Positive Health Online

This article updates and expands upon my previous article that appeared on PH Online (Issue 228, February 2016): Your CAM Practice and the Advertising Standards Authority Ltd – Time to take Action. It reviews changes to the guidance issued by the Competition & Markets Authority (CMA) and proposes strategies to make the Advertising Standards Authority Ltd (ASA) and its co-regulatory compliance partners more accountable to the practise of Complementary & Alternative Medicine (CAM) within the UK health and social care sectors.

Practitioners of CAM, together with the organizations that use or promote them, are vulnerable to challenge by the consumer protection organisations empowered to regulate them. Such challenge is likely to dispute an advertisement presenting the efficacy or effectiveness of a CAM treatment or a trading name or process. Ultimately, a dispute may lead to termination of a Practitioner’s practice causing professional, financial and social hardship.

As a result, it is anticipated that Practitioners and their professional, charitable and supporting organisations will increasingly need legal advice about how they can respond to this challenge and, more generally, as to how they may initiate reform of the regulatory system.

The purpose of this article is not to provide legal or other advice but rather to stimulate discussion about the predicament of CAM and to propose strategies that might be adopted to bring about a UK market-wide change in the way that the advertising of CAM is co-regulated and enforced.

This is not a practice area with which most legal professionals will be familiar, yet it is fundamental to the understanding of their client’s case should they be instructed to represent a CAM Practitioner or organisation involved in a dispute with the ASA or be instructed to advise on proposals for reform.

The antipathy between practitioners of CAM and the Advertising Standards Authority Ltd (ASA)[1] is a matter of record.[2]

There is evidence that Practitioners and their professional organizations are beginning to meet the challenge. For instance, with regard to the ASA and the practise of homeopathy, The Society of Homeopaths[13] (a professional organisation accredited by The Professional Standards Authority)[14] has sought legal advice on behalf of its members.

Please be aware that the parliamentary debates referred to in this article, although properly used to state the case for CAM, relate to the activities of the ASA generally and not specifically to CAM. Also, please note that the bolding and italicising of the text of this article are added by me.

The ASA and CAM

Despite what its name may imply, the ASA is not a part of the Government or of the wider public sector, although it operates with Government approval. It has no statutory powers in its own right. It is a self-regulating agency set up and funded by the advertising industry and is, together with its related Companies, registered at the Companies Registry as a private, limited Company.

Nevertheless, the ASA is a powerful organization that performs a public regulatory function with regard to the content of broadcast and non-broadcast advertising. Failure to comply with ASA requirements can result in considerable negative consequences that could have an adverse or even terminal effect on a CAM practice.

With this in mind, Practitioners should assess what (if any) help is provided by their professional membership organisations and health sector regulators. For example, guidance and, in some cases, Advertising Certification is available from:

The General Regulatory Council for Complementary Therapies[3] & GRCCT advertising certification;[4]

The Complementary & National Healthcare Council[5] & CNHC advertising guidance (paragraph 6);[6]

The Federation of Holistic Therapies.[7]

It would also be prudent to check the terms of a professional indemnity insurance policy regarding what (if any) cover it provides in the event of a dispute with the ASA.

The governance of the ASA has attracted critical parliamentary scrutiny in both the House of Lords[8] and the House of Commons.[9]

Some implications of this scrutiny were explored in my previous article.[10]

Guidance from the Competition & Markets Authority

Since publication of that article, the Competition and Markets Authority (CMA) has replaced its Guidance document CMA7[11] (referred to in my previous article and titled: Consumer Protection: Guidance on the CMA’s approach to use of its consumer powers”) with its Guidance document CMA58 titled Consumer Protection: enforcement guidance.[12]

How the ASA is Relevant to the Advertising of CAM

Practitioners should carefully scrutinize how the ASA is relevant to the way in which they advertise their practice.

The ASA advises[15] that its ‘Compliance Team’ will consider applying sanctions when an advertiser is unable or unwilling to comply with its publication of a ruling (‘adjudication’) declaring that there has been a breach of the advertising rules.

