News update and forthcoming events / Complementary Therapies in Clinical Practice 16 (2010) 174e179176

Pioneering new courses in CAM at the University of Westminster

B. Isbell*

School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, United Kingdom

Over the past 15 years five complementary medicine BSc (Hons)degrees have been developed at the University of Westminster. Themultidisciplinary, innovative and internationally renowned Poly-clinic, where the students complete their clinical practice, underthe close supervision of experienced practitioners, reinforcescollaborative working. Placement opportunities enable students toextend their expertise in inter-professional working.

Following the successful validation in April 2010, the Schemehas been extended to 14 courses. The new Integrated Masters andMSc courses are in response to demands for highly skilled CAMpractitioners. The Integrated Masters (IM) planned to commence inSeptember 2010, are in Acupuncture, Herbal Medicine, NutritionalTherapy and Complementary Medicine (with pathways in Natu-ropathy or Therapeutic Massage, Aromatherapy and Shiatsu). IMcourses are identical to BSc (Hons) courses for the first three years

of a full time course. The IM route may be particularly suitable forthose with previous learning at degree level, but it is available to allapplicants. The fourth year, full time IM, develops individual scholarpractice by developing therapy skills, supervision, research skillsand clinical governance. The MSc courses include Acupuncture,Herbal Medicine, Nutritional Therapy and Complementary Medi-cine for practitioners of other CAM professions. Two-year part timeMSc courses will be offered from September 2011 and one-year FTfrom September 2012. Both the IM andMSc courses consist of shortlearning bursts of three days incorporating tutor, peer support andvirtual learning environments. MSc courses also contain a researchmethods module and a dissertation contributing to the evidencebase of CAM therapies. This course can assist students wishing toprogress onto MPhil/PhD or Professional Doctorate programmesalso available in the School of Life Sciences.

* Contact Professor Brian Isbell, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW,United Kingdom. Tel.: þ44 20 7911 5036; fax: þ44 20 7911 5028.E-mail address: isbellb@westminster.ac.uk

doi:10.1016/j.ctcp.2010.05.005

A noble vision and a flawed outcome

Roger James*, Mij Ferrett, Vivien RaySecretary, Vice-chair & Chair of the Craniosacral Therapy Association, Monomark House, 27 Old Gloucester Street, London WC1N 3XX, United Kingdom

The Complementary and Natural Healthcare Council (CNHC) hasbeen established with the aim of having one single independent,reliable regulator of complementary and alternative medicine(CAM). A key role in its formation was played by Prof Julie Stone,now of the Peninsula College of Medicine at Truro. She wrotea report published in 2005 for the Prince’s Foundation for Inte-grated Health on a possible federal regulator for complementarymedicine.1 The eventual outcome of this carefully researched andvery thorough report was the formation of the CNHC. In her guesteditorial for the February 2010 issue of the journal ComplementaryTherapies in Clinical Practice, Prof Stone laments the poor take-uprate of complementary and alternative medicine therapists regis-teringwith the CNHC and says that the failure of the organisation tobecome the single recognised regulator in the field will be to thedisadvantage of CAM professions in general.

Prof Stone’s reasoning is as elegant as ever, but in our view thereare flaws in it. This becomes more evident when one compares the2005 report with the guest editorial. In the editorial she says that ‘astumbling block for sector-wide sign-up seems to be coming fromthe professional associations, who have concerns that if practi-tioners become registered with the CNHC, their own membershipnumbers will fall’. That may be true of some opponents of CNHCfromwithin the professions, but it is not why we, the writers of this

letter, have opposed this model of regulation from the time it wasproposed.

The crucial reasons for our opposition are that we believe this isan inappropriate model and it runs the risk of being imposed uponcertain professions without adequate discussion or the consent ofa majority of their members.

Why inappropriate or flawed? That can be answered in thewords of Prof Stone herself who said in her 2005 report, “A [federalCAM regulator] would be owned by the professions it regulated.”(ibid 29) She makes a similar point elsewhere:

Because this is voluntary regulation, professionals have to buyinto the proposals. A new voluntary system can’t be imposed onpractitioners, because theywill have the responsibility of settingup and running the scheme. A systemwon’t be successful unlessprofessionals support it. (ibid p 30, our emphasis)

If one compares the structure of the wholly voluntary CNHCwith that of the nearest comparable organisation, the HealthProfessions Council (HPC), the most striking difference is that theHPC council is composed of equal or nearly equal numbers of layand practitioner members. This is the current pattern in all statu-torily regulated health professions. The CNHC in contrast, is run bya main board composed entirely of lay people.2 Instead of health

News update and forthcoming events / Complementary Therapies in Clinical Practice 16 (2010) 174e179 177

professionals being on the main board there is an advisory panel(profession specific board) for each therapy which includes somepractitioners, who can make recommendations to the main board.We believe this is a clumsy structure which is likely to be expensiveand CAM professionals will have no say in the main boardproceedings and subsequent regulatory decisions emerging fromthe CNHC. Recommendations from a peripheral committee will notcarry the same weight as having members of the regulatedprofessions on the board.

