What Happened to the Regulation of Acupuncture in the UK?

[attilio]

Do you remember that time not so long ago, when we held the idea of statutory regulation of acupuncture close to our bosom? Well, what ever happened to it?

It seems the practice of acupuncture in the UK hasn't gotten any better and in fact has gotten worse. More and more physiotherapists, doctors and the like are performing acupuncture. The public are experiencing acupuncture first through physiotherapists.

Governing associations such as the British Acupuncture Council don't seem to be holding our best interests to heart. In face, it seems that they are advocating the practice of acupuncture by the likes of physiotherapists. Where does that leave us more qualified acupuncturists?

Have we been totally shafted?

[Janet Bardini]

Where I practice in New York State, our organization ASNY (acupuncture society of new York) remains hard at work to protect our profession. Everyone here would like to get a piece of our action..physical therapists, podiatrists, chiropractors. It is bad enough that medical doctors get away with obtaining an acupuncture license with only 300 hours worth of training, but also they can hire properly trained practitioners and pay them poorly. In New York state, many of us accept what we call "No Fault" insurance, which allows patients who have been in auto accidents to receive proper medical care like acupuncture. The insurance companies would like to shut that down so our lobbying efforts iN Albany keep busy. We are most concerned about "dry needling", which allows physical therapist to insert acupuncture needles into trigger points. Perhaps it's time for you guys to form another organization to address your issues. Best of luck to you, we are thinking of you here in the states.

[Nick Pahl, CEO, BAcC]

Dear Attilio and all,

I would like to state that the British Acupuncture Council do of course hold members best interests to heart with regard to recognition for its members - a wish to be statutory regulated is part of our published strategy and our public affairs plan states how we plan to put this into practice.

Positive steps are being taken. For example, currently, we are planning to join the Council for Healthcare Regulatory Excellence (CHRE - a govt super regulator or bodies such as HPC, NMC etc)) as an accredited professional body, later this year. This will provide members with the ability to be recognised in NHS bidding and we hope access to new private health insurer reimbursemnt e.g. from BUPA. The minister concerned suggests this is the best way forward and the Health Professions Council Chair said this was the best "first rung on the ladder" for us.

We do have to recognise the current political environment - that the current UK Government does not want to statutory regulate healthcare professionals unless there is a risk to the public. They are also aware of the cost to Govt of statutory regulation (which led to the self- financing CHRE scheme).

As I mentioned on a brief phone call to Atillio this morning, the British Acupuncture Council does not advocate the practice of acupuncture by the likes of physiotherapists. We wish to engage with them so they understand BAcC members level of training and what we offer on the ground. A formal meeting with AACP regional co-ordinators to explain this is planned in the Autumn. Our NHS toolkit was clear on the differences between what we offer and other professionals who practice acupuncture.

I also stated to Atillio that we do wish to work with Chinese associations -and have met on several occasions with ATCM, RCHM and others to explore partnerships around research (we hope the ARRC symposium next year will be in partnership with ATCMA and RCHM), accrediation and other areas. You will not that our conference this year has Prof Benny Mei from CMIR speaking.

I would encourage all those who read Chinese Medical Times to also come to our conference on 28-30th September at the Beaumont Estate, to continue this discussion.

thankyour

Nick Pahl
CEO
British Acupuncture Council

[Steven Owens]

Dear Attilio and all,

I would like to state that the British Acupuncture Council do of course hold members best interests to heart with regard to recognition for its members - a wish to be statutory regulated is part of our published strategy and our public affairs plan states how we plan to put this into practice.

Positive steps are being taken. For example, currently, we are planning to join the Council for Healthcare Regulatory Excellence (CHRE - a govt super regulator or bodies such as HPC, NMC etc)) as an accredited professional body, later this year. This will provide members with the ability to be recognised in NHS bidding and we hope access to new private health insurer reimbursemnt e.g. from BUPA. The minister concerned suggests this is the best way forward and the Health Professions Council Chair said this was the best "first rung on the ladder" for us.

We do have to recognise the current political environment - that the current UK Government does not want to statutory regulate healthcare professionals unless there is a risk to the public. They are also aware of the cost to Govt of statutory regulation (which led to the self- financing CHRE scheme).

