My complaint to Boots about their Learning Store website

The open letter to Boots on the 10:23 campaign website currently has 1450 signatures on it. I hope everyone reading this has added theirs. I know many of you will be in Red Lion Square overdosing alongside me next Saturday morning. I’ve already bought my ‘poison’ and I compensated myself for the embarrassment of buying a homeopathic remedy by leaving piles of leaflets about the 10:23 campaign by the shelves of these remedies at the both the Boots stores in my nearest town centre. To my fellow overdosers: in case things don’t go according to plan, I’ll take this opportunity to say it’s been a privilege and a pleasure…

And to all those who argue that homeopathic remedies are individualised, that it needs a consultation with a homeopath to build up a ‘symptom picture’ and that getting the remedy and dosage right is highly skilled work for which homeopaths are comprehensively trained, I trust you will join the campaign because otherwise you’ll look a bit silly.

Do you realise that the boxes containing homeopathic remedies aren’t kept behind the counter but sit openly the shelves at Boots, that they contain no information whatsoever about what they might treat and that Boots do not require their sales staff and pharmacists to be qualified homeopaths? The result is that customers self-prescribe and, because many inevitably get the remedy and dosage wrong, they end up thinking homeopathy doesn’t work. Imagine that!

‘Customer choice’ doesn’t justify the stocking of this shite. Some fifteen years ago, I was naive enough to buy homeopathic remedies from Boots precisely because they were stocked by what I considered to be a reputable chemist that I could trust. I certainly would not have chosen to buy a homeopathic remedy had I known they contain no active ingredients. That’s not customer choice – it’s customer conning. It’s a scam and I want my money back. Back in the mid-nineties, there would be a chart sitting on the shelf next to the homeopathic remedies Boots were selling, where you could look up what each remedy supposedly treated. Nowadays there is nothing. I wonder why? Nothing to do with the fact that they are just sugar pills, I’m sure.

I’m delighted the 10:23 campaign is getting so much publicity. If it brings to the attention of a few more people the fact that there really is nothing in it and they don’t waste their money like I did, it will have been worthwhile.

The stocking of sugar pills in a manner that misleads customers into thinking they are genuinely therapeutic remedies isn’t the only sin Boots has to answer for. The Boots Learning Store section on alternative medicine beggars belief. I’ve mentioned this appalling website before (as have other bloggers) and today I fired off a complaint about it. I’d already submitted a few comments using the online comments form but, as all you get if you do that is an automatic message saying ‘thanks’, I decided to take it higher. Here’s the main body of my letter of complaint:

Given both the seriousness of my observations and the fact that I have neither received any response to indicate that any changes to the information contained in this website were under consideration, I have decided to resubmit these comments as an official complaint to which I would appreciate a considered response from you.

1. On the comparison between homeopathy and conventional medicine

On 11th January I submitted the following comment:

“I note that the Learning Store purports to be an educational website – indeed, it claims to be “an excellent way to share our expertise and knowledge with teachers and pupils in a way that will stimulate and enthuse the learning process.”

With this in mind, I read through the entire 16+ section on alternative medicine and I have a number of concerns about it. I would like, in this communication, to put just one of these to you.

It is misleading about conventional medicine.

For example, under the heading of ‘holistic healing’, it states that “Holistic healing considers the whole person and how they interact with their environment. It does not just focus on the illness.” The implication here is that only practitioners of alternative medicine ‘consider the whole person’, while doctors do not. I believe this is unsupportable. In my experience, doctors ask whatever questions are necessary to make a diagnosis and this very often includes questions about lifestyle. Also, treatment will often involve a multi–disciplinary approach. In my experience, this is not the case with practitioners of alternative medicine.

Under the heading ‘Conventional v Homeopathy’, it states. “The homeopathic remedies here are picked out very generally and true homeopathy would involve a lengthy consultation where the individual consultation would be discussed.” No such qualification is made for conventional medicine. But it is obvious that the conventional remedies featured are also “picked out very generally”, so why not say so?

I understand that homeopathic consultations can take an hour while a consultation with an NHS GP may last only a matter of minutes. However, as the totality of evidence that we have at present tells us that homeopathy, if it is effective at all, works only as a placebo for conditions that are placebo–responsive and, bearing in mind that, Paul Bennett, Professional Standards Director at Boots admitted to the House of Commons Science and Technology sub–Committee that he had “no evidence to suggest that (homeopathic remedies) are efficacious”, it seems reasonable to conclude that it is the consultation itself that is beneficial to patients rather than whatever homeopathic remedy is prescribed.

