“[We have helped] shift the needle on how accepting the British public is of homeopathy … it seems we’ve won that battle for hearts and minds.”
–Michael Marshall
Skeptical Inquirer readers may know that the magazine’s parent organization, the Center for Inquiry, is suing two of the largest pharmacy chains in the United States regarding their sale of homeopathic potions. (For that story, see here.)
Across the pond in the United Kingdom, the battle against the continued public acceptance of this discredited pseudoscience as a viable medical alternative, and the public funding of the same, is being fought by the Good Thinking Society (GTS). Michael Marshall (who commonly goes by “Marsh”) is the GTS project director and was last interviewed for Skeptical Inquirer online by Susan Gerbic in 2018 in an article that mostly covered his Be Reasonable podcast. The focus of this article, however, is Marsh’s involvement in the ongoing battle being waged against homeopathy in the United Kingdom.
Rob Palmer: Please introduce yourself to those who may not know that much about you.
Michael Marshall: I’ve been an active skeptic for ten years; ten years this year, in fact. I was one of the cofounders of the Merseyside Skeptics Society (MSS). I spent five years with them as a volunteer skeptic, and I was doing quite a lot of activism in my spare time.
People might have seen the 10:23 homeopathic overdoses, which is something that we ran within the first year (2010) of the MSS existing. And then in 2011, I ran the overdoses internationally. At that point, we started running the QED conferences with the Greater Manchester Skeptic Society. I’ve been doing that for eight years now.
Initially, I threw myself into as many different bits of potential skeptical activism as I could, because I was really interested in seeing what was out there and trying to experience as much of it as possible and seeing kind of where my strengths lie, where my interests were, and what kind of unusual experiences are out there.
I did that for about five years. And then in 2014, the opportunity came along to work full time for a charity called the Good Thinking Society, which is now what I do for a day job as a full-time skeptical activist.
So now we tend to work a bit more on broader campaigns, and we try and do the kind of things that if you’re a volunteer skeptic you might hit a brick wall because you have a limit in terms of amount of time you can spend or a dollar limit in terms of the amount of clout you can have as an individual. And so, when you hit that wall, because you do it in your spare time, you might think, “I’ll find a different thing to do. I’ll find another outlet for my skeptical passions.” As an organization, we can pick up and try to get through that brick wall, because it’s what we do for a living. It’s not just something we’re doing as a hobby.
Palmer: How did you get pulled into this movement as an activist?
Marshall: As long as I can remember, I’ve been interested in things that aren’t true and why people believe them. I got into skepticism the way that many people do. You’ll come across a particular piece of media that will have kind of a skeptical bent to it, and you’ll go, “Oh, this feels a lot like me.” And for me, that was the Penn & Teller series Bullshit, that a friend of mine thought I’d be interested in, because I always had kind of a background interest in some of the types of issues that would come up in shows like Bullshit, and skepticism more generally, without ever really knowing what skepticism was.
But when it came to activism, it really came at the same time as becoming part of the MSS. And that started with a meetup group posting saying there should be a skeptics group in Liverpool. And I responded to that. And when Mike Hall (cofounder to-be of the MSS) looked at my profile on Meetup.com, he was slightly terrified. Because you can say all the things that you’re interested in, and I said I was interested in psychics and alternative-medicine and ghosts and UFOs and all these other things. And he thought “Wow, we’ve got someone here who doesn’t really get what we’re about!” He didn’t realize why I am interested in those things: because I don’t believe they’re true.
So, once we started that organization, we started saying, “We’re going to do a skeptics-in-the-pub.” That’s a monthly talk where you have somebody give a lecture. And it’s a really nice way of building a community, especially a community of people who might not have the unifying interests, typical in society, that quite easily form a group. If you are religious, it’s very easy to find a group of people who share your religion; at least one building near you will be filled with people who share the same religion as you. It’s dead easy to get a ready-made community of people who share at least some of your beliefs and values. And that community is quite important.
But if you aren’t a believer in something, there aren’t many communities (or there certainly weren’t ten years ago when we set up) whose central unifying interest is disbelief. And so that’s what we really wanted: to have this kind of community where you could move to Liverpool from anywhere in the world and know that if you are a skeptic, there are people there who, broadly speaking, will have some of the same background information as you and the same kind of background beliefs. But we set the group up not just to do in-group community events but as an activist society, so specifically we could have the mindset of saying, “What else is out there? And what can we do about it?”
So pretty much from the start of the MSS, I was going to psychic churches and mind-body-spirit festivals and alternative-medicine places and trying to gather as much information and experience and direct observations of these things as I could, so that I’d be much more effective as an activist and much more informed as a skeptic by doing so.
