11111It is important for healthcare providers to be properly regulated. An important aspect of this is the transparency of the regulatory process: for example, the GMC (which regulates Britain’s medical doctors) makes its guidelines on good practice available on its website, along with its hearings and decisions. Dieticians are regulated by the HPC, and you can view the standards they have to abide by, and details of the complaints heard by the HPC, online. Transparency is significant – it allows the public to monitor the standards to which medical doctors are held, and ensure that these are satisfactory (while also encouraging those with genuine complaints to submit them – as they can see that they will be fairly treated).
The British Association for Nutritional Therapy (BANT) claims to be “a governing, professional body regulating the activities, training and Continuing Professional Development of its practitioners“. Patrick Holford is a member, and the wikipedia page on Holford states that “Holford is a Fellow of…BANT…one of a number of bodies that aims to regulate nutritional therapists in the UK.” So, BANT looks like a regulator, and quacks like a regulator; however, BANT has told me that they are “a professional association and not a regulator”.
BANT’s disciplinary procedure completely lacks the transparency of the procedures of convincing healthcare regulators. I’ve been in contact with BANT about their complaints procedures for a good month or so now – I’ll use this post to outline what I’ve found out, and some of my objections to their procedures.
I first contacted BANT to ask about their complaints procedure in early April. I asked – reasonably enough, I thought – to see a copy of their ethics code (which they use to evaluate complaints against members). I was initially told that this is not available to members of the public – BANT is apparently concerned that people might misquote or steal their ethics code. Like you do – there’s a thriving market in nicked ethics codes down my local.
I pushed BANT to see if they would give me any details on their ethics code (I can be relatively stubborn). At the end of April, BANT relented a little and told me that “decisions are now based against the Nutritional Therapy Council Code“. I then asked whether BANT’s decisions are based solely on this code, and on May 8 BANT told me that they use “a rigorous complaints procedure, the requirements of which are given in the NTC Codes and expanded for clarity in a BANT document that is currently not available for public release”. Given that this BANT document isn’t available to the public, there’s no way of knowing whether or not it’s satisfactory, or for members of the public to determine whether a BANT member has breached it.
Of course, another thing to look at when determining how BANT regulates its members is the disciplinary proceedings that have already taken place. When I asked BANT about this, I was told that:
A total of six complaints were received in the previous year of which one was later withdrawn by the client and one was still being considered at the end of the year. Following examination of the complaints and the members responses two members were asked to write letters of apology to their clients where they had not maintained the usual high standards expected. No complaint was considered of sufficient substance or gravity to require a member to be excluded, and accordingly no further information is to be made available.
The details of these complaints and hearings (or even the names of those involved) is not publicly available, so there is no way to tell whether or not they were handled appropriately. For all I know, the complaints could have been very minor, or involving serious and dangerous professional misconduct. The hearings might have been completely fair, or could have been a total whitewash.
As I’ve said, if you’ve got such concerns about organisations like the GMC, you can read details of the hearings yourself and make your own mind up. With BANT, though, you have to take their word on this as details of their Ethics committee’s meetings and decisions are kept hidden from the public (I should note that BANT have told me that that their “Ethics committee do indeed meet in a room but there is nothing secret about the meetings and we have a lay-member on that committee.”)
I would also argue that – because of the lack of availability of information on BANT’s ethics codes etc. – the number of complaints may be artificially low. I’ve been pushing BANT for over a month for the limited amount of information in this post – many would have given up far sooner.
To summarise, then:
- BANT are not a regulatory body.
- BANT’s ethics code is kept secret from the public.
- BANT’s ethics committee meets in secret (sorry, meets in a non-secret room to which the general public does not have access, and does not publish details of its discussions)
While a ‘nutritional therapist’ being a member of an organisation like BANT might make prospective patients feel safe – lead them to assume that the therapist is properly regulated – I would therefore advise much greater caution. As BANT themselves acknowledge, they are not a regulator; I would also argue that there is no way of telling whether or not they adequately regulate their members.
22 Comments
May 9, 2007 at 8:51 pm
Nice digging, blood and stones comes to mind.
May 9, 2007 at 10:00 pm
I don’t know – you might be being a bit harsh on the stones…
Anyway, a couple of more bits and pieces to come out about this – when I’ve got the info together. Doubt there’ll be anything more from BANT, though…
July 17, 2007 at 9:01 pm
[...] is unprotected in the UK, unlike the term ‘Dietitian’. Nutritionists have no regulatory body which might oversee nutritionists working with [...]
