Switzerland
(ref 1)
Summary
In Switzerland treatment is restricted to legally regulated personnel. Chiropractics is regulated in all 26 cantons.
Professionals and non-professionals
Legally regulated personnel
In Switzerland every canton (26 cantons) is in charge of their own public health system and is free to regulate the medical practise, as they want. There is no national regulation of CAM. Some academic health professions (physicians, pharmacists, psychologists, ect.) are regulated on national level. Chiropractors are regulated by all the cantons, but the government is planning a national regulation in the near future (ref 2) . Osteopaths are regulated in 8 cantons (ref 3). All persons legally providing health care may apply homeopathy according to the standards of good medical practise. In some cantons those not medically qualified may practise homeopathy as well. In 1998, The National Medical Association recognised homeopathy and Chinese medicine (including acupuncture) as medical sub-specialities.
Anybody may not treat
In 15 cantons only authorised health personnel are allowed to give treatment to patients, but in some cantons there are exceptions to this general regulation, allowing definite CAM provided by non-physicians. Some cantons also have restrictions to the use of some techniques of CAM. The authorities in many of the cantons are relatively tolerant with regard to the practise of CAM providers.
In 11 cantons (mostly German speaking) only authorised health personnel and licensed personnel are allowed to give treatment to patients. The provider has to pass a state exam to obtain a licence from the state authorities. Most of the cantons also define specific medical acts that are reserved for physicians. Most often these are:
- treatment of communicable diseases,
- treatment of sexual diseases,
- practising surgery, or giving injections,
- providing care in obstetrics,
- prescribing drugs and medications.
The law restricts the scope of activities of licensed personnel, but there are no restrictions as to the use of CAM.
Reimbursement
(ref 4)
The law allows reimbursement for therapies whose efficacy is scientifically recognised. Since 1999 basic health insurance scheme has paid for five alternative treatments provided by qualified doctors, like homeopathy, Chinese medicine, acupuncture, anthroposophic medicine, neuraltherapy, and phytotherapy. To maintain the reimbursement for these therapies (except acupuncture) in the future, their efficacy and cost-effectiveness had to be proven by June 30, 2005. In June 2005 the interior ministry said the five therapies failed to meet the criteria on efficacy, suitability and cost-effectiveness laid down in Switzerland’s health insurance law, and therefore health insurance would stop paying for the treatment. Treatment by non-allopathic providers is not reimbursed.
Private insurance companies generally propose complementary health care policies including the coverage of 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. and Swiss Federal Office of Public Health, 12.08.05
2.http://www.bag.admin.ch/berufe/projektmed/gesetz/d/index.htm
3. Social and Health Directory, Norway. Report about Osteopathy, Naprapathy and Manuel therapy. Oslo 8. Mars 2005.
4. www.swissinfo Switzerland`s news and information platform. 03.06.05
