Official information kept secret too long

Official information kept secret too long

Official information is being kept secret for longer than it should be. For the past few months, I have been gathering and analysing data from 12 government agencies, looking at how they handle requests made under the Official Information Act.

My findings reflect what many have observed more anecdotally: responses to requests for information are often sent at the very last minute, and seem to often be delayed unnecessarily. Though it can be difficult to demonstrate that a response was not sent “as soon as reasonably practicable” — a requirement under the law — in any particular case, looking at a larger data set reveals some of the strategies used to delay the release of official information.

You can read my article here: Official information kept secret too long

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Chiropractors struggle to drop testimonials

Chiropractors struggle to drop testimonials

The latest newsletter from the regulator of chiropractors offers an insight into the industry’s culture problems.

In their June newsletter, the chair of the Chiropractic Board has admonished chiropractors for a discussion on how to circumvent consumer protection regulations:

At a recent chiropractic function, a presentation was given on advertising, chiropractors’ responsibilities and the Advertising Standards Authority (ASA). The information was well presented and informative however ensuing discussion revealed that the message is clearly not being heard by all. I urge you to please refer to my email of 30 August 2017 that clearly outlines your responsibilities, and reiterates very important points set out in the Board’s Advertising and Social Media Policy, and references to all other responsibilities. I was particularly disappointed in discussion among practitioners on how to best circumvent the prohibition on posting testimonials on Facebook – some very creative ideas were invented.

The Chiropractic Board published their current Advertising Policy in November 2015. It notes, correctly, that the use of health testimonials in advertising is prohibited in New Zealand by Section 58(1)(c)(iii) of the Medicines Act 1981:

A chiropractor shall not advertise any material which relates to the chiropractor’s qualifications, practices, treatment or the premises where they practice chiropractic if the material:

f) uses testimonials whether from patients or any other person (see section on Medicines Act);

This section [58 of the Medicines Act] provides further at Section 58(1)(c) that it is an offence to imply, claim, indicate or suggest that a medicine, treatment or device is a panacea or infallible for any condition or is recommended by an appropriately qualified person or had beneficially affected the health of a particular person or class of persons, whether real or fictitious.

This wording clearly prevents a health practitioner publishing testimonials.

Unfortunately, this law is widely ignored in New Zealand, particularly by promoters of dodgy health products. In my experience even when breaches are brought to the attention of the agency responsible for enforcing it – Medsafe, in this instance – nothing is likely to happen.

In 2015, my colleague at the Society for Science Based Healthcare Mark Honeychurch and I looked at how often New Zealand chiropractors were publishing health testimonials and various misleading health claims in online advertising. This was prior to the publication of the Chiropractic Board’s current advertising policy, but over 20 years after the law prohibiting the use of health testimonials in advertisements was passed. We found that just over a third of the 137 websites we looked at used health testimonials.

Thankfully, this does seem to have decreased following the introduction of the Advertising Policy, but the recent newsletter seems to imply that chiropractors are not happy about being unable to use testimonials to promote their services.

When looking at how often chiropractors use misleading claims and health testimonials in 2015, we hadn’t looked at advertising on social media. While writing this post, I have searched for “NZ chiropractic” on Facebook and clicked on the top three pages that showed up in the results – Bays Chiropractic NZ, Chiropractic Touch, and Revolution Chiropractic NZ – to have a quick look (I didn’t look through any comments or watch any videos) and see if any of them had been publishing testimonials there.

I didn’t see testimonials on the Bays Chiropractic NZ page, but I couldn’t help but notice that they shared an image in February featuring many misleading claims about chiropractic manipulation, including that it can reduce allergies, asthma, and ADHD. As the Chiropractic Board of Australia has clarified in their own Statement on Advertising in 2016, these claims are not supported by evidence:

Claims suggesting that manual therapy for spinal problems can assist with general wellness and/or benefit a variety of paediatric syndromes and organic conditions are not supported by satisfactory evidence. This includes claims relating to developmental and behavioural disorders, ADHD, autistic spectrum disorders, asthma, infantile colic, bedwetting, ear infections and digestive problems.

In August 2017, Chiropractic Touch posted a testimonial claiming that chiropractic manipulations had cured someone’s asthma. They used one of the “creative ideas” commonly used by chiropractors to try to circumvent the prohibition on publishing health testimonials: telling the testimonial in the context of it inspiring a chiropractor to pursue their career rather than framing it as a patient’s experience.