As I mentioned on a brief phone call to Atillio this morning, the British Acupuncture Council does not advocate the practice of acupuncture by the likes of physiotherapists. We wish to engage with them so they understand BAcC members level of training and what we offer on the ground. A formal meeting with AACP regional co-ordinators to explain this is planned in the Autumn. Our NHS toolkit was clear on the differences between what we offer and other professionals who practice acupuncture.

I also stated to Atillio that we do wish to work with Chinese associations -and have met on several occasions with ATCM, RCHM and others to explore partnerships around research (we hope the ARRC symposium next year will be in partnership with ATCMA and RCHM), accrediation and other areas. You will not that our conference this year has Prof Benny Mei from CMIR speaking.

I would encourage all those who read Chinese Medical Times to also come to our conference on 28-30th September at the Beaumont Estate, to continue this discussion.

thankyour

Nick Pahl
CEO
British Acupuncture Council

I joined the BAcC in 2008. At that time I recall reading a forum post stating that 'we (the BAcc) were going to to be statutorily regulated whether we liked it or not'. At that time SSR was the preferred option and not everyone was keen on SR. If that statement was true then future events did not support that. Eventually we failed to get SR on the basis that we were too safe )our level of safe practise did not justify being granted SR (as compared with those dangerous CH's - LOL). With the benefit of hindsight it's clear to me that the politicians were toying with us all along. They were never going to grant us SR. I daresay that at some point prior to failing to get SR we )the BAcC) were told that a good safety record was necessary to get SR? Then that same ssid safety record became the basis for denying us SR. From the politicians POV the process was predictable given the nature of British politics. The only thing about all of this that bothers me was the lack of foresight of those involved in the SR process (those in the BAcC) who didn't see this coming. They obviously didn't see it coming because if they did then it should have been discussed with the membership - which it was not (no surprise their as the BAcC do not have a great record when it comes to open discussion with its membership).

So now history starts to repeat itself. The BAcC CEO states that the minister concerned 'suggests' CHRE is the best way forward. We should learn from experience that 'suggestions' from politicians means nothing. The CHRE does to not equate to SR. It's a consolation prize at best.

The BAcC CEO says 'clear on the differences between what we offer and other professionals who practice acupuncture'. My question is to whom is this being addressed? If it's the general public then this approach is inadequate. The general public lack the intelligence, academic rigour and personal interest to be able to interpret what this statement means. On that basis the BAcC should be openly challenging the standard of non-traditional acupuncture practise versus traditional acupuncture practise (not to forget standards of education, training etc). Unfortunately the BAcc refuses to be confrontational in any way. A result of that is the general public do not appreciate what we do compared to what the dry needlers do. IMO this is a failure of the BAcC to educate the public properly and only the BAcC are to blame for that.

Not joining forces with other Chinese Associations was a big mistake. CHM got SR and had the BAcC aligned themsleves with the CHM community (RCHM etc) then we too would have been more likely to have gotten SR. The idea the CHM got SR because it is a bigger risk to the public (some of its herbs have toxic qualities) and acupuncture did not need to be SR'd becasue it is safer is bull. In the wrong hands an acupuncture needle can do as much damage to the health of a patient as any toxic herb. The fact of the matter is that CH's are trained to use herbs with toxic qualities correctly so that they do not poison their patients - in the same way that acupuncturists are trained to needle their patients safely. The basis on which CHM got SR and acupuncture did not (risk and public safety) is unsafe. Did The BAcC dispute the basis of SR being granted on the grounds of risk/public safety?

[CSuffolk]

"Unfortunately the BAcc refuses to be confrontational in any way. A result of that is the general public do not appreciate what we do compared to what the dry needlers do. IMO this is a failure of the BAcC to educate the public properly and only the BAcC are to blame for that."

I absolutely agree that BAcC are weak and toothless. I joined as a student in 1999 when they were saying all the same things, 'We'll protect your training and professional qualifications'. They also used to talk about dry needling and medical acupuncture as being different to TCM and that they should not use the word 'acupuncture' to describe these systems, which was great ...until they backed down and the medical acupuncturists were welcomed into BAcC.

