Should complementary and alternative medicine be regulated by the state?

Should complementary and alternative medicine be regulated by the state?


Dr Nicola Gale, Research Fellow in Medical Sociology, School of Health and Population Sciences, University of Birmingham

“Whatever your view on whether complementary and alternative medicine (CAM) is a useful part of the health system, there are strong arguments that statutory professional regulation is not appropriate for CAM practitioners.  Regulation is about the ‘protection’ of the public, but voluntary regulation could and should provide sufficient protection given the low level of risk involved in most CAM.  

Most patients find their CAM practitioner through word-of-mouth, and then check to see if they are registered with a professional body. Some specifically like to use CAM because it is not part of the medical/pharmaceutical establishment and would see statutory regulation as threatening that independence. At the other end of the spectrum, many so-called ‘sceptics’ argue that because there is a limited evidence base (judged by conventional medical standards) for the effectiveness of many CAM treatments, it would be unethical to regulate CAM practitioners as it would imply that they were ‘State approved’. What we do know is that CAM patients are generally pragmatic in their approach to CAM use and, if they have health concerns, continue to consult their doctor as well. The current consumer-led model means that the patient ultimately has the choice about whether they use CAM and can start or stop using it depending on whether they find it useful.

Common law gives freedom to practise any therapy to CAM practitioners in the UK, providing the therapist doesn’t use a protected title (such as doctor or nurse), or prescribe certain drugs. This liberal approach has allowed diversity to flourish. Some CAM practitioners believe that statutory regulation would bring them greater professional status and more integrated working with the NHS, but the experience of osteopaths and chiropractors (who are regulated) has not shown this to be the case. Social science and historical research suggests that the medical profession is likely to be able to retain its dominance in the health system and so true integration is unlikely, meaning the current system is probably the best way to ensure continued access to CAM.

The Government has indicated support for statutory regulation only where there are significant risks in terms of the safety of the medical treatment itself (such as herbal medicine or spinal manipulation). This is sensible, but where the risks of treatment are low, any effort in the field of CAM would be better directed towards supporting professional bodies that require their members to have a high quality professional education. Future areas for development would be improving systems for dealing with complaints and ensuring that, in all cases, registered CAM practitioners are required to undertake regular continuing professional development.