Jonathon Harper asks why a four-year course in homeopathy – an alternative therapy that’s been proven not to work – is approved and accredited by the New Zealand Qualifications Authority.
The ASA is our national advertising watchdog, and is funded by the advertising and media industries as a form of self-regulation. Our complaints are usually upheld, and the offending advertisements are toned down. However, recently the ASA seems to have been making exceptions for unproven acupuncture and chiropractic therapies because they are funded by ACC – even though ACC says its funding of a therapy should not be taken as proof of efficacy.
We buy our own drinks. Despite the occasional accusation that we are Big Pharma shills, we receive no money and not a lot of encouragement from anyone. Occasionally, a friend or family member becomes upset with one of us for challenging their friendly holistic healer or natural therapist. Government agencies, such as Medsafe and the Commerce Commission, seem to be unhappy with us making complaints about alternative medicine practitioners, because it means more work for them.
My colleague, Daniel Ryan, knows a lot about acupuncture and has published in the New Zealand Medical Journal on the scary number of acupuncturists in New Zealand who advertise treatments for medical conditions even their own associations do not consider to be treatable by acupuncture. Another member of our society, Mark Honeychurch, loves to delve into the brazenly bizarre. He has taken part in a satanic mass, attended Scientology sessions, and been to alternative health fairs, where he’s been treated with tuning forks, coloured lights and many more types of weird woo. We’re often joined by Robin Bodley, who spends his time investigating the Flat Earth groups now springing up in New Zealand, halfway around the globe from where the modern Flat Earth movement was born, in the US.
I have a background in psychology. And I have family and friends who think homeopathy works. I try to quietly explore with them why that makes no scientific sense, without casting personal aspersions. It’s not easy.
Funny, I thought. Why would NZQA, whose job it is to assess and accredit New Zealand qualifications, be spending time on an alternative therapy that has consistently been proven not to work? Homeopathy claims to treat or prevent illnesses by administering tiny amounts of a substance that produces similar symptoms (in a healthy person) to the illness in question. During an extreme dilution process, the product is shaken; the more dilute the product, the more potent it will be, homeopaths assert. Even when it is unlikely a single molecule of the chosen “active” substance remains, they say the water that has contained the molecules retains a “memory” of the substance – and is still effective.
Some homeopaths claim they can treat serious conditions such as cancer and the Ebola virus. There are even homeopathic alternative “vaccines” that are marketed as working as well as real vaccines – a promise not only irresponsible but downright dangerous.
So I contacted NZQA, asking first if public money was used to provide these assessments. I also wanted to know if there were any checks on the reliability and accuracy of the homeopathy information being taught at the college; and could NZQA approval be interpreted to mean the course was worthwhile?
My questions were treated as an official request under the Official Information Act (OIA). All appeals for information from government departments must be considered as OIA requests, even if you don’t specifically ask for them to be. The act allows up to 20 working days to respond, but government departments have a nasty habit of taking the entire 20 days to answer even the simplest of questions. In this case, the “answers” I received barely addressed the questions, so I had to rephrase and resend some questions several times, with corresponding delays each time.
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Meanwhile, I browsed the NZQA website, which said it will “ensure that New Zealand qualifications are regarded as credible and robust… and help learners succeed in their chosen endeavours…”. The Education Act also covers the College of Natural Health and Homeopathy, according to NZQA. One clause in the act mandates our education system to “foster high quality learning… a skilled and knowledgeable population… and strengthen New Zealand’s knowledge base”.
NZQA’s replies to me were signed off by CEO Dr Karen Poutasi, a medical graduate specialising in public health and a former Director-General of Health. Under Poutasi, NZQA was drawn into the headlines at the end of 2018 over the use of the word “trivial” in an NCEA exam. NZQA ended up deciding that Year 13 students who sat the history exam and did not know what the word “trivial” meant should not be penalised for their ignorance. In May last year, Poutasi was appointed as commissioner to replace the beleaguered Waikato District Health Board; she continues in her role at NZQA on a part-time basis.
