Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese ...

66 Pages·2011·2.77 MB·English

Statutory Regulation of Practitioners of
Acupuncture, Herbal Medicine, Traditional
Chinese Medicine and Other Traditional
Medicine Systems Practised in the UK

Analysis Report on the 2009 Consultation
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Initial report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional
Chinese medicine and other traditional medicine systems practiced in the UK

© Crown copyright Year 2011
First published February 2011
Published to DH website, in electronic PDF format only.
http://www.dh.gov.uk/publications
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DH INFORMATION READER BOX
Policy Estates
HR / Workforce Commissioning
Management IM & T
Planning / Finance
PCelinrfiocraml ance Social Care / Partnership Working
Document Purpose Policy
Gateway Reference 14961
Title
A Report on the Statutory Regulation of acupuncture, herbal medicine,
traditional Chinese medicine and other traditional medicine systems practiced
in the UK
Author DH/Professional Standards Division
Publication Date Feb 2011
Target Audience PCT CEs, NHS Trust CEs, SHA CEs, Care Trust CEs, Foundation Trust CEs ,
Directors of PH, Directors of Adult SSs, Allied Health Professionals, GPs,
Communications Leads, Privately practising Alternative Medicine
Practitioners, UK professional bodies representing acupuncture, herbal
medicine and TCM, NHS bodies (Scottish Health Boards, Local Health
Boards in Wales, community Health Councils in Wales, the NI Ambulance
Service, the Health and Social Care Board, Public Health Agency, Patient
Client Council and the Business Services Organisation), Royal Colleges, UK
Regulatory Bodies, consumer representatives, Herebal Industry, NHS Trades
Unions
Circulation List Voluntary Organisations/NDPBs
Description A Report from Government following the consultation on whether, and if so
how, to regulate practitioners of acupuncture, herbal medicine and traditional
Chinese medicine practitioners. The Consultation ended in November 2009. .
Cross Ref
Pittilo report
Superseded Docs
N/A
Action Required
N/A
Timing By 00 Jan 1900
Contact Details Janet Smith
Professional Standards Division
2N11
Quarry House, Quarry Hill, Leeds
LS2 7UE
0113 2545789

0
For Recipient's Use
Initial report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional
Chinese medicine and other traditional medicine systems practiced in the UK
Statutory Regulation of Practitioners of
Acupuncture, Herbal Medicine, Traditional
Chinese Medicine and Other Traditional
Medicine Systems Practised in the UK

An Analysis Report on the Consultation

Prepared by: Professional Standards Division, Department of Health

Acknowledgements and thanks to Paul Cosens of Cosens Consultancy for analysis and
preparation of this report.
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Initial report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional
Chinese medicine and other traditional medicine systems practiced in the UK
Contents

Page No.
1. Executive summary ……………………………………………………. 5

2. Introduction ……………………………………………………………... 8

3. Thematic analysis of consultation responses ………………………. 10

4. Annex A – Detailed analysis …………………………………………. 29

5. Annex B – List of organisations who responded …………………… 59

6. Conclusion ……………………………………………………………… 65

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Executive Summary

This paper presents the outcome of the joint consultation, on behalf of Health Ministers in the
four UK countries, on Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine,
Traditional Chinese Medicine and other Traditional Medicine Systems Practised in the UK.

Headline Messages From Respondents

RISK OF HARM

1. Perceived harm – there was a general perception of harm resulting from unregulated
practice of acupuncture, herbal medicine and traditional Chinese medicine (throughout this
report referred to as AHMTCM), and a view that this harm should be addressed.

PRO-STATUTORY REGULATION – BENEFITS AND COSTS

2. Pro-statutory regulation – there was a clear majority of responses (85%) in favour of
statutory regulation. The main benefits of statutory regulation were perceived to be:

• Qualified practitioners – ensuring AHMTCM practitioners are qualified will be an
important measure for assuring patient safety. Further work will be required to evaluate
qualifications awarded as a result of training taking place outside the UK.
• Quality and safety of practice – enhanced quality of practice/products and safety
would constitute an obvious benefit to practitioners as well as to the public.

3. Alternatives to statutory regulation not preferable – a strong message was noted that
safety would not be assured sufficiently by alternatives to statutory regulation.

4. Voluntary regulation as second best option – as an alternative to orthodox statutory
regulation, ‘voluntary regulation’ or a licence to practise were seen as preferable to no
regulation.

5. Financial costs unclear – generally respondents expressed difficulty in evaluating the
financial costs involved in different types of regulation.

ANTI-STATUTORY REGULATION

6. Anti-statutory regulation -–a significant minority of respondents (15%) including medical
Royal Colleges, considered that the scientific evidence base for efficacy of alternative
treatments needs to be strengthened before statutory regulation can be considered.

7. Unjustified credibility resulting from statutory regulation – in the absence of such
evidence, a decision to statutorily regulate may give the impression that the current
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A report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional Chinese
medicine and other traditional medicine systems practised in the UK
evidence base for alternative treatments is on an equal footing with that for mainstream
clinical practice (‘orthodox western medicine’).

8. Clearer public information – need for clearer information for the public relating to the
risks and benefits of alternative treatments and products, so they can make informed
choices.