My main objection to the way the Learning Store website presents homeopathy and compares it to conventional medicine, is that it does so in such a way as to make homeopathy seem a better choice in the first instance and this is potentially dangerous. I would therefore request that you remove from the section on alternative medicine, the misleading references to conventional medicine that I have specified.”

2. On ‘like cures like’

On 16th January, I submitted the following comment:

“Under the heading of ‘homeopathy’ we are told that, “Homeopathy is based on the philosophy of like cures like. An illness is treated by a substance capable of producing similar symptoms.” We are shown a picture of a man who has obvious cold symptoms and invited to guess which, out of a choice of three ingredients ¬ belladonna, onion and foxglove (digitalis) – used in homeopathic remedies, might be the appropriate one for treating a cold.

The correct answer, we are told is, onion. I presume the reasoning is that, because onions produce tear-jerking sulfoxides, they are deemed a suitable remedy for a condition that has watering eyes as a symptom.

Given that the object of the website is educational, I would suggest you add a rider to this section of the website, reminding the young students who are your target audience that the notion that “like cures like” is a pre-science idea that remains unproven and that homeopathy was invented before Louis Pasteur demonstrated germ theory and that, anyway, we know nowadays that nothing cures a common cold. I suggest the assertion on the Learning Store website that the onion remedy, Allium Cepa 30C, “helps treat a common cold”, could mislead young people into believing that it actually does treat a common cold, so I request that this statement be changed to one that is more accurate. For example, you could state that Allium Cepa 30c supposedly helps to treat a common cold but you have no evidence to this effect.

On the same page of the website I am particularly interested in one of the ingredients you say doesn’t help treat a cold: belladonna. According to Wikipedia, belladonna can cause “sensitivity to light, blurred vision, tachycardia, loss of balance, staggering, headache, rash, flushing, dry mouth and throat, slurred speech, urinary retention, constipation, confusion, hallucinations, delirium, and convulsions”. In keeping with the “like cures like” idea (as the website explains it using the onions remedy as an example), a dilution of belladonna would, presumably, be used to treat one or other of these symptoms.

Yet on this page, we are told that belladonna 30C can be used to “help treat ear pain”; in a different section, under the heading Effectiveness of Homeopathy, we are told that belladonna is “used to treat acne” and on the last section under the heading Conventional v Homeopathic, we are told that belladonna might treat influenza. I am mystified as to how any of these examples accord with the philosophy that “like cures like”, nor why belladonna might be used with influenza but not with colds. I don’t think it will be clear to your target audience either, so would suggest you give some thought to revising that part of the website to make it more appropriately educational.”

3. On the comparison with enzymes and the ‘Vital Force’

On 21st January I submitted the following comment:

“Further to my recent comments, I would like to raise an additional concern or two about the Learning Store website with a couple of further examples of misinformation.

Under the heading ‘Effectiveness of Homeopathy’, we are told that

“Homeopathic medicines may be compared to chemical catalysts. The amount of the catalyst is less critical than its form or quality. Enzymes are biological catalysts.”

The information preceding this talks of homeopathic dilutions of up to 100C. Homeopaths themselves readily acknowledge that homeopathic remedies typically lack even a single molecule of the original ingredient. So to compare it to an enzyme would seem to be misleading and at variance with the educational objective of the Learning Store website.

You may as well compare a sponge with a kettle. If you want to suggest that a sponge boils water as well as a kettle does, even though we’ve never seen it happen, you need to explain how the sponge does this – not just say ‘it can be compared to a kettle’. I realise it’s not a perfect analogy because at least a sponge is useful in other ways but I trust you get my point. I therefore suggest this comparison of homeopathy with chemical catalysts be removed.

On the next page of the website, we are told:

“The Vital Force is energy within the body keeping it healthy and helping to fight disease. Homeopathic remedies energise the vital force.”

Given the educational purpose of the Learning Store website, I don’t think you make it clear that the ‘vital force’ was a figment of Samuel Hahnemann’s imagination and that it doesn’t exist as such in reality. In any event, you don’t explain how homeopathic remedies “energise the vital force” and this explanation would seem to contradict the one on the previous page which compares homeopathic remedies to chemical catalysts. So I would suggest you make some amendment here. Perhaps point out that the vital force was just a story invented centuries ago when we didn’t know any better?”

That I have only specified these concerns shouldn’t be taken to mean that I don’t have others. In truth, I believe that the whole section on alternative medicine, together with the study notes provided is seriously misleading, and would question its inclusion in the website. The fact that there is a unit on alternative medicine in the syllabus for the GCSE Science and Public Understanding AS Module 1, does not justify it, particularly as so much of the information you provide is mendacious or just plain wrong.

I look forward to hearing from you.

