour of CAHF.
By the time of the second AGM in 1991, commitment appeared to be waning. While there had been over sixty members at the first AGM, only twenty-one were present at the second. The Campaign felt that it had been penalised when earlier in the year it had been refused charitable status because of its campaigning activities.
The meeting decided to change the name of the organisation from the Campaign Against Health Fraud to HealthWatch. The point of this cosmetic exercise was to make the organisation appear less combative and more charitable. It also placed HealthWatch in the context of a number of other groups, mainly set up by the police:
Neighbourhood Watch, Homewatch, Carwatch. In the following year, 1991, though its campaigning zeal had not abated and it had done immense damage to a range of alternative and natural practitioners, it was granted charitable status.
The British Health Fraud Philosophy
The modern health fraud philosophy is extensive and complex, but not really a philosophy, more a series of post hoc defensive arguments for orthodox medicine. At the heart of these assumptions is a simple equation: anything which challenges the monopoly hold of the chemical companies on food production and pharmaceuticals, the professional status of doctors, or the ruling paradigms of industrial technology should be attacked.
Much is made by activists of the fact that the health-fraud philosophy is based upon science. In fact health-fraud arguments are rarely objective, let alone scientific. Quite the opposite, they are usually highly personalised and apparently given weight by unsupported assertions.
The spate of articles and interviews which appeared between the beginning of 1989 and the end of 1991 give a good idea of the Campaign's preoccupations and points of intervention. Many of its arguments have a patina of seductive popularism.
One article which plainly illustrates the way in which CAHF uses opportunities to attack complementary medicine is an article by Anne Wiltsher in the New Statesman and Society of July 7th 1989.14 This article purports to be a look at the fortunes of complementary medicine as we approach new European regulations in 1992.
The article begins with a brief introduction which lampoons complementary medicine (the article is accompanied by one large and one small photograph of individuals undergoing acupuncture treatment; both pictures are visual jokes). It then briefly discusses the attitudes of the European powers towards complementary medicine, before launching into propaganda for the CAHF.
The January 18th 1991 issue of GP carried an article by Dr Charles Shepherd, a long-standing member of the CAHF and a Clinical Adviser to the Media Resources Service of the CIBA Foundation. Entitled' "Natural health" pills can be lethal', 17 a centre column subheading reads 'Many of the remedies can have bizarre and disturbing toxic effects'. It is one of the most climactic anti-vitamin articles ever published: a kind of 'Vita-disaster' article.
The piece is illustrated with a large picture of Barbara Cartland. The caption to the photograph reads 'Novelist Barbara Cartland: renowned for championing "natural health" pills'. As the heading states that 'natural health pills' can be lethal, one wonders why Barbara Cartland did not sue.
A good deal in Dr Shepherd's article reinforces the fact that GP magazine is subsidised by drug company advertising. 'Many of the new-age pills and potions in the alternative pharmacopoeia are drugs in all but name. But they masquerade as "nutritional supplements" in order to evade the strict rules on efficacy, safety and product promotion which the Medicines Act imposes on conventional drugs.' 18
The article proceeds to attack all vitamin and mineral preparations without giving any supporting evidence for statements made about their damaging effects.
'Thames Action', the ITV access programme, reported on vitamin supplements on November 23rd 1990.23 The programme began by explaining how much money the vitamin producers make. Vitamin producers must be the only groups within the capitalist economy, (apart from criminals such as drug dealers) constantly criticised for making profits. When it comes to vitamins and 'health foods', journalists and health fraud campaigners radically change their ideological position, suddenly finding the profit motive morally reprehensible. Drug company profits are never alluded to.
The tone of the item is determined by these sceptically introduced, unreferenced claims. Viv Taylor-Gee moved the item to its logical conclusion, before interviewing the expert, Professor Vincent Marks. 'It's possible to overdose on nearly all vitamins especially if the vitamin supplement comes in megadoses.' 26 It is also possible to overdose on ice cream and even water, not to mention a large array of pharmaceuticals, especially in megadoses! Vincent Marks explains:
Vincent Marks' message is simple and asinine: vitamins are basically very dangerous in the hands of ignorant people. If you take large quantities of halibut liver oil capsules to make yourself beautiful you will end up with kidney failure. The programme did not make it clear that Vincent Marks was an active member of Health Watch, or that he has spent most of his professional life persuading people that sugar does you no harm - even in megadoses.
This programme, like many others, failed to interview a doctor who works with vitamins and food supplements. The final word was given to Vincent Marks.
If the leading expert, Professor Ariel Lant, produced any evidence for his assertions, it was not reported by Thompson Prentice. 'The devastating effects of chronic fatigue syndrome have produced a host of alleged treatments, many from the realms of alternative medicine.' Professor Lant called for scientific trials to evaluate remedies, while Prentice intoned gravely: 'Professor Lant's comments on the treatments amount to some of the strongest criticisms expressed in recent years on the response by doctors to various forms of chronic fatigue.'
Although Professor Lant made it clear that he did not agree with the Caroline Richmond school of thought that ME is a figment of the 'imagination of either the patient or the practitioner', he did agree with HealthWatch that quacks were operating in this area: 'Patients were offered analysis of samples of their hair and skin, others were having tests for non-existent allergies, and some were paying for preparations of primrose oil or pumpkin seeds ... The list is enormous. Some of the hocus pocus treatments are so bizarre as to be unbelievable, and I believe some if them may be harmful.'(italics added). 30
Well, there we have the considered scientific view, people being tested for non-existent allergies, paying for evening primrose oil or pumpkin seeds, where will it all end? Thomson Prentice had got himself another big news story!
Bella is an inexpensive woman's magazine. On April 14th 1990, it carried a classic anti-health food article, 'Food For Thought: Health food is more popular than ever - but "natural" isn't always safe', by Andrew McKenna. 31 The full page article was accompanied by a small picture of a widely grinning Professor Arnold Bender, a large picture of a worried woman scrutinising a 'health food' product in a 'health food shop' and another small picture of a tub of organic germanium, which, says the caption, 'can kill in large doses'. The artwork was as 'pulp' as the message, a kind of True Health Fraud story, to be read in a slow exclamatory American accent, reminiscent of Broderick Crawford in 'Highway Patrol' or the introduction to the 'Streets of San Francisco'.
Professor Bender has worked, throughout his life, for the processed food manufacturers. He was head of research at Farley Infant Foods, head of research at Bovril, and has received research funding from Cadbury Schweppes, Heinz and Kelloggs. 33 Off he sounds on the pages of Bella: 'There is no such thing as a health food - there is such a thing as a health food industry. No one food is good or bad for you. What counts is a varied, balanced diet. A lot of people are being misled.'
That is certainly true! Andrew McKenna takes up the story: 'It's recent health scares over the £600 million a year diet supplement and herbal remedy industries that have led to the most scathing criticisms ... In Britain, we spend £137 million a year on mineral and vitamin pills. In 1989 alone, sales of Tandem IQ vitamin packs rocketed from 1,000 a month to half a million, after trials at a Welsh school claimed that extra vitamins boosted pupils' IQ.34
The article makes use of a Consumers' Association report on health foods, which it says concluded: 'If you were to eat only foods from a health food shop, you could be following a very unhealthy diet.' 35
According to McKenna, the Consumers' Association report found that health food shops stocked some nuts prone to cancer-causing substances; kidney beans which if improperly cooked could cause severe gastroenteritis and diarrhoea; a dried fruit preservative which causes asthmatic attacks in a few people and muesli bars with a very high sugar content. 36
What a condemnation of health food shops! The mind boggles, and just think, if they found these things in health food shops, what would they find in any of the major food retailers? Perhaps the most amazing thing about articles of this kind is that it makes one realise that the Medicines Act should cover the licensing of journalists, some of whom can of course seriously damage your health.
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References
From Chapter 7, Dirty Medicine: The Handbook.
Organising and Fighting Back
The cases of Dr Sarah Myhill MB BS in Britain and Meryl Dorey in Australia have many things in common. The objective of the cases from the perspective of those who attacked them are, in Sarah Myhill’s case, to force vaccine and therapeutic hegemony on Britain’s doctors, and in Meryl Dorey’s case to enforce the use of vaccination on Australia’s parents. They have both been the subjects of originally anonymous complaints by Skeptics, and after bogus investigations, they were both ordered to take down or alter parts of their websites.
The censoring of health information about medicine on the Internet is something that corporations have been very concerned about over recent years. Both the complaints against Dr Myhill and Meryl Dorey were made by Skeptic fellow travellers, citing material, in Dr Myhill’s case, which alluded to vaccination and the treatment of ME (myalgic encephalomyelitis) and chronic fatigue syndrome (CFS), (END NOTE 52) and on the Australian Vaccination Network (AVN) site about the problems and adverse reactions to vaccination.
The Skeptical complainants in both cases, however, manifest a different reaction from the complaints they had made, in England to the GMC and in Australia first to the Health Care Complaints Commission (HCCC). The Australian complainant appeared publicly with the over–aggressive emphasis used by quackbusters to protect themselves on film and on the Internet. In England, the medical research worker who complained about the content of Dr Myhill’s site wanted to remain anonymous — as they often do. When, however, Stuart Jones’s name entered the public domain, he suddenly became contrite in a thoroughly English way.
Stuart Jones explained on the BadScience site how he came to make the complaint almost be accident; presenting himself in the most reasonable of lights: (53)
OK, so I finally bit the bullet and complained (anonymously for reasons that will become clear) to the GMC about uber–quack, (54) Dr Sarah Myhill, and to my surprise they have decided to launch a Fitness to Practise investigation.Jones maintained that he had complained anonymously ‘for reasons that will become clear’, but all that became clear was that Jones wished to shield himself from criticism from Dr Myhill, her supporters, her patients and any other concerned citizen. There was a good deal of discussion on the Bad Science site about whether or not complainants’ anonymity should be respected.
Her response has been quite interesting so I thought I would share it with the Badscience community. It will be interesting to see how the GMC proceed as I believe she has been in the same situation on numerous occasions in the past with similar public campaigns resulting in the GMC dropping charges for undisclosed reasons.
In private the real reasons that Jones struck out for anonymity became clear when he emailed Dr Myhill, miserably complaining that he hoped the matter of his identity could be tucked away. In this communication he showed that he was now considerably embarrassed and slightly fearful of being criticised for behaving like a common informer.
He shouldn’t, of course, have been emailing Dr Myhill personally under any circumstances. His first worry was for that angel of medicine Ben Goldacre. It was important, Jones said, that no one identified Goldacre with him and his complaint, as this would have been terribly unfair:
Sarah, I have just been notified that somebody has posted a message on yahoo answers calling for Ben Goldacre to be struck–off by the GMC for instigating a ‘campaign’ against you. This is really quite disturbing, especially as the person adding the message appears to want to make it look as though you yourself posted it. Regardless of any opinion you may have of me, I do hope you share my concerns on this. Regards, Stuart. (55)Clearly Jones is a man of considerable feeling and sensitivity. His next email to ‘Sarah’ gave a hint that he himself might be concerned that people would think badly of him and others.
Dear Sarah, I think this particular conspiracy theory now needs to be laid to rest to save everybody concerned a lot of time/effort. As my details are now becoming publically available (thanks largely to GMC’s incompetence) it should be quite clear that I am not working in some kind of witch–hunt coalition with Badscience members/Ben Goldacre/Simon Wessely, in a ‘campaign’ against you. This is clearly nonsense as I have never had any contact with any of these people and have acted entirely on my own initiative in bringing this complaint, which in any case can hardly be considered a ‘campaign’. My only link with Badscience is that I happen to enjoy discussing topical issues from time to time on the forum there. You have my word that I am not conspiring with any other dr’s/health professionals in making this complaint and that I am not acting on anyone else’s behalf. I think my reasons for choosing anonymity following submission of the complaint (remember the GMC have my full details so the actual complaint itself was not anonymous) have become quite clear. You are obviously highly regarded by the various support groups who have bought into this particular theory, perhaps it would be wise to calm the waters before this particular situation gets out of hand? I think it would also be wise to keep any details we share by email private. (56)The attacks on Dr Sarah Myhill began in 2001 and since then she has faced the prospect of six GMC Fitness to Practise Hearings. No complaint ever came from a patient; all came instead from other doctors or from the GMC itself. During those investigations, her website was extensively examined by the GMC, including the use of a commissioned expert witness report; it was not found wanting. All allegations over a decade were dropped with no case to answer, and no sanctions were placed on her practice.
On 8 April 2010, Sarah received a letter from Rebecca Townsley, assistant registrar at the GMC, stating that there had been two complaints about her medical practice received by the GMC. The GMC considered that these complaints brought her fitness to practise into question and so instigated an Interim Orders Panel Hearing.
One complaint that was termed the ‘B12 Complaint’ came from a practice of eight GPs, Dr H L Moss and Partners, who complained about Sarah’s advice that they should prescribe vitamin B12 and magnesium sulphate injections to a patient at their practice who suffered from Batten’s disease.
The ‘Website Complaint’ concerned a complainant, described as a clinical scientist, who considered that Dr Myhill’s website represented a risk to public safety. As far as Sarah Myhill was concerned, the complainant was effectively anonymous, although he quickly became known as Stuart Jones.
These complaints were heard at an IOP Hearing held on 29th April 2010. Despite the fact that the GMC has frequently claimed that it does not control the practice of doctors, a major content of the complaint against Dr Myhill was evidently aimed at stopping her from taking various treatment courses. The complaints against Myhill arise from the belief that her treatments do not conform to National Guidelines, in the case of the website complaint, and that Sarah Myhill’s recommended treatments in the case of the B12 were off licence and therefore in some way not generally recommended. Both Neil Jinks, GMC assistant registrar in 2006, and the gynaecologist Wendy Savage in her book A Savage Enquiry(about her own struggle with the GMC, which became a cause célèbre), make the point that the GMC cannot get involved in treatment modalities, stating that:
It is not the place of the GMC to take a position on the correctness or otherwise of generally recommended or of possible ‘cutting edge’ treatment… One of the most important principles of the practice of medicine is that of clinical autonomy, which allows a fully trained doctor the responsibility for deciding which mode of treatment is best for his or her patients… Clinical autonomy means that consultants and GPs are responsible for their own clinical decisions and should not be criticised by their colleagues as long as those decisions are within the ‘broad limits of acceptable medical practice’.To me the most important aspects of criticism of any GMC hearing are to do with procedure. Due process is to my mind the most important part of law; without due process the law becomes a confusing area where vested interests compete with each other to serve their own ends. The GMC has made common practice out of processes that the Metropolitan Police at it most corrupt in the 1970s only dreamed about.
One of the first principles of British, European and even world law has always been that the accused is allowed to face their accuser in the court, not simply so that the accuser’s demeanour and physical presence can be seen by a jury, but also, and most importantly, so that the accused can cross–examine the accuser.
This process has only recently been forfeited in some terrorist trials or those involving informers to whom harm might later fall. Even then, in such cases, the witness has to arrive at the court and, though their voice might be disguised and though they may sit behind a screen, they are bound to answer questions from the defence that go to the heart of their accusation.
