Belgium
Summary (ref 1)
In Belgium treatment is restricted to legally regulated personnel. The practise of homeopathy, chiropractics, osteopathy and acupuncture is regulated.
Professionals and non-professionals
Legally regulated personnel
Until 1999 the practise of CAM was restricted to physicians, and there were no legal requirements or specific training regarding these techniques. The Order of Physicians promulgated a Code of Professional Ethics that practically forbade the use of CAM. By stating" to diagnose and to establish or pursue a treatment, doctors have to provide attentive and conscientious care in accordance with the present and acquired knowledge of science". Even though this code was not a law, provincial councils applied it. On these grounds, the disciplinary authorities set limitations on therapeutic freedom.
In 1999 the Government of Belgium adopted a law concerning the use of CAM (ref 2). The government considered that the population should have freedom of choice concerning therapeutic treatments. However, methods applied are required to be safe, structured and controlled. The law recognises the techniques of homeopathy, chiropractics, osteopathy, and acupuncture and provides for the recognition of other CAM techniques to come. The law provides a structure and a procedure that may lead to the regulation of a CAM therapy, and to the individual registration of practitioners of CAM. It must be mentioned that this law will only take effect after a series of implementing orders have been engaged. The ministry of the federal public service ‘Health, Food Chain Safety and Environment’ intends to do so. From 1999 persons who comply with the law’s conditions and its implementing orders will be able to obtain a license for a recognised technique. According this law the practitioners do not have to be allopathic health personnel. However, it will be forbidden to practise a regulated CAM therapy without a license (individual registration).
Supervising regulated personnel
Commission
The law also foresees the establishment of a commission to advise the government on the practise of CAM regulation. In this commission the representatives of the Faculties of Medicine and the representatives of the different disciplines of CAM are equally represented. This commission will advise with regard to insurance for professionals (including minimum coverage), membership in recognised professional organisations, a system of registration, regulation of advertising and a list of forbidden acts for non-physician practitioners. The commission is also designated to advise the Government on the registration of a CAM therapy and on the conditions for individual registration.
Chambers
A chamber will be established for each discipline of non-conventional medicine. These chambers will represent the non-conventional medicine concerned in the advisory commission. Each chamber will advise on the registration of the practise it’s representing and on a system of individual registration for the practise concerned. Each chamber will also advise the government on the organisation of a peer-review system and a code of professional ethics. Moreover each chamber will advise the minister on licensing and on the withdrawal of a given license. In this way it will be possible to sanction those practitioners who do not follow the adopted regulation.
Not anybody may treat
Practising medical acts without a legal regulation is an offence.
Reimbursement
The Belgian social security system does not officially reimburse CAM. However, allopathic physicians using CAM may assure their patients that at least part of their fees will be reimbursed. There are private insurance companies that partly reimburse chiropractics, acupuncture, osteopathic, and homeopathic remedies.
References
1. Reference for the chapter where nothing else is noted: Legal Department, FOD Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu Hoofdbestuur Directoraat-General Basisgezondheitszorg, 08.07.05.
2. Law of 1999 on non-conventional medical practises in Belgium. Text in French.