Honestly.
I had a medical acu practitioner call me up for advice last year. "How many treatments does it take to cure morning sickness? So i asked her if she had any syndrome diagnosis training, which she didn't. I had to advise that really the accuracy of the diagnosis is the (only) way to get a good and fast response, and without any she was going to really struggle. I was polite and encouraged her to go and get some more training which she said she would do. But how are the public supposed to know who to go and see??

I left BAcC and i have not regretted it. I am insured very well by the CtHA for £125/ year and i have not had any problems generating work without them. If i had stayed with BAcC i would have by now, paid them £10,000 in membership fees, which is pretty steep for inclusion on a website...

Now IF they had actually done anything to inform the public about who we are, what our training is, and about 'the others' who use needles, i'd have been happy to support them to have their nice smart offices in London to do it. But i don't see any support for us at all. Conferences are not what i want. It's like having the civil service running a post office. There really aren't that many of us. We all want the same thing, we want our profession protected so the public know who to choose. If you can't do it through legislation then do it through education.

[Steven Owens]

I absolutely agree that BAcC are weak and toothless. I joined as a student in 1999 when they were saying all the same things, 'We'll protect your training and professional qualifications'. They also used to talk about dry needling and medical acupuncture as being different to TCM and that they should not use the word 'acupuncture' to describe these systems, which was great ...until they backed down and the medical acupuncturists were welcomed into BAcC.

Honestly.
I had a medical acu practitioner call me up for advice last year. "How many treatments does it take to cure morning sickness? So i asked her if she had any syndrome diagnosis training, which she didn't. I had to advise that really the accuracy of the diagnosis is the (only) way to get a good and fast response, and without any she was going to really struggle. I was polite and encouraged her to go and get some more training which she said she would do. But how are the public supposed to know who to go and see??

I left BAcC and i have not regretted it. I am insured very well by the CtHA for £125/ year and i have not had any problems generating work without them. If i had stayed with BAcC i would have by now, paid them £10,000 in membership fees, which is pretty steep for inclusion on a website...

Now IF they had actually done anything to inform the public about who we are, what our training is, and about 'the others' who use needles, i'd have been happy to support them to have their nice smart offices in London to do it. But i don't see any support for us at all. Conferences are not what i want. It's like having the civil service running a post office. There really aren't that many of us. We all want the same thing, we want our profession protected so the public know who to choose. If you can't do it through legislation then do it through education.

A big problem with the BAcC is that they avoid being truthful about the benefits of traditional acupuncture versus the lack of benefits of non-traditional acupuncture because in doing so that would be interpreted as being confrontational (by non-traditional acupuncture practitioners/organisations). The fact is that traditional acupuncture offers better theory and better treatments than the non-traditional acupuncture styles. During my time as a BAcC member I would have liked the BAcC to have been open about this even if it did cause offence for others.

This ties in with educating the public. To help the public appreciate that what we offer (as traditional acupuncturists) is better than that offered by non-traditional acupuncturists would have to imply that we are a better option - that we are better at providing acupuncture treatment. IMO this is unavoidable but the BAcC refused and still refuse to acknowledge this. The truth always involves a degree of controversy but it is better to be accurate and truthful in one's dealings with the public than play the political game and fail to educate the public properly. As an organisation I think the BAcC have failed and continue to fail to educate the public properly - which is why their is an unhealthy pressure on individual members to do it behind closed doors as that helps the BAcC to avoid doing it publicly on a grander scale. It is as though the membership are being used to compensate the BAcC for its failings (as an organisation) where educating the public are concerned.

If the price to pay for not getting SR was/is an organisation that represents its membership and their profession truthfully and openly, then I would consider that as acceptable. However the BAcC do not represent their membership and the acupuncture profession adequately and to top it off failed to get SR.

The best thing I did as a BAcC member was leave. As far as I'm concerned the BAcC may be the leading governing organisation by virtue of the number of members (quantity) but they are not as far as quality is concerned. The BAcC are over rated and over priced. Students are encouraged to join the BAcC upon graduation with little discussion of the alternatives - of which there are several. Any idea that life outside of the BAcC is not so rosy is false.

