United Kingdom
(ref 1)
Summary
In Great Britain anybody is allowed to treat but law restricts the scope of their activities. Homeopathy is regulated and registered "Osteopaths" and "Chiropractors" are given legally protected titles. A voluntary official registration scheme for those who practise CAM has been established.
Professionals and non-professionals
Legally regulated personnel
The Medical Act of 1983 regulated the authorisation and registration of health personnel. By delegation from the authorities, the registration is being performed by the professionals’ own organisations. Only medical practitioners holding a university degree in medicine are officially allowed to practise medicine. However, the law tolerates alternative practitioners without a medical degree.
The Medical Act of 1983 does not regulate which forms of therapies registered doctors may practise. Thus, there is no restriction on medical practitioners applying CAM if they have the required skills or qualifications to practise. This means that CAM is considered responsible professional conduct when given by duly qualified medical practitioners. If physicians refer patients to non-allopathic providers during the period of treatment, they keep the clinical responsibility of their patients.
In 1950, the government gave official recognition to homeopathy in the Faculty of Homeopathic Act (ref 2) . This act empowers the Faculty of Homeopathic to train, examine, and confer diplomas in homeopathy to allopathic physicians and other statutory recognised health professionals.
According to the health acts, all authorised health personnel (pharmacists, doctors, physiotherapists, dentists, midwives, nurses, and others) are supervised. By delegation from the authorities, the control of personnel is ensured by the professionals’ own organisations. The government designates the Professional Conduct Committee of every professional organisation as disciplinary authorities. They may admonish, suspend and/or dismiss practitioners.
Anybody may treat-
But some treatments are restricted to authorised health personnel
The right to practise without formal recognition is established under British Common Law. CAM providers are allowed to practise medicine regardless of their training and without previous authorisation, providing that they do not infringe the Medical Act of 1983. Despite the principle of freedom to carry out medical acts, this independence is limited by some legal controls. Only registered doctors may:
- Treat cancer, diabetes, epilepsy, glaucoma and tuberculosis
- Prescribe controlled drugs
- Perform specific medical acts such as abortion or treat venereal diseases
(The Cancer Act of 1939, The Venereal Disease Act of 1917)
If acts by CAM providers result in maltreatment, they may be prosecuted under the penal law. Currently, individuals are protected under UK law from incompetence or unskilled therapists by the tort-based common law of negligence.
Statutory registration of CAM providers
The Osteopath Act of 1993 and Chiropractor Act of 1994 are regulating the registration of osteopathy and chiropractics. Registration and supervision are being ensured by the professionals’ own organisations. "Registered" practitioners of these two professions have special rights, including the right to use the title of "Chiropractor" or "Osteopath". Generally, in order to become a member of professional organisations, CAM providers have to be covered by insurance and have to adhere to a Code of Professional Ethics.
The Professional Conduct Committee in every professional organisation is supervising its members. The members are supposed to provide responsible professional conduct and practise only when duly qualified. The sanctions available to the Professional Conduct Committee are to admonish, suspend and/or dismiss practitioners.
In 2003, two reports were published making recommendations for the statutory regulation of herbal practitioners and acupuncturists working in the United Kingdom (ref 3). In particular, in the interests of the patient safety and choice, it refers to the need for professional herbalists and acupuncturists to be regulated as soon as possible. Regulation will safeguard the quality of treatment and offer a system of sanctions in case of irresponsible professional conduct. By the end of 2005, the UK Department of Health expects that there will be statutory regulation of herbalists and acupuncturists (ref 4).
Reimbursement
In general, public reimbursement is not available for complementary/alternative medicine, but alternative treatments are available in some hospitals. Private Insurance offers coverage of certain types of complementary medicine when provided by medical qualified personnel.
References
1. Referee for this chapter where nothing else is stated: Maddalena S. The legal status of complementary medicines in Europe. Berne: Universitè de Neuchâtel, Stæmpfli Publisher Ltd. 1999.
2. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, (document WHO/EDM/TRM/2001.2). Geneva: World Health Organization, 2001.
3. Editorial. The journal of alternative and complementary medicine. 2003: Vol 9, no 6.
