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Why is registration for naturopaths and Western herbalists an important public health issue?
Naturopaths and Western herbalists are now an integral part of the Australian healthcare system and form Australia’s largest complementary medicine professional group. Approximately half of Australians consult with complementary medicine practitioners and approximately 1 in 6 utilise them as their primary care practitioners. Australians rarely discuss this use with their conventional healthcare provides. Due to the ongoing popularity of naturopathy and Western herbal medicine, minimum educational and practice standards are required of these practitioners to ensure public safety and promote best practice.
Does the profession support registration?
Yes, the limited data that has been collected suggests that practitioners in naturopathic and Western herbal medicine professions do support independent registration. Registration is also supported by peak medical groups, public health bodies and other health professions.
Why haven’t naturopaths and Western herbalists been registered yet?
Naturopaths have been previously registered in the Northern Territory. The federal Mutual Recognition Act 1992 superseded this territory-based legislation and due to the low numbers of practitioners in the territory new replacement legislation was not drafted. The Victorian government initiated an investigation in 2003 into the registration of naturopaths and Western herbalists as part of its aim of improving public safety and raising the standards of complementary medicine practitioners following the implementation of the Chinese Medicine Registration Bill 2000. The report, entitled The Practice and Regulatory Requirements of Naturopathy and Western Herbal Medicine was published in 2005 and strongly recommended that these professions be statutorily regulated (a copy of the report is available in the links section). The implementation of statutory regulation in Victoria was delayed indefinitely in deference to the broader federal National Registration and Accreditation Scheme for Health Professionals. Naturopaths and Western herbalists will be considered for inclusion in the national registration scheme when the process examines unregulated health practitioners. This process may take some time and the current register is designed to protect public safety in the interim and be ultimately subsumed by the broader national registration scheme if and when naturopaths and Western herbalists are included.
Are naturopathy and herbal medicine registered anywhere else?
Yes, there is a definite trend towards registration. Naturopaths are currently licensed by the US and Canadian government in 19 US states and territories and 6 Canadian Provinces. Seven more US states and all remaining Canadian provinces and territories are pursuing registration. In the United Kingdom, where Western herbalism is a more common profession, moves are currently underway to develop statutory registration for that profession. Naturopaths and Western herbalists in other jurisdictions including New Zealand, South Africa, Germany and India are either already registered or it is being actively pursued.
Shouldn’t the professional associations register members?
The naturopathic and Western herbal medicine professions are currently self-regulated largely through the professional associations but standards such as minimum education requirements and complaints handling processes vary considerably. Professional associations do an excellent job of promoting and advocating for their professions but a conflict of interest arises when an organisation is trying to protect the interests of both the public and the profession. Whilst this arrangement has not been tested in Australia it has been legally tested and failed in other jurisdictions such as South Africa where it was mandated that registration of health professions such as naturopaths and Western herbalists needed to be carried out by an organisation independent of the profession.
How does this differ from the Code of Conduct for Unregistered Health Practitioners?
Each state has its own separate code of conduct for unregistered health practitioners.
ACT: http://hrc.act.gov.au/health/health-service-complaints/ (ACT human rights commission)
NSW: https://www.hccc.nsw.gov.au/ (Health care complaints commission)
NT: http://www.hcscc.nt.gov.au/ (Health and Community Services complaints commission)
QLD: http://www.hqcc.qld.gov.au/ (Office of the health ombudsman)
SA: http://www.hcscc.sa.gov.au/ (Health and community services complaints commissioner)
TAS: http://www.healthcomplaints.tas.gov.au/home (Health complaints commissioner)
VIC: https://hcc.vic.gov.au/ (Health complaints commissioner)
WA: https://www.hadsco.wa.gov.au/home/ (Health and disability services complaints office)
On the other hand, ARONAH is a national register, and offers prospective protection regardless of specific State or Territory legislation. Minimum practice standards are required by ARONAH and practitioners are expected to adhere to the Code of Conduct as set out by ARONAH.
The other major difference between each state and territory’s code of conduct is that the Code of Conduct is reactive in nature whilst the ARONAH is proactive. The Code of Conduct is based on negative licensing – which levies no barriers to entry to practise but can take the right to practise away once practitioners have been shown to act unethically or unprofessionally. It still requires harm to have occurred before the Code of Conduct legislation can be enforced. ARONAH is proactive in that it tries to actively prevent exposure to risk from happening by ensuring those practitioners with minimum qualifications and practise standards are known to the public before health advice is sought. Registration identifies practitioners who are less likely to pose risk before the patient sees them in addition to appropriately and independently handling retrospective events. In a statutory registration model punitive measures for those who breach ethical or professional standards are equal to or greater than the Code of Conduct and for this reason ARONAH will be advocating for the statutory registration of naturopaths and herbalists under the federal government’s National Registration and Accreditation Scheme.
Won’t this simply legitimise a therapy with little evidence of benefit?
It is not the role of an independent register to comment on the evidence or legitimacy of the profession it registers but to safeguard members of the public who choose the registered practitioners. These issues were dealt with comprehensively by the original Victorian government report “The Practice and Regulatory Requirements of Naturopathy and Western Herbal Medicine” and a copy of this report can be found in the links section of this website. The fact is that complementary therapies are widely used by the Australian population already and use of complementary therapists is increasing. Visits to complementary therapists account for nearly half of total health consultations in Australia. Naturopaths and Western herbalists are the largest complementary therapist group, are already being consulted heavily by the general public and are already seen as legitimate therapists by those who employ their services. This perceived legitimacy requires practitioners to abide by certain minimum educational and practice standards appropriate for any health profession. It relates to the ability to identify situations where referral to other health practitioners is appropriate as well as delivering effective and safe treatment. It is not the role of the register to promote or condone any one therapy, but rather to ensure that the therapies the public are choosing to use are delivered safely and ethically, and to ensure an independent and transparent complaints mechanism is available when appropriate.
Where can I find more information?
This issue has been explored at some depth by a variety of means. The information on this FAQ has been sourced from documents available in the external links.