The GMC, in line with organisations like the RSPCA and RSPCC and other lower tribunals, now allow complainants to keep their anonymity. In the 1990s, when the pharmaceutical companies desired to bring their own cases before the GMC against doctors who worked against their interests, the Association of the British Pharmaceutical Industry's (ABPI) own private investigation agency MEDICOLEGAL INVESTIGATIONS LIMITED worked with the journalists to bring a number of cases before the GMC. (57) It seems to have been the case that, at that time, the GMC was unprepared to act unethically bringing charges without complainants to the hearings.
A decade and a half later, however, in the case of Dr. Andy Wakefield, the GMC appeared happy to ditch all pretence of due process. Brian Deer, a journalist for The Sunday Times, ‘uncovered’ the story of Dr Wakefield’s wrongdoings and then, after consorting with MLI and its appearance in The Sunday Times, sent his ‘evidence’ to the GMC, who caught it and ran with it. The prosecution case never reached further than Deer’s improbable ‘exposé’. Deer was never asked to give evidence and it seems more than likely that the GMC felt Deer would have been a poor and perhaps volatile witness, unable to cope under cross–examination.
In the case of Dr Myhill, the GMC excelled itself, flying in the face of hundreds of years of jurisprudence. Despite there being two sets of original complainants, the GMC refused to bring any of them to give evidence or be cross–examined. Just how, a person would be able to prove their innocence without tackling the accuser is beyond reason. However, the GMC seems to sidestep such minor issues.
None of the partners of one complaint including Dr Y, a partner from the practice who had complained against Dr Myhill, was brought to any hearings. Neither was Professor Bouloux, the expert witness who tendered a flawed expert witness report. Of course, in relation to the second set of charges, Stuart Jones was not present for cross–examination. Keen to cross–examine all these parties, the defence asked to subpoena the practice partner, only to be told that only the GMC could subpoena witnesses. How does the GMC get away with this?
The website complaint against Dr Myhill was perhaps far more complex than either she or her lawyers understood. For the past 10 years, the FDA especially, but also all the corporate interest organisations and the UK regulatory agencies have tried hard to bring ‘health freedom’ websites under control. It’s the same old story: while pharmaceutical companies sell off their produce to agents who sell them over the Internet with no care about buyers’ medical status or full explanations of adverse reactions, alternative medicine practitioners or campaigners are increasingly coming under attack for explaining their therapies or criticising pharmaceutical medicine.
In Dr Myhill’s case, the website complaint from Stuart Jones was based on a personal belief system, which bore little relation to any objective reality. The complainant seemed to believe that NICE guidelines were in some way mandatory, and that doctors who do not abide by them should be investigated for malpractice. This is not the case. (58)
The website complaint brought up the issues of due process, perhaps more than any complaints made in Dr Myhill’s case. The GMC seems to have reassured the complaining medical research worker of his anonymity and the lack of need for him to attend the hearing. How, then, was his completely unreferenced complaint to be pursued? He had, for instance, objected to a claim on Dr Myhill’s website that women should not always attend for breast screening. And yet, the concept of regular mass breast screening it is now often criticised, as this reference in the Belfast Telegraph makes clear:
The UK’s national breast screening programme is harming almost as many women as it helps and must be urgently re–evaluated, a review in England has claimed. The benefits of breast screening — early detection of cancer followed by rapid treatment — are finely balanced against the harms of over–diagnosis followed by unnecessary treatment and suffering, the review says.In this account, I can only skate over the worst iniquities of the GMC abuse of process and false charges, but the outcome of the complaint against Dr Myhill, heard at the GMC in April 2010, was that she was found guilty without any evidence, in the face of completely manufactured charges, of advising some things on her website that some doctors and most pharmaceutical companies would disagree with. Her practice was restricted for nine months and her advice to patients had to be supervised, but perhaps most importantly, a number of statements and information alluding to vaccination were ordered to be taken down from her website.
Breast screening has divided the medical establishment for more than 20 years. The central drawback of screening is that in some cases the cancer (or other disease) detected does not need treating, either because it is a false alarm, because it resolves naturally or because it is very slow growing (so you die of something else) ... Critics of screening suggest for every woman saved, as many as 10 undergo unnecessary treatment. (59)
In 2009, the British Medical Journal (BMJ) published a paper on breast screening in Denmark, which showed that deaths had fallen faster in areas without screening than those with. Researchers were accused of ‘undermining trust’.
In October 2010, Dr Myhill was called before another hearing the outcome of which was that she was banned from acting as a doctor for a period of six months.
Finally, for the moment at least, on 6th January 2011 the Interim Orders Panel, GMC, made the decision to lift the suspension of her GMC registration and to restore her licence to practise medicine. The Panel again placed a small number of procedural conditions on Dr Myhill’s registration, reversing its fitness to practice order while substituting a whole list of conditions. Supporters of Dr Myhill promote this change as a win and suggest that the prescribed conditions are largely cosmetic and procedural. Dr Myhill herself suggests that this climb–down will enable her ‘to carry out about 95% of her normal work’. However, reading the new terms and condition of practice, one is struck by just how arrogant and partisan the GMC is as they continue to protect their backs, principally concerned about being taken to a real court.
In the book there is a section about Meryl Dorey that you will have to buy the book to read. It then continues ...
Fighting Back
The objective of the Myhill and Dorey cases from the perspective of those who attacked them, are, in Sarah Myhill’s case, to force therapeutic hegemony on Britain’s doctors, and, in Meryl Dorey’s case, to enforce the use of allopathic pharmaceuticals, specifically vaccines on Australia’s parents. To these ends, they were both the subjects of originally anonymous complaints by those sympathetic to the Skeptics, and they were both ordered, after a bogus investigation, to take down or alter parts of their websites.
The censuring of health information about medicine on the Internet is something that corporations have been very concerned about and committed to over recent years. This is interesting when one considers that these same people and these same organisations get hysterical about China and other countries interfering with the communications laws and regulations of other countries.
The complaints against Dr Myhill and Meryl Dorey were made by Skeptic fellow travellers, citing material, in Dr Myhill’s case, that alluded to vaccination and the treatment of ME (chronic fatigue syndrome) (64) and on the Australian Vaccination Network about the problems with adverse reactions to vaccination. This has involved concerted attacks on those who put forward such views. The contemporary vaccine wars have been waged at an escalating rate in Britain since the sixties and industry–protective organisations have worked hard to censor alternative views to mass vaccination and herd immunity.
The Skeptical complainants in both cases, however, manifest a different reaction to the complaints they had made, in England to the GMC and in Australia to the HCCC. The Australian complainant appeared publicly, with the over–aggressive emphasis used by quackbusters to protect themselves, on film and on the Internet. Collegiate organisations, and tipped–off regulatory organisations, rounded on Meryl, upping the stakes as days went by, name–calling and using vile threats on Twitters and other email facilities, while using every conceivable form of complaint to regulatory and oversight organisations.
In both cases the complaints were made by men against women; in both cases, the victims have fought back in a collective and exemplary manner. Both victims sought advice from radical academics and campaigners, and placed this advice on a similar parallel to the advice from lawyers. (65)
The way in which both organisations fought back and clearly survived, without massive public success but with an enhanced reputation amongst those who believe in freedom and democracy, shows that people are learning clear lessons about resistance. The lessons can be summarised in this way:
• Both groups framed their fight–back in political terms, with an emphasis on freedom of speech and civil and constitutional rights.
• In varying degrees, each organisation and both of the individuals involved understood from the beginning that they were being attacked, and that those who were attacking them were out to destroy their work and their published views.
• Both groups immediately publicised a message that answered and rebutted the accusations. There were no apologies, nor linguistic compromise.
• Both groups published contemporary information telling all their supporters what was going on.
• Both groups developed their websites, rather than curtailed them.
• The British group was immediately supported by patients who demonstrated outside the GMC.
• When Skeptics and their fellow travellers became involved in violent Internet threats against Meryl Dorey, she and her colleagues went straight to the police, publicised the threats, and demanded they record the incidents.
• Both groups learned very quickly that, on the whole, journalists are a waste of space because their newspapers and other media outlets are deeply tied to corporate interests.
In both these cases the whole point of the complaints was to censor the voices of pharmaceutical and chemical victims. It is very important that we understand the simple message exposed by both these complaints. In the Brave New World of science dictocrats, there is to be only one medical view, the official view, the pharmaceutical view. Anyone, whether a doctor or a layperson, who expresses any other view is first to be censored and then punished. Parents, for example, will not be allowed access to information about vaccination that is contrary in any respect to the orthodox view. Only one view is allowed: ‘four legs good, two legs bad’. Medically, politically and socially, this is totalitarianism engineered and provoked by powerful governments and corporations.
But perhaps even more frightening in this new world is the fact that it will ultimately not be intelligent four–legged animals making the decisions, but corporate science groupies, individuals whose cultural and intellectual acumen often ranks lower than a snake’s belly.
_____________________________________________________________________
END NOTES
51 (Cont.) is now in the parliamentary record, questioning the remit based on the people who had been invited to give oral submissions to the hearing. She also petitioned her MP and wrote a further two emails that were circulated to members accusing the Committee of obvious bias. She addressed the homeopathic community asking them to petition their MPs about this bias. However, there was no official statement on the issue and it proved impossible to get one on the table.
52 There has been a thirty–year campaign by psychiatric interests to prove that there are no environmental factors involved in ME.
53 Bad Science, posted on Thursday April 15th at 2.20.
54 Uber: an outstanding or supreme example of a particular kind of person or thing. He accuses Dr Myhill of being a supreme quack!
55 03 May 2010 10:12 to Sarah Myhill and subject titled: False accusations at Badscience/Ben Goldacre.
56 Mon, May 3, 2010 at 6:04 PM Jones to Myhill.
57 In the mid 1990s they worked with Duncan Campbell, the New Statesman’s journalist who joined the Campaign Against Health Fraud.
58 Dr Myhill’s legal brief.
59 Belfast Telegraph on 4 August 2010:
http://www.belfasttelegraph.co.uk/news/health/ breast-screening-harms-as-many-as-it-saves-report-14897265.html
60 http://hjhop.blogspot.com/2010/12/meryl-dorey-fucking-microphones-how-do.html
61 http://blogs.discovermagazine.com/badastronomy/2009/12/02/australian-skeptics-jeer-meryl-dorey/
62 An understanding of this organisation gives us a clear indication of what herbalists, homeopaths and nutritionists will be faced with when complaints are brought to the Health Professions Council (HPC), in the new regulatory system outlined at the beginning of this chapter.
64 (From previous page) Walker, J Martin. SKEWED: Psychiatric hegemony and the manufacture of mental illness, in Multiple Chemical Sensitivity, Gulf War Syndrome, Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. Slingshot Publications. London 2003.
65 Jayne Bryant and One Click helped organise support for Dr Sarah Myhill, while Brian Martin, the exceptional Professor of Science, Technology, and Society at the University of Wollongong, and I both helped Meryl Dorey, although with nothing she wasn’t capable of organising herself!
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The Campaign Against Health Fraud
by Martin Walker MA
[Chapters 26, 27, 31 DIRTY MEDICINE by Martin Walker. 1993]
1. Background and Beginnings
Covert propaganda operations are not new to British industry. In the years immediately after the Second World War, fearful of nationalisation by a victorious Labour Party, Conservatives and industrialists set up a number of clandestine organisations, to champion the cause of free enterprise. Aims for Industry, which later became Aims, was set up to fight the post-war Labour Party's plans for nationalisation. The Society for Individual Freedom, set up in part by the intelligence agencies drawing on industrial support, was an organisation which championed individualist political freedoms eroded by wartime constraints.The malignant spread of medicine turns mutual care and self medication into misdemeanours or felonies. 1
Organisations like the Economic League were set up to gather intelligence on trade unionists. In the mid-seventies, the National Association for Freedom, sponsored by big business and organised by individuals with backgrounds in the intelligence community, campaigned first to get Margaret Thatcher to lead the Conservative Party and then for monetarist policies.
The pharmaceutical industry, intimately related to the great oil and chemical conglomerates, has often been at the forefront of covert industrial subterfuge and propaganda. Those who controlled oil have often also been close to the centres of foreign policy.
Gulf Oil, founded by the Mellon family, was before the Second World War part of one of the largest chemical cartels in the history of modern capitalism. It was dominated by LG. Farben, a group of German chemical companies. 2 In the 1960s, the London offices of Gulf Oil, now known as Chevron, were based in an unobtrusive high-rise office building called Gulf House, just off Oxford Street. From that building in 1967, the Queen Anne Press produced Medicine at Risk: The High Price of Cheap Drugs, by F. H. Happold.3 The only acknowledgment the author gives in the book's foreword is to the Association of the British Pharmaceutical Industry (APBI).
The book was published at a particularly sensitive time. The British Trades Union Congress was raising social and political questions about the pharmaceutical industry and in America the Kefauver hearings had recently enquired about price and monopoly practices. Only six years before, the international effects of thalidomide had dealt the image of the pharmaceutical industry its most devastating post-war blow.
The themes of Medicine at Risk are the themes of propaganda for the next two decades: themes which were to surface with a vengeance in the late 1980s.
The thalidomide incident stimulated attacks by those who profess to despise 'orthodox medicine' and all its works. Before examining the fallacies behind the accusations of the politically-minded critics of the pharmaceutical industry, it is useful briefly to consider the views of the crank. (italics added) 4The only person whom Happold designates a 'crank' is Brian Inglis: he then cursorally looks at two of his recent books. 5
In Fringe Medicine, he [Inglis] describes approvingly the main forms of unorthodox healing, from naturopathy ('natural' food etc. school) to acupuncture (pricking with fine needles as practised in China); from Yoga to auto-suggestion; and from Christian Science (faith healing) to radiesthesia (black boxes, dowsing and all). 6The book outlines industry's arguments against such forms of natural medicine.
Throughout history, the sick have been exposed to quacks and confidence tricksters, and a great deal of money has changed hands, for spurious remedies and treatments which did more harm than good. 7Unwilling to look seriously at the efficacy of alternative medicine, the propagandist always turns instead to charges of financial exploitation, obscuring the fact that the pharmaceutical industry is one of the most profitable in the Western world.
Books like Medicine at Risk were foisted upon a relatively unsophisticated audience in the fifties and sixties. Its arguments are transparent but useful to explain the marketing strategies of the pharmaceutical companies in relation to alternative and complementary medicine. Twenty years after the inauguration of the NHS, Medicine at Risk supports the cosy relationships which socialised medicine introduced between general practitioners and the pharmaceutical industry.
Many attacks upon the pharmaceutical industry must be clearly recognised as attacks on doctors. The small minority of medical men who have associated themselves with wholesale denunciation of the drug industry ..... do not seem fully to realise that their views reflect on the competence and even integrity of their professional colleagues. 8This is another theme which re-emerges in the 1980s. In the scenario presented by Medicine at Risk, economic power, price and profit are not mentioned. An infallible medical science serves a universal mankind manufacturing drugs entirely to rid the world of ill health. Doctors, who are solely concerned with the health of their patients, live in a world free of cultural, personal or commercial pressures.
Another important symbolic battlefield is the medical press. This too exists in a perfect world concerned only with disseminating biasfree information about the most appropriate treatments.