I didn’t see any testimonials on Revolution Chiropractic NZ’s page, but they do seem to publish a lot of posts about adrenal fatigue. Adrenal fatigue is a fake diagnosis that I’ve seen most often used by naturopaths to sell unnecessary supplements. Revolution Chiropractic NZ also shared some of the same misleading claims as Bays Chiropractic NZ, including particularly concerning misleading claims about being able to treat children and infants for conditions such as colic and ear infections.

Whatever improvements there may have been over the past few years, it seems the chiropractic industry in New Zealand is still struggling with its culture of ignoring or sidestepping patient protection regulations.

NZ Police pursuits keep killing people

NZ Police pursuits keep killing people

Despite a repeated cycle of calls for change, people keep dying in police pursuits in New Zealand. Just today, a teenager and a child died as the result of a police pursuit in Palmerston North.

News stories like these keep appearing. In February this year I asked NZ Police to release a number of statistics regarding police pursuits so I could examine what, if anything, has changed. I began to write about it in March but didn’t end up publishing it, having intended to put it on a new “features” subdomain I’ve been working on where I’ll be able to do some more complicated stuff than WordPress will allow.

One of the statistics I included was the number of people who have died as a result of police pursuits since the most recent review began. I’ve gotten very sick of having to update that number. So out of that frustration, I’ve published my article. You can read it here: NZ Police pursuits keep killing people

Personalised Supplements

Personalised Supplements

Can an online quiz give good recommendations for taking supplements? Stuff today published an article about two New Zealand companies that launched recently, Vitally and Wondermins, which each use online quizzes to sell “personalised vitamins”.

Unfortunately, Stuff chose to focus on the question “What’s the point?” rather than “What’s the evidence?”. I thought it would be an interesting experiment to run through each of these quizzes to discover what supplements they would each recommend to me if I told them I had no health problems.

Both quizzes also included a bunch of questions about my current relationship to vitamins. Questions such as whether or not I already take any, how knowledgeable I am about them, were accompanied by questions about my health such as whether or not I took a long time to recover from infections.

For each health question, I gave the answer that would indicate better health. Do I often get colds or the flu? No. Do I have allergies, or sore joints? No, no. There were also diet questions, to which I attempted to give the healthiest answers based on what I thought they would be expecting.

Each quiz also asked me for a few areas of interest, though they didn’t phrase this as a health question. For example, Vitally asked “Which of these categories should we explore?” and gave me options such as “Immunity”, “Heart”, and “Inflammation”. The categories were pretty similar for both quizzes, so for both I selected immunity, bones/joints, and heart.

Vitally recommended I take four supplements for my 0 health problems and healthy lifestyle, which would cost $57 per month. Their supplements had “Find out why” tooltips with very useful information such as “Alpha-Lipoic Acid is recommended for healthy skin & inflammation and” (yes that’s the whole tooltip).

Wondermins’ loading screen after the quiz told me it was “Referencing research…”, and each of the supplements they suggested had a “View Research” link. However, these links all went to a page about Vitamin D deficiency. This didn’t do much for my peace of mind, especially since they didn’t even recommend I take Vitamin D (though Vitally did).

Wondermins recommended I take three supplements, none of which were the same as those recommended by Vitally. Their pack would cost me $68 per month.

If two quizzes for the same thing can give such different results for essentially the same answers, I don’t think that says very much about their reliability. They were both very lacklustre in terms of making evidence available to me if I wanted to make an actual informed decision about what they were suggesting I purchase.

If you’ve got money to burn and you think your urine isn’t expensive enough, then these services might interest you. Otherwise, do the sensible thing and talk to your GP if you have any heath issues.

What we owe our pets

What we owe our pets

I recently complained about a vet promoting quackery in the Bay of Plenty Times. In response to my complaint, the editor agreed to publish a response I wrote, regarding what we owe our pets. Now that it’s been up for a little while, I’m also publishing it here on my blog.


The Bay of Plenty Times recently published an opinion piece by veterinarian Liza Schneider about avoiding and treating cat abscesses. Liza Schneider runs the Holistic Vets clinic in Tauranga, and is the president of a special interest group of New Zealand vets focused on “complementary veterinary medicine”.