In reply to my funding and fees questions, Poutasi said: “NZQA charges a fee for qualification approval.” She referred me to the Tertiary Education Commission (TEC) to learn more about funding.
Considering the lack of evidence for homeopathy, I asked if NZQA thinks the teaching of homeopathy is “quality learning”. Was it strengthening our “knowledge base” – and was NZQA making sure the College of Natural Health and Homeopathy’s teaching was “credible and robust”, as their website suggested?
The written answers from NZQA ducked the “quality learning issue”, stating: “… for non-university tertiary education we… assure educational merit, [we do] not validate specific content.”
The response went on: “NZQA did not contract subject matter experts. If asked by a member of the public if NZQA has assessed the course contents for scientific legitimacy, NZQA would of course respond. Those teaching in homeopathy and those studying would be the ones to determine whether they are actually effective.”
Following this logic, I suppose a course in unicorn husbandry could also have “educational merit” – and be assessed for accuracy by fellow unicorn farmers.
A 2012 study by research company UMR reported that 51% of New Zealanders believe homeopathy has been scientifically proven. Many Kiwis likely also mistakenly believe NZQA considers homeopathy to be proven to work. Another recent survey by public-policy think tank The New Zealand Initiative found a third of New Zealanders think antibiotics kill viruses. They don’t.
Back at the pub, Mark suggested another interesting question to put to Poutasi. Could NZQA just avoid assessing homeopathy altogether, and not accredit these qualifications? Poutasi replied: “Any registered TEO [tertiary education organisation, including universities] may make an application… and NZQA will evaluate.”
So that would be a yes to unicorn husbandry. Or astrology, palmistry…
Then-director Alastair Gray (now listed on the website as a homeopathy lecturer) was reluctant to talk with me, but claimed homeopathy was supported by “robust” research. He referred questions about the college’s funding to Bruce Knox, of Knox International Consulting Services in Auckland, who helped the college obtain approval from NZQA. Knox has also advised theological colleges on the same processes.
In a telephone interview, Knox told North & South the college has written its own learning outcomes, in consultation with the NZ Homeopathic Society. He said the outcomes were “valid for that particular body of knowledge”, and he believed homeopathy was effective.
Knox quoted a 2001 English House of Lords report as evidence. But that report had only stated complementary and alternative medicine (CAM) should be publicly available after the required evidence has shown it “has an effect above and beyond placebo”. And, of course, this hasn’t happened yet.
This report was followed up by the English House of Commons Evidence Check 2 report in 2009, which recommended “the Government should not allow patients to buy non-evidence-based treatments such as homeopathy with public money”.
At the New Zealand college, there are 26 staff listed on its website, and the student fees don’t seem sufficient to pay all their costs (there were only around 90 students enrolled, according to a recent external evaluation report). I decided to look into the government’s involvement with the college, but repeated requests directed to the Minister of Education Chris Hipkins received no response.
I then contacted the Opposition spokesperson for tertiary education, National’s MP for Whangārei, Dr Shane Reti. He promptly agreed to be interviewed, in person, at Parliament.
Before going into politics, Reti was a GP in Whangārei. He maintains an interest in public health and was critical of Pharmac for failing to provide sufficient immunisation doses against meningitis during the 2018 Northland outbreak. He helped Hikurangi Primary School fundraise to vaccinate their children, after seven-year-old student Alexis Albert died from meningitis in 2018.
Reti decided to put some questions to Chris Hipkins in the House on my behalf. It took him a few attempts to extract answers from the minister, but Hipkins finally replied that “the Tertiary Education Commission funds the College of [Natural Health and] Homeopathy… In 2019 [it paid the college directly] $205,000… and [close to] $50,000 for animal homeopathy.” Additional government funding is provided for the homeopathy course (also an animal homeopathy course) through the one-year Fees Free programme.
