Spain
(ref 1)
Summary
In Spain treatment is restricted to legally regulated personnel. CAM is not regulated.
Professionals and non-professionals
Legally regulated personnel
According to the general health regulations only authorised health professionals are allowed to perform medical acts on patients, and according to the Royal Decree 3166/1966, licensed paramedics (odontologists, psychologists, nurses, physiotherapists) are allowed to perform medical acts only under the supervision of an allopathic physician.
Law 1277/2003 regulates the health services and establishments where such services are provided (ref 2). The law only recognises conventional therapies that are scientifically recognised, but accepts the physicians’ use of natural, homeopathic and similar therapies that have shown efficacy and are secure. However, according to the Spanish Code of Professional Ethics of 1990, non-scientifically proven means as well as the simulation of the making of a diagnosis, or the application of therapeutic treatments, are prohibited. Complementary medicines are not included within the Royal Decree 127/1984 regarding medical specialities. There are no specific legal regulations of CAM in the country.
Supervising regulated health personnel
The authority has delegated to The Council of Medical Colleges the supervising of physicians. The council may, in serious matters, withdraw the authorisation of a physician if the law is violated.
Not anybody may treat
The practise of medicine without a legal qualification is an offence. The illegal practise of medicine is regulated by the Penal Code stating that if persons without relevant academic certificates practise acts specific to a profession, they risk imprisonment for a period up to twelve months. This includes all intrusions made by non-allopathic providers in the field of medicine. However, providing CAM is not illegal when referred to as counselling service not intruding health service. The state authorities are tolerant to that kind of CAM providing.
Reimbursement
Public reimbursement is not available for CAM treatment. A few private insurance companies provide coverage for CAM.
References
1. Reference where nothing else is noted: Maddalena S. The legal status of complementary medicines in Europe. Berne: Universitè de Neuchâtel, Stæmpfli Publisher Ltd. 1999.
2. Information given by Nuria Borras, nborras@clinic.ub.es