Palmer: Please tell me about the Good Thinking Society.
Marshall: GTS is a skeptical charity that exists to promote curiosity, to challenge pseudoscience, and to promote science. We’ve got scientists whose job it is to discover new frontiers. And then in my mind, we’ve got skeptics whose job it is to defend the territories. We try to preserve the borders, while scientists are out there finding new frontiers.
We also look at where there’s not another big organization already set up to do that. So, we don’t really touch on religious issues, for example, in the GTS. Even though I’m an atheist, and I assume that many of my colleagues there have a similar sort of belief system, we don’t really get involved in the religious conversations, because you have Humanists UK, and you have the National Secular Society—big, big organizations whose job it is to cover the intrusion of religion on society.
So, we tend to look for stuff where there’s tangible harm, where it’s settled science, where there’s something we can clearly do, and where no one else is doing it. And that’s how we choose our topics, even if they’re quite ambitious.
Palmer: Okay. Let’s discuss your battles with homeopathy.
Marshall: For a long time, skeptics were aware that there was homeopathy being funded by the National Health Service (NHS) here in the United Kingdom. The government healthcare system was spending taxpayer money on homeopathy. But when I started with Good Thinking in 2014, nobody in the country had an idea how much was being spent on it. In fact, nobody in the government had any idea how much was being spent on homeopathy in the entire United Kingdom, because it was no one part of the government’s job to tally those figures up. All the decisions were made in local and regional councils. And so they knew how much they were spending, but they had no idea how much their neighbors were spending, and it was nobody’s job to ask them.
So, we found out how much was being spent. And then we looked at where it was being spent. And we found it was being spent in local councils where you saw your doctor, and they could refer you to a homeopath. That was one way of getting homeopathy. And the other way is the doctor could write you a prescription, and you could go to your local pharmacy and pick up some homeopathy.
Once we knew there were these different routes, and we knew exactly where in the country the funding decisions were being made, we knew we could then start challenging them.
Where I live in Liverpool, they were spending something like 45,000 pounds a year (about US $57,000) on homeopathy. But the Department of Health had just renewed the contract to continue funding it. So, we said, “Well, if you’re spending taxpayer money on something that even the government admits doesn’t work, that is not a legal way of using taxpayer money.”
So, we were willing to challenge that, and one of the things Good Thinking did was essentially say to the local NHS: “We’ll go to court to challenge that funding decision.” And Liverpool backed down and said, “We’re going to have a public consultation about whether we should spend the money this way.” And then we were able to get residents, local scientists, local university academics, and anybody who might have an interest to take part in that public consultation so that it wasn’t just filled with homeopaths and homeopathy fans and their patients.
Palmer: And the results?
Marshall: Liverpool stopped funding homeopathy, and then their neighbors just over the Mersey from Liverpool did the same thing. And then down in Bristol, where there was around 300,000 pounds (US $383,000) worth of spending, they did the same kind of consultation, and they stopped funding it too. So, we were able to use one success to kick start the domino effect and to write to different parts of the country to say, “This just happened here. Do you want to be the last part of the country to continue funding this?”
So that was one way. And then the other thing we did was the prescriptions route, which is where we did say to the Department of Health, “You have this list of things that are banned from prescription. Homeopathy fulfills every one of the criteria of what should be banned and should be on that list.” And so, the Department of Health said, “We’re not going to do that.” We said, “It’s literally your job. It’s your duty under the law to do that. And we will take you to court if you don’t.” And they said, “Okay, we’ll have this consultation.” Again, we had lots of people from all around the country who have an interest in skepticism and interest in evidence-based medicine. So, doctors, and university academics, and people who are pharmacists … people who care about evidence … we got them to take part in the consultation.
Palmer: And how did that go?
Marshall: As a result, first of all, there was guidance issued to every GP in the country not to prescribe homeopathy. But they were told you shouldn’t do it, not that you can’t do it. Which isn’t quite far enough for us, because there are some GPs in the country who are also homeopaths, and they’re going to see voluntary guidance and say, “Well, you might say that, but I’m going to carry on.”
But since then, the body that issued that guidance has formally written to the Department of Health to say, “No, they will write: ‘You need to blacklist this.’” And this should really have happened in about June 2016. But if anybody has been following British news, something else happened in June 2016, which took up a lot of the government’s time. And has taken a lot of the government’s time since then.
So, it’s been quite difficult for us to find time in the Department of Health’s schedule to push through this issue when there’s a million other things going on. But it’s not something we dropped. And we think, because the NHS has formally requested the Department of Health put homeopathy on the blacklist, it should just be a matter of time, and then it should be banned. But it’s just something we need to stay vigilant on and keep monitoring.