Events took a surprising turn when Reti turned his attention to Health Minister David Clark, asking if he supported homeopathy “as a valid intervention suitable for health funding”. His response: “Any valid intervention suitable for health funding must have sufficient evidence of efficacy. I am advised there is insufficient evidence for homeopathy…” When Hipkins was asked in the House about this obvious inconsistency, he replied that the TEC “ensures that all its tertiary education funding… can be reconciled with the Education Act”. It was a statement that circled right back to my earlier questions to NZQA, about the Education Act requiring “high quality learning” and a “skilled and knowledgeable population”.
Hipkins then dropped this bombshell into the MPs’ exchange: “It is not now the case, nor has it been the case at any time in the last 20 years, that validating the science [in a private tertiary education institution] is a component of either quality assurance or funding approval processes.”
This led Reti to ask if a course that denied climate change would receive taxpayer funding. The speaker allowed Hipkins to refuse to answer, claiming he had somehow already done so. Based on everything that had gone before, I have to assume the answer is yes – and yes again to unicorn husbandry.
In response to another of Reti’s repeated questions, Hipkins stated that NZQA and the Committee on University Academic Programmes merely ensure a course that is approved is “useful and valuable to the relevant stakeholders”.
The manufacturers of homeopathic products are clearly stakeholders, but so surely are the potential future clients of homeopaths? Perhaps the TEC is not compelled to fund all programmes accredited by NZQA. But that discretion, if it exists, seems to have rarely, if ever, been applied.
Hipkins’ final reply to Reti’s questions was that “any concerns about educational performance in a tertiary education organisation are followed up and may result in compliance action”.
That is probably true in regard to financial issues, as revealed in a 2018 NZQA report on the College of Natural Health and Homeopathy, which in an early 2016 internal audit found non-compliance with some TEC funding rules. The college was required to repay $400,000 to the TEC.
Still, it’s disheartening that “educational performance” in New Zealand does not seem to include concerns such as factual accuracy, truth, scientific validity or reliability of information.
In 2011, a group of doctors published a letter in the NZ Medical Journal urging their colleagues not to prescribe homeopathy. They noted that homeopaths had thus far failed to collect the $1 million prize offered by American sceptic James Randi to anyone who could prove it actually works. They described homeopathy as “biologically implausible and completely inconsistent with our understanding of medicine, biology, pharmacology and pathology…”.
Evolutionary biologist and author Richard Dawkins tweeted recently: “Not only is there no evidence that homeopathy works, it CANNOT work unless ‘water has a memory’. If they could show that they’d win the Nobel Prize for physics as well as medicine. Needless to say, they can’t. Homeopathy is fraud, pure and simple.”
The chief executive of England’s National Health Service was reported by the BBC last year describing homeopathy as “bogus treatments which at best do nothing and at worst can be potentially dangerous” and “no replacement for rigorously tried and tested medical treatments, delivered or prescribed by properly qualified professionals”.
Homeopathy is not approved by medical doctors or medical schools. Its principles are pseudo-scientific and implausible. Homeopaths surely have a duty to prove homeopathy is medically efficacious before our taxpayer dollars are spent teaching it as fact.
Community education has long dabbled in the alternative health fringe, offering courses on the likes of aromatherapy and reflexology – but a course on “Homeopathic First Aid: Prescribing the Basics”? This was among weekend workshops offered at the Wellington High School Community Education Centre last June. For a fee of around $80, attendees were promised an introduction to the principles of homeopathic medicine, with a “focus on the administration of homeopathic remedies in first aid – on the sports field, accidental mishaps and travel scenarios, among others”.
This is the stuff of TV satire, if only the first-aid course wasn’t for real. But for satire, nothing out-spoofs David Mitchell and Robert Webb’s 2009 TV comedy sketch Homeopathic A&E – now on YouTube with more than four million views.
Take it from them – on the sportsfield or being wheeled into ED, the last person you want checking your vital signs is a homeopath.