[attilio]

I would like to state that the British Acupuncture Council do of course hold members best interests to heart with regard to recognition for its members - a wish to be statutory regulated is part of our published strategy and our public affairs plan states how we plan to put this into practice.

We do have to recognise the current political environment - that the current UK Government does not want to statutory regulate healthcare professionals unless there is a risk to the public. They are also aware of the cost to Govt of statutory regulation (which led to the self- financing CHRE scheme).

As I mentioned on a brief phone call to Atillio this morning, the British Acupuncture Council does not advocate the practice of acupuncture by the likes of physiotherapists. We wish to engage with them so they understand BAcC members level of training and what we offer on the ground. A formal meeting with AACP regional co-ordinators to explain this is planned in the Autumn. Our NHS toolkit was clear on the differences between what we offer and other professionals who practice acupuncture.

I also stated to Atillio that we do wish to work with Chinese associations -and have met on several occasions with ATCM, RCHM and others to explore partnerships around research (we hope the ARRC symposium next year will be in partnership with ATCMA and RCHM), accrediation and other areas. You will not that our conference this year has Prof Benny Mei from CMIR speaking.

Dear Nick and all,

I believe that letting physiotherapists know the different level of education that BAcC members have undertaken compared to them, isn't going to have much benefit to the public or to us. To use Chinese medicine theory, this is like treating the branch when we need to treat the root problem and that is the government's stance on statutory regulation of acupuncture. I hope that the BAC decides to work alongside other Chinese associations rather than against them (previous administration) and lobbys the government for the statutory regulation of acupuncture in the UK. We want to adopt a similar field for Chinese medicine to that being developed in Australia. Anything else will undermine our profession and see the slow death of it.

I would like readers to note that i am not attacking the BAcC. Instead, i am offering this advice to help is stay alive and keep us acupuncturists centre stage in the practice of acupuncture. If the measures I've described above are not taken, less people will study acupuncture, it will be watered down by poorly educated physiotherapists and the BAcC itself will see a loss of member numbers and it's eventual demise or merger with a physiotherapy association. Becoming chartered or members of the CHRE is just a stop-gap approach that will not help us in the long run.

[Steven Owens]

Dear Nick and all,

I believe that letting physiotherapists know the different level of education that BAcC members have undertaken compared to them, isn't going to have much benefit to the public or to us. To use Chinese medicine theory, this is like treating the branch when we need to treat the root problem and that is the government's stance on statutory regulation of acupuncture. I hope that the BAC decides to work alongside other Chinese associations rather than against them (previous administration) and lobbys the government for the statutory regulation of acupuncture in the UK. We want to adopt a similar field for Chinese medicine to that being developed in Australia. Anything else will undermine our profession and see the slow death of it.

I would like readers to note that i am not attacking the BAcC. Instead, i am offering this advice to help is stay alive and keep us acupuncturists centre stage in the practice of acupuncture. If the measures I've described above are not taken, less people will study acupuncture, it will be watered down by poorly educated physiotherapists and the BAcC itself will see a loss of member numbers and it's eventual demise or merger with a physiotherapy association. Becoming chartered or members of the CHRE is just a stop-gap approach that will not help us in the long run.

Unless there is going to be a ban on the practise of acupuncture in the UK then the governments stance on SR is not such a problem. The acupuncture profession is dependent more on patients than government approval. education of the public about different styles of acupuncture and their pros and cons is of most importance - which would remain an issue even were we to be granted SR. Unfortunately the BAcC will not promote acupuncture properly because of the controversy that might encourage - the BAcC will not directly imply/say publicly that traditional acupuncture is a better treatment option than non-traditional acupuncture treatments. It makes statements that are left to interpretation by a public ill equiped to arrive at the correct interpretation. The issue of educating the public is the most pressing issue facing the BAcC.

The fact that the acupuncture and CHM have become more or less seperate entities has undermined the development of TCM in the UK in all respects. There are too many courses teaching only acupuncture or only CHM. In the future courses should develop which teach the two practices together under the banner of TCM. The more there are courses which teach one or the other undermines the credibility of TCM in the UK.

