Jurisdiction, supervision and reimbursement status

Tittel
How are European patients safeguarded when using complementary and alternative medicine (CAM)? Jurisdiction, supervision and reimbursement status in the EEA area (EU and EFTA) and Switzerland.

Forfatter(e)
Ersdal, G., Ramstad, S.

Tidsskrift/bok
Kan lastes ned fra nettsiden CAM-CANCER.

Årstall
2006

Abstract
The use of the methods often characterized as complementary or alternative medicine is steadily growing among citizens of Europe. This development has been met with different legal approaches by the European countries. This report describes the legal regulation of complementary and alternative therapies in the EEA area (EU and EFTA) and Switzerland (29 countries).

Information about legal regulation has been collected from the Ministries of Health. Secondary literature, as well as documents published on the Internet has been used when complete primary data was unavailable. Each country has been described as completely as possible.

The report shows that in 19 out of 29 countries (Middle and Southern Europe) only regulated personnel may legally treat sick people while in the remaining 10 countries (Northern Europe) both regulated and non-regulated (anybody) may treat. In Middle and Southern Europe CAM, when provided within the public health service, is mostly practised by physicians. If practised outside the public health service it is administered by "consultants". In Northern Europe anyone may offer CAM within the limits set by the monopolisation to qualified medical doctors of some medical procedures and the treatment of certain diseases.

Health authorities regulate CAM by offering authorisation, license, protected title or voluntary registration. Wide variations exist throughout Europe regarding the types of CAM that are legally regulated. Eighteen of twenty-nine countries regulate specific CAM therapies. In each country the supervising body (health authorities or medical federations), defines which type of CAM is considered "responsible professional conduct" when provided by regulated personnel. In some countries the practise of CAM by regulated personnel is severely restricted, while in other countries regulated personnel may perform CAM quite freely.

EU directives regulate herbal products in the European countries, and these directives are being implemented in national legislation. This report does not present the national legislation work carried out as a follow up of the EU directives.

A major challenge for the authorities in all countries is to what degree and in what way patients attending "consultants" of CAM (Middle and Southern Europe) and non-regulated CAM providers (Northern Europe) can be adequately and legally safeguarded. An additional challenge is to agree on the efficacy and quality of CAM, and consequently determine the therapies to be offered as a regulated health service.