But I’m not holding my breath.

11/2/10 Update

Well, it didn’t take long following my complaint to Boots about the Alternative Medicine section altogether on the Learning Store website, for the section to be removed altogether. Not that I am taking all the credit for it. As Andy Wilson comments below, the Merseyside Skeptics lodged an official complaint about the same website to the Medicines and Healthcare products Regulatory Agency (MHRA).

To date, I’ve never had more than this standard acknowledgement.

Your enquiry has been referred to one of our team for a response and we’ll be contacting you as soon as possible. I would, however, like to reassure you that your enquiry is very important to us and I thank you for your patience whilst we are looking into this further.”

It seems that while they were looking into it further, they realised that the (unnamed) course the altmed misinformation had been “designed to support” had ended in 2009. How convenient! So there’s no need to do anything more about it and everyone’s happy.

Just one little thing before we draw a line under the matter.

Here’s what Boots said about the compalint to the MHRA: is our educational website for schools and does not support the sale of any specific products. Therefore the information on the site does not breach any advertising laws.”

The altmed section of the site was aimed at students aged 16+. It included the assertion that homeopathic belladonna can treat acne. Boots sells belladonna 30c for about £5. It doesn’t treat acne or anything else because there’s nothing in it. If making a false claim about about a remedy for a condition that affects teenagers on a website aimed at teenagers and run by a company that happens to produce and sell the remedy “does not breach any advertising laws”, then it’s time those laws were revised.

Just saying.

23 thoughts on “My complaint to Boots about their Learning Store website”

  1. I have already satisfied myself that homeoverdoses don’t do anything either bad or good. Like you I bought these things in the 1990s, when Boots had the wee charts of pills v symptoms (and also, I am sorry to say, because I was recommended them by my GP and my vet). Clearing out a cupboard a few months ago I came across a dozen different remedies in their bottles. I mixed them all together in a mug. Then I and my daughter had a tablespoonful each of the mixture; I gave another tablespoonful to my three hens, and – just to see whether they had any other uses – sprinkled the remainder over one half of a bed of vegetables. The other controls were my husband and my cat, who kept to their normal diets.

    I can report that the results were entirely consistent with the absence of active ingredients.

  2. Nice work Skepticat

    Although it’s been somewhat overlooked in the overall 10:23 campaign publicity, this event wasn’t just about an “overdose”. We have parallel activities under way. One of them precisely addresses these points and last week we submitted a complaint to the MHRA detailing 19 specific elements of the Boots online presence and asking them to investigate.

    There are strict rules, though they appear only to be invoked in the case of a complaint.

    You may wish to submit your own data to the same authority if they continue to fail to respond. Happy to provide details.



  3. Thanks, Andy.

    I’ve received this so far:

    “Thank you for your email about homeopathy and conventional medicine.

    Your enquiry has been referred to one of our team for a response and we?ll be contacting you as soon as possible. I would, however, like to reassure you that your enquiry is very important to us and I thank you for your patience whilst we are looking into this further.

    If you need to contact us please use the details above and quote the customer reference that you?ll find at the top of this email and of course, we?ll be back in contact with you soon.

    Yours sincerely

    Boots Customer Care.”

  4. Hi Rick

    No, I’m not planning to start blogging about more conventional medicine any time soon. There is, after all, a lot of clear and accessible information already out there – the page you link to is a case in point. Furthermore, I don’t see a zillion websites authored by NHS doctors trying to boost their personal finances by making false claims for this or that implausible therapy in an effort to get gullible people to buy it. Finally, I see it saving millions of lives. Therefore, I don’t feel any particular compulsion to challenge it.

    Hope that clarifies. 🙂

  5. Your response seems to side-step the issue of EBM. The main complaint of skeptics about CAM therapists is their lack of evidence to support their treatments. It is absolutely a fair point, but for the sake of impartial clarity it is important to note that conventional medicine also lacks this evidence for almost 50% of its procedures. Is the point of the Skeptic argument that practitioners of any sort shouldnt be making therapeutic claims which aren’t supported by a firm evidence base, or that if something isnt “conventional” then its just not acceptable?

    You state that NHS doctors dont try “ boost their personal finances by making false claims for this or that implausible therapy in an effort to get gullible people to buy it”.

    Well doctors don’t need to “boost” their income because they are already paid substantially well in the first place. If 50% of the treatments supplied by the doctors are not supported by good evidence then they are in fact guilty of making unsubstantiated claims and yes people DO “buy it”.

    You have to give a more balanced argument to be taken seriously as a voice in the critique of health care be that primary or “complementary”. Your method of reasoning should be applied across the board and not just to cherry-picked cases which suit your argument.