To explain its sanctions, the ASA has issued a short guide outlining how it and the Trading Standards Services (TSS) work together to enforce advertising rules.[16] The TSS can commence a criminal prosecution (in the Crown or Magistrates Court) leading to an unlimited fine or to a prison sentence of up to 2 years. It reminds advertisers that, as a deterrent to bad practice, it can inform the media of the criminal conviction.

The guide also discloses that National Trading Standards has contracted with Camden Council’s Trading Standards team (i.e. at the London Borough of Camden) to provide the ‘legal backstop’ for the ASA.

The ASA confirms that the damage to an advertiser’s reputation caused by bad publicity is one of its most persuasive sanctions.

More detail about these sanctions may be found on the ASA website.[17]

The following strategies are proposed in support of Complementary & Alternative Medicine generally. They are not limited to a particular practice specialism, although it is accepted that some CAM healthcare sectors have been targeted by the ASA more than others.

Outline of Proposals for Reform

With regard to the regulation and control of advertising of CAM:

• Compile a dossier of evidence describing unfair treatment of practitioners and organisations by the ASA and TSS;
• Identify discrepancies between guidance issued by the Competition & Markets Authority [19] and compliance criteria and procedures applied by the ASA and TSS;
• Making best use of the evidence, lobby to initiate an intervention by the CMA to resolve such discrepancies on a CAM UK market-wide basis. Prioritisation principles for the CMA (CMA 16, April 2014) may be found here;
• In general, use any checks and balances in the system to argue for reform of the system;
• Thereby facilitate a fair and accountable process by which the ASA and the TSS review advertising by practitioners and enable a fair and competitive market for CAM, its practitioners and organisations using or promoting CAM.

The Co-Regulatory Compliance Partners

The relevance of the Competition & Markets Authority (CMA)

The CMA is the UK’s primary competition and consumer Authority (CMA Guidance Document CMA 58, paragraph 1.1, page 2). CMA58 paragraph 2.3, page 4, states:

“…The CMA’s specific consumer powers form part of a wider range of legal mechanisms which it may use to examine and, where necessary, address problems found in markets…”

Most of the CMA’s consumer enforcement powers are shared with other authorities. The CMA cooperates with them to ensure that action is taken in each case by the most appropriate body. Trading Standards (TSS) is the lead enforcer of The Consumer Protection from Unfair Trading Regulations 2008 (CPRs) which impose a general duty on businesses not to trade unfairly with consumers and seek to ensure that traders act honestly and fairly towards consumers (CMA58: paragraph 2.6, page 6 and Annex A, pages 32 – 34).

Section 3 (pages 8 – 14: “The CMA’s approach to compliance and enforcement”) and Annex B (pages 35 – 37: “Compliance partners”) of CMA58 describe how the CMA works with its consumer enforcement partners.

The CMA and the ASA

The CMA describes the ASA as an independent, self-regulatory agency that is suitable in principle to act as constituting ‘established means’ and thus as a compliance partner for the purposes of ensuring consumer protection and compliance with the Advertising Codes (CMA 58: Section 3 paragraphs 3.6 & 3.7 + footnote 16 at page 9 & Annex B, paragraph 11, page 37).

The ASA and TSS at the London Borough of Camden (LBC)

The ASA works in partnership with the LBC with which it has agreed case-handling principles.[20] These principles confirm that the LBC has contracted with the National Trading Standards Board (NTSB)/Trading Standards Institute (i.e. The Chartered Trading Standards Institute: CTSI) to provide the ASA’s “legal backstop”. The principles state that the ASA (as ‘established means’) will usually be best placed to serve the consumer interest but where it is not able to achieve compliance with the UK Code of Non-broadcast Advertising, Sales Promotion and Direct Marketing (the CAP Code) or to resolve a case of misleading, aggressive or unfair advertising, it can refer the case to the LBC to act as its legal backstop.

