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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.
CAM is in high demand by the citizens of Europe: as many as half of all citizens in Europe use complementary and alternative medicine for their healthcare needs; speaking at the final conference in Brussels, project coordinator Dr Wolfgang Weidenhammer, centre for CAM research at the TU Munich said, “Citizens are the driver for the use of CAM. Their needs and views on CAM are a key priority and their interests must be investigated and addressed in future CAM research.”
There are more than 150,000 registered medical doctors with additional CAM certification in Europe and more than 180,000 registered and certified non-medical CAM practitioners, meaning up to 65 CAM providers per 100,000 inhabitants compared to the EU figures of 95 general medical practitioners per 100,000 inhabitants. However, regulation of and education in CAM is different in each of the 39 European countries. Speaking at the conference, Prof. Vinjar Fønnebø, director of the Norwegian Institute for CAM research at the University of Tromso said: “The current EU regulation and education chaos for CAM provision makes it impossible for health professionals to give safety and security to their patients and clients.”
Substantial lack of data about CAM
To date, there has been no thorough investigation of this field of health care in Europe. There is almost no knowledge about the prevalence of CAM use by European citizens and patients. In most European countries, there has been no research into the needs of citizens regarding CAM provision and nothing much is known about the providers’ concerns.
What is CAM and what do people use it for?
CAM is an umbrella term for popular treatment strategies mostly outside conventional medicine. Practices such as herbal medicine, homeopathy, manual therapy (massage, osteopathy and reflexology), acupuncture, anthroposophic medicine or naturopathy are applied in the care of chronic conditions, disease prevention and health management. Herbal medicine is the most frequently reported CAM practice, and musculoskeletal problems the most reported conditions for the use of CAM.
The CAMbrella “Roadmap for European CAM research”
The CAMbrella researchers call on the EU to support and implement CAM research that pays proper attention to the real world conditions of European healthcare. Professor Jarle Aaarbacke, rector of University of Tromsø explains, “CAM is not part of the medicine we teach and learn in European universities – but it is nevertheless used by large numbers of patients and providers across Europe, so better we understand more about it.”
“If CAM is to be employed as part of the solution to the health care challenges we face in 2020, it is vital to obtain reliable information on its cost, safety and effectiveness in real world settings. CAMbrella’s vision is for an evidence base which enables European citizens and policy makers to make informed decisions about CAM,” adds Prof. Dr. Benno Brinkhaus, who led the roadmap workpackage, at the conference today.
CAMbrella recommends the establishment of a European research centre for CAM, allowing researchers to develop a uniform and scientific approach to CAM research, and thereby to determine the prevalence of CAM in Europe, research the most promising CAM treatments for the most common health problems such as obesity, diabetes and cancer; review patient safety, and evaluate the integration of CAM into routine healthcare treatments. And Dr. Weidenhammer sums up: “The CAMbrella project thus plays a central role for CAM and healthcare in Europe, it alls depends now on taking up the proposals and put them in action.”
Comprehensive information on the CAMbrella project can be found here