IMPACT OF EUROPEAN MEDICINES LEGISLATION

9. EU medicines legislation – as a consequence of complying with EU medicines legislation
in the UK, respondents estimated that unless practitioners were regulated the supply of
alternative herbal products would decrease and that there would be a detrimental impact
on ‘consumer choice’

REGULATE ALL THREE GROUPS?

10. Treat all 3 practices the same – the general consensus was that it would be simpler and
more cost effective to regulate herbalism, TCM and acupuncture in the same way.

WHICH REGULATOR?

11. Regulation - The Health Professions Council (HPC) was the preferred option for
regulating all three practices.

12. Alternative regulation - establishing a ‘Complementary and Alternative Medicine’ (CAM)
Council was a popular alternative to HPC regulation.

13. Local regulation – considered by some that it would lead to complications and be
impractical for practitioners if they were required to register with multiple Local Authorities.

PROTECTION OF TITLE AND/OR FUNCTION?

14. Protect title and/or protect function – popular support for both approaches.

“GRANDPARENTING” OF EXISTING PRACTITIONERS

15. Grandparenting – many respondents were unfamiliar with the term ‘grandparenting’ and
seemed confused when asked to evaluate the implications of this approach.

ENGLISH LANGUAGE COMPETENCE

16. English language ability- there was a general consensus that some level of English
language ability should be required in order to practise alternative medicine in the UK.
Furthermore, most people expressing this view felt that the level of English language
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A report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional Chinese
medicine and other traditional medicine systems practised in the UK
competence ought to be the same as for health professionals such as nurses and doctors
within mainstream medicine. Interestingly, many respondents also felt that the use of
interpreters would not be an obstacle to safe, effective practice. Finally, it was agreed that
the cost of achieving English language competence should be borne mainly by the
practitioner.

COMPLEXITY , CONFUSION AND QUALITY OF RESPONSES

17.Confusion – It was clear that many respondents, notably individual members of the public
and practitioners, rather than organisations, found the consultation document confusing.
Some respondents did not attempt to answer the questions at all but wrote in simply to
express the view that they were in favour of statutory regulation. Many respondents said
they had not read the Pittilo report on which the consultation was based. The evaluation of
consultation responses has tended to focus on the views of individuals and organisations
who considered the issues and provided evidence to back up their views. We have, of
course, taken into account the number of respondents who favour statutory regulation.  
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A report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional Chinese
medicine and other traditional medicine systems practised in the UK
Introduction

On 3 August 2009 the four UK Health Departments published a consultation paper on
Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese
Medicine and other Traditional Medicine Systems Practised in the UK.

This report is a factual analysis of the responses to the consultation.

The consultation took place over a 15-week period and closed on 16 November 2009. The
Department of Health alerted major stakeholders (relevant professional associations, statutory
and voluntary regulators, educational bodies etc, including organisations in Scotland, Wales
and Northern Ireland) to the consultation, which was published on the Department’s website.

6669 responses to the consultation were received by the closing date, and this analysis takes
account of all these replies. A further 231 responses were received after the consultation
closed, and this document does not take account of these.

This paper sets out the factual analysis of the consultation, which focused on whether, and if
so how, practitioners of acupuncture, herbal medicine, traditional Chinese medicine should be
regulated.

Ministers in all four countries, including Health Ministers in the previous UK Administration,
decided to hold this consultation in view of the complex and controversial issues raised by the
work of the DH Steering Group on the Statutory Regulation of Practitioners of Acupuncture,
Herbal Medicine, Traditional Chinese Medicine and other Traditional Medicine Systems
Practised in the UK, chaired by the late Professor Mike Pittilo, which reported to them in May
2008.

The consultation focused on the purpose of regulation (i.e. public protection) and asked
respondents to consider:
• the nature and degree of risk to the public associated with the practice of acupuncture,
herbal medicine and TCM;
• whether these risks can best be managed by introducing statutory professional
regulation or by some other means of (or no) regulation;
• the costs, benefits and impact of various kinds of regulation on practitioners, businesses
and the public; and
• whether it is appropriate for these practitioners to be regulated in the same way, and to
the same extent, as other healthcare professionals.

The consultation discussed potential alternatives to statutory professional regulation such as:
• statutory or voluntary licensing schemes;
• voluntary professional self-regulation;
• product regulation; and
• system regulation

which could be underpinned by some or all of the following:
• accreditation of regulators;
• health and safety and consumer legislation;
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A report on the consultation on statutory regulation of acupuncture, herbal medicine, traditional Chinese
medicine and other traditional medicine systems practised in the UK
• local authority licensing regimes; and
• better public information.

The consultation also considered related European and domestic legislation on regulating
medicinal products and the effect of statutorily regulating, or not regulating, herbal
medicine/TCM practitioners; and whether acupuncture should be subject to the same, or a
different, regulatory regime as the other groups under consideration. Furthermore, the
consultation covered a variety of issues which would need to be resolved should a decision be
made to statutorily regulate these groups:

• who should the regulatory body be, and should it be the same for all three groups?
• how should registration and ‘fitness to practise’ issues be dealt with for practitioners
eligible for regulation by more than one regulatory body?
• should regulation be by protection of title, protection of function, or (in the case of
certain procedures) both?
• what should the ‘grandparenting’ arrangements be for current practitioners who wish to
join the register but who do not possess the threshold entry qualifications?
• what level of English language competence should be required of applicants seeking
registration?

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