Norway
Summary
In Norway anybody is allowed to treat but law restricts the scope of their activities. Chiropractics is regulated. A voluntary official registration scheme for those who practice CAM has been established.
Professionals and non-professionals
Legally regulated personnel
The Health Personnel Act regulates the requirements for practising medicine and authorisation / licensing of health personnel (ref 1) . Chiropractic practitioners were authorised in 1988. According to The Supervision Act (ref 2), the authority (Board of Health) supervises health services and health care personnel and ensures fulfilment of laws and regulations. The Board of Health can withdraw the authorisation of health personnel if the law is violated. If the violation is serious, they may also ask the police to investigate the matter.
Anybody may treat-
But some treatments are restricted to regulated health personnel
CAM providers are allowed to practise alternative treatment regardless of their training and without previous authorisation, but some medical procedures and the treatment of some serious diseases are restricted to health personnel. CAM providers are, however, not recognised as official health care personnel, their titles are not protected, they are not integrated into the national health care system, and they are not under the supervision of the authorities.
A new law about alternative treatment was implemented 01.01.2004 (ref 3). The objective of this law is "to contribute to safety for the patients who seek and receive alternative treatment and to regulate the right to practise such treatment". The law makes the restrictions that health personnel only may practise the following specific procedures and treat the following diseases:
- Medical intervention or treatment that may entail a serious health hazard.
-
Treatment of communicable diseases that is hazardous to public health.
Non-health personnel may nevertheless administer treatment in cases where the sole purpose is to alleviate or moderate symptoms or consequences of the disease or disorder or side effects of given treatment or where the purpose is to strengthen the body’s immune system or its ability to heal itself. -
Treatment of serious diseases and disorders.
Non-health personnel may nevertheless administer treatment in cases where the sole purpose is to alleviate or moderate symptoms or consequences of the disease or disorder or side effects of given treatment or where the purpose is to strengthen the body’s immune system or its ability to heal itself.
The provision in the first paragraph does not apply if the treatment takes place in cooperation with or in consultation with the patient’s physician and the patient is of age and is entitled to consent to healthcare pursuant according to the Patient’s Rights Act. This also applies to other patients if the health service has no curative or palliative treatment to offer the patient.
The law contains a requirement of confidentiality concerning patient information, which is quite similar to the requirement in the Health Personnel Act.
According to the law covering alternative treatment, "any person who wilfully or through gross negligence infringes the provisions of the act or provisions issued in pursuance of the act, or who is an accessory thereto, may be punished by fines or by a term of imprisonment" but not for more than three months. This also concerns "non-health providers who by medical intervention or treatment wilfully or through gross negligence place a person’s life or health in serious danger, either by the treatment itself, or because the patient as a result of the treatment does not seek expert help". Public prosecution may be instituted. However, non-allopathic providers are only prosecuted for exposing patients to a provable danger, or causing them serious deterioration or death (ref 4).
Voluntary registration of CAM providers (ref 5)
The act regarding alternative treatment also imposes the government to establish a voluntary official registration scheme for those who practise CAM. The regulation of this register was implemented 1.01.2004. The objective of the regulation is to contribute to increase safeguarding of the patient and to ensure the rights of consumers who seek registered CAM providers. The regulation is also meant to contribute to trustworthy commercial conditions among the providers of alternative treatment. To be registered, the practitioner must have a membership in a practitioners’ organisation approved by the government and have a current insurance.
If a CAM provider violates the legal rules, the Board of Health or patients can ask the police to investigate the matter. As CAM providers are considered to be self-employed, the consumers’ authority supervises the law. If a CAM provider is "registered" according to the law, violation of the rules of the federation may exclude the person from membership in the federation.
The act regarding alternative treatment safeguards all patients concerning the area of confidentiality, and against being treated by unauthorised personnel, in cases of some restricted medical procedures and diseases. If the patient seeks a "registered" CAM provider, the safeguarding of the patient may extend to areas comparable to the legal regulation of authorised health personnel. The safeguarding depends on the requirements set by the authorities when approving a federation. Also, the legal code will protect the patients in serious matters.
Marketing
The law of alternative treatment also regulates the marketing of CAM providers. The law expresses that "persons providing alternative treatment may in marketing their activity only give an objective and factual description of the nature of their activity".
The Consumer Ombudsman (CO) is an independent administrative body with the responsibility of supervising measures in the market.
Reimbursement
Public reimbursement is not available for complementary/alternative medicine.
Norwegian Health Insurance offers private coverage of certain types of complementary medicine. The company has a connection to International Health Insurance, Denmark AS, which distributes insurance in several European countries. The insurance covers acupuncture performed by licensed medical doctors as a part of medical treatment.
References
1. Act of July 2nd 1999 No. 64 Relating to health personnel etc.
2. Act of March 30th 1984 No. 15 About supervision
3. Act of June 27th 2003 No. 64 About alternative treatment of illness etc.
Norwegian laws in English text: http://www.ub.uio.no/ujur/ulov/english.html
4. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, (document WHO/EDM/TRM/2001.2). Geneva: World Health Organization, 2001.
5. Forskrift om frivillig registrering for utøverer av alternative behandling. Departement of Health. Norway: 11 December 2003.