Doctors regard M.I.M.S. (Monthly Index of Medical Specialities), distributed free by Medical Publications Ltd, as one of the most useful guides for general practitioners. It lists all products by brand name, has a therapeutic and pharmacological index, cross referenced to detailed information on individual products, manufacturer, formulation, disease, indications, possible side-effects, dosage and price. It is entirely financed by manufacturers' advertisements.To suggest that the pharmaceutical companies finance the medical press, via advertising, so as to support an 'independent information service', gives new meaning to the word 'independent'.
The medical journals, which in Britain have a high reputation, provide in particular a source of information and opinion on treatment and drug action mainly at consultant level and also act as media for the exchange of medical opinion. They, in turn, are partly dependent financially on manufacturers' advertisements. Thus, the main part of the £ 1.5m (1964) spent by the industry on journal advertising is in fact devoted to supporting independent information services to doctors. 9 (italics added)
The arguments put forward by Happold show that even in the mid-sixties, it was difficult to separate doctors from the pharmaceutically-orientated infrastructure, which had grown up, densely, around them.
The Contemporary Scene
It was evident, in the early years of the nineteen eighties, that there was a growth of interest in alternative and complementary medicine. It was an interest about which pharmaceutical companies were becoming increasingly concerned.
In 1981, the Threshold Foundation, a body primarily interested in complementary healing, published the results of a survey into the status of complementary medicine in the United Kingdom. 10 The survey, thoroughly researched, was a major contribution to the understanding of the status and social position of a wide range of complementary treatments in Britain.
Some results of the Threshold Foundation study gave the pharmaceutical companies serious reason to be concerned. Findings showed that increasing numbers of patients were turning to non-orthodox practitioners and that in the year 1980 to 1981, the numbers of such practitioners were increasing annually by around 11 %. The number of lay homoeopaths registered with a professional association, for instance, had risen from 25 in 1978 to 120 in 1981. The number of practising acupuncturists had doubled during the same period, rising from 250 in 1978 to 500 in 1981.
Such figures had a relevance far beyond their simple arithmetic. The growing number of complementary practitioners would not be prescribing or advising the use of drugs. Perhaps more startling to the pharmaceutical companies, as each discipline set up its own training programme, the education of 'healers' and specialists would begin to change. The survey showed that already, by 1981, the rate of increase in complementary practitioners was nearly six times that of the annual increase in the number of doctors in the UK. 11
In July 1983, the BMJ 12 carried an editorial which warned doctors to remain sceptical about alternative treatments until they had passed the supreme scientific test of the 'controlled trial'. More should be done, the editorial suggested, to carry out rigorous clinical trials for alternative treatments: 'Stricter standards should be required, however, by a doctor proposing himself (sic) to use alternative treatments. If the treatment he (sic) proposes using has not been validated by a clinical trial then he (sic) is in just the same position as a clinical pharmacologist with a new drug.'
In 1984, the Royal College of Physicians and the British Nutrition Foundation published Food Intolerance and Food Aversion, which brushed over alternative treatments in relation to allergy. In 1986 the Board of Science and Education of the BMA published a report on Alternative Therapy, 13 which was clearly the profession's answer to the Threshold report.
Alternative Therapy argues the case for the allopathic doctor against the alternatives. The report was overseen by Sir Douglas Black at a time when he was President of the BMA. The first thirty six pages discuss the history of medicine from the birth of man, very useful for first-form secondary school pupils, but not so useful for those interested in alternative therapies. The description of the alternative therapies themselves is twenty five pages long. A short historical description of each practice - homoeopathy gets three pages, herbalism gets one page, acupuncture two pages - is followed by eighteen pages of discussion and analysis.
These eighteen pages represent the tablets of stone upon which later and more acerbic critics of alternative medicine, campaigning in the late eighties, came to base their case. The discussion begins with a short discourse in praise of science and from that point onwards a fog of cynicism emanates from the pages.
Inasmuch as scientific method lays such firm emphasis on observation, measurement and reproducibility, historically it has become inevitably and increasingly separate from doctrines embracing superstition, magic and the supernatural.What is interesting about such reflections on 'science' is that they expose some of its value-laden assumptions. If scientific method emphasises observation, measurement and reproducibility, why can we not use such method to appraise homoeopathy? The report as a whole argued that modern medicine began with the enlightenment and any medical treatment which cannot be explained is invalid.
Herein lies the first and most important difficulty that orthodox medical science has with alternative approaches. So many of them do not base their rationale on any theory which is consistent with natural laws as we now understand them. It is simply not possible for example, for orthodox scientists to accept that a medicine so dilute that it may contain not so much as one molecule of the remedy in a given dose can have any pharmacological action. 14 (italics added)
The authors of Alternative Therapy considered it important to make clear not only that many alternative treatments were in their opinion non-scientific but also to point out the fact that a number of alternative therapies are propagated by 'cults'. By discussing medicine within this context, the report begins the process of the 'criminalisation' of alternative practitioners, which the Campaign Against Health Fraud was to take up in 1989.
Our attention has been drawn by many people to the activities of what have become known as 'new religious movements', a term which is perhaps more acceptable and descriptive, if not more accurate, than 'religious cults and sects'.The inclusion of these unreferenced and poorly explained paragraphs about 'new religious movements' and alternative therapies is gratuitous to any proper analysis of such therapies in an apparently serious work.
Our particular interest is in the fact that many of these 'religious' organisations make direct claims to be able to cure disease, including cancers and fractures ... There are now over 100 groups operating in the UK in such a manner as to have come to the attention of FAIR (Family Action Information and Rescue), which was formed in 1976.
Alternative therapies may be used by these groups to induce belief, thus strengthening the religious dimension (which can qualify for charitable status with resulting tax benefits). Illness may be proclaimed as being a 'punishment' for lack of faith or other misdemeanour.
We believe that, subject to the necessity to maintain the principle of freedom of religion in this country, they [the cults] should be carefully and continuously monitored in order to ensure that they do not become a threat to the health and wellbeing of those who enter into association with them. 15
Another idea which enters the public domain with this report, is that many alternative therapies are actually bad for you. Never is the information about health damage caused by alternative medicine compared to the dangers implicit in pharmacological treatment, or surgical intervention. Rarely are references given for claims and never are these claims the result of scientific studies.
The 365 traditional points in acupuncture, run near, some perilously so, to vital structures, and complications ranging from the minor to the serious and the fatal have been reported. The public should not be exposed to acupuncturists who have not been trained to understand the relationship between the acupuncture points and anatomical structures, and also the physiology of organ structure.Early Targets
The potential dangers of local and systemic infection following an invasive technique such as acupuncture are real and well documented. While strict asepsis and sterile needles are self-evident requirements, we were led to believe it was an aim rather neglected in practice. Yet the transmission of infectious hepatitis has been reported and the increasing incidence of AIDS virus infection makes the possibility of transmission by contaminated needles a reality (italics added). 16
Ordinary monopolies corner the market; radical monopolies disable people from doing or making things on their own. 1Caroline Richmond called the first meeting of what was to be called the Campaign Against Health Fraud in 1988. She had been laying the foundation for the group, gathering information and organising critical attacks upon clinical ecologists and allergy doctors, for at least two years previously.
The campaigns against allergy medicine in particular, and clinical ecology generally, had perhaps been strongest during the previous decade in the north of England. The pragmatism of industrial Protestantism is seemingly unwilling to accept ideas about the delicate interleaving of the mind and body, and the hard commercial instinct remains unconvinced by alien notions of industry being bad for the health.
In the mid-eighties, after going to work with Wellcome, Caroline Richmond consolidated her friendships with a variety of natural allies, most especially orthodox doctors working in the field of immunology. Her most enduring contacts were made with doctors and activists in the Manchester area, the city which was to become host to the UK Skeptics. Two doctors in particular, Dr Tim David and Dr David Pearson, joined Richmond in her campaign against the alternative treatment of allergy.
In 1982, Dr David Pearson returned from the United States, where he had been working in an occupational illness centre funded by the US public health department. His first stop was Manchester University where he had previously received his PhD. Now his area of research was classical food allergy. Dr Tim David also became prominent in the early eighties working as a paediatrician, with an interest in allergy, at Booth Hall Hospital in Manchester. Dr David's interest in allergy developed in the late seventies and grew from his work with the National Eczema Society, a group which even then was patronised by the oil and pharmaceutical companies.
Both David and Pearson felt particularly offended by the work and life style of Dr Keith Mumby. His practice, in the early eighties in Stockport then later in Stretford, on the edge of Manchester, used the 'provocation neutralisation' technique to diagnose and then treat allergies. Mumby, a writer as well as a doctor, had come late to environmental medicine, and when he did get involved, it was with great enthusiasm. He travelled frequently to America to train with Dr Joe Miller, the 'father' of provocation-neutralisation. By the mid-eighties Dr Mumby was at the centre of a small northern contingent of environmental practitioners.
Another doctor who had been attracted to environmental medicine and especially to food allergy treatment was Dr David Freed, at that time based in Prestwich near Manchester. Despite being a classically trained allergist and immunologist, Freed turned away from orthodox medicine and towards clinical ecology in the late seventies. He is a large, bearded man, whose avuncular nature disguises a clear, disciplined mind. It was during his postgraduate training at Manchester University that Dr Freed first met Dr Pearson. In the mid-eighties, Dr Freed was working with an allergy therapist and dietician, Anna Foster.
From the early eighties onwards, these northern practitioners were to become the subjects of a propaganda assault organised by Caroline Richmond and her two close friends.
While at Manchester University, Pearson carried out an investigation into people who said they suffered from food allergy; he later published the study.2 Pearson and his psychiatrically trained colleagues took a small group of individuals who either maintained that they suffered from allergy, or had been diagnosed as so suffering. Each patient was challenged with capsules of food additives and chemicals. Only 5 out of the 35 patients produced reproducible symptoms in a double blind test. The researchers concluded that the remaining 30 patients were suffering from psychiatric complaints.
This single piece of research by Pearson was to form the basis for the next decade of campaigning against doctors working in the field of allergy. The singular work was also to form the basis of Caroline Richmond's later contentions that people who complained of allergic responses or chemical sensitivity were in fact psychologically ill.
By the mid-eighties, both Pearson and David had got themselves quoted in the papers denouncing 'private allergy clinics'. 3 Dr Freed, who was working with Anna Foster in one of the few private allergy clinics near Manchester, 'The North West Allergy Clinic', inevitably felt that such attacks by Pearson and David were personal attacks on him.
Even in those early days of the campaign against clinical ecology, the vested interests supporting orthodox allergy work were beginning to show. Tim David denounced Dr Freed to the General Medical Council, after his name appeared on a list of doctors supporting the Hyperactive Children’s' Support Group, which had begun campaigning against chemical food additives.
In November 1986, a large two-day conference of classical allergists and immunologists was held in London. The proceedings were to be published as a book on food allergy. 4 The conference was sponsored by a leading nutrition company, Wyeth Nutrition, and held at Regents College. About twelve doctors attended a critical seminar prior to the conference at the Royal College of Physicians, at which each paper and potential chapter was discussed.
Following the seminar, the doctors gave a series of talks to the full conference. The audience was an invited audience consisting mainly of paediatricians and GPs. One of those present who was not a clinician of any kind was Caroline Richmond. When Dr David Freed went up to the podium to read his paper on 'provocation neutralisation', Richmond came bustling from the audience with a tape recorder.
In the mid-eighties, Richmond was already developing the tactics and gathering the intelligence, which were to form the basis of her work for the Campaign Against Health Fraud. A year after the Swiss Cottage conference, in Autumn 1987, while working at the North West Allergy Clinic, David Freed received a phone call from Caroline Richmond. She introduced herself as a journalist and asked for his comments on an article which she had written about the clinic.
After it had been read to him, Freed thought Richmond's article:
In the article, Richmond accused Anna Foster of making a false diagnosis of the patient. Dr Freed, who had been present during the consultation, knew that no mistake had been made. Freed was so concerned about the style and the content of the article that he immediately rang the Medical Protection Society, who in turn put pressure on Richmond to withdraw her story. At the time, Freed recalls, there were a number of heated exchanges between himself, Foster and Richmond over the phone.fairly scurrilous; a biased story about a patient who had fallen out with the clinic. Although there was nothing factually wrong with the article, the slant of it was antagonistic to environmental medicine. 5
By the end of 1987, Dr Freed had a very clear idea that he was considered by Caroline Richmond and her small group of campaigners to be in the enemy camp. In 1988, after Anna Foster had set up a new organisation in Bolton called 'Nutritional Medicine', she received another call from Richmond. Richmond said she was working for the Observer on an article about allergy. When it became apparent that Anna Foster was not going to take part in an interview, Richmond used tactics which were to become common in later campaigns. She rang Foster frequently. The continual calls, as late as midnight, became so annoying that Foster was forced to refer the matter to the Press Council.
The Beginning of the Campaign Against Health Fraud
The major players in the British health-fraud movement, Caroline Richmond, Dr David Pearson, Dr Vincent Marks, Professor Michael Baum and Dr Nick Beard, had been coming together since 1985. They were all heavily involved in the defence of scientific medicine and most of them had a connection, however tenuous, with the Wellcome Foundation.† Each founder member also had contacts who would be drawn into the campaign and help in reporting information and publicising cases. One 'quackbuster', whose role in the organisation was to be shrouded in misinformation, was Duncan Campbell. Campbell was later to claim on a number of occasions that he had never been a member. There are, however, a number of references from the early days of the organisation which show clearly that he was involved. ††
† As well as working in the Wellcome Institute, and receiving a Wellcome bursary, Richmond acquired 250 Wellcome shares in December 1986. She held these shares until they were sold in 1990.
†† The Autumn 1989 CAHF Newsletter quotes a letter sent by Campbell to Hospital Doctor. 'I enthusiastically welcome the recent launch of CAHF. In the few weeks since they launched, I and others have already benefited immensely from their assistance in working to expose the many (other) charlatans who are preying on the vulnerable for commercial gain'. 7 Around the time that the Campaign was launched, Campbell had meetings with Caroline Richmond and Nick Beard. He was cited in the Campaign's newsletter as a member and attended ordinary Campaign meetings and closed Annual General Meetings at the Ciba Foundation and St Bartholemew's Hospital.8 At around the same time that it became public that the Campaign was funded by the Wellcome Foundation, Campbell began to distance himself from the organising core of the Campaign, and later claimed that he had never been a member. For the purposes of this book, Duncan Campbell has been considered as an associate member of the Campaign Against Health Fraud. He added a great deal of authority to the Campaign's strategy and was instrumental in many of its critical attacks. He used information supplied to the Campaign and was happy to use its founder members as a rich source of quotes for his articles, without questioning their vested interests. From the first 1989 issue of the UK Skeptic, Caroline Richmond and Nicholas Beard had the space to outline the strategies and attacks organised by the CAHF. In the February 1989 issue, Nick Beard contributed an article about the need to put natural or alternative remedies through clinical trials. He used the article to consolidate the attack on Jacques Benveniste carried out the year before, by CSICOP member James Randi.