September 12, 2007 at 3:18 pm
So BANT says decisions of the Ethics Committee: “are now based against the Nutritional Therapy Council Code,” yet their website declares that they take, “a proactive role maintaining the ethical standards ensuring they are relevant and leading-edge.” Using another group’s ethical code does not sound very proactive or leading-edge.
One of the members of the ethics committee, Roger Corbey Dip ION says: “Have had a wide variety of complaints to deal with; these have been enlightening. ” I can’t see how six complaints can be seen to be “a wide variety”, especially since presumably some of them would be extremely minor.
September 12, 2007 at 8:36 pm
of course, if BANT were to make their Ethics Committee meetings open to the public – and publish the transcripts – we could be reassured about the ‘wide variety’ of complaints (and how well they were handled). As things stand, though, we just have to trust – or not trust – such secondhand reports…
September 17, 2007 at 10:13 pm
[...] DipION (awarded from an Institute that he founded, while he was director), is an honorary fellow of BANT, and has recently signed a £400k+ deal with Biocare. Although Holford has had some serious [...]
September 20, 2007 at 3:08 pm
Well, another little bit of research. Hope no one is unfortunate enough to ask what I did with my leave when I return on Monday …
The Nutrition Therapy Council’s aim is to “uphold and advance the standards of qualifications, competence and conduct of those who practice nutritional therapy.” The members of The Nutrition Therapy Council are the British Association for Nutritonal Therapy and The Wholistic Nutritional Medicine Society. (I can’t find a website address for the latter which seems rather odd. Can anyone else help?) Their performance and ethical code can be found at http://www.nutritionaltherapycouncil.org.uk/NTC%20Professional%20Standards%202005.pdf People on the BANT directory would be bound by it so it could, presumably, be the basis for a complaint by a member of the public about one of their practitioners. It is four pages long which, to me, seems rather short. Does anyone else have knowledge or experience of codes of ethics for professional organizations?
Incidentally, the home page of the NTC does draw our attention to the fact “The Register of Nutritional Therapists” is no longer a member. That’s just as well really when you read on “The Register of Nutritional Therapists” website that “self-taught [!!] and formally trained therapists can join the register.” They also mention that they were one of the founder members of the NTC whilst forgetting to say they no longer remain so. How strange.
You might to look at http://www.raworth.com/courses/nutrition.html It would appear that before September 2005 BANT accredited courses, but now this is down to the Nutritional Therapy Council. However, since September 2005 Raworth has been waiting for accreditation from the NTC. Don’t worry though as they are part of the Schools Forum of the “NTC and the tutors are all experienced nutritional therapists, including the current Chair of BANT.”
Hope that’s all clear and clears up any confusion about BANT and the NTC. If not read it all up again as there will be a test on Saturday morning.
Finally, these words from these words from the FAQ section of the NTC may be of some comfort: “Why Voluntary Self-Regulation? The government do not consider it necessary for practitioners in nutritional therapy to go down the statutory route at this time. The cost of statutory regulation may be disproportionate to the rewards expected and a voluntary system of self-regulation is considered appropriate in our current case. If, at some future date, statutory regulation is considered more appropriate, this work towards a voluntary self-regulating system will enable this to happen.”
September 20, 2007 at 10:12 pm
I am going to fail this test, I can tell. I’ve found a phone no. for the WNMS but that’s hardly as good as a website. I may come down with a serendipitous feeling of ‘unwellness’.
September 21, 2007 at 11:15 pm
Okay Shinga, and anyone else with a desire to prove your advance knowledge of nutrition it is now the end of the week so see how you do with the “Nutrition Exam.” Anyone who has read this thread, the rest of the website and who follows the web links should have no trouble. This is an open exam so you may consult your notes and other sources.
(1) What do the letters BANT and ION stand for?
(2) How many adjudications has Patrick Holford had from the ASA in the last five years?
(3) How much extra work does one have to do to convert a diploma in nutrition therapy to a Bedfordshire university foundation degree?
(4) What is the advice of the British Dietetic Association to young healthy adults in relation vitamin and mineral supplements?
(5) Which of the following problems of the modern world can Patrick Holford NOT help to resolve or improve: impotence, obesity, schizophrenia, autism, Alzheimer’s disease, youth crime, alcoholism, Down’s Syndrome, AIDS, dyslexia/dyspraxia, epilepsy, Parkinson’s disease, thermonuclear warfare caused by terrorists building a nuclear bomb and global warming?
(6) What, according to the Optimum Nutrition Bible, will be the likely effect of a man having sex more than three times a day?
(7) How many DIP ION nutrition therapists practise in the whole of Ireland? (You may like to consult the ION directory on their website.) According to his website how many locations is Patrick Holford visiting in Ireland between 15 and 18 October 2007?
