Interview with the Complementary and Natural Healthcare Council

The Complementary and Natural Healthcare Council opens its regulatory register to the first practitioners in January 2009.  We caught up with Maggie Dunn, co-Chair of the CNHC to ask what's been happening - and to discuss the politics of regulation.

Complementary healthcare practitioners have been working in some cases for a couple of decades to get here. They don't want just another register. They want a proper regulator who can offer a kitemark and a gold standard.

The CNHC has existed for six months now.  What's been happening behind the scenes?

We've finalised the Code of conduct, performance and ethics  as well as the complaints procedures and had them approved by lawyers and the Board.  We've recruited a number of lay members for our functional committees such as finance and education & standards.  We've been looking for permanent offices.  We've been recruiting staff. Up until now we've managed with a part time Chief Executive and a part time admin assistant, but a business manager and admin staff are just coming on board - all this in preparation for the register going live in January.

We've attended numerous AGMs and conferences of  the complementary healthcare professions and individual professional associations.  We've also met with the CHRE and Kate Ling, who is head of regulation for complementary healthcare at the Department of Health.

Maggie Dunn co Chair of the CNHC © CNHCWho will be able to register in January?

The register will be immediately open to massage and nutritional therapies.  The reason why they are ahead of the game is that they've established their Professional Specific Boards - (PSBs) which is one of the requirements for registration.  Also, the Aromatherapists are interviewing for their PSB representatives in early November, so we expect to hear from them fairly swiftly that their profession is ready to seek entry to the register as well. 

There are a number of criteria to fulfill before a practitioner can seek admission.  The most important of these are that their profession needs to have National Occupational Standards in place for their profession and a PSB.  In addition the practitioner is required to demonstrate their good character and sign up to the CNHC Code of  conduct, performance and ethics.

So anyone belonging to those 2 (and probably 3 professions) can go onto the register if they meet the standards of the CNHC?

Yes, unless there's any reason why they should not – e.g. if their own professional body has had cause for concern.  But generally, yes you'd expect them to be registered.   They have to go through an approval process.  When a practitioner applies to be admitted to the register, we will seek references on good character and health, proof of qualifications and so forth.  When all of that has been received, then they'd be admitted to the register.

You're doing that process for every single practitioner - that sounds pretty rigorous.

Yes, it is rigorous.  Some Professional Associations already have rigorous standards in place, plus processes like grandparenting and AP(E)L.  Where we're confident that's the case, we'll be working with those Professional Associations to try and foreshorten the procedure and reduce the  time it takes for individual practitioners  to join the register.

What's the response been from complementary practitioners as you've travelled around the country?

It's been a bit like the curate's egg - good in parts.  Some people whose professional associations have kept them up to date through their newsletters and magazines are positively enthusiastic, even if they are not quite ready to be admitted yet.  For example at an aromatherapy conference in Cardiff a couple of weeks back, I had a slot at the end of the conference and delegates were invited to remain if they wished.  I was delighted at the number of people who stayed at the end of a very long day.  When it finished people were still buttonholing me and said they couldn’t wait for the opportunity to be registered with a body that had such high standards.

How long do you think it will be before the majority of non-statutorily regulated therapists can come in? - a couple of years?

Less I would have thought.  We are seeking to regulate people who've been on the FIH programme, because it requires that people work with Skills for Health and have National Occupational Standards (NOS).  A couple of the professions left the programme without completing it last year.  One of them, the aromatherapists, will have met all of the CNHC criteria for the admission of members of their profession to the register, once they have established their PSB.  Two of the others that left the programme, we're unsure about - we are talking to them about where they are, but we're probably quite close to them being ready to make an application.

We've had approaches from the big health insurance companies and some private providers who would like to talk to us about integrating complementary care with orthodox medicine because their clients and patients are asking for it.

The GRCCT is selling itself as an alternative regulator to the CHNC.  What are your views on their work?

