News Analysis: A report released yesterday represents the first real attempt to regulate complementary therapists. Sylvia Thompson reports
Statutory regulation should be put in place for herbalists, acupuncturists and traditional Chinese medicine practitioners, according to the report from the National Working Group on the Regulation of Complementary Therapists, launched by the Minister for Health and Children, Mary Harney, in Dublin yesterday.
All other complementary therapies should develop a robust system of voluntary self-regulation, according to the report, the first official document on complementary therapies. Its publication puts Ireland ahead of many of the countries in the governing sector.
With statutory regulation, practitioners can be prosecuted if they are not registered. With voluntary self-regulation, practitioners can be struck off the professional register if they do not comply with the code of ethics and good practice.
The publication of an up-to-date information booklet incorporating a client/therapist charter for the public was another recommendation of the National Working Group, which was chaired by broadcast journalist Teri Garvey.
"It is frequently the case that the term 'complementary therapist' is inaccurately applied, usually by the media, to an untrained and/or unregistered self-styled practitioner who has come to public notice through malpractice," wrote Teri Garvey in the forward to the report.
Greater unification of the sector and availability of reliable, accessible sources of information for the public, would, she hoped, make such sad cases "even more of a rarity".
The consumer would also have greater safeguards against sham practitioners if professional associations of one therapy joined together to form a federation of associations working as one overall registering body. This body would have agreed standards regarding length of training, level of qualifications, codes of ethics and good practice.
Some complementary therapies, including reflexology and yoga, have already formed federations, and bio-energy therapists and herbalists are currently developing federations.
The efficacy of one therapy over another was not dealt with in the report. However, some attention was given to the so-called scope of practice of various therapies.
"As part of their code of ethics and good practice, all professional associations for complementary therapies should advise therapists to refer a client for conventional medical investigation if they have any doubts as to the seriousness of the condition, the presenting symptoms or any new symptoms which arise in the course of treatment," it stated. The diagnostic limits of various therapies were also discussed.
The area of integrated medicine where complementary therapies are available in a conventional healthcare setting was discussed. Examples were given such as the use of complementary therapies in cardiac programmes, in certain chronic conditions and in palliative care. In some cases, these therapies resulted in financial saving on conventional medicine (fewer GP consultations, reduction in secondary referrals and drug use) as well as high rates of satisfaction among patients.
The working group also recommended the immediate establishment of a forum for dialogue between the complementary and conventional medical sectors. And in the longer term, the establishment of a complementary therapies council to oversee the sector.
The importance of independent, external assessment, validation and accreditation of training courses for various complementary therapies was also stressed in the report. In particular, concerns were raised about the number of therapists practising after the completion of inadequate home study courses.
Members of the working group were also concerned about courses taught by therapists whose own practical experience was inadequate or non-existent. The report also stated that professional association needed to be independent of training providers with commercial interests.
Regarding the beauty industry, the report expressed concern about the use of the terms, complementary therapies, complementary therapist and holistic therapist by people working in the beauty industry.
While acknowledging that some beauticians may have additional qualifications as a therapist which are recognised as full qualifications and may be registered by a professional association, the report stated that others may have done modules as part of an overall beautician training course which would not be recognised by a professional association of that therapy. A client may be paying full price for a service from a person without full qualifications.
In the light of expansion of the beauty industry into the hotel/leisure and day spa industry, the report also questioned the scope of practice covered by the level of qualification of the therapist involved in therapies such as massage, aromatherapy and reflexology.
The report also raised concerns about treatments such as cosmetic acupuncture or colonic hydrotherapy where the risk of injury or cross-infection may arise.