It was first decided to call the Campaign, the Council Against Health Fraud. 6 This is a clear indication that the British Campaign had links with the American Council.† In November 1988, Caroline Richmond organised the first steering committee meeting for what was to become the Campaign. The meeting was advertised in the newsletter of the Medical Journalists Association (MJA). The MJA, of which Richmond is a long-standing member, is supported by Ciba Geigy and a number of other pharmaceutical companies. Companies use the Association's newsletter to advertise meetings and conferences and 'freebies' at which they promote their drugs to journalists.
†The Campaign Against Health Fraud was listed in the Newsletter of the American Council as an associate organisation. 9
Following the meeting, Caroline Richmond sent round a circular to the press and interested parties. 'At a meeting on 1st November 1988, a group including doctors, journalists and a barrister decided to form the Council Against Health Fraud, an information and action service against the growing tide of quackery.' At the bottom of this short advertisement Richmond gave her address, for contact purposes, as The Wellcome Institute, 183 Euston Road.† 10
† Richmond later claimed that she was not influenced by her employers and that the Campaign was not supported by Wellcome. She told a number of people that she had almost lost her job as a consequence of using the Wellcome address at the bottom of the leaflet. In an attempt to correct the blunder she later replaced the Wellcome address with a box number and her home telephone number.
Between the first meeting and the official launch of the Campaign in May 1989, the steering committee met at the Ciba Foundation, 11 the academic front for the drug company Ciba Geigy. The Ciba Foundation has an information service, the Media Resources Service (MRS), which was to some extent already doing the kind of work, in defence of science, health and the pharmaceutical and chemical industries, that CAHF planned. The MRS put scientists and sympathetic journalists in touch with each other.
At least two patrons of the Service were known to Caroline Richmond. Professor Sir Hermann Bondi was influential within the British Humanist Association, and Sir Alastair Pilkington was at that time one of the principal directors of the Wellcome Foundation. Amongst MRS Steering Committee members were two people with whom Richmond had closer links, Sir Walter Bodmer † and Dr Bernard Dixon. Dixon was both a founder member of the Campaign Against Health Fraud and a member of CSICP, the British branch of CSICOP.
† For Caroline Richmond's links with Sir Walter Bodmer in the British Association for the Advancement of Science see Chapter 22, The Pollution of Science.
The Ciba Foundation also plays host to a number of other organisations with which Caroline Richmond and Sir Walter Bodmer are associated. These include the Wellcome-administered Association of Medical Research Charities and the Association of British Science Writers. The British Association for the Advancement of Science holds meetings there for its Media Fellows, as does the Medical Research Council.
During the gestation period of the Campaign Against Health Fraud, Caroline Richmond was involved with the magazine UK Skeptic †, which had been set up in 1987 with money from CSICP. 12 On its inauguration, CAHF was advertised as a co-member of the UK Skeptics in the first page of their magazine UK Skeptic. The British branch of the CAHF had the same relationship to UK Skeptics, as the American Council Against Health Fraud had to CSICOP. The health fraud campaign was, as it were, the armed wing, while CSICOP and CSICP were made up of theorists.
† See Chapter 18.
From the first 1989 issue of the UK Skeptic, Caroline Richmond and Nicholas Beard had the space to outline the strategies and attacks organised by the CAHF. In the February 1989 issue, Nick Beard contributed an article about the need to put natural or alternative remedies through clinical trials. He used the article to consolidate the attack on Jacques Benveniste carried out the year before, by CSICOP member James Randi.
Using UK Skeptic and the CSICOP journal, both a long way from being 'peer-review' publications, health-fraud activists were able to publish unreferenced stories. Both magazines were able to continuously recycle 'debunking' stories years after actual allegations had been found wanting. John Maddox, the editor of Nature, also had great fun talking to UK Skeptics about Benveniste.Last year Nature published a paper which claimed to provide in vitro evidence for an effect which could have helped to explain homoeopathy - the start of the Benveniste fiasco. The research appeared to show that basophil degranulation (an immune response in white blood cells) continued to be triggered by solutions of an antigen even to concentrations of 10 -120. However, this was followed shortly afterwards by a damning report from a team of investigators who found serious errors in the research methods involved, invalidating the research. 13
Let me just tell you a bit about our visit to Paris, a year ago to investigate Dr Benveniste's claim that it was possible to take a biological reagent, put it in water, dilute the water virtually indefinitely and still find the biological activity in the solution. We took with us a conjurer, an exceedingly good one, James Randi. When we arrived in Paris we found Dr Benveniste was not doing his experiments with his own hands but that somebody else was doing them for him in an exceedingly sloppy way. He was not actually taking proper account of the statistical controls that in those circumstances any first year undergraduate biologist would recognise to be necessary. 14The UK Skeptic, for which both Richmond and Beard wrote, and which was financed by CSICP, continued to report the attacks mounted by the Campaign Against Health Fraud throughout 1991 and 1992.†
† In the 1991 January/February edition of UK Skeptic, there is a biased account of the flawed Lancet paper on Bristol Cancer Help Centre, and a one-sided account of the CAHF-engineered attack upon Dr Jean Monro.
The Campaign proper finally got off the ground at a press conference held on May 8th 1989, at the Royal Society of Medicine. The invitation briefly stated that the campaign organisers were 'worried about the growth of quackery, and false, pseudo-scientific claims'. 15 Coincidental with the launch of the CAHF was a CSICOP European conference also held in May near Munich, West Germany. The launch of CAHF was discussed, as was the general subject of 'fringe medicine'.
The press conference was chaired by Caroline Richmond and attended by 20 or so journalists, who were treated to speeches from Professor John Garrow, the TV and radio presenter Nick Ross and Professor Michael Baum. The 'Today' programme reported the Campaign's concern about 'private food allergy clinics' and hair analysis, while Vincent Marks managed to get himself on LBC, attacking 'worthless cancer treatments' which deterred people from having surgery.
The CAHF launch got publicity in the BMJ and was reported with some seriousness in some daily papers, particularly The Times.
Last year, Caroline Richmond, a medical journalist and research scientist, decided that the public needed to be protected from 'unproven and worthless' treatment, and she decided to set up a British equivalent of the American National Council Against Health Fraud or 'Quackbusters'.'Carefully controlled trials' for new treatments sound very laudable, until it is remembered that Wellcome was then involved in the most prestigious, costly and contentious 'controlled trial' of any modern pharmaceutical product: the Concorde trials for AZT. Was it simply coincidence that the CAHF, an organisation set up to investigate quacks, was linked with Wellcome, and began its life at almost the same time as major trials of AZT were begun in Britain and France?
The campaign aims at promoting assessments of new treatments and protecting consumers from fraudulent claims. It will act as an independent information service for journalists who want to comment on fraud in medicine, and it will also set up specific enquiries. 16
Reports of the launch of CAHF by Thompson Prentice, published in The Times, made little attempt to disguise links between CAHF and Wellcome. The article in which news of the launch appeared was an unadorned advertisement for AZT. Headed 'AIDS RESEARCH', the sub-heading 'Drugs May Protect Carriers' stretched across three columns. The news content of the article simply reiterated basic information about the Concorde trials. Set in the centre of this article in bolder type was a single paragraph article about the launch of CAHF.
For a self-styled independent organisation, the proximity of these articles, their intimacy even, was a little embarrassing. On the following day, Thompson Prentice went to town in promoting CAHF, when The Times ran a four by three inch column article bannered 'ANTI-FRAUD CAMPAIGN', as if the newspaper had adopted the campaign. Even in this article, which described the new organisation and its launch, Thompson Prentice could not resist placing information from Wellcome in close proximity.
The article was clever in its orientation: headlined 'Quacks risk women's lives', 17 it quoted mainly from Dr Michael Baum: 'A growing number of women are dying from breast cancer because they are putting themselves in the care of "quacks", rather than orthodox specialists. '
Baum went on to describe how women came to his surgery with little chance of survival after they have sought 'unproven alternative therapies ... I have a cluster of patients who have been convinced that homoeopathy and special diets will help them. In fact, their cancers go unchecked' .
Vincent Marks was quoted as stating: 'Bogus explanations for ill health bring the genuine concept of scientific medicine into disrepute.' CAHF was an organisation, the article said, 'of doctors and lay members who aim to protect the public from taking cures and untested medical treatments'.
Following the launch, Michael Baum gave an interview to the Journal of Alternative and Complementary Medicine. In this interview he at least made clear his views about alternative medicine. He did not believe, he said, 'that any system of alternative medicine had any basis in scientific fact'. 18
After the launch, Steering Committee meetings continued to be held at the Ciba Foundation, the first being on the 15th of May. 19
3. The Players and the Game, 1989-1991
Quackery is practiced not only by barkers at carnivals, but also by men with doctoral degrees who are members and officers if prestigious medical- scientific: organizations and who are shielded from detection and criticism by such organizations, by public officials, and by governmental corporate and organizational secrecy and public relations. 1
Those who represented the core of the Campaign Against Health Fraud at its formation in 1989 remained involved over the next two years; others pulled in on the fringe soon drifted away. On April 3rd 1989 at a Steering Committee meeting held at the Ciba Foundation, two joint presidents were elected: Dr Michael O'Donnell, broadcaster and former GP, editor of GP magazine, and television and radio presenter Nick Ross.
At that time, soon after the press launch, the leading Campaign activists were Dr Nick Beard; Dr Christopher Bass, a psychiatrist and committee member of the British Association for the Advancement of Science; Dr Simon Wessely; Professor Michael Baum and his brother Professor Harold Baum, Professor of Biochemistry at King's College Hospital; Diana Brahams, barrister and journalist; John Walford; Mark Pownall; Dr lain Chalmers; Dr Vincent Marks and Duncan Campbell.
An initial statement from the Campaign about funding suggested that it was largely funded by individual subscriptions which stood at £12 per annum. The claim that individual members were paying for the Campaign was similar to that made by the American Council Against Health Fraud. It might strictly have been true, but as the majority of the early core activists had some financial connection with Wellcome, as well as other companies, or worked in projects funded by the pharmaceutical industry, the exact source of their corporate funds is relatively unimportant. †
† In 1992, the minutes of the CAHF Annual General Meeting disclosed that in the year 1991-1992 the Campaign received a grant from the Wellcome Foundation. Other granting bodies included medical insurance companies and other pharmaceutical companies.
Apart from Caroline Richmond's obvious connections with Wellcome, most other leading members also had links. Professor Michael Baum worked at the Royal Marsden Hospital which was joined to the Institute of Cancer Research where Dr Robin Weiss had developed testing kits with Wellcome. In 1990 at the same time as he took up a position at the Institute of Cancer Research, Michael Baum became clinical advisor to Breakthrough, a cancer charity which is raising money for a Breast Cancer Centre at the Royal Marsden Hospital. The Centre will be staffed by, amongst others, a team of eight Wellcome-funded scientists.2 Michael Baum also ran the Tamoxifen trials in Britain throughout the 1980s for ICI. Wellcome and ICI had a number of joint projects, not least between 1985 and 1990, when they jointly owned Coopers Animal Health. Professor Harold Baum with two other medical scientists received a large grant from Wellcome in 1985. Dr lain Chalmers was running the National Perinatal Epidemiology Unit, which was hugely subsidised by Wellcome. 3† John Walford was the Grants Officer for the Multiple Sclerosis Society of Great Britain and Northern Ireland; this Society is a member of the Association of Medical Research Charities, an organisation administered by Wellcome. 4 The MS Society research is funded by a number of industrial interests including pharmaceutical companies. 5 Vincent Marks, biochemist and entrepreneur, heads the Department of Biochemistry at Surrey University which received nearly half a million pounds from Wellcome between 1985 and 1990. 6
† In 1990, the Wellcome Foundation gave £186,182 and the Wellcome Trust gave £24,888, to the National Perinatal Epidemiology Unit.
Given that considerable emphasis was later to be placed upon the idea of supporting the National Health Service and the general practitioner, the above members and those who were to follow were an odd collection. Just as the Campaign did not have any representation from patients, there were few hard-working general practitioners or people with clinical experience of everyday illness. Even more interestingly, few of the active members obtained their salary from working as medics of any kind; a large percentage of them were journalists or scientists of one kind or another. Caroline Richmond describes herself as a medical journalist; the two Presidents, Dr Michael O'Donnell and Nick Ross, were both journalists. When Dr Nick Beard met up with Richmond he had just finished working for Coopers and Lybrand and was on a course at Imperial College while also doing some free-lance journalism. Bernard Dixon was a writer and journalist. Later, Andrew Herxheimer from the Drug and Therapeutics Bulletin was to join. James Le Fanu, who joined later, though working as a doctor was also a free-lance journalist. In various articles, Duncan Campbell was to make much of the idea that those he attacked were at the centre of private medicine, and yet those he was working with were often supported by private interests.
As the campaign began to gather members, others with a Wellcome connection joined. Dr Jeremy Powell-Tuck, for example, had been a Wellcome Fellow and Sir John Vane, who joined with his wife Daphne Vane, had recently been one of the most senior scientists at the Wellcome Laboratories. A number of those who were to join the Campaign soon after its launch were associated with the processed food industry. John Garrow and Arnold Bender, whose wife became the membership secretary in May 1990, had both previously been grant-aided by large processed food concerns. 7
By the time of the second Annual General Meeting in July 1990, at the Nutrition Department of St Bartholomew's Hospital, there were a few committed new members. One in particular, Professor Tim McElwain, must have seemed like a prestigious catch. McElwain was one of Britain's most renowned cancer doctors and a man who had been committed to orthodox cancer treatment for the whole of his working life. †
† See Chapter 36, for Professor McElwain's involvement in the survey of patients attending the Bristol Cancer Help Centre.
By the first months of 1990, the Campaign literature was quoting the names of those who although they had been associated with the campaign from the beginning had never been listed as members before: Dr David Pearson, the allergy specialist from Manchester, Duncan Campbell who had been involved from the beginning with Nick Beard, and a medical sociologist with a good reputation in the field of orthodox medicine, Dr Petr Skrabanek of Dublin University.
The Game
Within a couple of months of its launch, the Campaign Against Health Fraud had produced a newsletter. It was not as professional as its American counterpart 8 but it provided a good platform for the Campaign to promote attacks and debunking projects which it had initiated.
Caroline Richmond seemed most concerned that journalists got the proper view of health matters. To her, one of the principal aims of CAHF was to inform the media about treatments which did not reach an acceptable standard. 'The campaign will give journalists and everyone in the media concerned with health, access to an independent assessment of the many claims about health that are currently in circulation.' 9 Nick Ross, writing as the co-chairman, pursued a line common amongst American campaigners: that it is the elderly, the old and the ill who are exploited by health-fraud. Ross seemed to envisage the Campaign as an extension of the para-policing work which he did on the television programme 'Crimewatch', homing in on criminal fraud: 'it is a particularly offensive form of fraud when people pose as healers and exploit that desperate need for help by offering illusions of cure that can never be fulfilled.' 10
The newsletter provided Campaigners with a forum where they could criticise what they saw as 'unscientific' ideas about health in the media. In the first newsletter, Caroline Richmond complains about the absurdity of suggesting that electricity has anything to do with illness; John Garrow complains about an article in the Today newspaper which talks about apricot kernels in the context of nutrition and Nick Beard complains about an item on reflexology in the TV Times.