In the proposals for setting up the CNHC there was the ratherodd provision for three representatives of the professions to beallowed to attend main board meetings e but as observers only.This has been quietly dropped.

The decision to have a lay-only structure of the CNHC mainboard may be based on the opinion that CAM professions would beunable to come to mutual agreements regarding overarchingguidelines encompassing disparate therapeutic groups. There is noevidence to suggest that CAM professionals are incapable ofworking together.

So how did we get from the passage we have quoted from the2005 report to the current structure of the CNHC wherethe professions do anything but own the federal regulator? Theresponsibility must lie with those, including representatives ofthe CAM professions, who drew up the initial proposals whenestablishing the CNHC prior to its inception in 2008. It could bethat lack of support for the new regulator is related to the speedwith which it was set up which allowed no time to settle difficultissues.

Prof Stone made the critical observation in 2005 that estab-lishing a federal regulator was a process that could not be rushed.She called this a ‘significant task’ (ibid p 36) e in less academiclanguage one might translate this as a mammoth job e and that itwould take years rather than months. In a subsequent assessmentof the feasibility of the formation of a CAM federal regulator carriedout by Maggy Wallace for the Prince’s Foundation for IntegratedHealth in 2006, she wrote that any profession wishing to beinvolved ‘must wish to participate in the establishment of a federalapproach for complementary healthcare and must demonstrate itscommitment to the concept.’3

Our observations from within our own profession and what wehave learned through contacts with other CAM professional asso-ciations are that the consent and commitment of a majority in eachprofession have in some cases not been secured, with the resultthat numbers registered with the CNHC are very small in relation topotential registrants e even in those professions where the CNHCregister has been open for over a year. The feeling that is createdsuggests many CAM practitioners are being dragged kicking andscreaming into something their professions may not have beenproperly consulted about, still less approved.

There is also widespread concern among complementarypractioners about the methods the CNHC is employing to verify thequalifications of applicants to its register. The regulator is usingprofessional associations to carry out this task 4 One can seea reason for this e these associations may be considered capable ofknowing how well qualified their own members are. However, the

question arises as to why the CNHC does not do its own checking ofqualifications, and standards. In certain circumstances CNHC veri-fication can be done by an association to which the applicant doesnot belong.4 This is not likely to lead to confidence in the integrity ofthe CNHC or the credentials of its members.

One can understand that the management of a hospice or someother institution, within the NHS or outside, would be glad to knowthat they could refer to one central register to see if someonewanting to work for them was a fit and proper person. While thismay be a laudable aspiration, we do not believe the CNHC looks inthe least likely to be able to be able to provide the authoritative andinclusive listing of competent therapists which is its raison d’etre.Large numbers of CAM therapists have registered with a rivalorganisation, the General Regulatory Council for ComplementaryTherapies. Many more have decided to keep their trust in thealready existing tried and trusted professional organisations. Thelikelihood is that the CNHCmodel is not going towork in its presentform. It needs to ensure that it listens to the needs of healthprofessionals in order to meet these needs and gain the trust ofpractitioners and the public. CAM practitioners have years ofexperience and knowledge related to regulation and should beintegral to the structural development of the CNHC or equivalentorganisations.

Prof Stone says that the Government has ‘thrown its weightfully’ behind the creation of the CNHC. It is unclear what the newGovernment’s view will be, now that the CNHC has been inoperation for over a year. Taxpayers’ money has been put in to getit started and we would be surprised if the Department of Healthwere not having some misgivings by now. Without large addi-tional finance, the CNHC will not be able to finance its operationsfrom registrants’ fees for some time to come e possibly someyears.

Supporters of the CNHC talk as though self-regulation by CAMprofessions was unknown until the federal regulator appeared.CAM practitioners are regulated by a variety of professional asso-ciations which commonly utilise rigorous schemes of self-regula-tion, appropriate to the level of potential risks involved, andamatch for anything in the CNHC. The question and concern here iswhether the regulatory practices and roles of professional associ-ations can be safely and effectively left to one body. ProfessionalCAM associations are far more zealous for the safety of their clientsand the good name of their profession than any federal regulator islikely to be.

References

1. Stone J. Development of proposals for a future voluntary regulatory structure forcomplementary health care professions. The Prince of Wales’s Foundation forIntegrated Health; 2005.

2. Website of Complementary and Natural Healthcare Council, http://www.cnhc.org.uk/pages/index.cfm?page_id¼60. The Prince of Wales’s Foundation forIntegrated Health [2008] A Federal Approach to Professionally-Led VoluntaryRegulation for Complementary Healthcare p. 6.

3. Wallace M. PFIH feasibility/implementation study; 2006. p. 25.4. CNHC website, http://www.cnhc.org.uk/pages/index.cfm?page_id¼22.

* Corresponding author. Tel.: þ44 01342 810112.E-mail address: roger-james@tiscali.co.uk (R. James).

doi:10.1016/j.ctcp.2010.05.012