The NTSB is a member of the Consumer Protection Partnership (CPR). The primary responsibility of the CPR in the consumer landscape is “Enforcement and threat assessment – regional and national in England and Wales” (CMA58: paragraphs 3.2 – 3.5, pages 8/9). The CTSI is a not-for-profit membership organisation whose primary purpose is to support and represent trading standards professionals and to be the main source of advice for business and consumer law. It also operates a scheme under which codes of practice are approved and monitored for consumer protection purposes in general (CMA58: paragraph 10, page 37).

Baroness Deech - Photo by John Cairns

Challenging the System - Some Conclusions

The established relationship between consumer organisations

There is an established relationship (including, where stated, a contractual one) between the CMA, the ASA and the TSS (NTSB & CTSI) as “compliance partners” for the purposes of ensuring and enforcing consumer protection. The relationship is enhanced by the CMA, the NTSB and the CTSI all being members of the Consumer Protection Partnership (CPP) (CMA58: paragraph 3.2-3.4, pages 8/9). Furthermore, the CMA, TSS (LBC) and the ASA are members of The Consumer Concurrencies Group (CCG). The CCG aims to improve clarity and share best practice on overlapping areas of responsibility, such as unfair terms legislation, especially in relation to enforcement. The CCG meets with the Consumer Enforcement Forum of Competent Authorities (CMA58: paragraphs11 & 12, page 37).

Challenging the co-regulatory structure of consumer organisations

I believe it has to be accepted that, for the foreseeable future at least, it will be impracticable to achieve substantial restructuring or replacement of the established relationships and partnerships (legislative and contractual) described above.

As mentioned above, the Government has refused to accept cogent challenges expressed in both the House of Lords (principally by Baroness Deech) and in the House of Commons (in the adjournment debate tabled by John Glen MP). In the House of Lords debate, Lord Clement-Jones refers to a Government paper (July 2013) which concludes:

“…The UK benefits from a healthy and successful advertising sector, underpinned by an exemplar of successful self-regulation, the Advertising Standards Authority…”

This intransigence is unlikely to be changed by representations made by or on behalf of CAM practitioners and their patients, particularly in these uncertain economic and political times. Similarly, the various organisations involved are unlikely to accept that any change to the status quo is either necessary or desirable (unless, it is proposed, they are presented with evidence to the contrary that they cannot ignore).

Lobbying Members of Parliament

For the same reasons, Members of Parliament are also unlikely to respond effectively (or willingly) to a request (e.g. through a petition) that they lobby for change, either on behalf of their constituency CAM practitioners and patients or, more generally, in the public or national interest (including from a health and social care perspective).

Court proceedings

Seeking redress from the courts would be prohibitively expensive. In her speech to the House of Lords, Baroness Deech declares:

“…Successful judicial review is very difficult, as it is directed only to the lawfulness of the ultimate review by the independent reviewer – one person – and in general cannot look at the reasonableness of the ASA decision itself…”

Later in that debate, Lord Smith of Finsbury is able to say, in support of the ASA:

“…in 53 years we have failed in judicial review on only one and a half occasions…”

Strategies for Reform

Scrutiny of the relationships between the CMA, the ASA and TSS

One approach to challenging the respective activities of the ASA and the TSS, could be to identify and contest any inconsistency, anomaly, injustice and lack of fairness that exist within the criteria and procedures they apply when investigating advertising by CAM practitioners.

This approach would necessitate the disclosure and scrutiny of the contracts, agreements, case handling principles and other memoranda of understanding that regulate the relationship between the ASA and the TSS at the LBC.

In addition, the relationship between the CMA and the ASA/TSS (as “compliance partners”) could be similarly scrutinised to ascertain whether or not the ASA and the TSS (LBC) comply with the guidance issued by the CMA, in particular as defined in CMA58.

Integral to this approach would be the scrutiny of the relevant (i.e. CAM related) UK advertising codes (CAP Codes) of The Committee of Advertising Practice (which is a sister organisation of the ASA)[21] to establish whether or not they are being drafted, interpreted and applied fairly with regard to CAM.

Any incompatibility between CMA guidance and ASA/TSS procedures and the CAP Codes (or their interpretation) could, it may be argued, constitute evidence for reform of the current co-regulatory system.