Towards the end of my membership of the BAcC I felt that there was an air of resignation within the BAcC hierarchy underlying their acceptance that eventually traditional and non-traditional acupuncture will merge into something else that the government feels it can recognise and that that something will be far from what we recognise today as traditional acupuncture. If that's the case then the BAcC is being run by the wrong people and is being run the wrong way.

[Nick Pahl, CEO, BAcC]

Hi all,
Certainly I accept there has been expectations that we were going to achieve SR in the past, that did not materialise. This was before my time at the BAcC, but its fair to say there are many other professional bodies who also wished to get SR, such as Counsellors and Psychotherapists, who did not achieve their aim either.

I do think our PR and marketing has been successfull. Between May and July this year we acheived a coverage reach for members of 13.4m and a total circulation reach of 10.6m people. The new Acupuncture Awareness week has brought in increases in patients of up to 50% for some members. We also have over 42000 unique hits from members of the public to the BAcC website - better than our "competitors".

I would like to invite you to our "nice smart offices in London" ! They are certainly cheap (£11/sq foot) but hardly smart. However, I do defend our aim to be ambitious for the acupuncture profession. A London office presence is important to be able to lobby and make our case to the Department of Health, the Privy Council and MPs, amongst others. We have achieved recognition from the Dept of health NHS Personal budgets team recently (to be featured in the forthcoming Acupuncturist).

Regarding our lack of being confrontational. Certainly we are making our case strongly to the AACP and are meeting them in the Autumn to make state how traditional acupuncture offers its theory and treatments in a way that is significantly different to non-traditional acupuncture styles.

Finally, a reminder of what membership offers:
1. the Acupuncturist
2. marketing and PR support
3. monthly E news
4. the European Journal of Oriental Medicine, the major professional publication for news, and science articles
5. access to the members' area of the BAcC website. The members' area has the following facilities: members' news and information; CPD Centre; and discussion forums allowing members to exchange views, professional advice and scientific information in discipline specific, general, CPD, education and other issues
6. reduced fees at the BAcC Conference, the largest and most comprehensive conference of its kind in the UK
7. free national workshops such as on the NHS
8. regional group meetings
9. (from 2013) - recognition by the Council for Healthcare Regulatory Excellence
10. fellowship - a standard for senior professionals
11. designatory letters to confer professional status
12. professional indemnity insurance
13. expert advice to members on professional issues such as safety, education, careers, management and other matters affecting working lives
14. the opportunity to become involved in BAcC Governance
15. legal advice: 24 hour legal helpline
16. (from 2013) web based learning area
17. PDQ machine offer

Nick Pahl
CEO

[Steven Owens]

'Regarding our lack of being confrontational. Certainly we are making our case strongly to the AACP and are meeting them in the Autumn to make state how traditional acupuncture offers its theory and treatments in a way that is significantly different to non-traditional acupuncture styles.'

Making a case to the AACP regarding what we do (theory/treatments) is going to benefit traditional acupuncturists in what way/s?

It is not the AACP that we need to explain ourselves to - it is the public that need to understand exactly what we represent, what we do, how we do it, why we do it and, how they can benefit in terms of their health needs. It is the public that we need to explain ourselves to. It needs to be done in a better way than it has been done in the past.

'significantly different' is a typical BAcC phrase used to differentiate traditional from non-traditional acupuncture/ists. Unfortunately it's equally typical of the language used by the BAcC to avoid controversy of any degree because the word 'different' is open to interpretation (and therefore less likely to offend anyone who is a non-traditional acupuncturist). Interpretation by who? The public will not be able to appreciate 'different' as meaning 'better' or 'more effective' or more likely to help you with your health problem than dry needling'. If the public are not able to appreciate the meaning of 'different' then why continue to use it if it does not help traditional acupuncturists to distinguish themselves from non-traditional acupuncturists (apart from avoiding courting controversy)?

Proper education of the public is a win-win situation. Patients benefit from getting higher quality (more effective) acupuncture treatment. Acupuncturists attract more patients and therefore make more money. The acupuncture profession attracts more practitioners (who are happier in what they do). Fail to make the correct choice about who we need to educate and then fail to educate them properly will not benefit anyone.