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The new law stipulates that these CAM modalities can only be practised by professionals with higher education qualifications and a publicly registered professional license.
Access to the registers of these CAM professions will depend on the ownership of a degree in one of the therapies, obtained following an education consistent with the requirements set by members of the Government responsible for health and higher education. Requirements for the practice of these modalities should follow the WHO guidelines and those issued by the Portuguese Agency for Assessment and Accreditation of Higher Education and the Directorate-General of Health.
The exercise of the professions is permitted only to holders of a professional license issued by the Central Administration of the Health System. A register will allow identification of the health professionals holding the adequate qualifications. The use of professional titles is only permitted to holders of such a license.
The law also stipulates that health professionals keep a patient record, provide accurate and understandable information about the prognosis and treatment duration, verify the patient’s consent, do not falsely claim that the therapies can cure illnesses, dysfunction or malformations, and have a liability insurance.
The Minister of Health has established the Advisory Council for Non-conventional therapies that will specify requirements related to exercise, training and regulation of the professions. The Council will comprise representatives of the Central Administration of the Health System, the Directorate-General of Health, the Ministry responsible for higher education, the Ministry responsible for labour, the individual professions (two from each profession, nominated by the most representative professional organisations), the Medical Council, the Order of Pharmacists, Faculty members nominated by educational institutes, and patients’ organisations.
There is a transitional provision for health professionals currently practising a particular CAM modality. To qualify for a license, these health professionals are to submit proof as to their registration in a social security scheme and their level of education and training. Depending on the quality of the submitted data, the Central Administration of the Health System is to decide on the issuance of a license, an interim license or no license at all.
The Council of Ministers based their approval on the official recommendation given by the Belgian Minister of Public Health, Ms Laurette Onkelinx – formulated after 21 meetings of the Unio Homeopathica Belgica representatives and university professors with Health Ministry representatives. With this decision, the Colla law on non-conventional practices (named after Minister Colla), adopted by the Belgian Parliament in 1999, can finally be fully implemented after 14 years of struggle. This law only regulates human medicine. The practice of homeopathy by veterinary doctors will be discussed in a separate commission.
The Royal Decree is not an official recognition of homeopathy but lays down the requirements for registration of homeopathic doctors. These requirements are the following:
- As for conventional medicine, doctors must comply with all standards of accreditation including the obligation to participate in a duty doctor service on weekends and to have Continuing Medical Education (minimum of 20 credit points a year)
- As for homeopathic medicine, doctors must have received homeopathic education at a teaching centre in accordance with the ECH / LMHI Medical Education Standards and must have Continuing Education in homeopathy (minimum 10 credit points a year).
The registration is essential with regard to the safety of the patients.
The national teaching centres will have to comply with the CEN quality standards which are to be formulated in the next few years. Transitional provisions will be developed for doctors practising homeopathy who do not comply with the above-mentioned requirements as well as for practitioners who do not have a medical, dentistry or midwifery diploma.
As soon as the Royal Decree will have been published, non-medically qualified practitioners can no longer start an education in homeopathic medicine and the practice of homeopathy by non-medical qualified practitioners will finally expire in Belgium.
"Patient empowerment is on the increase. It progressively serves to put patients in the driver's seat – taking charge and control of their own health. Patients often know what treatment works for them, and which healthcare is efficient for their condition. This can include the use of complementary medicine." This statement, given by EU Commissioner Tonio Borg at a recent meeting in the European Parliament, is a clear sign that the EU Commission is taking CAM more seriously.
The conference heard a presentations from range of expert providers and researchers on the growing popularity of CAM with citizens and patients, what characterizes the holistic approach of CAM to patient care, various aspects of the current provision of CAM in the EU and the potential benefits of its integration into health systems.
Other speakers presented recent studies on the economics of CAM. These studies seem to support the proposition that its widespread use and integration could potentially result on cost-savings for health systems.
In their closing remarks Mr Peterle and Ms Pietikäinen, members of the European Parliament, called for the EU to invest more in researching the effectiveness and cost-effectiveness of CAM and to take action to resolve the highly confused and inhibiting regulatory situation that currently exists for products, providers and patients.
On 20 December 2012, a proposal of National Agreement among the State and the Regions and Autonomous Provinces on rules of CM education, that includes at the moment only medical doctors and dentists, was approved by all the Italian Regional Presidents and finally the Agreement was officially signed on 7 February 2013.
Now Italy is one of the few European countries with a national law stating the rules for education in Complementary Medicine.
The agreement defines the training and accreditation of complementary medicine professionals and education institutions and provides for the establishment of lists of CM professionals who practice acupuncture, herbal medicine and homeopathy. Those wishing to register must have a certificate issued by accredited public and private training centres and must have completed a course of no less than 500 training hours, included 100 hours of clinical practice, after having passed a theoretical and practical exam and discussed a thesis. Courses for medical doctors cannot last less than 3 years.
Transitional provisions for professionals who initiated the practice of CM before the law were also set up.
In addition to the basic principles and clinical application of complementary medical techniques, courses must ensure the teaching of medical criteria based on evidence, the capacity to conduct clinical research, and the knowledge of legislation and regulations on rights to information and informed consent.
So far, the Italian rules on CM education can be a point of reference aiming at possibly defining European rules in all the Member States.
The document was produced in close cooperation with the Italian Medical Council FNOMCeO, along the lines of a previous similar agreement in Tuscany and proposed by the interregional Technical Group for Complementary Medicine. It was the main hurdle to pass on the way to a national regulation. Now it is up to the State-Regions Conference to approve the agreement, probably early this year.
The agreement stipulates that doctors specialised in one of these therapies should have taken a minimum of 500 hours of theoretical and practical training over 3 years, in addition to individual study and tutoring. Also learning objectives, teaching methods, teacher training and transition rules are part of the agreement.
The assessment of qualifications for admission to the registers will be entrusted to special committees of experts nominated by the Medical Council. The accreditation of teaching institutions (public or private) will be issued by the Regions.
There are more than 20,000 doctors in Italy practising homeopathy, acupuncture and herbal medicine, while around 20% of the population use these therapies.