Palmer: I read that in June 2019, the GTS filed a judicial review claim to challenge an earlier decision by the Professional Standards Authority for Health and Social Care (PSA) to re-accredit the Society of Homeopaths register. What’s that about?
Marshall: Yeah, this isn’t NHS related, but it is still a kind of government seal of approval for homeopathy. So, you have a situation here in the United Kingdom where there’s a number of homeopaths who offer CEASE therapy. This stands for “Complete Elimination of Autistic Spectrum Expression.” So it is, by definition, a claimed “autism cure.” CEASE is part homeopathy, part vitamin supplement, and heavily anti-vax. So, homeopaths who offer CEASE therapy are saying “We can cure autism, and we know that it’s caused by vaccines.” It’s anti-vax propaganda. There is a regulatory body in the United Kingdom called the Society of Homeopaths, whose job it is to ensure that homeopaths aren’t making claims they can’t substantiate, which—being homeopathy—they can’t substantiate any of their claims.
But there’s a limit to what is currently allowed under U.K. advertising law, and the Society of Homeopaths are meant to be there to make sure that homeopaths stay at least within the rules of advertising. But we’re finding that routinely they just aren’t doing that. So, homeopaths are saying they can cure autism and the Society of Homeopaths is basically holding their hands up and saying, “We’re not really going to do too much about this.” They weren’t taking any real action.
But the Society of Homeopaths is part of a government scheme, called the Professional Standards Authority, a government body that regulates healthcare professionals. If you are a doctor, you’re going to be part of the General Medical Council, and the General Medical Council, by law, has to be part of the PSA. And that’s true of dentists, physiotherapists, and pharmacists too.
But then you have a voluntary part of that, where an organization that doesn’t have to be overseen by the PSA can choose to be, in order to be able to put a big government stamp all over their website and on their member websites saying, “You can trust us; we are regulated by the government.” And that’s where the Society of Homeopaths is. They’re part of this voluntary scheme. So, if you go on a homeopath’s website, they’ve got a big stamp saying, “PSA accredited” or “PSA approved,” and they point at that stamp as a mark of legitimacy. “We must be legit because even the government is backing us!” The PSA has to evaluate the Society of Homeopaths every year. And they saw that these homeopaths were saying they could cure autism and were putting out anti-vax statements.
And even though they saw that and said, “This is harmful to autistic people… this is misleading, it could put people in harm’s way,” they also said, “We’re going to carry on giving you our seal of approval anyway.”
Palmer: Totally ridiculous. So, what is your recourse?
Marshall: We’re currently in the process of bringing a legal case against the PSA to say, “That was not a lawful decision, because you’ve said autistic children can be hurt by this,” and “this is anti-vax misinformation.” So, you can’t then say, “But it’s totally fine” if your job is to make sure that patients aren’t being put in harm’s way. You’re literally saying, “Yeah, you’re putting them in harm’s way, but we’re going to let you do that anyway.” So, we’re currently in the process of that case. I think where we are now is that we’re looking for it to find time in court. And if the PSA is not backing down, if they don’t say “Yes, fair enough, you’ve got a point there,” we will end up taking this to court to make our case in front of a judge.
Palmer: So clearly homeopathy fits the criteria that you defined before, regarding something that was both worth doing and something that you’d have an impact with. It seems like this has been a center point of the GTS’s work for the past several years. Has it been time well spent?
Marshall: Yeah, we spent a decent amount of time on homeopathy. People will criticize that occasionally and say, “Homeopathy is a low hanging fruit.” Well, yes, but it’s still there. And we still know that people are being harmed by taking homeopathy, and there are government bodies that’ve got an attachment to homeopathy that they really should not have. And this helps us get the evidence against homeopathy into the public discourse by playing these cases out and doing these campaigns, which we think are very important.
There’s an added benefit: it allows us to have quite a lot of public discourse about the issues within homeopathy, including the reason that it can’t possibly work and the dangerous, misleading claims that homeopaths are making for all manner of things.
And that helps sort of shift the needle on how accepting the British public is of homeopathy. And we’ve actually seen that change in the past couple of years. It certainly feels, in the past decade since I’ve been involved in skeptical activism, that homeopathy has gone from being something that most people don’t really know very much about but are inclined to think maybe it’s natural and probably fine to now most people are aware that homeopathy is not effective. And it seems we’ve won that battle for hearts and minds.
Palmer: Is the Royal Family pushing back on this?