The strong American flavour of the Campaign showed clearly in their choice of books they reviewed. Nick Beard reviewed a book published by Paul Kurtz and CSICOP's publishing company Prometheus, while Caroline Richmond reviewed an American Medical Association bibliography of health fraud.
In June 1989, Michael Baum gave an interview to the Journal if Complementary and Alternative Medicine. The article was entitled: 'Why I Will Bust Quacks'. 11 From his first utterances about the Campaign, Michael Baum, like other members, was 'economical with the truth' about its objectives. 'What the campaign is not, I must emphasise, is a clique of doctors, ganging up against alternative medicine. Alternative and complementary therapists would be welcome to join the campaign as long as they agreed with its aims.' In fact, the CAHF had from the beginning a practice of restricting membership to those who endorsed the use of pharmaceuticals. The few natural medical practitioners who tried to join were usually turned down, without any reason being given.
CAHF was formed, Baum claimed, 'for the specific purpose of protecting the public by highlighting examples of fraudulent practice and providing a panel of experts to independently assess health claims. † Recent years have seen a flood of explanations and promised cures for illness whose validity has never been tested; vitamins to increase intelligence, hair analysis which reveals vital missing minerals, diets that promise to counteract childhood hyperactivity or prevent cancer.' 12
† From the beginning CARF was keen on 'assessing' claims for diagnostic techniques and treatments. As in the main they knew nothing about alternative and complementary medicine, and some like Caroline Richmond had no clinical experience, it is difficult to see from where they thought their authority in this judgemental capacity came.
In three lines of this interview, Baum gave away a good portion of the game plan which CAHF activists had been working on for the previous year. The vitamins to increase intelligence alluded to the work of Larkhall Natural Health and Cantassium products. Hair analysis related to the work of Biolab and Stephen Davies and diets which promise to counteract childhood hyperactivity alluded to the work of Belinda Barnes on child hyperactivity. In fact, in each of these cases there were mountains of referenced work and scientific papers, none of which were ever alluded to by the Campaign.
By the time the first newsletter was published, it was evident how the Campaign were to go about prosecuting their complaints against non-pharmaceutical treatments. Apart from sundry bodies like the Advertising Standards Authority, they were to rely upon the investigators at MAFF and the Medicines Commission, inside the DoH. The Campaign even made overtures to the Department of Health, asking if they might be formally recognised as a prosecutorial agency by them.
It is not surprising that they expected such official bodies to prosecute their complaints; both MAFF and the DoH generally have a cosy relationship with industry and what might be called an intimate relationship with the pharmaceutical and agri-chemical business. In the second newsletter, Mark Pownall, writing about a 'MAFF crackdown on misleading nutritional claims', points out germanium as being 'clearly dangerous', a product which 'should be subject to the Medicines Act' as should 'promotional claims of other health enhancing properties of "health food" products'. 13 Clearly the CAHF had powerful friends in high places, because germanium was not simply made subject to the Medicines Act; a short time after the newsletter was written it was banned. †
† For the story of how germanium was banned see Chapter 34.
At the Annual General Meeting of CAHF in 1990, members voiced concern that the organisation had been accused of being in the pay of the pharmaceutical industry (in particular the Wellcome Foundation). This was refuted and the minutes recorded that: 'There is no connection, nor has any money been received from any pharmaceutical company towards any of our activities.'
Some time was taken up at the Annual General Meeting discussing under what circumstances and from whom, the campaign might accept money. 'The Committee decided that money from any source, including the pharmaceutical industry, would be acceptable if it was given on a hands off basis and provided that no single interested party contributed more than 25% of CAHF's annual requirement.'
Nick Ross was apparently unhappy with the decision, believing that the pharmaceutical and food industries had the greatest interest in the survival of CAHF. He felt that such donations would be used against the Campaign. In the discussion which followed, Professor Vincent Marks, Professor John Garrow, Wally Bounds, Dr lain Chalmers and Dr Jeremy Powell-Tuck all agreed that money could be taken from any source. Sir John Vane pointed out naively that anyone contributing would do so because they had an interest and this need not influence the behaviour of CAHF.
By the time of the second AGM in 1991, commitment appeared to be waning. While there had been over sixty members at the first AGM, only twenty-one were present at the second. The Campaign felt that it had been penalised when earlier in the year it had been refused charitable status because of its campaigning activities.
The meeting decided to change the name of the organisation from the Campaign Against Health Fraud to HealthWatch. The point of this cosmetic exercise was to make the organisation appear less combative and more charitable. It also placed HealthWatch in the context of a number of other groups, mainly set up by the police:
Neighbourhood Watch, Homewatch, Carwatch. In the following year, 1991, though its campaigning zeal had not abated and it had done immense damage to a range of alternative and natural practitioners, it was granted charitable status.
The British Health Fraud Philosophy
The modern health fraud philosophy is extensive and complex, but not really a philosophy, more a series of post hoc defensive arguments for orthodox medicine. At the heart of these assumptions is a simple equation: anything which challenges the monopoly hold of the chemical companies on food production and pharmaceuticals, the professional status of doctors, or the ruling paradigms of industrial technology should be attacked.
Much is made by activists of the fact that the health-fraud philosophy is based upon science. In fact health-fraud arguments are rarely objective, let alone scientific. Quite the opposite, they are usually highly personalised and apparently given weight by unsupported assertions.
The spate of articles and interviews which appeared between the beginning of 1989 and the end of 1991 give a good idea of the Campaign's preoccupations and points of intervention. Many of its arguments have a patina of seductive popularism.
One article which plainly illustrates the way in which CAHF uses opportunities to attack complementary medicine is an article by Anne Wiltsher in the New Statesman and Society of July 7th 1989.14 This article purports to be a look at the fortunes of complementary medicine as we approach new European regulations in 1992.
The article begins with a brief introduction which lampoons complementary medicine (the article is accompanied by one large and one small photograph of individuals undergoing acupuncture treatment; both pictures are visual jokes). It then briefly discusses the attitudes of the European powers towards complementary medicine, before launching into propaganda for the CAHF.
CAHF wants to see testing by clinical trials of all health products and procedures and better regulation of practitioners to protect the public. 15CAHF has, the article says, the backing of the Advertising Standards Authority and the Consumers' Association.
Oddly enough, both these examples are given in the report on complementary medicines published by the BMA, three years ago in 1986.The latter has recently pointed out the dangers of creating fashionable herbal remedies from garden plants. For example, camomile which is often taken as tea is now thought to cause vomiting if taken in large doses. Comfrey is now linked with liver cancer in rats. 16
The January 18th 1991 issue of GP carried an article by Dr Charles Shepherd, a long-standing member of the CAHF and a Clinical Adviser to the Media Resources Service of the CIBA Foundation. Entitled' "Natural health" pills can be lethal', 17 a centre column subheading reads 'Many of the remedies can have bizarre and disturbing toxic effects'. It is one of the most climactic anti-vitamin articles ever published: a kind of 'Vita-disaster' article.
The piece is illustrated with a large picture of Barbara Cartland. The caption to the photograph reads 'Novelist Barbara Cartland: renowned for championing "natural health" pills'. As the heading states that 'natural health pills' can be lethal, one wonders why Barbara Cartland did not sue.
A good deal in Dr Shepherd's article reinforces the fact that GP magazine is subsidised by drug company advertising. 'Many of the new-age pills and potions in the alternative pharmacopoeia are drugs in all but name. But they masquerade as "nutritional supplements" in order to evade the strict rules on efficacy, safety and product promotion which the Medicines Act imposes on conventional drugs.' 18
The article proceeds to attack all vitamin and mineral preparations without giving any supporting evidence for statements made about their damaging effects.
On January 7th 1991, Derek Jameson interviewed Professor John Garrow, at that time Chairman of HealthWatch, on Radio 2.20 The interview was mainly about vitamins. Professor Garrow put forward the HealthWatch line, saying firstly that vitamin supplements were of no medicinal use and secondly that some of them were positively damaging.Far from being natural and safe, remedies sold in health food shops, can have disturbing toxic effects. Aromatherapy can result in allergic reaction and bums to the skin. Selenium is toxic and excess zinc can depress the immune system. Excessive intake of both fat and water-soluble vitamins can result in severe toxic effects. Vitamin A accumulates to cause encephalopathy (swelling of the brain). Vitamin B3 can produce severe hepatoxicity (poisoning of the liver). Vitamin B6 causes peripheral neuritis (inflammation of the nerve ending) at daily doses above 200mgs: and vitamin C is known to increase the bioavailability of oestrogen, so converting a low-dose contraceptive pill into a high-dose one. 19
Professor Garrow, like Professor Bender, has a consuming passion against health food and health food shops. Professor Garrow took advantage of the interview to make an acute point about them:My view and the view of HealthWatch is that if any material, whether it's vitamins or minerals or Royal Jelly or Ginseng, or whatever is sold to people making them believe that it's going to do something for their health, it should have a product licence, they have to show the Department of Health that they are safe and effective ... Lots of these things which are sold in health food shops - so-called health food shops - as if they were foods, really are being sold as medicines to make people healthier. 21
The greatest fallacy promulgated in these bizarre discourses about 'health foods' and 'health food shops' is the idea that the production of processed foods is tightly controlled, and free of any damaging substances. Only recently have manufacturers had to describe contents on packaging. Now that they do, it is with reluctance and often in mystifying terms. None of the substances added to processed foods go through trials, or are tested over time for adverse effects.people go into health food shops thinking that everything there is natural and is bound to do them good, often it won't do them good, usually it's a waste of money, sometimes it'll do them harm. 22
'Thames Action', the ITV access programme, reported on vitamin supplements on November 23rd 1990.23 The programme began by explaining how much money the vitamin producers make. Vitamin producers must be the only groups within the capitalist economy, (apart from criminals such as drug dealers) constantly criticised for making profits. When it comes to vitamins and 'health foods', journalists and health fraud campaigners radically change their ideological position, suddenly finding the profit motive morally reprehensible. Drug company profits are never alluded to.
Vitamin supplements are big business - we're all taking them but are they just a waste of money and are they safe ... The vitamin industry is massive. Last year it's estimated that we consumed a record 133 million pounds worth of vitamins - that means we popped an astonishing 2,000 million pills. 24
'Thames Action' used a viewer to comment on the issue during the programme, while experts supplied specialised views. Viewer Shelley Batheram talked about the things which it was claimed vitamins do; holding up a book she said: 'This book lists some of the claims that have been made about vitamins in the past. For example, vitamin D keeps you young and beautiful, vitamin E boosts your sex drive and potency, vitamin A is meant to stop you getting cancer, vitamin B6 retards ageing and prevents tooth decay, and vitamin C, as we all know, stops you catching a cold.' 25The tone of the item is determined by these sceptically introduced, unreferenced claims. Viv Taylor-Gee moved the item to its logical conclusion, before interviewing the expert, Professor Vincent Marks. 'It's possible to overdose on nearly all vitamins especially if the vitamin supplement comes in megadoses.' 26 It is also possible to overdose on ice cream and even water, not to mention a large array of pharmaceuticals, especially in megadoses! Vincent Marks explains:
We recently had a patient in the hospital where I work ... a woman who had been led to believe that by taking vitamin D and A she would be made to look young and beautiful. She took her vitamins in the form of halibut liver oil capsules and ... believing that if one was good, two must be better, in fact she took so many [she turned into a fish ... No?] that by the end of a relatively short period of time she had produced severe kidney damage and presented in the hospital as a case of kidney failure. 27Once again we are given a truncated, anecdotal case history which tells us next to nothing about the clinical condition of the woman involved. Could it be for instance that she was mentally ill? After all most people know that while an aspirin can stop a headache, it would not be advisable to take a whole bottle to combat a bad headache.
Vincent Marks' message is simple and asinine: vitamins are basically very dangerous in the hands of ignorant people. If you take large quantities of halibut liver oil capsules to make yourself beautiful you will end up with kidney failure. The programme did not make it clear that Vincent Marks was an active member of Health Watch, or that he has spent most of his professional life persuading people that sugar does you no harm - even in megadoses.
This programme, like many others, failed to interview a doctor who works with vitamins and food supplements. The final word was given to Vincent Marks.
I don't think that people believe that there are any risks associated with taking vitamins. They subscribe to the view that vitamins are good for you and therefore things which are good for you cannot do you any harm. But of course they are completely and utterly wrong. 28Thompson Prentice of The Times is not a member of HealthWatch, although he reported sympathetically on its propaganda from the organisation's inception. In September 1990 he reported on a BMA conference in Edinburgh. 29 The piece, snappily headlined: 'Cures for chronic fatigue disorders "may be dangerous"', begins 'Many thousands of people suffering from chronic fatigue disorders are being exploited by private practitioners peddling "hocus pocus" remedies that are unproven and may be dangerous, a leading specialist told a medical conference yesterday.'
If the leading expert, Professor Ariel Lant, produced any evidence for his assertions, it was not reported by Thompson Prentice. 'The devastating effects of chronic fatigue syndrome have produced a host of alleged treatments, many from the realms of alternative medicine.' Professor Lant called for scientific trials to evaluate remedies, while Prentice intoned gravely: 'Professor Lant's comments on the treatments amount to some of the strongest criticisms expressed in recent years on the response by doctors to various forms of chronic fatigue.'
Although Professor Lant made it clear that he did not agree with the Caroline Richmond school of thought that ME is a figment of the 'imagination of either the patient or the practitioner', he did agree with HealthWatch that quacks were operating in this area: 'Patients were offered analysis of samples of their hair and skin, others were having tests for non-existent allergies, and some were paying for preparations of primrose oil or pumpkin seeds ... The list is enormous. Some of the hocus pocus treatments are so bizarre as to be unbelievable, and I believe some if them may be harmful.'(italics added). 30
Well, there we have the considered scientific view, people being tested for non-existent allergies, paying for evening primrose oil or pumpkin seeds, where will it all end? Thomson Prentice had got himself another big news story!
Bella is an inexpensive woman's magazine. On April 14th 1990, it carried a classic anti-health food article, 'Food For Thought: Health food is more popular than ever - but "natural" isn't always safe', by Andrew McKenna. 31 The full page article was accompanied by a small picture of a widely grinning Professor Arnold Bender, a large picture of a worried woman scrutinising a 'health food' product in a 'health food shop' and another small picture of a tub of organic germanium, which, says the caption, 'can kill in large doses'. The artwork was as 'pulp' as the message, a kind of True Health Fraud story, to be read in a slow exclamatory American accent, reminiscent of Broderick Crawford in 'Highway Patrol' or the introduction to the 'Streets of San Francisco'.
This sounds like an interesting case, a little like the fish oil woman reported by Vincent Marks. A classic of its kind, it makes all kinds of unsupported statements, which are backed up by the 'expert', Health Watch member Professor Arnold Bender.Nurse Jessie Thompson felt stressed, so she bought some herbal relaxation pills from a health food shop. She took 30 pills - and suffered jaundice, kidney failure and such serious liver damage she spent 10 weeks in hospital. Jessie, 60, who was off work for a year in total, has now recovered. 'I thought herbal pills were safe because they're natural ... 1 was wrong.' 32
Professor Bender has worked, throughout his life, for the processed food manufacturers. He was head of research at Farley Infant Foods, head of research at Bovril, and has received research funding from Cadbury Schweppes, Heinz and Kelloggs. 33 Off he sounds on the pages of Bella: 'There is no such thing as a health food - there is such a thing as a health food industry. No one food is good or bad for you. What counts is a varied, balanced diet. A lot of people are being misled.'