At the end of her article, she said “complementary therapies like homeopathy, herbal medicine, ozonated gel, hyperbaric oxygen therapy and others can help aid healing tremendously.”

The claimed efficacy of homeopathy is in stark contrast with evidence-based practice. As the UK’s Royal Council of Veterinary Surgeons said in a statement last year, “Homeopathy exists without a recognised body of evidence for its use. Furthermore, it is not based on sound scientific principles.”

Like children, our pets rely on us to make healthcare choices for them. Just as pets cannot talk to us about their symptoms, they are unable to discuss treatment options, make an informed decision of their own, or consent to treatment. These important decisions are left to their carer, and their vet is the carer’s guide to making this decision.

When we welcome a pet into our homes, we take on a responsibility to care for them. When their health becomes an issue, they have no choice but to rely on us to make the best decision in their stead. We must be their advocate.

If we choose poorly, their health may suffer. In my view treatments like homeopathy, which are not supported by robust evidence, will at best cost you money and do nothing, but at worst they may delay effective treatment.

Though we are fully capable of making informed decisions about our own healthcare that might involve trying treatments that are not backed by good evidence, I strongly believe that we have a duty to our pets not to experiment on them in this way.

This responsibility also applies to veterinarians. When a vet says things that are not soundly based on scientific evidence, such as “homeopathy… can help healing tremendously”, I believe they are failing in that responsibility.

The New Zealand Veterinary Association has a policy on the use of “complementary and alternative treatments” that requires, among other things, that vets must say if a treatment they are advocating is not supported by evidence:

“Clients must be made aware of the likely effectiveness of a given treatment according to recognised peer-reviewed veterinary medical publications, notwithstanding the individual beliefs of the veterinarian. They must also be told the degree to which tests, treatments or remedies have been evaluated and the degree of certainty and predictability that exists about their efficacy and safety.”

I sincerely hope that your vet fulfils this responsibility in their practice.

New rules for pharmacists

New rules for pharmacists

The Pharmacy Council has (finally) published their new Code of Ethics 2018.

I’ve written several times on the ongoing saga of the Pharmacy Council’s Code of Ethics. In late 2014 we put together a complaint at the Society for Science Based Healthcare arguing that their Code of Ethics 2011 had been violated by an Auckland pharmacy, in which a salesperson had recommended and sold a homeopathic product to someone who didn’t realise they were buying quackery.

Following this complaint, the Pharmacy Council decided they would not enforce the rule in their Code of Ethics at the time that prohibited pharmacies from purchasing or supplying any health product that was not backed by “credible evidence of efficacy”.

This led to two protracted consultation processes, first about that specific part of the code and then about rewriting the code entirely. I worked on the Society for Science Based Healthcare’s submissions during each consultation period, and we met with the Pharmacy Council twice to discuss the topic.

The consultation processes also saw well-voiced support for strong patient protection rules coming from the New Zealand Medical Council and the Pharmaceutical Society (who represent professional pharmacists). Whereas the Pharmacy Guild (who represent pharmacy owners) was in favour of the more relaxed rules that had been suggested. For more detail on this, you can read my submissions roundup from 2015.

The Code of Ethics 2018 will come into force on the 12th of March 2018. It’s principle-driven, and accompanied by a number of guidelines that go into more detail on what’s expected of pharmacists in various areas. One of these guidelines is the Pharmacy Council Complementary and Alternative Medicines – Statement and Protocol for Pharmacists.

Unlike the Code of Ethics 2011, the new rules don’t prohibit pharmacists from selling quackery. While this is unfortunate, it’s seemed clear from the outset that the Pharmacy Council had no intention to keep this rule given they aren’t prepared to enforce it. Instead, there has been an increased focus on ensuring patients are given the opportunity to make an informed choice.

I’m feeling cautiously optimistic about the change. Though ideally pharmacists shouldn’t be lending their credibility to ineffective health products, if pharmacists must be allowed to sell quackery then I think the next best approach to regulation is to protect patients’ rights to make an informed decision.

On the face of it, I think the new rules seem good. But enforcement has been a concern in the past and parts of the previous code were widely disregarded. Come the 12th of March, I plan to have a look for pharmacists who aren’t complying with the new rules and lodge complaints to see how they are treated, and if the behaviour is corrected. Unfortunately, there are a few pharmacies in New Zealand that have a history of promoting quackery, including by selling ineffective health products online, which seems like a good place to start.

