Should complementary and alternative medicine be regulated by the state?

Should complementary and alternative medicine be regulated by the state?


Professor Julie Stone, Visiting Professor in Ethics, Peninsula Medical School

Healthcare is an intensely regulated activity in all countries because all healing activities have the capacity to harm as well as to heal. This is most obvious in an area like surgery, where there are known risks alongside the many obvious benefits. Whilst some people dispute the benefits of complementary and alternative medicine (CAM), they are extremely popular with members of the public with half of the UK population accessing such therapies at one time or another. 

Osteopaths and chiropractors are already regulated by the State in the same way as doctors, and herbalists are about to be regulated. Currently around 1.2 million health professionals in the UK are regulated by the State across 30 different healthcare professions.

Even though the public tend to associate regulation with disciplining practitioners who have been guilty of misconduct, the functions of regulation are much broader, aimed at providing public protection and public reassurance that practitioners are safe and competent. Regulation achieves this by:

  • Setting the standards of behaviour, competence and education
  • Dealing with concerns about professionals who are unfit to practise because of poor health, misconduct or poor performance
  • Maintaining a register of health professionals who are fit to practise
  • Power to remove professionals from their registers and prevent them from practising if this is in the best interest of the public

Regulation needs to be proportionate to risk and some people argue that because CAM therapies are ‘natural’ they are safe and don’t need State regulation, but CAM therapies also have risks; some of which can be serious. These include risks from acupuncture needling, adverse reactions to aromatherapy oils, herbal or homeopathic remedies and risk of interaction with conventional medicines. Practitioners can also exploit their power to harm patients psychologically or exceptionally, by violating sexual boundaries. 

Most practitioners are well trained and act in their patients best interests, but regulation is an important long stop to ensure patients can be kept safe. Statutory regulation is the only way to ensure that when a person is struck off a register, they can’t continue to practise. For patients to be able to feel fully safe in accessing a wide range of therapies, many of which are offered by doctors as well, formal regulation is required. This is not to give therapies credibility, but to protect patients so that they can make informed choices.