‘Free and impartial’ addiction helplines paid secret commissions by rehab clinics
Helplines claiming to provide “free” and “unbiased” addiction care have been reprimanded by the advertising watchdog for hiding the fact they receive thousands in commissions from private rehabilitation clinics.
Amid record drug death figures and high demand for services, one website promises ‘free, impartial, expert’ advice for those trying to find the best treatment.
Another “advice service”, which ranks high in Google search results, said it will help people “choose the best drug and alcohol rehab for you”. “We will advise you on the best options for your circumstances,” it claimed.
But while they look like nonprofits and claim to provide unbiased help, the websites are a front for brokers who refer people to partner facilities in exchange for a referral fee.
Last week, the Advertising Standards Authority (ASA) issued rulings against seven companies, accusing them of misleading vulnerable people about the true nature of their business.
The ASA said six brokers – Which rehabilitation?, Help 4 Addiction, Rehabs.UK, Rehabilitation guide, Action Rehab And Serenity Addiction Centers – had posed as direct practitioners or impartial counseling services, when they were primarily referral companies earning commissions from partner facilities.
A seventh service, UK Addiction Treatment (Ukat), a chain of “200 CQC (Care Quality Commission) regulated detox and rehabilitation beds across the UK” was found in breach of the advertising code for running a directory website, UK Rehab, which failed to make it clear that she owned the clinics to which she referred people.
The UK Rehab website claimed it had “no preference for one rehabilitation clinic over another”, when in reality it was “primarily a referral service for Ukat facilities”, the ASA said.
Ukat denied misleading people and disputed the regulator’s findings.
Services were also reprimanded for misleadingly using the logos of the Care Quality Commission, NHS or other government bodies to falsely suggest they were affiliated, and for using terms such as ‘addiction counsellors’ or ‘specialists’ to imply that call handlers were healthcare workers when they did so. not.
Which rehabilitation? broke the advertising rules by “promptly making it clear that it was primarily a referral company that received commission for placements at partner rehabilitation facilities,” and also broke the rules by displaying CQC’s name and logo on its homepage with the words “regulated by ” .
The ASA said this would lead people to believe the service was CQC regulated when it was not.
The rulings provide insight into the lucrative, loosely regulated world of patient mediation – a little-known sector that falls into a regulatory gray area because it is not technically a healthcare service and therefore not regulated by the CQC.
Brokers deny that their model is exploitative, arguing that they help patients access life-saving support while supporting smaller rehabilitation centers that would otherwise struggle to compete with high-street chains.
But Dominic McCann, director of Castle Craig, a private rehabilitation center near Edinburgh, said it was a “social evil” and patients often had “no idea” the money was changing hands.
He said his company stopped using brokers after realizing “very high-handed practices were going on.”
“They called our finance department and demanded early payment. They want their commission for the entire length of stay up front, even though people might drop out and want a refund,” he said. “And we were getting all these emails from the brokers with people’s names, saying, ‘If this person writes to you, he’s ours… And we want our commission.’” Depending on the facility, he said patients might would pay between £10,000 and £30,000 for a 28 day private rehabilitation stay, of which the agent could take 20%-40%. “What is going on is a manipulation of a commercial process to enrich certain people who are making money off naive, vulnerable people,” he added. “It is deeply cynical and damaging to the reputation of an entire sector that should be based on integrity.” Professor Harry Sumnall of Liverpool John Moores University, an expert on substance abuse who has advised the government on drug policy, said it was unclear how brokers made decisions about where to refer patients “and whether this was in the best interest of the questioners is done. ”.
Although the brokers did not charge patients upfront, he said commission payments could drive up prices for private rehabilitation centers in general.
The Ethical Marketing Campaign for Addiction Treatment – a coalition of addiction professionals, academics and private providers who complained to the ASA about patient brokers – said it had heard of people being ‘referred to rehab facilities that are not right for them’ because brokers were incentivized on a commission basis.
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“Not all rehabs use patient brokers, but many of them are over the edge because they can’t afford to advertise,” says campaign coordinator Evelyn McKechnie. She called the ASA’s crackdown “unprecedented” but said the rulings were the “tip of the iceberg” and that the problems were systemic.
The companies censured by the ASA have now been ordered to review their advertising practices, clarify their business models and commission structure, and remove false claims about direct services and relationships.
Most made changes after being contacted by the regulator, but the ASA said Action Rehab did not respond.
The brokers have been contacted by the broker for comment Observerbut Action Rehab, Rehab Guide and Serenity Addiction Centers did not respond.
Rehabs.UK said it had a ‘robust triage system’ that provided ‘impartial and personalized’ recommendations to clients based on ‘location, budget and treatment ethos’, and that it always put care before cost.
Ukat said it disagreed with the ASA’s ruling and claimed the complaint to the watchdog had been made in bad faith by competitors.
Daniel Gerrard, CEO of Ukat, said the UK Rehab website is an “online directory of both free and private addiction treatment options”. “The suggestion that the Ukat group misled customers is untrue and this has been reported to the ASA,” he said.
Which rehabilitation? said it has never claimed to be CQC regulated, only that its partner rehabs “adhere to CQC standards”, but that it has nevertheless updated its website. It said it was a free service that had “helped hundreds of people” and that commission payments did not increase the price or impact the commitment to putting people in the “best and most appropriate care”.
Jo Poots, head of complaints at the ASA, said: “These statements send a clear message to operators in this sector. We will continue to monitor this area closely and will not hesitate to take action against businesses that break the rules.”
The Department of Health and Social Care said “attempts to exploit people with addictions” were “reprehensible”.
A spokesperson said: “Free drug and alcohol treatment is available in every part of the country and we urge everyone to visit the NHS drug addiction website.” The CQC said it could take legal action against companies that misuse the logo. Google said it would remove search results from companies that “misrepresent their business practices.”
Nicholas Conn, CEO of Help 4 Addiction, which broke advertising rules by not making it clear it was a referral service that earned commission, said the ASA’s crackdown was “great” and would lead to more transparency.
But he rejected wider criticism of the patient mediation model, arguing that referral agents “provide a very valuable service” and that Help 4 Addiction had supported “God knows how many people”. He said his company never forced anything on anyone, that the maximum commission was 30% and that when anyone asked, the agency said, “Yes, we’ll get money if you go to rehab.” We never lie to anyone.”
“We are not bad people,” he said. “We have to make money, just like a doctor has to make money to help people. We have a service to run. I think it’s fair that we get paid.”