That is certainly true! Andrew McKenna takes up the story: 'It's recent health scares over the £600 million a year diet supplement and herbal remedy industries that have led to the most scathing criticisms ... In Britain, we spend £137 million a year on mineral and vitamin pills. In 1989 alone, sales of Tandem IQ vitamin packs rocketed from 1,000 a month to half a million, after trials at a Welsh school claimed that extra vitamins boosted pupils' IQ.34
The article makes use of a Consumers' Association report on health foods, which it says concluded: 'If you were to eat only foods from a health food shop, you could be following a very unhealthy diet.' 35
According to McKenna, the Consumers' Association report found that health food shops stocked some nuts prone to cancer-causing substances; kidney beans which if improperly cooked could cause severe gastroenteritis and diarrhoea; a dried fruit preservative which causes asthmatic attacks in a few people and muesli bars with a very high sugar content. 36
What a condemnation of health food shops! The mind boggles, and just think, if they found these things in health food shops, what would they find in any of the major food retailers? Perhaps the most amazing thing about articles of this kind is that it makes one realise that the Medicines Act should cover the licensing of journalists, some of whom can of course seriously damage your health.
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References
CHAPTER TWENTY SIX. The Campaign Against Health Fraud, Part One.
1. Illich, Ivan. Limits to medicine, medical nemesis: the exploration of health. London: Marion Boyars, 1976.
2. Griffin, Edward G. World without cancer: the story of vitamin B17. Westlake Village, Calif: American Media, 1974.
3. Happo1d, F.H. Medicine at risk: the high price of cheap drugs. London: Queen Anne Press, 1967.
4. Ibid.
5. Inglis, Brian. Fringe medicine. London: Faber, 1964. Inglis, Brian. Drugs, doctors & disease. London: Andre Deutsch, 1965.
6. Happo1d, op. cit.
7. Ibid.
8. Ibid.
9. Ibid.
10. Fulder, Stephen, Monro, Robin. The status of complementary medicine in the United Kingdom. London: Threshold Foundation, 1981.
11. Ibid.
12. Smith, Tony. Alternative medicine. Editorial. EMJ 1983; 287: 307.
13. British Medical Association. Alternative therapy. 1986.
14. Ibid.
15. Ibid.
16. Ibid.
2. Griffin, Edward G. World without cancer: the story of vitamin B17. Westlake Village, Calif: American Media, 1974.
3. Happo1d, F.H. Medicine at risk: the high price of cheap drugs. London: Queen Anne Press, 1967.
4. Ibid.
5. Inglis, Brian. Fringe medicine. London: Faber, 1964. Inglis, Brian. Drugs, doctors & disease. London: Andre Deutsch, 1965.
6. Happo1d, op. cit.
7. Ibid.
8. Ibid.
9. Ibid.
10. Fulder, Stephen, Monro, Robin. The status of complementary medicine in the United Kingdom. London: Threshold Foundation, 1981.
11. Ibid.
12. Smith, Tony. Alternative medicine. Editorial. EMJ 1983; 287: 307.
13. British Medical Association. Alternative therapy. 1986.
14. Ibid.
15. Ibid.
16. Ibid.
CHAPTER TWENTY SEVEN. The Campaign Against Health Fraud, Part Two.
1. lllich, Ivan. Limits to medicine, medical nemesis: the exploration of health. London: Marion Boyars, 1976.
2. Pearson, David J., Rix, Keith J.B., Bentley, Stephen J. Food allergy: how much in the mind? Lancet 1983; i: 1259 - 61.
3. Hodgkinson, Neville. Doctors against the allergy quacks. Sunday Times, 31 August 1986.
4. Dobbing, J., ed. Food intolerance. London: Bailliere Tindall, London: 1987.
5. David Freed, interview with the author.
6. Letterhead in possession of the author.
7. CAHF Newsletter, Autumn 1989, quoting a letter sent by Campbell to Hospital Doctor. Campaign Against Health Fraud, London.
8. CAHF Newsletter and Minutes of CAHF Annual General Meetings 1989 and 1990.
9. Newsletter of the National Council Against Health Fraud throughout 1990.
10. Four-paragraph article sent to media by Caroline Richmond headed Council Against Health Fraud.
11. Ciba Foundation. Report and Handbook, 1990.
12. Beard, Nick. The Committee Against Health Fraud. U.K Skeptic, 3 (3).
13. UK Skeptic, February 1989.
14. Maddox, John. The case against PSI. E&IS. January/February 1990.
15. Campaign Against Health Fraud. Invitation to Press Conference, May 8 1989, at the Royal Society of Medicine.
16. Prentice, Thomson. AIDS research. The Times, 8 May 1989.
17. Prentice, Thomson. Quacks risk women's lives. The Times, 9 May 1989.
18. Journal of Alternative and Complementary Medicine, May 1989. 19. Ciba Foundation. Report and Handbook, 1990.
19 Ciba Foundation. Report and Handbook 1990
2. Pearson, David J., Rix, Keith J.B., Bentley, Stephen J. Food allergy: how much in the mind? Lancet 1983; i: 1259 - 61.
3. Hodgkinson, Neville. Doctors against the allergy quacks. Sunday Times, 31 August 1986.
4. Dobbing, J., ed. Food intolerance. London: Bailliere Tindall, London: 1987.
5. David Freed, interview with the author.
6. Letterhead in possession of the author.
7. CAHF Newsletter, Autumn 1989, quoting a letter sent by Campbell to Hospital Doctor. Campaign Against Health Fraud, London.
8. CAHF Newsletter and Minutes of CAHF Annual General Meetings 1989 and 1990.
9. Newsletter of the National Council Against Health Fraud throughout 1990.
10. Four-paragraph article sent to media by Caroline Richmond headed Council Against Health Fraud.
11. Ciba Foundation. Report and Handbook, 1990.
12. Beard, Nick. The Committee Against Health Fraud. U.K Skeptic, 3 (3).
13. UK Skeptic, February 1989.
14. Maddox, John. The case against PSI. E&IS. January/February 1990.
15. Campaign Against Health Fraud. Invitation to Press Conference, May 8 1989, at the Royal Society of Medicine.
16. Prentice, Thomson. AIDS research. The Times, 8 May 1989.
17. Prentice, Thomson. Quacks risk women's lives. The Times, 9 May 1989.
18. Journal of Alternative and Complementary Medicine, May 1989. 19. Ciba Foundation. Report and Handbook, 1990.
19 Ciba Foundation. Report and Handbook 1990
CHAPTER THIRTY ONE. The Campaign Against Health Fraud, Part Three.
1. Mintz, Morton. By prescription only. Boston: Beacon Press, 1967.
2. Centre aims for breast cancer breakthrough. Wellcome Journal, December 1991. Wellcome Foundation supports "Breakthrough Breast Cancer" Initiative. News release, Wellcome Foundation Ltd, 1991.
3. National Perinatal Epidemiology Unit. Report 1989-90.
4. AMRC. Handbook 1990 - 91.
5. Personal communication with the author.
6. University of Surrey Gazette, 1985 - 90.
7. Cannon, Geoffrey. The politics of food. London: Century Hutchinson, 1987.
8. NCHF Newsletter. National Council Against Health Fraud Inc.
9. CAHF Newsletter, 1, 1989.
10. Ibid. 11. Baum, Michael. Why I will bust quacks. Journal of Alternative and Complementary Medicine, June 1989.
12. Ibid.
13. CAHF Newsletter, 2, 1989.
14. Wiltsher, Anne. Faith and doubt. New Statesman and Society, 7 July 1989.
15. Ibid.
16. Ibid.
17. Shepherd, Charles. Natural health pills can be lethal. GP, 18 January 1991.
18. Ibid.
19. Ibid.
20. Derek Jameson. BBC Radio 2, 7 January 1991.
21. Ibid., Professor John Garrow.
22. Ibid.
23. Vitamin supplements. Thames Action. ITV, 23 November 1990.
24. Ibid.
25. Ibid.
26. Ibid.
27. Ibid.
28. Ibid.
29. Prentice, Thomson. Cures for chronic fatigue disorders may be dangerous. The Times, 18 September 1990.
30. Ibid.
31. McKenna, Andrew. Food for thought: health food is more popular than ever - but 'natural' isn't always safe. Bella, 14 April 1990.
32. Ibid.
33. Ibid.
34. Ibid.
35. Ibid.
36. Ibid.
--------------------------------------------------------------------------2. Centre aims for breast cancer breakthrough. Wellcome Journal, December 1991. Wellcome Foundation supports "Breakthrough Breast Cancer" Initiative. News release, Wellcome Foundation Ltd, 1991.
3. National Perinatal Epidemiology Unit. Report 1989-90.
4. AMRC. Handbook 1990 - 91.
5. Personal communication with the author.
6. University of Surrey Gazette, 1985 - 90.
7. Cannon, Geoffrey. The politics of food. London: Century Hutchinson, 1987.
8. NCHF Newsletter. National Council Against Health Fraud Inc.
9. CAHF Newsletter, 1, 1989.
10. Ibid. 11. Baum, Michael. Why I will bust quacks. Journal of Alternative and Complementary Medicine, June 1989.
12. Ibid.
13. CAHF Newsletter, 2, 1989.
14. Wiltsher, Anne. Faith and doubt. New Statesman and Society, 7 July 1989.
15. Ibid.
16. Ibid.
17. Shepherd, Charles. Natural health pills can be lethal. GP, 18 January 1991.
18. Ibid.
19. Ibid.
20. Derek Jameson. BBC Radio 2, 7 January 1991.
21. Ibid., Professor John Garrow.
22. Ibid.
23. Vitamin supplements. Thames Action. ITV, 23 November 1990.
24. Ibid.
25. Ibid.
26. Ibid.
27. Ibid.
28. Ibid.
29. Prentice, Thomson. Cures for chronic fatigue disorders may be dangerous. The Times, 18 September 1990.
30. Ibid.
31. McKenna, Andrew. Food for thought: health food is more popular than ever - but 'natural' isn't always safe. Bella, 14 April 1990.
32. Ibid.
33. Ibid.
34. Ibid.
35. Ibid.
36. Ibid.
The Company Director: Dr Vincent Marks
by Martin Walker MA
[Chapter Twenty Eight: DIRTY MEDICINE]
Many children are suffering from 'muesli-belt malnutrition', which could cause stunted growth and weight loss. 1
Vincent Marks, a sixty two year old medical doctor and Professor of Biochemistry, is the perfect professor for the end of the twentieth century: an age when intellectual endeavour has been turned into private property and the greatest accolades of learning are tucked away in bank accounts. On the returns of one of his companies, Professor Marks describes his occupation as that of 'company director'. Like that of many other university scientists, his road to the top of his profession has been strewn with garlands from chemical, pharmaceutical and processed food companies.In 1985, as a member of the British Association of Clinical Biochemists, of which he was later to become President (1989-1991),2 Marks received the Wellcome Award for Good Laboratory Practice. The prize, which consists of a cheque and a piece of engraved glass, was for 'a significant contribution to the quality of laboratory practice'. Between 1985 and 1990, the Department of Biochemistry which Marks heads at Surrey University received over half a million pounds in grants from Wellcome. 3
Marks comes from an eminent medical family, his brother John Marks being the head of the General Council of the BMA. He is one of the most influential founder members of the Campaign Against Health Fraud; his presence on MAFF and MRC committees gave him access to powerful agencies which CAHF were able to use in its attacks upon natural medicine.
At Surrey University Marks has built up the Biochemistry Department, and the Department of Nutrition, by linking up the work of his staff colleagues with lucrative grant-funding from the large food processing, chemical and pharmaceutical companies. For his own research work, Marks is adept at choosing funding bodies and has become an influential and experienced grant receiver from many powerful sources. Over the last ten years, he has received major grants from such diverse sources as the Cancer Research Campaign, the pharmaceutical company Eli Lilly, the Institute of Food Research at Norwich (AFRC) and the American National Institutes of Health. He has attracted to the Department staff who have a good track record of working with industry; in November 1984, for example, Dr Juliet Gray† was appointed a Lecturer in the Department. 4
† See Chapter Nineteen: From the Table to the Grave.
Other large industrial concerns funding projects in the Biochemistry Department throughout the second half of the eighties were Ciba Geigy, 5 Sandoz Pharmaceuticals, 6 Unilever 7 and the Flour Milling and Baking Research Association. 8
Marks has also attracted the major grant-aiding organisations in medical research. The Cancer Research Campaign, (CRC) which unlike the Imperial Cancer Research Fund does not have its own laboratories, has throughout the eighties developed a base at Surrey University where it uses the laboratory services of the Biochemistry Department. In 1988 the CRC gave the Department in excess of £50,000 for work on two research projects. 9
In 1989, the Breast Cancer Biology Group was established within the Biochemistry Department at Surrey. The Group grew from the amalgamation of two laboratories, the Hormone Biochemistry Laboratory at Surrey and the Tissue Cell Relationships Laboratory, which had previously been a part of the Imperial Cancer Research Fund Laboratory in Lincoln's Inn Fields. The location of the new group at Surrey maximised contact with the surgical, histopathological and breast screening teams already established at the Royal Surrey Hospital, Guildford. 10 It meant also that Vincent Marks was to work closely with the two major British cancer charities.
One of Vincent Marks' closest colleagues at Surrey University, a man who has often represented the HealthWatch view on his behalf, 11 is Andrew Taylor. Taylor studies deficiencies and over-exposure to toxicity; he is a member of a number of Department of Health working groups. He works in the Robens Institute for Occupational Health and Safety, which is responsible for researching industrial, occupational and environmental health. The Robens Institute is completely dominated by chemical and pharmaceutical interests. In 1985, the Management Committee was chaired by the Research Director of ICI, Dr C. Reese, and included: the head of the Division of Toxicology and Environmental Protection at what was then the DHSS, Dr McGibbon; a BP executive; Sir Geoffrey Allen of Unilever; Sir William Paton, then Director of the Wellcome Institute for the History of Medicine and Wellcome Trust Trustee from 1983, and Dr J. Griffin, who had been head-hunted from the top job in the Department of Health, Medicines Division, by the Association of British Pharmaceutical Industries, of which he became Director. 12
A Commercially Interesting Area
As well as being a founder member of the Campaign Against Health Fraud, Vincent Marks is an active spokesman for populist campaigns against health foods, and those who he insists make large profits from the sale of vitamins. Although he is usually presented as an independent scientist, he is himself involved in a number of private companies which depend for their survival upon private medicine and processed food companies.
During the nineteen eighties, Marks was the director of no less than eight companies, † most of which are involved in the measurement and analysis of biochemicals.
† Radio Immunoassay, Probus Biomedical, Guildhay Laboratory Services, Guildhay, Clifmar, The Food and Veterinary Laboratory Limited, Bio-Stat Diagnostics and Quatro Biosystems.