  6. Rick

    I will address your ‘argument’ about EBM in a moment but first I would point out that you seem to be missing the purpose of my blog. I’m not writing an academic essay for you here and I am under no obligation to meet your idea of “impartial clarity”. If I want blog about the evils of religion, I don’t in the interests of “balance” include an apologetic paragraph or two about the perceived problems of atheism as well.

    My purpose is not “to be taken seriously as a voice in the critique of health care” by devotees of altmed. Rather, it is to expose the false claims made by such people so that fewer of us are conned (like I was) into buying their crappy products. My target audience are people like I was fifteen years ago. I only wish I’d seen a blog like this one back then. (And I wish all those who’ve tragically died because they placed their faith in altmed had seen it too.)

    If you think I’ve said anything in my blog that isn’t true, then you are at liberty to challenge it. But there’s no point in saying that “conventional medicine is just as bad”, or whatever, because I’m not interested in conventional medicine, I can’t do anything about conventional medicine and, anyway, there are already plenty of more scholarly resources about it. You sound like a car salesman who relies on pointing out the problems of public transport to sell a car.

    As to your assertion that “conventional medicine also lacks this evidence for almost 50% of its procedures” – is that the kind of assertion you think I should include in the interests of “impartial clarity”? Or should I just include the link in the hope that most people don’t make the mistake you have made and assume that all 2,500 of the treatments included in the study purported to be ‘conventional’? In fact, they included all manner of treatments that are offered by the healthcare system, including altmed like homeopathy and chiropractic as well as conventional treatments.

    The true figure for scientifically supported medical treatments in the developed world is said to be around 80%.

  7. Skepticat,

    Thanks for your reply and the links to those interesting articles.

    From reading them both it appears that substantially less than 50% of medical interventions were supported by the “gold standard” measure of RCT. Of course there are other forms of evidence which may be counted, but these studies do not go into detail of what these might be. Standard protocol and received wisdom of more experienced medics is a form of evidence but not a particularly methodologically strong one in terms of the hierarchy of evidence used in assessing EBM.

    I realise you aren’t an academic and nor am i really, but i think it is important to differentiate between types of evidence and recognise their relative value. CAM is constantly got at for not having passed strict placebo controlled RCT, but on the evidence supplied by yourself above, far less than 50% of the medical treatments assessed in most of those studies have been assessed this way either:

    anesthetic interventions 32% by RCT, UK [13]

    dermatologic out-patient therapy 38% by RCT, Denmark[14]

    major therapeutic interventions’ in an internal medicine clinic 57% by RCT, Canada)[15]

    surgical interventions in one practice (24% by RCT, UK)[16]

    pediatric surgical interventions (11% by RCT, UK)[17]

    psychiatric interventions 65% by RCT, UK [18]

    interventions in general practice 25.5% by RCT, UK [19]

    general medical interventions 53% by RCT, UK[20]

    general practice interventions 38% by RCT, Spain [21]

    laparoscopic procedures 50% by RCT, France [22]

    primary hematology-oncology interventions 24% by RCT, USA [23]

    internal medicine interventions 50% by RCT, Sweden [24]

    pediatric surgical interventions (26% by RCT, UK)11

    primary therapeutic decisions in a clinical hematology practice 22% by RCT, UK [25]

    interventions in a community pediatric practice 39.9% by RCT, UK)[26]

    The aim of science and of acquiring evidence to base a sound practice on is to in some way arrive at an agreed upon truth rooted in reality. To achieve this an open and inquiring mind is needed. You seem only interested in ranting against an enemy which you are apparently still struggling to come to terms with “fifteen years” later. Wouldnt it be more productive to keep a more open mind and to assess the value of the available evidence on both sides?

    Just a thought.

    Hope you dont stay so bitter for much longer.

  8. Nice try but it is through having an open and inquiring mind that I have arrived at the position I am now. I see that, having failed to impress me through your diversionary comments about conventional medicine, you are resorting to ad hominems and I’m grateful for the addition to my quackolades column.

    No doubt, if I’d never tried altmeds, I’d be accused of being too closed-minded to try them. If I was a doctor or scientist, I’d be accused having a vested interest in attacking altmed. The one thing I can be absolutely sure of is that you won’t actually address any of the arguments I’ve presented on this blog.

    Thanks for being so predictable.

  9. Dear oh dear, you accuse me of not addressing any of your arguments? What are they? That homeopathy doesnt work? Well i personally dont think it does either, i have absolutely no argument with you on that front, but i think the way you go about slamming CAM generally without having a working understanding of EBM and how poor evidence is found on all sides is lamentable.

