Etat des lieux de l'homéopathie en Belgique - KCE

6 Homeopathy KCE Reports 154
1 INTRODUCTION
1.1 BACKGROUND
Acupuncture, chiropractic, osteopathy and homeopathy are practices classified as
complementary and alternative medicine. In 2007, the National Center for
Complementary and Alternative Medicine (NCCAM) of the National Institute of Health
(US) defined these medicines as a ’group of diverse medical and healthcare systems,
practices and products that are not currently considered to be part of conventional
medicine’. These therapies are referred to as ‘complementary’ where they are used
jointly with conventional treatments, and as ‘alternative’ where they are used instead of
conventional treatment.
Prior to this, in 1993, the British Medical Association 1 defined them as ‘those forms of
treatment which are not widely used by the orthodox health care professions and the
skills of which are not taught as part of the undergraduate curriculum of orthodox
medical and paramedical health care courses’.
The WHO defined them as: ‘a broad set of health care practices that are not part of the
country’s own tradition and are not integrated into the dominant health care system’* 2 .
In Belgium, performing a diagnosis and dispensing treatment for a physical or
psychological disorder are legally restricted to the holders of a diploma of doctor of
medicine approved by the competent medical commission (Royal Decree 78) 3 . In
principle, only they can use Complementary and Alternative Medicines (CAMs) to care
for patients. There are a number of treatments that can be dispensed legally by
physiotherapists – on medical prescription – that may form part of a non-conventional
treatment.
In 1999, a law concerning non-conventional medicines was promulgated. This law
covers homeopathy, chiropractic, osteopathy and acupuncture, and also holds out the
possibility of recognising other alternative or complementary therapies. The purpose of
the law is to allow practitioners of these practices to be registered as such and to
practice legally the non-conventional medicines concerned. For this to happen, the nonconventional
practices must also be registered. The law establishes the creation of a
joint commission (one for all four practices) and four chambers (one for each nonconventional
medicine) to advise the Minister for Public Health on the practice of
CAMs. This includes among others the conditions for the registration of practitioners
and the practices themselves, treatments not authorised for non-doctor practitioners
and membership of recognised professional unions.
Since 1999 very little of the Colla law has been executed. A Royal Decree and a
ministerial order have been published, which describe the recognition procedure and
the conditions for the recognition of professional unions for non-conventional practices.
In addition, a number of professional unions have been recognised by this Royal Decree.
Ten years later, the law of 1999 has only been partially implemented because neither
the commission nor the chambers have been established. At the end of 2010, a number
of initiatives have been taken to execute the law. The Minister for Public Health and
Social Affairs have meanwhile asked the Federal Healthcare Knowledge Centre (KCE)
to draw up a report on the situation of these practices in order to review or implement
the law of 1999.
The alternative medicines project includes the publication of three reports: the first
published report dealt with osteopathy and chiropraxy; the second was devoted to
acupuncture; this last one is dealing with homeopathy.