There's another regulator out there as well.  I think in any situation like this where there's a groundbreaking innovation,  then you're bound to have several organisations competing for a share of the market. 

We believe that our standards are very robust. We're the only regulatory body that has been supported and funded - and indeed continues to be funded - by the Department of Health.  The Health Minister attended our launch and wished us well. In addition, all our procedures have been signed off by lawyers who don't just provide services to us, but to the statutory bodies as well. 

Some people think it's taking us a long time to launch our register and therefore a couple of other organisations have nipped in.  But we think it's worth taking time to get it right.  Our two co-Chairs have a lifelong experience around regulation and health professions.  We're both anoraks in this business.  And we thought it would be a disservice to complementary healthcare practitioners if we were to rush and get it wrong.  Complementary healthcare practitioners have been working in some cases for a couple of decades to get to where we are today.  They don't want just another register - they are registered already with their Professional Associations.  They want a proper regulator with gravitas, which can offer a gold standard and a recognised kite mark. 

Maggy Wallace, co Chair CNHC © CNHCNew therapies seem to come into being every day.  Will it be possible to regulate novel therapies in the long term and are there groups that you wouldn't regulate?

The criteria that everyone has to meet is ensuring public safety.  If a therapy can demonstrate that there are National Occupational Standards recognised by Skills for Health - and they meet CNHC's other standards, then we may get involved. 

There might be areas of practice that do benefit the public,  but are not professions we should regulate. 

Take massage for example. You might be staying in a nice hotel  where you  have a swim, a sauna and a massage.  And that's usually a gentle relaxing massage given by someone trained in the beauty therapy industry - many of us will enjoy this experience when we're on holiday and it is lovely.  But the CNHC wouldn't be regulating those massage providers, because their services are not about healthcare but rather about relaxation and wellbeing. We would hope that they'd be hygienic and we'd hope that they would be people who are bound by their own codes.  But they are not qualified to NOS standards and thus the CNHC would not regulate them.

What comes across very strongly about regulation is the benefit to the public.  Are there also benefits for complementary practitioners?

 Some practitioners are saying 'well what's in it for us, because all we can see is that we're going to pay money'.   And I think what's in it for them are a number of things.  

Complementary healthcare is constantly under attack. But there are PCTs,  GP practices, acute trusts and others who know that their patients benefit from having sessions with complementary healthcare practitioners.  That can be anything from recognising that working with an Alexander Technique teacher can ease your lower back pain, through to massage reducing the pain in arthritic joints.

I think that, not far down the line, it will not be possible for anyone using public money to employ complementary practitioners who are not on the register.  I think it will become a requirement. 

We've also had approaches from the big health insurance companies and some private healthcare providers who would like to talk to us about integrating complementary care with orthodox medicine because their clients and patients are asking for it. But they need some reassurances; they want to be sure they won't be sued for appointing someone who's not appropriately qualified.   So I think there are going to be a signifcant commercial advantages to signing up.

Perhaps more importantly for many practitioners, for the first time they will have the opportunity to be registered with a gold standard regulatory body and will be able to display the CNHC kite mark in recognition of their attainment of and commitment to the highest possible standards for their profession.

 

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  • Sarah Roberts

    December 14, 2008

    I'm a first year undergraduate studying Complementary Medicine Practice at Glyndwr University, Wrexham. Having read your interview with Maggie Dunn it really excites me that complementary therapies are being recognised and integrated into our Health Service. More importantly the work which is being done to provide standards which will be acknowledged by health providers and drive complementary therapies forward it so essential for people wishing to access an integrated service. I look forward to becoming a member Kind Regards Sarah

  • Maggie Dunn

    November 21, 2008

    Just one clarification. Of course many masseurs who work in spas and beauty salons across the country are qualified to NOS standards. However there are others - including some working in major hotel chains - who do not have this qualification. So the simplest way to express it would be to forget about the venue and say NOS + professional body = you can apply for self-regulation, but no NOS or professional body = no self-regulation.