I’d recommend you read the rules for yourself if you’re interested, but here’s my summary of what I think are the most important new patient protection rules regarding informed consent:

[Principle 1H: A pharmacist] Before recommending, supplying or promoting a medicine, complementary and/or alternative medicine or other healthcare product or service, considers available evidence, and only supplies a product when satisfied that it is appropriate, and the person understands how to use it correctly and safely.

[Principle 4C: A pharmacist] Provides accurate, truthful, relevant, and independent information in an appropriate form that is not misleading to patients, the public and/or other healthcare professionals.

[Principle 4H: A pharmacist] Ensures that when providing any medicine, complementary and alternative medicine, or other healthcare product or service, that the health and wellbeing of the patient or consumer is the primary consideration, and that the benefit of use outweighs the risk.

[Principle 4I: A pharmacist] Does not engage in advertising, promotion or supply of goods or services that could include misleading or unsubstantiated claims, and/ or undermine public trust in the profession.

[Principle 6A: A pharmacist] Maintains contemporary knowledge of evidence-based practice.

Where it makes sense, all of these principles are effectively extended to non-pharmacist salespeople who work in pharmacies via Principle 5G:

[A pharmacist] Is responsible for actions of staff under their supervision.

Looking at the associated guideline on “complementary and alternative medicines”, the requirements in parts 14 and 15 seem like they will be particularly important for protecting patients from quackery in pharmacies:

14. When supplying products or information about treatments/products/services that have no current evidence of proven efficacy pharmacists are expected to:

a. ensure that patients are informed about the degree to which treatments or products have been evaluated, and

b. the degree of certainty and predictability that exists about their efficacy and safety

15. Pharmacists must advise patients when scientific support for treatment is lacking.

Part 18 of the guidelines also includes the following requirements:

e. provide sufficient information regarding the CM/NHP [Complementary Medicine/Natural Health Product] to allow patients to make informed choices

f. not misrepresent information or opinion. Patients must be made aware of the likely effectiveness of a given therapy according to recognised peer-reviewed medical publications, in spite of your personal beliefs

g. provide the patient with a timeframe for accessing conventional medicine if their condition is unresolved or there is no improvement

Time will tell if these rules really do enhance patient protection in the pharmacy industry, which has a long-standing problem with promoting quackery on the side.

From the 12th of March onwards, if you see behaviour that you think is non-compliant with the code feel free to let me know about it. I can be contacted via email at mark@honestuniverse.com.

OIA accessibility follow-up

OIA accessibility follow-up

What will be done about the Official Information Act’s accessibility problem?

Late last year, I published an open letter on the accessibility of the Official Information Act. I gave examples of inaccessible responses to requests under the OIA, and suggested a solution. I sent this letter to the Ombudsman, and later also forwarded it to Associate Minister of State Services (Open Government) Clare Curran and to Minister for Disability Issues Carmel Sepuloni.

I’ve now heard back from the latter two, and want to share their responses so others interested in this topic can read what’s being done to address it.

I’d also lodged an OIA request with the Ministry of Defence last year, as their Briefing to Incoming Minister document was released as a text-based PDF with watermarks and redaction. I’d asked them what software they used to produce this, and the associated costs, so I’d be able to give a specific recommendation to agencies who send me inaccessible responses in the future.

I’ve received a response to this request as well. As with the responses from Clare Curran and Carmel Sepuloni, you can find the text and PDF link to this response below.

Unfortunately, and somewhat ironically, all three responses were received in the form of image-based PDFs of documents that had been printed, signed, and then scanned. This is the primary accessibility issue I’d raised in my letter regarding OIA responses, as this format cannot be easily converted to text and is inaccessible to people who rely on screen readers. A couple of the responses also contained links that I’ve had to type out by hand instead, due to this inaccessible format. I’ve made the original PDFs available, and also converted them to text (by hand, so please assume any mistakes are mine), which you can find below:


Response from Clare Curran, Associate Minister of State Services (Open Government). Original PDF

Dear Mark Hanna

OIA Accessibility

Thank you for your email on 30 November 2017, regarding the accessibility of information released to requesters under the Official Information Act 1982 (OIA). I note your concerns about the format some agencies choose to provide information in, which can render that information unsearchable by the recipient.

