Go directly to legislation of specific CAM therapies in The Netherlands:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) - Other treatments
The Netherlands was a founding member of the European Union (EU) in 1952 (11), and a founding member of the Council of Europe on 5 May 1949 (11).
The legal and regulatory status of CAM and CAM practices
In the Netherlands provision of alternative care is legal (283). Both medically and nonmedically qualified professionals are allowed to practise CAM (106, 284). By passing
amendments to the Individual Health Care Professions Act on 1.12.1997 (Beroepen in de
Individuele Gzondheidszorg), practice of medicine is open to all with some limitations; some procedures may be carried out only by categories of professional practitioners authorized to do so by law (see supervision below) (284).
“Professions can be regulated in two ways: by Act of Parliament (section 3 of the Individual Health Care Professions Act lays down rules governing eight) or by an Order in Council pursuant to an act (section 34 of the aforementioned legislation). Both regulations enable titles to be legally protected; the most important differences are that the government only maintains a register for the professions covered by section 3, and that the government regulates the disciplinary procedures applying to practitioners of these professions”(284).
The act introduced a system to protect the titles of a limited number of professional groups. Persons practising a regulated profession may use a professional title, protected under public law, if they are registered in the legal status register (284). They must meet a number of statutory requirements, the most important of which are of an educational nature (284).
The eight health professions regulated by Section 3 of the Individual Health Care Professions Act are: doctor, dentist, pharmacist, health care psychologist, psychotherapist, physiotherapist, midwife, nurse. The new registration and title protection of these professions started 1 December 1997. At the same time professions not governed by law but by an Order in Council (regulations based on section 34, applying mainly to paramedical professions) will likewise enjoy title protection (284).
The criteria applicable to a profession under section 34 are the need for public information (protected title), the need for a regulation to govern the independent carrying out of reserved procedures in practice, and the need for a legal regulation to govern training. he declaration of professional competence and registration of persons with foreign qualifications who wish to practise their profession in the Netherlands is regulated in the Individual Health Care Professions Act (284).
In 2008 the Minister of Health, Welfare and Sport announced that he intended to investigate a further regulation and restriction of alternative treatments (283, 285).
The governmental supervision of CAM Practices
According to the Individual Health Care Professions Act, the performance of certain medical procedures are limited to categories of professional practitioners authorized to do so by law (284). Performance of such a procedure by an unauthorized practitioner is a criminal offence.
The procedures specified are: surgical procedures, obstetric procedures, catheterizations and endoscopies, punctures and injections, general anaesthetics, procedures involving the use of radioactive substances and ionizing radiation, cardio version, defibrillation, electroconvulsive therapy, lithotripsy, artificial insemination (3).
The reimbursement status of CAM practices and medicinal products
A new health insurance system was introduced in 2006 (283). CAM treatments are not covered by basic health insurance, but health insurers cover alternative treatment as either additional “free” benefits or covered by complementary Voluntary Health Insurance (VHI) (283).
Acupuncture treatment, fees for consultation with an anthroposophic physician and anthroposophic medicines are partially covered by private insurance companies (106). Homeopathy treatment and homeopathic medicines are covered by private insurance companies (106). Chiropractic treatment is covered by private insurance if the chiropractoris connected with a professional body such as De Nederlandse Chiropractoren Associatie (NCA) and that he/she is registered at the Netherlands Foundation for Chiropractic (SCN) (286).
If osteopathy treatment is offered by an osteopath registered in the Nederlands Register voor Osteopathie (NRO) all health insurers reimburse all or part of osteopathic consultation under the supplementary package. Most insurers require no referral from a doctor to osteopathic treatment (287).
3. Wiesener S, Falkenberg T, Hegyi G, Hök J, Roberti di Sarsina P, Fønnebø V. Delieverable 9 – Report No. 3 – CAM Regulations in EU/EFTA/EEA. In: Wiesener S, Fønnebø V, editors. CAMbrella project FP7-HEALTH-2009, GA No.241951; Work Package 2; Deliverable 9 – Legal status and regulation of CAM in Europe, 2012.
11. EUROPA. Gateway to the European Union; member countries. Brussels EUROPA
Communication department of the European Commission; 2011 [cited 2011 November 3]; Available from: http://europa.eu/about-eu/countries/index_en.htm.
106. CAMDOC Alliance ECH ECPM ICMART and IVAA. The regulatory status of Complementary and Alternative Medicine for medical doctors in Europe. Brussels 2010 January 2010. Report No.: 2010.
283. Schäfer W, Kroneman M, Boerma W, Berg Mvd, Westert G, Devillé W, et al. Health Systems in Transition: The Netherlands: Health system review. Copenhagen: WHO Regional Office for Europe, on behalf of the European Observatory on Health Systems and Policies; 2010. p. 1–229.
284. Ministerie van Volksgezondheid Welzijn en Sport – NL. The Individual Health Care Professions Act (Beroepen in de Individuele Gzondheidszorg); Act of 11 November 1993, amended December 1,1997; Text of the act as per 1-1-2001. The Hague 2001.
285. The Ministry of Health; Welfare and Sport. Klink wil alternative genezers aanpakken (Klink wants to regulate altenative healers); press release. The Hague: Ministry of Health, Welfare and Sport; 2008 [cited 2012 February 27]; Available from: www.rijksoverheid.nl/nieuws/2008/03/28/klink-wil-alternatieve-genezers-aanpakken.html.
286. De Nederlandse Chiropractoren Associatie. Vergoedingen (Fees). Be Joure: NCA; 2012 [cited 2012 February 27,]; Available from: www.nca.nl/home/.
287. Osteopathie Maastricht. Osteopathy in the Netherlands: the Nederlands Register voor Osteopathie (NRO). Maastricht2012 [cited 2012 February 27, ]; Available from: www.osteopathiemaastricht.nl/en/reimbursement.html