As an incidental outcome, such scrutiny might also lead to the revision of arrangements concluded between the ASA and other (non-CAM) organisations with which it “works in partnership”.[22]

Where scrutiny reveals the unfair or unlawful treatment of CAM, evidence of this could be presented to the CMA

In the event that scrutiny reveals evidence of failures in due process or unlawful or otherwise unacceptable and unfair activity on the part of either or both the ASA and the TSS (LBC), then a dossier of such evidence could be presented to the CMA together with a request that it intervene and initiate reform of the co-regulatory system that currently controls the advertising of CAM.

In this way, pressure could be brought to bear on the ASA and/or TSS (LBC) to make changes to their procedures to facilitate the fair and proper investigation of CAM practitioners.

Complaint to the Ombudsman: maladministration

Evidence of maladministration by the TSS (LBC) or the CMA (but not by the ASA [23]) could form the basis of a complaint to the Parliamentary and Health Ombudsman Service (PHSO) [24)] regarding the CMA and/or to the Local Government Ombudsman (LGO)[25] regarding the LBC (TSS). An explanation of the term maladministration may be found here[28] (pages 1 to 4).

The LGO cannot consider complaints about the commencement or conduct of court proceedings but it has issued the following Guidance (concerning its jurisdiction) to its staff (at page 56):[28]

“…The exclusion of court proceedings from the Ombudsman’s jurisdiction was intended to prevent us considering those matters decided by the courts using different evidential standards, and applying the more restrictive test of legality as opposed to maladministration. But there is no prohibition of an investigation about whether, had fault not occurred, court proceedings could have been avoided. This is because, in such cases the court proceedings are the injustice as opposed to the fault. We have in the past criticised councils for taking bankruptcy proceedings where – even though the application was successful – we did not feel it was a proportionate response to enforcement of a debt, given the prohibitive nature of the costs involved for the person being made bankrupt…”

It is arguable that the LGO’s consideration of issues of “costs”, “injustice” and “proportionate response” in the context of maladministration could be significant when balancing the interests of justice and proportionality against a decision by the TSS to prosecute a CAM practitioner in relation to the advertising of CAM. 

It should be noted that whilst the PHSO can ask an organisation to review its policies or procedures, guidance or standards, it cannot make it do so.[26] There is a time limit for a member of the public to bring their complaint to the Ombudsman, which is normally 12 months from the maladministration complained about.

Some Matters Requiring Scrutiny

The CMA could be asked to investigate various matters

1. For instance, as I mentioned above, CMA7 has been replaced by CMA58 which, in paragraph 3.7 (page 9), refers to the ASA as being:

“…suitable in principle to act as ‘established means’…”

What does ‘suitable in principle’ mean?

The CMA has confirmed that paragraph 3.7 of CMA58:

“…is intended to be a broader summary of the principles, which are still laid out in our earlier publications covering the subject, such as CMA7. This is a change in presentation rather than a change in policy…”

Paragraphs 4.34 to 4.36 (“Principle 3”) of CMA7 (page 20) stipulate the “Essential qualities/systems” that the CMA requires its “compliance partners” to “demonstrate” including (among other things) that “there is an appropriate degree of independence of governance”, “there is an appropriate degree of objectivity of governance”, and that “it has regard for the principles of better regulation and the Human Rights Act with regard to the rights of consumers and traders/businesses”.

If the ASA and/or the TSS do not ‘demonstrate’ all or any of these ‘essential qualities / systems’ then, it is suggested, the CMA should intervene.

Furthermore, paragraph 4.38 of CMA7 states that the CMA:

“…will always retain its discretion to refer or not to refer to a compliance partner and whether to intervene in any case following referral…”

2. The CMA, as the UK’s primary competition and consumer authority, could be asked to intervene and establish whether or not the ASA (when it investigates and adjudicates upon advertising published by CAM practitioners) and the TSS (LBC) (when it acts as the ASA’s “legal backstop” and enforcer) fully and properly comply with its guidance on consumer protection/enforcement and fair competition, particularly as defined in CMA58.