(8) Who in the United Kingdom of Great Britain and Northern Ireland can call him/herself a nutritionist?
(9) In his Guardian column Ben Goldacre suggests several things that will improve the health of the nation. Give one of them here.
(10) (Essay Question): compare and contrast the views of Patrick Holford on the causes of autism with those of leading experts in the field. You may like to take a look at http://en.wikipedia.org/wiki/Causes_of_autism and http://www.patrickholford.com/content.asp?id_Content=1022
September 22, 2007 at 11:24 am
Excellent set of questions, Lee.
Do we submit them to you or post the solutions here, bar the essay?
September 22, 2007 at 11:40 am
Yeah, post the answers – the wittier and funnier the better: no libelous or unprovable comments of course!
September 22, 2007 at 12:34 pm
heh, nice test. re. no. 6, I did actually start to write a post on this. However, I find there’s a limit on how much I can read about the mineral content of ejaculate in an evening before my attention starts to wonder…
September 22, 2007 at 10:24 pm
1 Braggarts and nutritionists tea-club
Institute for orthomolecular neophytes
2 2, but that is what happens when the little people keep getting in the way of visionaries, thinkers and doers: see Holford quoting George Bernard Shaw in his BMJ Rapid Response.
3 Bupkiss – unless there is a tad of extra bodily energy involved or a mu-second extra involved in writing that Foundation Degree into your CV.
4 Take the money that you would otherwise have spent on supplements that you don’t need and spend it on books that will expand your mind; travel to broaden the same mind or invest it in a supplement company and use it to pay your tuition fees.
5 Trick question. By the time that the world has been converted to the need for seal oil capsules, multi-supplements, swallowing Vitamin C and carnitine several times a day – no-one will have neither the inclination nor the organisational energy left to plan such naughty activities as explosive devices. You should also know that Prof Holford of Teesside University is
So, he obviously has global warming cracked and is eventually going to go for a Nobel Prize in one of these areas, like his hero, Linus Pauling.
6 He will need supplements. And oysters to replace the Zn. Lots of oysters.
On which note, I may suspend the remainder of these answers until tomorrow.
September 23, 2007 at 1:10 pm
To continue in between landscaping back garden…
7 1, surprisingly. This may not be unrelated to the fact that nutritionists in Eire have to be graduates in nutrition, I think…
8 Absolutely anybody with chutzpah; it isn’t even necessary to have a diploma in nervology.
9 Goldacre seems to be very hot on the importance of eating your greens. Beyond that, he seems to be with Michael Pollan. Eat food. Not too much. Mostly plants.
The essay definitely needs to wait…
April 7, 2008 at 9:59 pm
[...] 7, 2008 · No Comments A while back, I asked BANT – which promotes itself as “The Professional Body for Nutritional Therapists”, and [...]
April 15, 2008 at 9:53 am
Hi, thanks for that..very entertaining and very apt to my last 6 months…you see..I am hitting 40 and have 5 kids and live in what seems a fairly remote place educationally…I would love to be a Nutritional Therapist..or any other title to do with Nutrititionism…however after spending 6 months waiting for NTC to accredit some distance learning courses and not wanting to be a quack I started banging my head off the wall….the NTC cant reccommend a course to me at this moment but I would like it to be above board! When I have done a course…costing anywhere between £4000 and £15000..they would then be able to tell me it wasnt suitable!! lol I then tried to get hold of the CNCH the new register for all and after a few unanswered emails I picked up the phone and called them instead….eventually some lovely guy called me and could see my problem! I explained lots of therapists are very open to the voluntary register and welcome it…but the interim period is too long! I will have wasted a a year initially a lot of money and possible a massive ammount of time …and still not become registered! lol
April 15, 2008 at 9:56 am
but I am still no wiser…can anyone recommed a good distance learning course in Nutrition..at least a diploma and not too costly and that WILL be recognised by the NTC and then the CNCH! Thanks
April 15, 2008 at 3:15 pm
If the NTC and CNCH can’t tell you then that is deplorable but it would seem as if no one can make any guarantees because these people won’t finish their work and issue their list.
May 11, 2008 at 9:23 pm
As an Occupational Therapist, I have the copy of our code of ethics in front of me. It is 18 pages in total – significantly longer than NTC’s. It’s published by the College of Occupational Therapists and is easily available from them. http://www.cot.org.uk if interested.
October 31, 2008 at 3:07 pm
[...] Therapists (BANT) as the nutritional therapists body that claims to regulate nutritionists yet is remarkably secretive about its code of ethics and disciplinary procedures, perhaps because it altered them after [...]