As you are aware, section 16(2) of the Official Information Act provides that information can be made available in a way preferred by the requester, unless there is good reason identified by the agency not to do this. In the first instance it is for the requester to ask the agency to make information, and in particular data sets available in a searchable format. If the agency refuses then this can be the subject of a complaint to the Ombudsman.

The State Services Commissioner has been delegated the functions under section 46 of the OIA by the Ministry of Justice. This function includes providing advice and guidance to agencies to act in accordance with the OIA. SSC has established an official information work programme which includes developing guidance for agencies. I think that the issues you have raised are worthy of further consideration.

I have asked the State Services Commission to consider whether accessibility of information should be part of the official information work programme that the Commission is undertaking.

Yours sincerely

Hon Clare Curran
Associate Minister of State Services (Open Government)


Response from Carmel Sepuloni, Minister for Disability Issues. Original PDF

Dear Mr Hanna

Thank you for your email dated 30 November 2017, regarding accessibility issues with Official Information Act (OIA) practices and across government more generally. The Government is committed to being open and transparent and we expect the same of the public service.

I have been advised that the Official and Parliamentary Information team within the Ministry of Social Development will soon utilise more sophisticated redaction software. This software will enable the Ministry of Social Development to send and publish OIA responses and documents that are text searchable and text recognisable for those requesters who use reading software.

Providing OIA responses in accessible formats should be standard practice as part of an open and transparent government. To this end, the Ministry of Social Development is leading a work programme to increase the accessibility of information and communications across government agencies. This will involve providing clear and practical advice to support government agencies to meet accessibility requirements for all their communications with the public. Participating Chief Executives have signed up to an Accessibility Statement to commit to this. You can find more information about this here: www.odi.govt.nz/nz-disability-strategy/outcome-5-accessibility/

Thank you for writing. I hope this information is helpful.

Ngā mihi

Hon Carmel Sepuloni
Minister for Disability Issues


Response from Ministry of Defence. Original PDF

Dear Mr Hanna

RESPONSE TO YOUR OFFICIAL INFORMATION REQUEST

Thank you for your email of 7 December 2017 regarding the software used to create the redacted and watermarked 2017 Briefing to the Incoming Minister of Defence, published on the Beehive website.

The Ministry of Defence recognises that publishing a document online as a text-searchable PDF file makes is easier to access. We prepare material for release in this form wherever possible, and endeavour to provide alternative formats on request for non-searchable documents, such as older files.

In order to produce searchable, redacted and watermarked files, the source documents are generally prepared using Microsoft Office software and then exported as searchable PDF files. Adobe Acrobat Professional software is then used to make redactions and add watermarks.

The Ministry has an agreement with the New Zealand Defence Force on software licensing. The Defence Force pays for an all-inclusive software bundle and is charged a flat rate. They distribute the licenses for Adobe Acrobat Professional as needed by staff. Please refer to the Adobe Acrobat website for costs: https://acrobat.adobe.com/nz/en/acrobat/pricing.html. The cost to agencies will be affected by volume. Assuming multiple licenses are purchased, the Adobe website indicated pricing of A$22.99 per seat per month (about NZ$25 at present exchange rates) or A$275.86 per year (about NZ$300).

Under section 28(3) of the Official Information Act 1982 you have the right to request the Ombudsman to investigate and review this response.

Yours sincerely

Helene Quilter
Secretary of Defence


It’s not clear yet whether or not accessibility of information will be part of the SSC’s official information work programme that Clare Curran mentioned. Though I’m hopeful that it will be, I’m not sure how likely this is to effect change.

I strongly agree with Carmel Sepuloni’s statement that “Providing OIA responses in accessible format should be standard practice as part of an open and transparent government”, and hope that she will do her best to ensure our government meets that standard. I’m cautiously optimistic, though the fact that this response itself was delivered in an inaccessible format isn’t encouraging.

For the foreseeable future, it sounds like the best course of action will be to ensure that all OIA requests specify that the response should be delivered in an accessible, searchable format. I have included this recommendation in the OIA Guide that I published last year.

If I receive inaccessible PDF responses in the future, I now intend to direct the agency to the Ministry of Defence’s response regarding the software they use.