The government says that the current self-regulation system is robust enough to protect the public health.
But without statutory regulation some acupuncturists believe that the profession will struggle to gain recognition and consistency of standards. Others disagree.
Then there is the matter of how to integrate into the NHS and regulate a profession that stands on a fundamentally different paradigm to Western medical theories. If acupuncture were to be regulated more closely, what kind of skills and knowledge would be included in the requirements? Would GPs and physiotherapists wanting to use acupuncture need to prove a knowledge of traditional Chinese medical theories? Or would those traditional Chinese theories be left out of the definition of a qualified acupuncturist?
Since the British Acupuncture Council (BAcC) was formed in 1995, it has pushed for statutory regulation for acupuncturists. The House of Lords recommended this in 2000, with the government finally initiating a consultation process in 2009. The current government concluded, however, that acupuncture was low risk to the public, with few complaints, so statutory regulation is unnecessary.
The BAcC estimates there to be 12,000 registered practitioners of acupuncture nationwide. The BAcC is the UK’s largest body, representing more than 3,000 professionally qualified acupuncturists.
Nick Pahl, chief executive of the BAcC, says: “There are a lot of Chinese shops on the high street that are not necessarily a member of us and people might not be able to distinguish between people who could really give quality like us.”
“There are people out there who are not well-trained and their quality is dubious,” he continues.
Read on Some acupuncturists agree.
Some acupuncturists agree. BAcC member Gary Minns, who has a clinic in London, says regulation would protect against backstreet practitioners. “People presume anyone they see is regulated and they’re not,” he said.
But not all professionally trained acupuncturists belong to a regulatory body.
John Li is a Chinese doctor in Leeds, who has practised for 16 years, following a five-year professional training in traditional Chinese medicine, Western medicine, and Chinese herbal medicine in China. But Li isn’t a member of the BAcC.
“I can’t join because I haven’t passed the English language exam,” he says.
With three million acupuncture treatments being given annually, acupuncture has already established itself in the nation’s health care. National Institute for Health and Clinical Excellence (NICE) guidelines recommend acupuncture for lower back pain.
Moving closer into mainstream medicine is welcomed by some, but others fear it may dilute the traditional Chinese understanding of health, which they regard as the cornerstone of acupuncture’s effectiveness.
Pahl is campaigning for traditional acupuncture to be available on the NHS and says statutory regulation would also allow for funding from private health insurers like BUPA.
“We see acupuncture as a core part of the nation’s health service, and we think alongside professionals like osteopaths and physiotherapists who are statutory regulated that we should be statutory regulated too,” he said.
In place of statutory regulation, the government has offered another option. Self-regulatory bodies like the BAcC could be regulated by a state organisation called the Council for Healthcare and Regulatory Excellence (CHRE), leaving the regulation of individual practitioners to the BAcC.
For Pahl, this is a way forward. He hopes joining the CHRE will improve the public’s perception of acupuncture and show that BAcC members are competent. Members will vote on the option by next summer.
The CHRE would open the door for BAcC members to have access to the new NHS initiative of personal health budgets.
Read on The NHS might change
“The NHS might change in a way that would favour patients being able to choose what they think is right for them,” he says.
But then there is the challenge of running two completely different medical systems in parallel.
Craig Minto, joint principal of The International College of Oriental Medicine, East Grinstead, says there is a difference in medical paradigms between traditional and Western styles of acupuncture.
“Traditional Chinese medicine (TCM) acknowledges the conceptual and historical framework that has been used and developed in the Far East for the last 2,500 years, as well as embracing the more recent developments in bio-medicine. GPs and other health care professions understand its effect only through the bio-medical model.”
Gabriella Doran, an acupuncturist in London with over seven years’ experience, and a member of the BAcC, says: “With many different styles of acupuncture available it is inappropriate to try to fit something that is not Western into a Western framework.”
“There are different styles of acupuncture, if it’s regulated, who regulates it? If it’s predominantly one particular style, they [the NHS] would start to impose what they think should be right in a different style,” she explains.
“People who look for acupuncture are looking for something outside the box and regulation speaks of boxes.”
Like some acupuncturists, Doran also objects to the add-on treatments carried out by GPs and physiotherapists being dubbed acupuncture. She says patients have come to her saying, “I’ve had six acupuncture treatments at the GP’s. It didn’t work.” She wants NHS treatment to be renamed, to for example “local needle treatment”, so as not to confuse it with traditional Eastern methods.
“Acupuncture is a complete system of medicine, it takes years to train, years of observing nature, developing our senses, and working on people skills is very important,” she said.
There is no such perceived problem from the medical profession.
Vivienne Fort, chair of the Acupuncture Association of Chartered Physiotherapists says: “Historically there may have been issues of ownership of acupuncture. We are trying to work together with the BAcC.”
She is worried that physiotherapists who use acupuncture have been painted negatively because they do only an 80-hour course. She says the acupuncture training is at a Master’s degree level in addition to the BSc in physiotherapy.
“They would never call themselves acupuncturists,” she says. “Our 6,500 members have introduced acupuncture to people who would otherwise not have been introduced to it before through the NHS.”
“It has made it more normal and accessible to have acupuncture, therefore we have increased referral rates to traditional acupuncturists,” she adds.
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