Healing a thorny problem

Plans to regulate the alternative-healthcare system can't come soon enough for consumers. But how do practitioners see it working? Protection for consumers from bogus alternative and complementary therapists is finally in sight. The Government's recently published health strategy includes proposals to register alternative and complementary therapists, as well as other measures to regulate the sector.

Each therapy organisation will have to compile an official register of practitioners, whose qualifications and clinical competence will be scrutinised before they make it onto the list. Only registered therapists will be legally permitted to call themselves herbalists, homeopaths, acupuncturists and so on. The bottom line will be that if you want to see a therapist, first check if they are on a register. If they are not, don't make an appointment.

"The public will be protected by knowing that anyone using the title of herbalist will be a trained, registered professional, and those who aren't properly trained will not be able to use the title. It's wonderful that the Government has made a commitment to this," says Celine Leonard of the Irish Herbal Practitioners Association, the joint body of the Irish Association of Medical Herbalists and the Irish Register of Chinese Herbal Medicine.

"We will not have situations where people can do active damage to patients, like in the Limerick case in which herbal creams were found to contain steroids, and by implication to hard-working practising herbalists who have put a lot of time into their training."

Statutory regulation has further implications for herbalists, in that once they are recognised as professionals, they will, like GPs, have access to prescription-only herbal medicines.

"We are very anxious that the Department of Health don't delay on this. More and more people are using homeopathy and other therapies that have proven their worth. It's in everybody's best interests that statutory regulation is implemented without delay," says Sally Quinlan of the Irish Society of Homeopaths. Quinlan argues that people are less likely to pick up infections when they are taking homeopathic remedies, meaning homeopathy could become a cost-effective addition to the healthcare system.

There are also the questions of compulsory continuing education and training and the establishment of fitness-to-practise committees, to follow up complaints. How such a disciplinary unit works in practice will be critical to anybody who uses the services of complementary-healthcare practitioners.

Amanda Hughes, an acupuncturist and practitioner of Chinese medicine, says one big advantage of a state-regulated alternative-healthcare sector will be the official nature of the registers.

"A lot of colleges have member registers attached to them, and these colleges attract students by telling them that they will be registered on qualification. Such registers can't be independent when they are attached to colleges, because if someone is disciplined by a code of conduct of such a register, they can always say: 'But that is how I was taught to do it.' Official registers would squeeze out people running two-year courses. You can't learn Chinese medicine in two years, no more than doctors can learn acupuncture in six weeks."

With each discipline's registration board setting strict educational standards, many short-term therapy courses will probably lose credibility once statutory regulation is in place.

The Government's proposals are based on discussions held last June between the Department of Health and Children and approximately 100 therapists, representing more than 20 alternative and complementary therapies. Each therapy group then made a submission to the Department. The Calm Report, which incorporates the submissions' findings and a review of practices in other countries, is due to be presented to the Department next month by Tim O'Sullivan of the Institute of Public Administration.

The model put forward for use by the alternative-healthcare sector is one that has already been used by the so-called allied health professionals, a group that includes physiotherapists, occupational therapists, speech and language therapists and social workers. Physiotherapist Aileen Barrett has been involved in the almost-complete process of acquiring statutory regulation for the sector.

"Previous to this, membership in the various associations was voluntary; now there is compulsory registration before members can practise," she says. They will be governed by a policy-making umbrella council, which will have a chairperson nominated by the Department of Health and Children and whose board will include professional and lay members.

Osteopaths and chiropractors are pushing for regulation as part of the allied health professionals group. "We are ready for regulation now, and because manipulation therapies can potentially do harm, we feel we need to be regulated," says Alexander Gibbs of the Irish Osteopathic Association, all of whose members are already vetted by the General Osteopathic Council, the London-based statutory regulatory body.

"We feel that we are closer to allopathic medicine and physiotherapy than to acupuncture and homeopathy, because we have a science degree, and the General Osteopathic Council are committed to acting as a standards body for Irish members."

Catherine Dowling, a rebirthing therapist, chairs the Federation of Irish Complementary Therapy Associations, which represents yoga, aromatherapy, reflexology, rebirthing and about 10 other disciplines. She is unsure whether statutory regulation is the best way forward for all complementary therapies.

"Some form of state-supported regulation is appropriate, but once something is statutory it is written into law and very difficult to change. Some therapies are still growing and changing and need a more open system," she says. Dowling also points out that if complementary therapies are going to be integrated into the healthcare system, the Department's research unit should widen its remit to include them.

Kerry McBride, another practitioner of Chinese medicine, is concerned the Government might not have enough independent expert advice. She fears it will gloss over the detail to find a plan that is workable but will not benefit consumers. "Also, there is no market research in this country to see what people are interested in. That costs money and takes time and real political commitment."

The biggest problem, it seems, is the time the process will take. The Dáil has not yet passed the Allied Health Professionals Bill, but even when it does, it will be a further two years or so before it becomes law. The alternative-healthcare sector is awaiting the Calm Report before it can proceed.

Meanwhile, the public continues to be at risk of unwittingly making appointments with unqualified, unscrupulous practitioners.