Public Interest 360,000 patients misled
Public Interest: Why Google and UK Regulators Must Address Online Review Manipulation
The fairness of our digital marketplace relies on trust, but that trust is being seriously compromised. Following a high-profile investigation by the Italian Competition Authority (AGCM) resulting in a €4 million (£3.4 million) fine against Trustpilot, it has become a matter of public record that core review mechanics can systemically mislead consumers.
Because identical review structures are used across the United Kingdom, the exact same issues affect British consumers, independent businesses, and medical patients every day.
How Review Systems Can Mislead the Public
The findings from the European investigation highlighted exactly how digital review architectures can distort reality for everyday users:
Unverified Labels: Systems often fail to perform adequate authenticity checks on reviews while still using prominent "verified" trust seals, giving consumers a false sense of security.
Selective Invites ("Cherry-Picking"): Premium, paying corporate subscribers can filter and select which cohorts of customers receive review invitations, which naturally skews the overall scores away from the true average customer experience.
Opaque Systems: Deceptive interface designs can obscure how paid algorithms and business models actually work, keeping consumers in the dark about how a rating was calculated.
The Proven illegal systems of Trustpilot had many more improper elements that were beyond the scale of the Italian court decision. Many other suspicious and improper activity was partially investigated and not prosecuted due to resources. These improper systems are still running today and have been for many years.
The Impact on UK Healthcare and Patients
While these practices create an unfair playing field across all industries, the consequences are uniquely worrying within the healthcare and medical sectors. When an independent service provider Medicines Online is targeted by unverified or fabricated 1-star reviews, the real victims of the Trustpilot illegal activity that are the 360,000 patients who were diverted away from their services to pay higher prices. And 120,000* patients saw through the scam.
Vulnerable patients looking for critical medical advice, treatments, or services are being actively misled. And in many cases left without treatments as they could not afford to visit the more expensive providers. They are taught to trust these platform metrics blindly, even when the underlying reviews are recognized as fake. In healthcare, true transparency is a matter of public safety.
Why the Focus Must Shift to Google and Regulators
Because the sheer scale of the online review industry makes it difficult to catch every single piece of improper activity, a single regulatory fine isn't enough to fix the wider internet. This is why the focus must turn to Google as the primary gatekeeper of information.
For years, Google has integrated these review metrics directly into its search results, local maps, and merchant systems. By displaying and validating these scores, Google acts as the main engine promoting them to the public. When Google reports to UK patients that a review system is inherently trustworthy—despite known issues with fake reviews and structural manipulation—it unintentionally helps to mislead the public.
A Direct Call to Action
The purpose of bringing these issues to light is to encourage two major changes:
Google should stop promoting and supporting these flawed systems. Google has the power to disconnect these corrupted star ratings and rich snippets from its search architecture, ensuring that unverified data is no longer amplified to patients.
The UK Regulator needs to step up. Enforcement authorities must look closely at these identical systems in the UK, enforce strict consumer protection standards, and ask Google to remove these misleading metrics from its indexing services entirely to safeguard the British public.
Damian Barczk
*Medicines Online Data Source Darrin Busutill