Marks set up Radio Immunoassay in 1986 with two other scientists and a publisher. The company, which was based in Cardiff and provided services for medical research laboratories, folded in 1987. Probus Biomedical was incorporated in 1986, to design and market biomedical diagnostic systems.
In 1982, Marks set up Guildhay Anti-Sera, in partnership with Surrey University, and Guildhay Laboratory Services with his wife Avril, to develop laboratory reagents and provide laboratory services. Clifmar Associates, set up in 1985, was again a joint enterprise with Surrey University, to research processes for purification and recovery by specific binding (extraction of materials by chemical separation).
Companies with which Vincent Marks has been associated have had varied success. Three of them are specifically located within the University of Surrey and their directors or share interests overlap with those of the University. One of these companies, Guildhay Anti-Sera, made a £17,500 loss in 1988, and in 1989 had to acquire a mortgage on its property in order to stay afloat.
One reason for the Guildhay losses is probably the fact that although the company is able to carry out research, it is not able to go into production. A good example of this grant-aided research work, which tends not to make a profit, is the research into monoclonal antibodies carried out by Vincent Marks under the auspices of Guildhay. In December 1987, Vincent Marks and a business partner in Guildhay Anti-Sera, Dr K. Tan of Surrey University, together with Professor R. Spier of the University's Microbiology Department †, were given a Medical Research Council grant of £109,025 to investigate the production of human monoclonal antibodies to HIV.
† Spier is also a director, with Marks, of Probus.
The research into monoclonal antibodies was carried out at Guildhay Anti-Sera and, in November 1988, the three scientists were given an additional £10,000 to complete the work. It is difficult to find any published papers on the results of this work: the author made enquiries of both the MRC and Professor Marks' colleagues, and neither were able to put their hands on any published material.
Coincidentally, the Wellcome Foundation must have been working on the same research, for in October 1990, it joined forces with the MRC to support a new Therapeutic Antibody Centre, in Cambridge. The Centre was set up to produce monoclonal antibodies, for use in different scientific and commercial circumstances, such as those of HIV antibody testing kits.
All the companies with which Marks is associated carry out biochemical measurement or testing of some kind. They fall into two groups: those which do the research tend to make a loss, while those which produce the systems based upon the research do well.
A particular example is the Probus Quatro Robotic Sample Processor, designed in 1986 by Probus Biomedical, a company incorporated in 1986 by Vincent Marks. Probus received a SMART award from the Department of Trade and Industry in its first year, and the annual returns stated a desire to trade in the United States. Despite such early promise the company failed to thrive. In 1990, another company of which Marks is a director, Quatro Biosystems, a thriving company set up within the new light industry enclave of Manchester's Old Trafford Park area, produced the Quatro Robotic Sample Processor.
The most interesting of Vincent Marks' companies, in relation to his involvement in the Campaign Against Health Fraud and the attacks upon health foods and natural medicines, is the Food and Veterinary Laboratory Ltd (F&VL).† Set up in October 1986 with Vincent Marks as one of its first two directors, F&VL opened early in 1988. Clear indications that the company was close to MAFF and other government departments emerged when the laboratory was formally opened in April 1988 by Dr M.E. Knowles, then Head of the Food Science Division of MAFF.
† In 1988, a subsidiary of Sari Holding Company.
The Food and Veterinary Laboratory tests a range of foodstuffs for the large food-producing companies and MAFF. In 1988, the company worked on computer graphics for the prediction of chemical toxicity, and a major contract was pending for chemical toxicity screening. 13
During 1989, the company continued the development of an immuno-diagnostic product range and was one of the biggest suppliers of immuno-assay kits for the detection of anabolic hormone residues, which they exported to 17 countries. F&VL also produces large animal disease diagnostic kits, specifically a brucella antibody kit. 14
During 1988, a collaborative review for environmental analysis (pesticide analysis) was undertaken with manufacturers of pesticides and those responsible for their monitoring and control. It was, however, decided to stay with disease diagnostics in the short-term. 15
In the late eighties and early nineties, F&VL became involved in the analysis of chemicals used as colorants and in food packaging. This service was aimed specifically at, and carried out with, food producers. F& VL also began assessing and analysing pharmaceutical products. 16 In 1989, F&VL was asked by the Overseas Development Agency to undertake a consultancy in South Africa. 17
Despite the fact that Vincent Marks was a member of such relevant committees as the joint MAFF and DoH 'Advisory Committee on Novel Foods and Processes', and even though F&VL appeared to have access to an expanding market, collaborating with government departments, chemical, pharmaceutical and processed food companies, in 1989 the company made a loss of £275,954.18
Vincent Marks and Sugar - Sweet as a Nut
Vincent Marks' ongoing links with the sugar industry have been well documented by both Geoffrey Cannon 19 and John Yudkin. 20 As well as being involved in the promotion of sugar, Vincent Marks is also a member of the MRC Committee on Diabetes and has written substantially about hypoglycaemia. Many doctors and research scientists who believe that sugar plays a major part in the development of diabetic illness consider that there is a conflict of interests involved in these two areas of work. ‡
† For other information on sugar and the MRC see Chapter Twenty Three.
Scientists who are paid retainers by food producers, or public relations firms which represent them, are left to their own devices as to how they may best pursue the interests of these companies. The Sugar Bureau publishes a number of booklets and occasional reports mainly for dieticians. The C-H-O International Dialogue on Carbohydrates is published by Advisa Medica on behalf of the Sugar Bureau. The second issue of the eight page advertising freebee, published in June 1990,21 carried a letter from Vincent Marks flattering Michael Gibney, who wrote for C-H-O in April 1990. 'If you continue to publish articles of a standard similar to that by Michael Gibney, C-H-O will become compulsive reading to anyone with an interest in nutrition.' Michael Gibney in turn was responsible for an article in the Guardian which introduced the British public to the work of the American Council Against Health Fraud, Victor Herbert and the role which the British Nutrition Foundation could play in defeating 'quackery'.†
† See Chapter Nineteen : From the Table to the Grave.
Assay, Assay, Have You Heard the One About British Food?
In 1991, Vincent Marks wrote a booklet for the Institute of Economic Affairs (IEA) entitled Is British Food Bad For You? 22 The IEA, in conjunction with the Adam Smith Institute, was responsible for floating many Thatcherite policies. It is a free market organisation of the 'monetarist Right', funded by, amongst others, the large agro-industrial organisations which tend to determine food policies with and for successive governments.
The choice of title for the booklet is interesting; the use of 'British' in the title immediately deflects the argument of most contemporary critics of processed food. Another less misleading title like 'Is Industrially Produced Food Bad For You?' would have engendered quite a different debate. In fact the booklet does not actually apply itself to the issue of British food, except in a couple of cases where, by implication, Marks argues against himself: on BSE for instance, 'So far the occurrence of BSE in other countries has not been reported'.
The first twelve pages comprise an assault upon those who do not share Marks' views on industrially produced foodstuffs. In these pages he manages to touch upon all the favourite targets of the Campaign Against Health Fraud. Of those who feel uncomfortable with the involvement of industrially-funded science in food production, Marks says:
These, mainly middle-class, scientifically ill-informed individuals feel more comfortable with things that are naively or exploitatively referred to as 'natural' - without understanding quite what that term means - than they are with products they perceive as being manufactured or synthetic. 23 †Such scathing and irrational attitudes have no place in a serious text, especially from someone who purports to be a scientist. Marks however seems to enjoy this kind of populist harangue. As he moves from the scientifically specific to the pathologically general, his science turns to ideology.
† Unless otherwise stated all further quotes in this chapter are taken from Is British Food Bad For You?
In its most blatant form, exploitation of the gullible is through the sale of worthless, if not actively harmful, nostrums, elixirs or medicines. These are often marketed as 'health foods' or 'Nutritional Supplements' in order to circumvent laws designed to protect the public from the sale of potentially harmful drugs and medicines. Many 'nutritional supplements' are sold at greatly inflated prices, compared with identical or frequently much purer products which are available from reputable chemical suppliers but which do not carry spurious or misleading labels. Two worthless 'food supplements' causing damage are 'organic germanium' - which was heavily promoted as an essential nutrient when it is not - and tryptophan. †† For a discussion of the banning of L-Tryptophan and Germanium see Chapter 34 of this book, and Manders, Dean W. The Curious Continuing Ban of L-Tryptophan and the Serotonin Connection, in Morgenthaler, John and Fowkes, Steven. Stop the F.DA. Manders draws attention to the fact that L-Tryptophan, despite having been used for years in the effective relief of depression, was banned only a few years after Prozac, a chemical anti-depressant which has a similar effect, was launched. It is estimated that by 1995 sales of Prozac will have topped $1 billion, despite repeated reports of serious, adverse side effects. Prozac is produced by Eli-Lilly.
By page seven, still continuing his invective, Marks is firing off shots into the intellectual darkness, on such grand themes as integrity and patronage.
Some of the most notorious of today's hucksters have the effrontery to accuse scientists whose work is of the highest ethical and internationally recognised standards, but of whom they disapprove, as being in the pocket of those who fund their research. The intention, is to make such workers appear unreliable and untrustworthy.Again we are not provided with any references, so it is difficult to know to whom Marks is referring; perhaps he was thinking of Geoffrey Cannon. Although not a 'huckster', Cannon gave Marks and other 'scientists' a good drubbing in The Politics if Food. Cannon meticulously recorded sources of research funding, in order to demonstrate clearly, not that funding necessarily compromises the integrity of the researcher, but something more simple. It is his thesis that when industry pulls the purse strings of research and guides political decision making, there can be a critical vacuum created around issues of food and health.
Many of those who oppose Vincent Marks and his populist claptrap do so because in the field of health he is one of the major architects of that critical vacuum which exists around the issues of power, industrial food production and health.
In Is British Food Bad For You?, Marks outlines the tactics of the 'other side', saying that they indulge in 'character assassination' which is 'an anathema to scientists and similarly reputable people. It is, however, commonplace among gutter journalists and others who work on the basis that if you throw enough mud, some of it will stick.' It would have been interesting to see a referenced example of a reputable scientist whose character has been assassinated by a gutter journalist working for the health food lobby!
One of the often repeated assertions of those who support the paradigm of pharmaceutical health care and industrially processed food, is that their work is open to peer review: 'A scientist's work is reviewed critically by his peers, that is by people who actually understand what he says, and if it cannot withstand their criticism and be reproduced by those who are competent to do so, it will be discarded along with his reputation.' Such assertions are references to a mainly illusory world, which may have existed in the halcyon days of science but in more cynical times has crumbled. Many scientists now fail to write up their results in papers. If they do, and results are commercially viable, such papers frequently do not see the academic light of day but are passed directly to project funders. Other papers are published by 'in house' journals edited by sympathetic and likeminded people and funded by the research patrons.
Before Marks gets to British food, on his way through allergy and vitamin and mineral supplements, he even finds space to tilt at one of Caroline Richmond's favourite subjects, 'chronic fatigue syndrome' or ME. His unreferenced and anecdotal comments about vitamins could have been culled from one of a thousand pulp productions written by health-fraud activists. Even when talking about allergy, he manages to cram in a derogatory remark about health foods: 'A recently well-publicised example was the near-death of someone who ate a vegeburger containing, unbeknown to him, peanuts, to which he knew he was allergic and ordinarily avoided like the plague.'
By using this example, Marks ingeniously turns the focus away from allergy and the possibility that peanuts specifically can cause anaphylactic shock, onto the apparently poor labelling practices of vegeburger producers. At the same time he makes the surreptitious point that vegeburgers can be more dangerous than hamburgers. It's all very clever, but like most propaganda once you have the key it fails to stand up to intellectual scrutiny.
The central thesis of the booklet, which defends coffee, sugar, beef and irradiated food - hardly major British products - employs commonplace arguments unsupported by references or any mention of critical research. As well as admitting that BSE has not yet been reported in any other country, Marks suggests that British poultry farming practices which produce salmonella are long overdue for review. He puts forward the idea of poultry screening, by 'modern analytical methods, for carriers of the infection'. Just exactly the kind of work which the Food and Veterinary Laboratory Limited was set up to take on.
References1. Marks, Vincent. Quoted in The Times, 2 June 1986.
2. British Association of Clinical Biochemists. Annual Report, 1990.
3. University of Surrey Gazette, 1985 -1990.
4. Ibid., November 1986.
5. Ibid., February 1986.
6. Ibid., July 1987.
7. Ibid., July 1990.
8. Ibid., March 1989/November 1990.
9. Cancer Research Campaign. Annual Report, 1987, with Handbook, 1988.
10. Cancer Research Campaign. Annual Report, 1988, with Handbook, 1989.
11. Food and Drink Programme. BBC 2, 15 January 1991.
12. University of Surrey Gazette, 18 July 1985.
13. The Food and Veterinary Laboratory Limited. Directors' Reports, 1987/1988/1989.
14. Ibid.
15. Ibid.
16. Ibid.
17. Ibid.
18. Ibid.
19. Cannon, Geoffrey. The politics of food. London: Century Hutchinson, 1987.
20. Yudkin, John. Pure, white and deadly. Harmondsworth: Penguin, 1988.
21. C-H-O, June 1990. Advisa Medica on behalf of the Sugar Bureau.
22. Marks, Vincent. Is British food bad for you? London: Health and Welfare Unit, Institute of Economic Affairs, 1991. 23. Ibid.
23. Ibid
-----------------------------------------------------------------------------------
Professor Michael Baum: The Trials of a Cancer Doctor
by Martin Walker MA
[Chapter Thirty: DIRTY MEDICINE]
'No consideration was given to my personal circumstances, my possible wishes or my individuality 1
'As a sick patient I am at my most vulnerable. I must have absolute trust in those doctors treating me'. 2
Like Vincent Marks, Professor Michael Baum comes from a 'medical family'; not long after he had helped set up the Campaign Against Health Fraud, his brother Professor Harold Baum joined.† Both Harold and Michael are very successful in their chosen fields. Unlike his brother's, Professor Michael Baum's career has not however been free from controversy. In fact, at the very time that he was helping to found the Campaign Against Health Fraud, which intended to disseminate information about science and medicine and put the case for clinical trials, he was at the centre of a major controversy over the issue of 'informed consent'. Criticism of Professor Baum had first been raised in an Observer article by Adam Raphael. The article brought to light, in detail, for the first time, the case of Evelyn Thomas who had been unwittingly subjected to a randomised drug trial in 1982 at King's College Hospital. Her consultant had been Professor Michael Baum.† In 1986 Harold Baum and two other doctors were awarded a grant of over half a million pounds for the period 1986-7 by Wellcome. Harold Baum has also received funding from CRC, SERC, MRC, Nuffield, NATO, and Eisa Pharmaceuticals Ltd. Michael Baum has carried out most of his research work for the CRC and ICRF, but he has also received funding from ICI for work on Tamoxifen.
Conflicts between the patient's right to know and understand what is likely to happen to them, and the progress of medical science or the careers of surgeons, have been endemic to scientific medicine from its beginning. Such conflicts, although inherent in the everyday relationship between the physician and the patient, are brought into sharper focus in the circumstances of a drug trial. In the randomised and blinded trial, one group of patients are, unknown to themselves, given a non-effective treatment, a placebo, while others are given the treatment on trial.