Such intervention could establish whether or not the ASA operates with an appropriate degree of consistency and independence and objectivity in its governance and with proper regard to the principles of better regulation and the Human Rights Act 1998. This is especially important because, as the ASA is not a public sector organisation, it is not subject to the Legislative and Regulatory Reform Act 2006 and the Regulators Code made under that Act. Nor is it subject to the Freedom of Information Act 2000 or to the jurisdiction of the Parliamentary and Health Service Ombudsman.

3. The CMA could scrutinise the accountability of the ASA with regard to the principles of ‘Natural Justice’, ‘Good Regulation’, ‘Best Practice’ and ‘Transparency’ and in relation to the following matters raised by Baroness Deech in her address to the House of Lords:

“…The ASA suffers from all those defects: the control of the funders over appointment and setting standards. The ASA is not a government agency, not elected, and not overseen. It is funded by the advertising industry through the levy collected by the Advertising Standards Board of Finance (ASBOF). The chair of the ASA is appointed by ASBOF. The council members appear to be appointed by the chair alone, and the fact that the majority are not connected with the advertising industry does not make the ASA independent in the regulatory sense. The codes of practice are written by an industry committee, the Committee of Advertising Practice – CAP - which shares an executive with the ASA.

“Therefore the code-writing, administration, appointments and funding are entirely in the hands of the advertising industry. There is no external input at all, save for the very tiny consumer input, the Advertising Advisory Committee, which gives advice only to the Broadcasting Committee of Advertising Practice, and can be ignored after the advice is received. The chair and council members of the ASA double up as the company directors of the ASA with “oversight”. The ASA is not subject to freedom of information requests. Three industry panels advise the CAP and the ASA. It is not accountable to anyone outside the industry—indeed, it is hermetically sealed…The time has come, after 50 years of lagging behind best practice in regulation, to bring the ASA into the 21st century…”

4. The above matters could also be placed on the agendas of the CCG, the CCP and the Consumer Enforcement Forum of Competent Authorities all of which, in one way or another, claim to supervise the standard of consumer protection and enforcement for the benefit of both consumers and businesses.

5. In Section 2.2 of CMA58 (page 4), the CMA claims its consumer protection work supports competition including, in particular, by:

“…Enabling consumers to make well-informed choices, which reward those firms that best satisfy their needs…”

Arguably, the freedom to practise and to receive CAM and thereby to provide CAM patients with ‘well-informed choices’ and to ‘reward’ those CAM practitioners that best ‘satisfy their needs’, is a market-wide consumer/competition matter that deserves the scrutiny and support of the CMA.

Scrutinising the Transparency of the ASA

On its website (Transparency), the ASA confirms that neither it nor the Committee of Advertising Practice (CAP) or the Broadcast Committee of Advertising practice (BCAP) are designated “public authorities” for the purposes of the Freedom of Information Act 2000 but that it is committed to operating as a transparent organisation further to which it will voluntarily publish some information and also consider requests for unpublished information to be disclosed (Note: my bolding of text).

In her speech to the House of Lords, Baroness Deech observes:

“…If the ASA observed the rules of natural justice and gave adequate reasons, and treated both sides equally, there might be trust, but more often than not the reasoning of the rulings are guesswork and subjective…there is a lack of consistency in judgements. Some take an impressionistic line; others are more objective with scientific input, but only a handful of experts are listed on the ASA’s website and there are no guidelines on whether an expert is going to be called in on the scientific or political matter under review…”

Further on in that debate, Lord Palmer of Childs Hill adds:

“…The ASA is not subject to requests under freedom of information, which it would be in another guise. What is required is: governance by a board mainly from outside the industry; an appeal system; and – dare I mention it? –transparency. This could be achieved at the same cost by a statutory or consumer-led body funded by a levy on members. In this case, it is funded by a levy on members on a board that is self-regulated and which is not what we should be aiming for in this century…”

Scrutinising the ASA’s response to criticism

During the House of Commons adjournment debate on 23^rd May 2016, the Government’s Minister for Culture and the Digital Economy (Mr Edward Vaizey) commented as follows with regard to the ASA:

“…I hope that the ASA will…take on practical suggestions as to how it can improve its process…”;

“…I hope that it will sit down…to talk through how it can increase transparency in order to embed greater trust…”;

“…my strong advice to the ASA is that…it should listen well…”;

“…as you can imagine, Mr Speaker, we therefore take the concerns raised by Hon. Members in tonight’s debate very seriously indeed…”;

“…I hope that the ASA will take their points on board…and reflect on whether it can take forward some of the judiciously put critiques of how it has worked…”

These statements could be interpreted as ministerial challenges to the ASA. Enquiries could now be made of those MPs present at the debate about the ASA’s response to these statements in so far as they related to their constituents’ complaints about the ASA. If the ASA’s response has been unsatisfactory, then this provides additional evidence with which to challenge its activities and of the need for change to its procedures.

The ASA and conflicts of interest

On its website (“Our funding”),[18] the ASA states that it is funded by advertisers and that its independence is guaranteed by the commitment of those in the advertising industry. It confirms that it doesn’t know who is paying or how much is being paid and that, accordingly, its decisions are independent and unaffected by funding considerations.

It is arguable, however, that the ASA is not independent when the interests of advertisers funding it conflict with the practise and promotion of CAM.

For example, a conflict of interest could be especially prevalent in relation to advertising of the supply of goods (i.e. remedies) and services (i.e. CAM treatments) aimed at promoting health. It is accepted by many that the trading interests of the pharmaceutical industry can conflict with the professional practice and use of CAM. Logic dictates that the ASA must be aware that it is receiving very substantially more funding from advertisers in the pharmaceutical industry than it is receiving (if at all) from practitioners and promoters of CAM.

Such conflict of interest (together with other matters that I refer to above) have UK market-wide competition and consumer protection/enforcement implications that, I suggest, require the intervention and scrutiny of the CMA in its capacity as the UK’s primary competition and consumer Authority.

The ASA and Google

Arrangements made between the ASA and Google should be scrutinized and assessed by the CMA, particularly with regard to any purchase of Sponsored Advertising against the sites of CAM practitioners that are not compliant with ASA adjudications.

Proposals for Action by CAM Organizations, Regulators, Practitioners and Patients

To resolve to:

1. Work together to support the implementation and funding of the strategies proposed above;
2. Obtain (i.e. from their practitioner members who have been unfairly dealt with by either or both the ASA/TSS) and compile a dossier of evidence in support of these strategies;
3. Obtain evidence from practitioners, patients and organisations (that use or promote CAM), applying a process designed to elicit information capable of being used to produce high-quality, unbiased, academic, peer-reviewed research (e.g. to evaluate the use, outcomes, healthcare benefits and evidence-base of CAM) and to resolve that such research can be used to support the above strategies;
4. With appropriate authority and consent, share evidence and legal advice;
5. Use the dossier of evidence, to lobby and to initiate an intervention by the CMA and/or other appropriate authorities to facilitate a fair and accountable process by which the ASA and the TSS review advertising by practitioners so as to enable a fair and competitive market for CAM, its practitioners and organisations using or promoting CAM;
6. Form (or adopt), fund (including for the cost of premiums payable for insurance indemnifying against all appropriate risks, including litigation) and generally authorise a representative body (“CAM Advertising Group”) to pursue the above strategies on behalf of named CAM practitioners, organisations and regulators;
7. Either before or after implementation of the strategies, commence an informed media campaign (including a high-quality website and social media facilities) to promote the health benefits, evidence-base and professional status of CAM and its practitioners and to counter media and online campaigns pursued by sceptics;
8. Recruit a panel of articulate, well-prepared and expert representatives from both CAM and conventional practice and/or academia and from organisations that regulate, use or support CAM, who may be called upon to contribute to the media campaign and to present to all forms of media at short notice;
9. Generally ensure that the media campaign informs consumer organisations, including the ASA/TSS/CMA, of the effectiveness and probity of CAM and its practitioners.