    Its interesting that you dont respond to posts which threaten your way of thinking and which find flaws in your argument. A minute ago you were telling me that ” scientifically supported medical treatments in the developed world is said to be around 80%” and when i have illustrated using your OWN evidence that this statement is full of holes you conveniently ignore it.

    All you really seem interested in is banging your repetitive drum and preaching to the converted.

    Good luck with that.


  10. This is getting wearisome. You haven’t “threatened my way of thinking,” you’ve confirmed it. I did not respond to your stuff about RCTs because it isn’t an argument. I pointed to evidence that a large majority of conventional medical treatments are scientifically supported. This statement is not “full of holes”. The article is fully referenced and correct. You seem to want to disregard evidence that is not an RCT on the grounds that skeptics point to the dearth of good quality evidence for altmed. Please yourself. It makes no difference to the fact that there is a dearth of good quality evidence for altmed and there is plenty of good quality evidence for conventional treatments. “Far less than 50%” is a lot more than “hovering just above zero”.

    I do have a working knowledge of EBM and an understanding of evidence and I know that the totality of evidence for most altmeds indicate no efficacy above placebo. Whatever may be wrong with conventional medicine, it still doesn’t change the fact that there is no good evidence for altmed. Have I said that enough times now?

    You have not found any “flaws in my argument”, you haven’t addressed any of my arguments. You have found imaginary flaws in an imaginary argument. You ask what my arguments are? There are numerous arguments in my many blog posts – take your pick.

    Thanks for the extra quackolade – it’s duly added. And now I’m going to bed.

  11. Thanks, but I’ll feel bitter as long as I hear about people suffering and dying because they were conned into buying worthless therapies by people like you.

  12. Perhaps Rick could provide insight on large scale homoepathic production methods.

    What is known about the standards of manufacture for homoepathic meds sold in a chemist like Boots? Are the purity laws for the manufacture of real meds met? What is done for thorough cleansing of equipment after one batch run is finished, but before the next is run to guarantee no contamination across batches? Do the ingredients meet the chemically pure level most real meds require? Is the diluent (presumably H2O) free of bacteria? Is it free of prior “vital force energizings” (I would certainly hate for any sewage contact to remain)?

    Is the preparation diluted to X, C, or M levels and carefully rapped by hand to energize the diluent or is it mixed in large vats and an unstoppered tincture bottle passed over the vat as Vermouth is for a dry martini? Are the Boots’ preparations proved in classic homeopathy fashion or just copied out of the handbook, “Homeopathy for Dummys”?

    The more I read about homeopathy, the more credulous I would have to become to believe any such system with so many internal contradictions. Anyone I have met, who self doses on alt-meds, doesn’t know the difference between herbal medicine and homeopathic medicines.

  13. See Wed. comment, I decided to see what Boots had to offer.
    A search on homeopathy surprisingly yielded no results.
    However, it appeared as a subheading under complementary.
    They seem to have some outside sourced 6C meds and inhouse 30C meds. All warn of lactose and sucrose ingredients. One hopes no one with lactose intolerance doses on these meds as they might be quite dangerous. There was the warning that none are have approved applications.. None of the pills/pillules must be touched. For standard treatment it is two pills/pillules every 2 hours for 12 then no more than 2 every 6 hrs. for no more than 5 days. That’s over 50 pills/pillules, neary 2/3 of a 72 pill bottle. Their website seems to imply that these meds are useless

  14. From:

    >>Reply by rick harter on February 4, 2010 at 1:00pm
    To pull the tail of the Skepticat and hear her howl i posted a link to those figures on her website and asked her what she made of them.


    Reply by Steve on February 4, 2010 at 4:35pm
    You’ve stirred up a potential hornets’ nest there, Rick! Hope you don’t draw too much flak.

    Nice to see the Organised Skeptic ducking the issue – no surprise there, then!<<


  15. Boots may well be right in saying they are not breaking advertising ‘law’ per se, but they may well be breaching the ASA’s CAP. However, it’s not clear if the Learning Store website falls within the ASA remit, since it is advertising on their own website. It almost certainly falls within the remit of Trading Standards, who, unfortunately, seem to have little interest in misleading claims.

  16. dear Skepticat – I haven’t before now commented on your alternative medicine blogs as I have no experience of this subject, but I am struck by the abusive and ad hominem nature of the Quackolades etc. Have you had any rational responses from the industry?

  17. The responses from altmed practitioners are generally of very poor quality and include lots of ad hominems. I recall only one or two instances of these people trying to address any of my arguments – the majority just come here with straw men arguments or to fling abuse. At the risk of sounding pompous, they seem a bit cerebrally challenged, on the whole.

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