At the heart of such conflicts is the single principle of 'informed consent'. A doctor who is completely open and honest with a patient, who gives the full information about the nature of the trial and the drug being used, before obtaining the consent of the patient, is unlikely to be criticised on ethical grounds. However, many doctors and scientists argue that to forewarn a patient about the exact nature of a trial is to reduce its scientific usefulness, increasing the chances of subjective responses distorting the outcome.
Drug trials are at the very heart of industrial medicine, and it is at this interface between the loyalty doctors feel to science and industry and the individual patient in need of care, that the most seminal medical conflicts emerge. Trials not only take place in hospitals but are also organised by general practitioners who can give unknowing patients new and unproven drugs. To organise drug testing in any other way would, according to orthodox doctors and scientists, involve bringing the individual's subjective response to illness into the relationship and erode the principles of science.
If patients were fully informed, there is a possibility they might refuse to take part in trials. Hard commercial considerations also come into the frame, some patients might take the view that medicine is not a philanthropic affair and by making themselves available for experimentation, they will in the long run help a drug company to make profit. This being the case, they might ask for payment commensurate with risk, or commensurate with the failure to be effectively treated. They might also ask for insurance contracts covering the eventuality of adverse effects or serious mishap. Such an eventuality would put the relationship of the doctor and the patient into a clearly different alignment than presently is the case; it would perhaps be a more honest relationship.
The pressure to introduce informed consent and to democratise drug trialling has inevitably opened up a market for agencies which recruit subjects for drug trials on a commercial basis. Governed entirely by commercial contracts, there is the possibility that the work of such trial centres and their recruiting agencies could exploit populations such as students, the unemployed, the low paid and captive populations such as prisoners. It has been estimated that in excess of 10,000 human volunteers were used for drug trials in 1988; they were paid fees of about £2million, by drug companies. 3
Hospitals which opt out of the National Health Service could well consider making a proportion of their money by using their facilities and patients for drugs trials. In 1988, it was estimated that individual doctors and hospitals in Britain were paid sums 'ranging up to £100,000 to test new drugs on human volunteers'. 4
Spurred on by two deaths in 1984, the Royal College of Physicians produced a report entitled Research on Healthy Volunteers in 1986.† They concluded specifically that large amounts of money should not be used as an inducement to get people to take part in trials and that all volunteers should be fully informed. The report, however, dealt only with 'healthy volunteers' and not with those people who turned to their doctor wanting treatment for an illness and later became the subject of a trial.
Many critics of scientific medicine believe that science and its needs should never take precedence over the rights of the sentient human being. They argue that one of the most fundamental human rights is the right not to be subjected unwittingly to experimentation. Another basic right is that, on turning to a doctor, a sick person should receive the most proven, effective and available treatment.
† Deaths occurred during drug trials in May 1984 and July 1984.5
* * *
Evelyn Thomas (1932-89) came from a family of which four members had died of cancer; she herself was in her late fifties when she found out that she had cancer of the breast. After diagnosis, she went into King's College Hospital, one of London's most prestigious teaching hospitals, accepting the fact that she would have to have her left breast removed. The operation for the removal of a breast is called a mastectomy; one of the surgical alternatives to mastectomy is lumpectomy in which only the tumour and surrounding area IS removed from the breast.Shortly after her operation, Evelyn Thomas noticed that the woman in the bed next to her, who had been through a similar operation, was being treated with a different regime. While her neighbour had received counselling and been given useful information, the counsellor, she said, had 'avoided me, and a breast prosthesis was given to me by a male fitter more used to fitting artificial limbs'. It took Evelyn Thomas four years to find out that she had been included without her consent in a trial, and a little longer to find out the full details of the trial, the treatment she had been given and the treatment she had been denied. †
† Evelyn Thomas claimed that besides the trial to which it transpired she was unknowingly subjected, she was also involved without her knowledge in a trial of surgical alternatives. However, although there had been at least one known mastectomy versus lumpectomy trial at Guy's Hospital, this trial had finished by 1982 when Evelyn Thomas was admitted to King's.
The randomised trials of which Evelyn Thomas had been a part were initiated in 1980 by the Cancer Research Campaign, under the auspices of Professor Michael Baum. They were titled the 'Collaborative trial for adjuvant systemic therapy in the management of early carcinoma of the breast'. Translated, this means simply that the trials were looking at supportive treatment following breast cancer surgery. Besides the granting and denial of counselling, two hormonal drug therapies,Tamoxifen and Cyclophosphamide, were given to the different trial groups.
The trials involved 2,230 women at thirty hospitals across the country between 1980 and 1985. None of the women involved in the trials were informed that they were subjects. The progress and condition of one group of women who were given the different treatments singly or in combination with or without the counselling, were compared with the condition and progress of another group who were given no adjunct treatments at all.
When Evelyn Thomas read about the results of the trial in 1986, it confirmed her suspicions that she had been part of a randomised trial. She was furious.
Evelyn Thomas's anger was the anger of the just, and it was not to be placated by excuses later offered by doctors and others who sprang to defend the medical and scientific establishment. To further her argument, Evelyn Thomas quoted the Nuremburg Code, drawn up after Nazis had experimented on concentration camp inmates: 'the voluntary consent of the human subject is absolutely essential'."I placed absolute trust in those treating me and assumed our relationship was based on openness and frankness. Actually patients at that time had their treatment determined by computer randomisation. My rights to have information and to choose, and my responsibility for my own body were denied. My trust was abused." 6
The defence of those who had experimented on Evelyn Thomas without her consent was weak. King's College Hospital claimed that their Ethics Committee had originally stipulated that informed consent must be obtained. However, after a nurse counsellor pointed out that some patients became distressed when faced with the uncertainty of having to choose their treatment, informed consent was waived for all trial subjects who passed through the hospital. This explanation did not really tell the whole story. The trial administrators had been against allowing informed consent but had found themselves compelled to compromise with the Hospital Ethics Committee.
Following the compromise, the trial administrators arranged for women coming into King's for this serious and frightening treatment, to be asked the night before their operation for their consent to be included in the trial. The raising of this complex and worrying issue on the eve of an awesome operation threw most women into a state of immobility and confusion. The majority declined to be included in the trial. When the poor results of trial subject selection were brought to the attention of the Hospital Ethics Committee, they withdrew their demand for informed consent.
In the public debate which followed Evelyn Thomas's campaign, Professor Michael Baum, who headed the trial and was Thomas's consultant, failed to tackle the important issue and chose instead to take offence at the wording of Evelyn Thomas's complaint as it was presented in the Observer:
Professor Baum said that he deeply resented Mrs Thomas's charges (that her trust had been abused) as he was one of the leading advocates of giving patients greater information. 7Only six years previously, Baum had entered his patients into the trial without obtaining their informed consent. In a long letter to the Observer the week following Adam Raphael's first article, 8 Baum claimed that, with hindsight, Evelyn Thomas was not actually denied any treatment, because after randomisation she had been one of the subjects given Tamoxifen.† He side-stepped the mention of counselling, which some would consider a vital aspect of recovery, and of which Evelyn Thomas was deprived.
† Another future member of the Campaign Against Health Fraud, the barrister and medical journalist Diana Brahams, makes the same irrelevant comment in the aftermath of the Evelyn Thomas case, saying that as it turned out, she got the 'preferred regime'. 9
In his attempts to defend himself, Professor Baum went through intellectual contortions, drawing attention to such facts as: 'Mrs Thomas was a victim of breast cancer, not of human experimentation.' 10 This was not denied. What was in question was Professor Baum's right to administer or withhold experimental treatments to patients without their consent. In the same letter to the Observer, Baum complained that the paper used a photograph of him which made him look like Mussolini. In a debate which touches upon mastectomy and its resultant problems for the patient's self image, such a remark might be judged vain in the extreme.
In his letter, Baum asks what he considers to be the seminal question of the debate: 'Was her [Evelyn Thomas's] treatment in any way compromised by my concern to improve the quality of cancer care for future generations of women?' Again, he evaded the central issue. While it is clearly within the authority of a physician to ruminate in the abstract about what mayor may not be best for future generations, in the present it is the patient's choice of treatment, not the doctor's, which is primary. Many patients may not wish to make the same personal sacrifices as Professor Baum for the glory of medicine's future.
Also writing to the Observer in support of Michael Baum was Caroline Richmond. Richmond, who made clear her friendship with Baum, argued in favour of science and randomised clinical trials, while at the same time failing to address the matter of informed consent. 'I respect and admire Professor Michael Baum of King's College Hospital, and was disturbed by Adam Raphael's one-sided report last week.' 11 †
† In May 1992, Caroline Richmond reported a surgeon to the police and the Director of Public Prosecutions, after he performed a hysterectomy on her, without informed consent, during the course of a routine operation.12
Richmond's letter was sent from the Wellcome Institute for the History of Medicine and was written in the same month that she called the first steering committee meeting of the Campaign Against Health Fraud, of which Baum was a member and which was to campaign, amongst other things, for randomised clinical trials.
When Evelyn Thomas found that she had been used as a guinea pig, she complained to the South East Thames Regional Health Authority. The complaint was dealt with by professional medical and health workers, whose system of complaints investigation makes the Police Complaints Authority look like something from the Magic Roundabout. Her case was reviewed by two assessors, a cancer specialist and a consultant surgeon. The cancer specialist who oversaw the complaint was a close colleague of Baum, and another future member of the Campaign Against Health Fraud, Professor Tim McElwain. Unsurprisingly, the professional review found that Evelyn Thomas had been treated in a correct and professional manner.
* * *
Regardless of what many doctors say in public, those like Michael Baum who are involved in and under pressure from the drugs industry, are secretive about drug trials and their accountability, or lack of it, to the patient. Doctors involved in drug trials see themselves as a beleaguered community.Despite a number of deaths which have occurred as a consequence of uninformed trialling † throughout the eighties, attempts to change medical research methodology have not been completely successful.
† In 1982, an 84 year old widow died after having been involved in a secret randomised trial, in Birmingham. 13 In 1983, another trial patient died; the woman had been reluctant to take part in the trial. 14
Carolyn Faulder, a writer with a history of taking up women's issues, has been writing about breast cancer since 1977. In 1986, she was the first person to publicise the case of Evelyn Thomas. The circumstances of Carolyn Faulder's involvement with the Evelyn Thomas case and the issue of informed consent are ironic.
In December 1980 Carolyn Faulder was invited by Professor Baum to sit on a Cancer Research Campaign committee, 'The Working Party on Breast Conservation', which serviced the 'Breast Cancer Trials Co-ordinating Sub-Committee'. Carolyn Faulder was invited, Michael Baum said in correspondence, as 'a member of the public to help us with our deliberations on "informed consent" '. 15
The breast conservation working party was formally set up in 1981, to prepare the protocols for a further trial which measured the effectivity of mastectomy against lumpectomy similar to the one which had been carried out earlier at Guy's Hospital. The new trial was to take place at the Rayne Institute, the trial centre at King's College Hospital where Professor Baum was the consultant. It was due to begin in 1983.
Carolyn Faulder accepted the invitation to join the working party, thinking that she could make a real contribution to the debate about informed consent. Besides Professor Baum, the Working Party on Breast Conservation included some of the most influential heavyweights of the cancer industry.†
† A number of these doctors were to appear in the late eighties aiding the Campaign Against Health Fraud to attack the Bristol Cancer Help Centre, in particular Dr Jeffrey Tobias and Dr Lesley Fallowfield. See Chapter Thirty Six.
Carolyn Faulder's time on the working party began well; she was treated courteously, and apparently included in the important discussions. Over the five years that she remained a member of the committee, however, she became increasingly uneasy about the reality of informed consent and her use to the committee. More than anything else, her involvement as a well-known woman writer and adviser appeared to fulfil a useful public relations role for the doctors, who did not appear that interested in changing their own ideas about the scientific method.
In 1983, at the time the new trial began at King's, Carolyn Faulder wrote an article entitled 'A Conspiracy of Silence'. 16 Before it was submitted, the article was shown to members of the working party, some of whom felt that it was 'too hard on members of the medical profession'. Carolyn Faulder, seeing the consensus in the group turn against her, made it clear to the committee that it was her article, and though she was willing to 'soften' some of its points, she would not change its central theme.
After 1983, and the article, the feeling in the working party became hostile to her, with disagreements being expressed about her criticisms of doctors, both inside and outside the group. For her part, Carolyn Faulder had become so concerned about information coming to light during her ongoing research into informed consent, that she began work on a book.
When women were properly informed about the trial at King's, few of them wanted to take part in it. After just over a year, with only 160 women signed up for the trial, the administrators were forced to close it down. With the trial closed down, the working party also became imperilled because its sole job had been to work out protocols for the trial.
As far as Carolyn Faulder was concerned, the working party could not close down a minute too soon. By late 1984, some members of the working party had all but stopped speaking to her. In October, at a working party meeting, from which she was absent, Dr Jeffrey Tobias expressed considerable dissatisfaction with Carolyn Faulder's role on the committee. The minutes record him as saying: 'Although Ms. Carolyn Faulder had been recruited to the working party to introduce the subject [informed consent] to the National Press, it would seem that a disproportionate emphasis was now being placed on the issue.' 17
When she saw these minutes, Carolyn Faulder was hurt and amazed; the comment had reduced her role on the working party to one of public relations. It crossed her mind that this may have been the role the group had in fact wanted her to perform. She re-read the letter from Professor Baum, in which it was unambiguously stated that she was invited onto the group so that she could give her advice and help about informed consent from the patient's point of view.
Before the working party was closed down in early 1985, Carolyn Faulder forced an apology and a retraction of the minuted remarks. The atmosphere had become so bad that she felt she was being deliberately ignored. Later that year, Carolyn Faulder's book Whose body is it? was published by Virago. 18
In 1986, Carolyn Faulder was able to redress the balance in the case of Evelyn Thomas, by helping to get her case made public. Even then, it was not until 1988, six years after she was the subject of the trial, that her case was taken up by Adam Raphael and became a real issue of concern.
References1. Evelyn Thomas.
2. Evelyn Thomas, cited in the Observer, 2 October 1988.
3. Clayton, Paul. Evening Standard Magazine, January 1992. Raphael, Adam. Wanted: human guinea pigs. Observer, 2 October 1988.
4. Ibid.
5. Ibid.
6. From unpublished writings of Evelyn Thomas.
7. Observer, 9 October 1988.
8. Observer, 16 October 1988.
9. Brahams, Diana. Informed consent and randomised controlled trials. Law Society Gazette, 25, 28 June 1989.
10. Observer, 16 October 1988.
11. Ibid.
12. Daily Mail, 29 June 1992.
13. Brahams, Diana. Death of a patient who was unwitting subject of randomised controlled trial of cancer treatment. Lancet 1982; i: 1028-9.
14. Brahams, Diana. Lancet 1984; i: 1083-4.
15. Correspondence between Michael Baum and Carolyn Faulder.
16. Faulder, Carolyn. A conspiracy of silence. Good Housekeeping, February 1984.
17. Minutes of the Working Party on Breast Conservation, October 1984.
18. Faulder, Carolyn. Whose body is it? The troubling issue of informed consent. London: Virago, 1985.
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