Regulation of Complementary and Alternative Medicine Practitioners

The use of complementary and alternative therapies (CAM) among cancer patients in Australia is common. However, while the use of some complementary therapies, for example, yoga and massage, is generally safe and may have benefits, there have been several high profile examples of unscrupulous CAM providers taking advantage of vulnerable individuals, often at great expense and, at times, high risk to the patient. These cases have highlighted a gap in the regulatory framework for CAM practitioners, in which not all practitioners are required to be registered. Whereas registered health practitioners are governed by professional Boards with the power to set standards and discipline member practitioners, there is limited oversight of unregistered practitioners. Given the high use of CAM among cancer patients, including therapies provided by unregistered practitioners, having appropriate regulatory mechanisms to protect the public from unregistered CAM practitioners who fail to meet a reasonably expected standard of competency, ethics and efficacy, is important.

Making the law work better for people affected by cancer: report findings

Australia has a two-tiered legal framework for the regulation of health practitioners. The most rigorous form of regulation applies to health professionals who are registered under the National Registration and Accreditation Scheme (NRAS). These professions are Aboriginal and Torres Strait Islander health practice; Chinese medicine; chiropractic; dental practice; medicine; medicinal radiation practice; nursing and midwifery; occupational therapy; optometry; osteopathy; pharmacy; physiotherapy; podiatry; and psychology.

In the absence of a specific regulatory mechanism (and subject to the provisions of the new Health Complaints Act 2016, introduced after our report findings), unregistered practitioners in Victoria have been subject to different and overlapping legal frameworks, not all of which are directly targeted at health professionals.

Self-regulation has been the dominant form of regulation for most unregistered health practitioners, but unlike the National Law or negative licensing schemes, self-regulatory measures are ultimately not enforceable by the courts and practitioners may choose not to join, or may cease membership of, the relevant association to avoid disciplinary procedures.

Consumer protection law has proved to be a particularly important, although seldom used, tool for regulators against unregistered health practitioners who provide unproven treatments to cancer patients.

All states and territories, including Victoria, have independent statutory health complaint entities - the relevant health complaints entity in Victoria is the Office of the Health Services Commissioner (OHSC) (to be renamed the Health Complaints Commissioner under the new Act).The OHSC offers an alternative dispute resolution process, allowing patients to seek remedies from a provider such as an explanation, apology, remedial treatment or compensation, without going to court.

In 2016, new legislation was passed in Victoria to address some of the regulatory gaps. The Health Complaints Act 2016 which will commence on 1 February 2017, establishes a new Code of Conduct for general health services (unregistered health providers) which will prohibit a practitioner from:

  • making claims about curing cancer;
  • making unsubstantiated claims about being able to treat or alleviate the symptoms of cancer or other terminal illnesses;
  • financially exploiting clients, including by providing services or treatments for purposes other than maintaining or improving clients' health or wellbeing, and asking clients to give, lend or bequeath money or gifts.

Formerly known as the Health Services Commissioner, the Health Complaints Commissioner will now be able to initiate their own investigations. The Commissioner will be able to:

  • place conditions on or prohibit practice by general health service providers where necessary to avoid serious risk to health, safety or welfare of a person or the public;
  • undertake follow-up investigations to assess compliance with undertakings made in complaints resolution processes and recommendations made during investigations;
  • publish public health warnings when necessary to avoid serious risks to the health, safety and welfare of a person or the public. 

Resources

Cancer Council's complementary therapies online resource
Cancer Council's position statement  on complementary and alternative therapies
The Clinical Oncology Society of Australia's position statement and online resources

Publications

AHMAC, A National Code of Conduct for Health Care Workers (Consultation Paper) (2014).
AHMAC, Options for Regulation of Unregistered Health Practitioners: Final Report (2013).

Links

Cancer Council Victoria, ‘Alternative Therapies in Cancer Care - Regulation and Risk Webinar' 
Australian Health Practitioner Regulation Agency (AHPRA)

Australian Competition & Consumer Commission

Office of the Health Services Commissioner (OHSC)