The attempted regulation of herbalism looks doomed to failure with a clear difference of opinion between government and practitioners, the latter prefer statutory regulation which has been rejected as an option by government.

Last week the Department of Health (DoH) recommended that the Complementary and Natural Healthcare Council (CNHC/Ofquack)  regulate herbal medicine, traditional Chinese medicine (TCM) and acupuncture.  Minister for Health, Andy Burnham, said:

“Emerging evidence clearly demonstrates that the public needs better protection, but in a way that is measured and does not place unreasonable extra burdens on practitioners.

“I am therefore minded to legislate to ensure that all practitioners supplying unlicensed herbal medicines to members of the public in England must be registered with the Complementary and Natural Healthcare Council (CNHC).

The CNHC have expressed their pleasure at this announcement:

CNHC is pleased to be asked by The Secretary of State for Health to register practitioners supplying herbal medicines to members of the public in England.

The Council already registers a significant range of practitioners in complementary healthcare who meet its standards and is well positioned to expand its public protection role in this way. Since 2008 CNHC has established its reputation as a regulatory body with robust and effective standards for registration and fitness to practise. It has positive and collaborative links with the statutory healthcare regulators.

This is probably regarded as good news by the CNHC, they have had a well documented struggle for funding and have trouble attracting some of the more popular forms of quackery.   Regardless of this, the CNHC are not fit for purpose, they have recently told sceptical blogger Simon Perry that they will not consider his complaints for the next 6 months:

I began making complaints to the Complementary and Natural Healthcare Council about reflexologist members who happily promote their bogus treatments despite the fact that there was not a jot of evidence to support them.

The CNHC has now informed me that for the next six months, they will no longer be processing any complaints that are similar to the ones I’ve submitted. By similar, I take this to mean complaints regarding practitioners who mislead their clients by making unjustifiable or false statements, including practitioners who have already been cautioned by the CNHC for doing it before.

The CNHC was set up under the aegis of Prince Charles’ Foundation for Integrated Health (FIH) to be a self-regulatory body for alternative health, now it is one that is not prepared to regulate.  However this is not unexpected.  Organisations purporting to regulate quackery rarely do so beyond upholding the doctrines and articles of faith of the respective field of quackery, managing risks to consumer health are generally not a priority.

It would be a concern for those with an interest in exposing the practices of alternative medicine if the CNHC were to regulate herbal medicine, traditional Chinese medicine and acupuncture.  This, despite the recommendations of Andy Burnham, is unlikely to happen for two reasons.

1) The government is unlikely to exist in its current form within a month or two.  A general election is expected early in May and the Labour party are unlikely to win, if they are to remain in power it will be in a coalition but it is more likely that the next government will be formed from the Conservative party.  None of the major parties have a clearly stated policy on the regulation of alternative medicine, nor is it likely to be a major election issue, so the Department of Health’s current proposals are likely to be mothballed for some considerable time.

2) Herbalists  and TCM practitioners do not want CNHC regulation.

This latter point is the most important.  The European Herbal & Traditional Medicine Practitioners Association (EHTMPA), the Register of Chinese Herbal Medicine (RCHM), the Association of Traditional Chinese Medicine (ATCM), and the National Institute of Medical Herbalists (NIMH) amongst others in the alphabetical smorgasbord that represents the various denominations of herbalism, have all campaigned for statutory regulation.  Their intent was to be regulated by the Health Professionals Council (HPC), a more serious organisation than the CNHC, that regulates practitioners in proven fields of health.  This statutory regulation would confer protected status on their profession, restricting the title of Herbalist to those regulated by its rules.

By and large these organisations are disappointed with the DoH’s announcement:

the CNHC (the proposed regulator) was formed to regulate complementary health practitioners on a voluntary basis, and as currently constituted, is not equipped for statutory regulation.

the government seems to have failed to deliver its promise, and has changed its mind from HPC as our regulatory body to CNHC. We would like to demand an explanation from the government on what ground it has changed its mind, as CNHC is only a voluntary body with no statutory power. From the rather short DH press release which lacks details, we doubt whether the government still wants to introduce statutory regulation, or decides to go for an alternative.

Herbalists should be regulated like other statutory regulated healthcare practitioner or, the public will lose access to properly regulated herbalists and a wide range of herbal medicines. The Government must give detailed assurances that the legal and structural basis of statutory regulation is fit for purpose or it will betray the millions of people who regularly consult herbal practitioners. So far the Government has singularly failed to provide these guarantees.

As the CNHC is voluntary these organisations have no need to insist that their members sign up, in fact as they are holding out for statutory regulation it is unlikely that they will be willing to express any support for the CNHC, to do so would undermine their campaign.  This will damage the CNHC’s longterm viability, no new members means no new funding sources, and with the homeopaths mired in infighting the herbalists represent their last decent chance of acquiring new members in the medium term.

This is good news for those that are concerned about poor practice in alternative medicine.  The collapse of the CNHC will further damage the reputation of alternative medicine.  Hopefully a new government will take stock of the intransigence of the herbalists, the infighting of the homeopaths and the inability of the CNHC to regulate and instead apply a more robust external form of regulation for quackery.