Go directly to legislation of specific CAM therapies in the United Kingdom:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) - Other treatments
The United Kingdom (UK) entered the European Union in 1973 (11) and consists of England, Wales, Scotland (who together make up Great Britain) and Northern Ireland (11). UK became a founding member of the Council of Europe from 5 May 1949 (12).
The legal and regulatory status of CAM and CAM practices
Under Common Law all practitioners have a duty of care towards their patients, and nonmedically qualified individuals are prohibited from curing or treating specific illnesses and medical conditions, for example cancer and venereal disease (301). The Health and Safety at work Act 1974 places a statutory duty of employers to ensure the health and safety of people affected by the various activities undertaken on their premises (301).
According to the House of Lords’ report 2000 5.9. (301). ”The Common Law right to practise medicine means that in UK anyone can treat a sick person even if they have no training in any type of healthcare whatsoever, provided that the individual treated has given informed consent”.
Osteopathy and chiropractic are statutorily regulated while acupuncture and other CAM
treatments are voluntarily regulated (or not) depending on the associations/groups (234). The UK Government has announced that it is planning to statutorily regulate practitioners supplying unauthorized herbal medicines on a one-to-one basis (after an individual consultation) under the aegis of the Health Professions Council. Both statutory and voluntary regulations are based on minimum standards for practices.
However, for voluntary selfregulated practitioners there are no legal sanctions against practitioners who fail to meet these standards (302). The Government’s Command Paper Enabling Excellence (February 2011) stated that the Council for Healthcare Regulatory Excellence (CHRE) was to be given new powers to accredit voluntary registers of health professionals who are currently not regulated by statute. These powers will be enacted when the Health and Social Care Bill becomes law, and the CHRE is expected to commence the implementation scheme in the autumn of 2012 (303).
On 1 March 2012 the Law Commissions of Scotland, England & Wales, and Northern Ireland published a joint consultation “REGULATION OF HEALTH CARE PROFESSIONALS”, seeking views on how the regulation of health care professionals in the UK and social workers in England can be made clearer, simpler, more modern and more consistent. Chiropractic and osteopathy are listed among the regulated professions in question (304).
Non-medically trained homeopaths, acupuncturists, and herbal medicine practitioners are all registered and self-regulated in their own individual councils. A number of other disciplinary groups of non-medically trained CAM practitioners are registered under the banner of the Complementary and Natural Healthcare Council (CNHC). CNHC has put into place the policies and procedures necessary for an effective running of a regulatory body, including an on-line multi-disciplinary register that opened in January 2009 (305).
The governmental supervision of CAM Practices
In England the Care Quality Commission, established under the Health and Social Care Act of 2008, regulates health and adult social care under the Care Standards Act 2003 (302). Similar inspectorates are established for the other UK states, but they do not regulate CAM services under current legislation (302).
Anyone may practise and provide various CAM treatments as long as they do not claim to be a medical practitioner registered under the Medical Act or claim to cure diseases as
proscribed by the law (301). The above mentioned groups fall outside the governmental health supervision systems.
The reimbursement status of CAM practices and medicinal products
A number of private health insurance companies cover some CAM treatments in their policies but many private insurance companies will only reimburse treatments carried out by statutorily regulated practitioners.
Some acupuncture treatments (largely for pain) is covered mainly by private insurance companies in the UK (106). Some acupuncture, anthroposophic medicine and homeopathy treatments are also provided by the NHS (60, 106).
Some therapies are available through the NHS in pain clinics and terminal care environments but the vast majority of CAM provision in the UK is within the private sector and is not covered by medical insurance.
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.
12. Council of Europe. Council of Europe. Strasbourg: Council of Europe; 2011 [cited 2011
November 7]; Available from: http://www.coe.int/lportal/web/coe-portal.
60. ECHAMP. Homeopathic and Anthroposophic Medicine: Facts and Figures. Second Edition ed: ECHAMP E.E.I.G: European Coalition on Homeopathic and Anthroposophic Medicinal Products E.E.I.G; 2007.
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.
234. CAMbrella Work Package 1. Questionnaire definition and terminology of CAM and Legal status of CAM. In: CAMbrella WP1, editor. Münich 2010
301. House of Lords Select Committee on Science and Technology. Session 1999-2000, 6th Report, Complementary and Alternative Medicine. HL Paper 123 London: Her Majesty’s Stationary Office; 2000.
302. DH (Department of Health) Professional Stadards Division. Joint UK-wide consultation on the Report to Ministers from the DH steering Group on the statutory regulation of practitioners of herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK. London: 2009 Contract No.: 12123.
303. Paul W Long, Council for healthcare regulatory excellence. Email: Developing a risk assessment tool for CHRE’s voluntary registers accreditation scheme. 2012.