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Dáil Éireann debate -
Tuesday, 15 Dec 1998

Vol. 498 No. 4

Adjournment Debate. - Practitioners of Complementary Medicine.

Mr. Hayes

Every Member is aware of the growing use of non-conventional methods of medicine in society. The growth in use of acupuncture and traditional Chinese medicine in Ireland in the past ten to 15 years has been astonishing. While we all recognise the existence of alternative forms of medicine, the State has flatly refused to recognise the phenomena and to implement standards for professionals working in the area. The Minister for Health and Children should establish a national register of practitioners so that the public and professionals are aware of their rights and responsibilities.

Under current law, any member of the public is entitled to establish as a practitioner of traditional Chinese medicine without qualifications. I understand there are currently 200 trained practitioners of acupuncture and Chinese medicine in Ireland, the majority of whom are self-regulated, carry insurance cover and are governed by a voluntary code of conduct. While there is no doubt about the commitment and professionalism of these people, there is widespread concern within the profession about the absence of agreed national standards in training and qualifications. Any member of the public can legitimately establish a training course in alternative medicine or establish a practice. This cannot be allowed to continue and the Department of Health and Children has a direct responsibility to introduce national standards for the training of people in acupuncture and Chinese medicine. I cannot think of another profession in which this would be allowed.

Non-conventional medicine is here to stay and it is self-evident that increasing numbers of people will turn to acupuncture or other forms of traditional Chinese medicine to seek medical cures. I understand it is now 20 years since the World Health Organisation drew up a list of diseases it considered responsive to acupuncture treatment. The majority of western countries have established official bodies for the regulation and recognition of Chinese medicine. In Britain, acupuncture is available on the National Health Service, and many private health insurance providers reimburse clients for acupuncture and Chinese medical services. It is wrong that people are charged VAT when they obtain acupuncture therapy. Taxing people as they attempt to alleviate their pain and suffering through non-conventional medicine does not seem equitable or just.

The most worrying aspect of the debate is that the State has implicitly and explicitly failed to recognise the existence of non-conventional medicine. This is against a background of international research which shows the positive effects of such medicine. Given the number of people involved in the area, it seems ridiculous to ignore it. I am aware of many medical practitioners who view acupuncture and Chinese medicine as complementary to the work of their profession. Patients should have a right to the broadest type of therapy but, more importantly, they have a right to be protected in law by standards and regulations governing the performance of alternative medicine. This issue cannot be dodged any longer and the Government has a responsibility to respond to the many voices calling for a register and a code of practice in the area. Ignoring the existence of non-conventional medicine will simply allow a rogue element to fester and grow within the profession. Recognising the existence of acupuncture and Chinese medicine would greatly assist in establishing long-term confidence in this growing area of medicine.

The areas of acupuncture and Chinese medicine can be included under the umbrella title of complementary or alternative medicine. The position of such medicine in Ireland is that it is not regulated by statute, and there are no proposals at present to do so.

I recognise it is desirable to afford some protection to the public who wish to use such medicines. The legal position of practitioners of complementary or alternative medicines is that their dealings with clients are regulated by civil law. Regarding control of standards and codes of practice in the area, my Department's policy has been to encourage the various therapies to establish their own regulatory structures and to develop mechanisms to inform the general public about the availability of services from reputable therapists. Many of the therapies have adopted this system of self-regulation. Officials of my Department meet representatives of various alternative medicine practitioners, the last such meeting took place in May 1998. Practitioners of complementary medicines are free to provide services to the public as long as they do not represent themselves as being registered medical practitioners. Practitioners of such treatments are not employed within the public health services and regulation to date has been introduced only in areas where employment has been within the public health services.

I am aware proposals are before the European Commission at present to consider conducting a research study into the area of complementary or alternative medicines. Any such study will undoubtedly investigate the subjects of safety, effectiveness and area of application. It is anticipated that, on completion, the research project will result in state registration of some type in each member state. The question of such registration would pose many problems in that the nature of the services undertaken by complementary or alternative medicine practitioners is not easily defined and ranges from chiropractice to acupuncture to homeopathy to even herbal remedies. It would be difficult to devise a practical system of registration that would encompass such a maze of unrelated activities. For example, it is suggested that there are at least 30 main branches of alternative therapies in the UK. With the exception of those who are already qualified doctors, nurses, physiotherapists, etc., many practitioners in this area would hold non-standard qualifications from unrecognised bodies which do not enjoy external validation or chartered status. The matter is further complicated by the fact that many of the complementary or alternative therapies are riven by factional disputes, which have produced rival groupings within a therapy, each one opposed to the training and methodologies of the other.

I do not propose at present to regulate standards of practice and training for alternative or complementary medicine, including acupuncture and traditional Chinese medicine.

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