Marshall: Well, earlier this year Prince Charles was appointed to be the Patron of the Faculty of Homeopathy, basically the body for people who are doctors, midwives, vets, and other medical professionals who are also homeopaths. They become members of the faculty, and Prince Charles is now the notional head of that faculty. There was an article in many newspapers that made quite a lot of media attention recently, where a journalist asked us what we thought about that. And I said, “It’s absolutely obscene that we have the first-in-line for the throne, who believes this is an issue, at a time that we know that there are homeopaths who are making anti-vax statements, and who say they can cure all manner of things. But they really can’t and are putting people in harm’s way. It’s ludicrous that this is where he thinks the important stance is to take on this issue.
If he really does care about the health and well-being of the people which he hopes to one day effectively rule, he should be siding against the people who are making misleading claims, rather than signing for them.”
Palmer: So, what can be done about that? In American politics, clearly, there’s no equivalent role. Anyone who is problematic to such an extent can be voted out of office—eventually. But in this case, you don’t have that option, and he is a big public influencer now and may become King Charles. So, what can you do?
Marshall: I mean, it is tricky. There’s only so much you can do. But at the same time, if you look at the work we’ve done on the NHS, I don’t imagine that Prince Charles was unaware of it. And I don’t imagine that he was disinterested in it. But I know that we were successful partly because we carried out a lot of our campaign in public.
So, along the course of our five-year campaign on it, there have been maybe 100 or more news stories about this. So, there’s a lot of light shone on it, which leaves very little space for things to be done behind the scenes. And also when you are challenging in court that a contractual decision isn’t lawful because it involves spending money on something that the body involved in spending the money has recognized isn’t worth it, it’s not like anybody who wanted to have external influence could say, “I’m going to stop this legal case going forward.” That’s because we have the laws and systems that we have. So, if we can carry on finding ways that are robust and clear, then hopefully things will carry on having a positive outcome.
Palmer: Public perception has changed on homeopathy in just a short time. Do you think this has also had an impact on opinions on other alternate treatment modalities such as acupuncture, reiki, and even chiropractic?
Marshall: I’m not sure… Those are all areas that we’re actively working in. If you look at chiropractic in the United Kingdom, my colleague Laura Thomason at GTS has spent a long time over the past few years looking at chiropractors who make misleading claims and then writing to the regulator of chiropractors, the General Chiropractic Council (GCC), to say “These are claims that go way beyond the evidence, and it is your job to make sure your members do not do that.” And when the GCC didn’t take our claims as seriously as we would have liked, we said, “Okay, because you are the formal regulators of chiropractors, and it’s your duty to investigate complaints, we’re going to send you twenty-five complaints about chiropractors every single month until you take this seriously.” And so, by the end of the year, there were 300-plus complaints open about chiropractors. And that’s not a small amount of work.
And we’ve heard from some chiropractors who are whistleblowers who have spoken to us to say, “I work in sports therapy type of chiropractic, and there are chiropractors saying some really out-there stuff that I disagree with. But I think they’re actually saying less of it now, and that’s partly because they’re aware that you are making complaints about them.” So that’s anecdotal, but it’s interesting that it seems we are having some effect on that industry, and it’s something we really want to continue focusing on.
Palmer: And how about the other big medical pseudosciences such as naturopathy?
Marshall: Naturopathy is not as big here in the United Kingdom, oddly enough. You’re more likely to come across a homeopath or an herbalist or a chiropractor than you are to find a naturopath, who would do a bit of each of those kinds of things. It’s here, but it’s not as prominent.
I think regarding chiropractors, there are still large segments of the public who believe that chiropractors are basically back specialists and won’t realize anything about the history of chiropractic as an industry or any of the claims that it makes.
Acupuncture similarly gets something of an easy pass, generally speaking, in the public, but it also gets quite an easy pass with doctors, and that makes it quite hard to shift public opinion. Because I think there are some doctors who might believe that acupuncture has some effectiveness, and some may go even further and say that it’s actually very effective for certain conditions. Others will think it’s relatively harmless and if it has some effectiveness, or if it has some placebo effect, then great. So, there is a big range of acupuncture belief, I think, here in the United Kingdom among even medical professionals, and I think that filters down to a lot of acceptance by the public. So, there are a lot of people who might think “Acupuncture is a bit out there, but it’s not out there in the sense that it doesn’t work.” They think it’s just more out there in the sense of it is something you can try. So that’s definitely something on our long-term list of things to take a look at.
Palmer: Well, thank you very much for your time, and keep up the good work.
Marshall: Thanks a lot, Rob. Take care.
Acknowledgements: I want to thank Marsh for his participation in this interview and for his skeptical activism. You can read more about him in his Wikipedia article here*.
This interview has been edited for continuity and clarity with the subject’s consent and participation. All photos are from Wikimedia Commons and are by zooterkin except as noted.
Sites of interest:
*These Wikipedia articles were written by the Guerrilla Skeptics on Wikipedia team.