Risk, regulation and the growing marginalisation of CAM

doi:10.1016/j.ctcp.2009.11.003

Complementary Therapies in Clinical Practice

Volume 16, Issue 1, February 2010, Pages 1-2

https://doi.org/10.1016/j.ctcp.2009.11.003 Get rights and content

Introduction

This editorial reviews the status of regulation of CAM and conventional medicine in the UK. In the statutory sector, a major review of regulation followed the publication of the Shipman Inquiry Report,¹ which was commissioned in response to the serial murder of over two hundred patients by a UK General Practitioner. Regulatory reforms have not been extended to the CAM sector. Significantly, with statutory regulation for acupuncture, TCM and herbal medicine delayed by a further round of consultation,² and with sign up to the Complementary and Natural Healthcare Council (CNHC) sluggish, CAM patients in the UK continue to be denied the protections offered by a formal system of regulation. Post-Shipman regulatory reforms could have transformed the entire sector by creating an umbrella structure to regulate all forms of healthcare, including CAM. But the UK Government rejected this model, bowing to pressure to keep the existing number of statutory regulators, albeit with increased levels of Parliamentary scrutiny. Critically, further protections come in the form of five-yearly revalidation for mainstream professionals, an ‘MOT’ to ensure that registered professionals keep their skills up-to-date. Unless CAM professions put their weight behind the recently formed Complementary and Natural Healthcare Council (CNHC), the only CAM regulatory body endorsed by the UK Government, the gulf between conventional health professionals and CAM practitioners will continue to widen, with knock on implications for public protection, National Health Service (NHS) commissioning and CAM's ability to contribute to wider healthcare agendas.

Section snippets

Trust, safety and assurance – for regulated health professions

The Shipman report and subsequent reviews of medical and non-medical regulation provided an historic opportunity to overhaul professional regulation in the UK. Two obvious arguments were raised, but largely ignored – firstly, that regulation is a poor deterrent against determined mass murderers, and secondly, that non-medical health professions were being made to pay the price for yet another medical scandal. Whilst bowing to pressure to retain the existing number of regulators, the Government,

Why regulation needs to be based on assessment of risk

The White Paper did not seize the opportunity to alter fundamentally the structure of professional regulation in the UK, nor did it redefine the need for regulation on clearly spelt out principles of risk. Despite rhetoric that regulation needs to be risk-based and proportionate,⁴ the failure, to date, to set out criteria for judging risk means that there are still anomalies as to which professions are statutorily regulated and which are not. Risk in the context of the House of Lords Select

Why CAM practitioners should seek registration with the CNHC

The current Government has been anxious to ensure that regulation is ‘light touch’ as far as possible.⁴ In the context of CAM, the Government has thrown its weight fully behind the creation of the Complementary and Natural Healthcare Council (www.cnhc.org.uk). It has made it clear that it regards the CNHC as the most suitable vehicle for the regulation of potentially a wide number of CAM professions, and has matched its support with funding.

The success of the CNHC depends, critically, on it

Why leadership is required to prevent CAM being marginalised

Professional associations need to demonstrate leadership and recognise that the need for public protection in CAM serves not only patients' interests, but also has political advantages which CAM professions need to pursue in the UK's current political and economic climate. Government support of CNHC is critical to the commissioning debate, and whilst registration doesn't guarantee NHS contracts, absence of registration will probably thwart any such ambition. CNHC is also the only standards

References (6)

Shipman Inquiry's fifth report. Safeguarding patients: lessons from the past, proposals for the future. Cm 6394 [TSO,...
UK Department of Health
A joint consultation on the report to ministers from the DH Steering Group on the statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK
(2009)
UK Department of Health
Trust, assurance and safety – the regulation of health professionals in the 21st century
(2007)

There are more references available in the full text version of this article.

Cited by (3)

Protecting patients through professional regulation: Audit of registration of nutritional therapy practitioners via a grandparenting process
2014, European Journal of Integrative Medicine
Citation Excerpt :
More recently nutritional therapy, massage therapy, reflexology and aromatherapy also developed their individual voluntary regulators. Representatives of several of these CAM professions then cooperated to develop a UK federal voluntary regulator, which was established in 2009 as the Complementary and Natural Healthcare Council (CNHC), with UK Department of Health funding [7]. This article describes the registration scheme developed for nutritional therapy before the establishment of the CNHC.
Registration of practitioners of complementary and alternative medicine (CAM) has been proposed as an important measure towards assuring the safety of individuals choosing to use therapies that are outside the practice of mainstream medicine. The Nutritional Therapy Council, an independent body established by a group of professional associations representing nutritional therapists, with funding from the UK Department of Heath, launched a voluntary national registration scheme in 2006 for practitioners of nutritional therapy, a bioscience-based branch of CAM.
Registrant data for 2006–2009 were audited for age, gender, years in practice, route of registration according to qualification compared to National Occupational Standards. Records were audited for patient safety complaints.
Audit of the scheme demonstrated that the majority of applicants had formal training to the level of the NOS, most had been in practice for less than 10 years and the cohort was predominantly female, with a mean age of 45 years. The small number of unsuccessful applications for registration may demonstrate that a high degree of self-selection of applicants operated. No complaints against practitioners were received during the duration of the scheme.
This practitioner registration scheme enabled over 600 Nutritional Therapy practitioners to demonstrate alignment to the National Occupational Standards (NOS). Safe, effective, lawful practice was demonstrated through verified qualification, or by assessment of a portfolio of evidence, including evidence-based clinical case studies. Professional registration has an important role in patient safety by providing potential users of complementary medicine with information on qualified competent practitioners.
This article belongs to the Special Issue: Clinical Guidelines.
Aspirations, integration and the politics of regulation in the UK, past and future
2015, Routledge Handbook of Complementary and Alternative Medicine: Perspectives from Social Science and Law
Patients' expectations of private osteopathic care in the UK: A national survey of patients
2013, BMC Complementary and Alternative Medicine

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Guest EditorialRisk, regulation and the growing marginalisation of CAM

Introduction

Section snippets

Trust, safety and assurance – for regulated health professions

Why regulation needs to be based on assessment of risk

Why CAM practitioners should seek registration with the CNHC

Why leadership is required to prevent CAM being marginalised

A joint consultation on the report to ministers from the DH Steering Group on the statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK

Trust, assurance and safety – the regulation of health professionals in the 21st century

Guest Editorial
Risk, regulation and the growing marginalisation of CAM