Conclusion

In my written evidence (BRE0004) to The Health Committee’s Eighth Report of Session 2016-17, Brexit and Health and Social care – People & Process, which was published on Friday 28^th April 2017 (HC 640) [27], I submitted as follows:

“…The Committee will please note that professionally trained, qualified, regulated (including by regulatory organisations recognised by the Department of Health) and insured CAM practitioners predominantly practise alone, or in association with other CAM practitioners in Health Centres, as small or micro business owners. They also practise, very often on a voluntary basis, within the National Health Service (NHS). As is the case with many vocational professions, CAM practitioners generally provide their treatments (talking and non-talking) and their experience for a modest fee, notwithstanding that such treatments present significant savings to the NHS and other public sector budgets…”

The major contribution by CAM practitioners and by supporting organisations to the UK Health & Social care sectors should not be underestimated. Accordingly, the regulation of advertising of CAM must be informed, proportionate and responsible as well as being sympathetic to the needs and requirements of its practitioners and patients. In the interests of justice and of fairness (with regard to consumer protection/enforcement and competition) the regulatory and compliance criteria applied by the ASA and its compliance partners must recognise and underpin the freedom to practise and to receive CAM.

Richard Eaton LL.B

Sources

1. https://www.asa.org.uk/
2. http://anhinternational.org/ ; http://anhinternational.org/?s=ASA
3. http://www.grcct.org/
4. http://www.grcct.org/advertising-certification/
5. http://www.cnhc.org.uk/
6. http://www.cnhc.org.uk/sites/default/files/Downloads/Advertising-guidance.pdf (pdf)
7. http://www.fht.org.uk/article/advertising-and-the-cap-code (pdf)
8. https://hansard.parliament.uk/Lords/2015-10-29/debates/15102957000848/AdvertisingStandardsAuthority
9. https://hansard.parliament.uk/commons/2016-05-23/debates/16052325000002/AdvertisingStandardsAuthority
10. http://www.positivehealth.com/article/complementary-medicine/your-cam-practice-and-the-advertising-standards-authority-ltd-time-to-take-action
11. CMA7: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/288624/CMA7_Consumer_Protection_guidance.pdf (pdf)
12. CMA58: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/546521/cma58-consumer-protection-enforcement-guidance.pdf (pdf)
13. http://www.homeopathy-soh.org/
14. http://www.professionalstandards.org.uk/what-we-do/accredited-registers/find-a-register/detail/society-of-homeopaths
15. https://www.asa.org.uk/about-asa-and-cap/the-work-we-do/our-proactive-work.html
16. https://www.asa.org.uk/asset/447A954A-A36D-4FEE-A9DCCC72DB35E66F/ (pdf)
17. https://www.asa.org.uk/codes-and-rulings/sanctions.html
18. https://www.asa.org.uk/about-asa-and-cap/about-regulation/our-funding.html
19. https://www.gov.uk/government/organisations/competition-and-markets-authority
20. https://www.asa.org.uk/asset/9C523FF7-FEE8-44A2-B4C77CAC219DCEAE/ (pdf)
21. https://www.asa.org.uk/about-asa-and-cap/about-regulation/about-the-asa-and-cap.html
22. https://www.asa.org.uk/transparency/who-we-are-and-what-we-do.html#
23. https://www.ombudsman.org.uk/making-complaint/if-we-cant-help/television-radio-newspapers-and-advertising
24. https://www.ombudsman.org.uk/ 
25. http://www.lgo.org.uk/make-a-complaint/fact-sheets/other-topics/trading-standards
26. https://www.ombudsman.org.uk/making-complaint/what-we-can-and-cant-help
27. https://www.publications.parliament.uk/pa/cm201617/cmselect/cmhealth/640/64002.htm; http://data.parliament.uk/WrittenEvidence/CommitteeEvidence.svc/EvidenceDocument/Health/Brexit%20and%20health%20and%20social%20care/written/40386.html (pdf)
28. http://www.lgo.org.uk/information-centre/staff-guidance/guidance-on-jurisdiction (pdf)