CAM legislation in Denmark

Doctors and other authorized health professionals only have a monopoly over well-defined treatments such as surgical procedures or prescribing medicine. Others are allowed to "give treatment to patients".

In order to improve quality and patient safety, Denmark established a registration scheme for CAM-practitioners in 2004:

Law regarding an industry-administered registration scheme for alternative practitioners (the RAB law) https://www.retsinformation.dk/Forms/R0710.aspx?id=9900

The act defines an alternative practitioner as follows:

"By alternative practitioner is meant a person who performs health-related activities outside the publicly funded health services, and who is not authorized to perform these activities, nor subject to supervision by the Health Authorities of healthcare services provided by persons within the national health services."  https://www.retsinformation.dk/forms/r0710.aspx?id=143297

Note: The most recent revision of the act, which will become law on the 1st of July 2017, says (among other things) that: "The law applies to registered alternative practitioners and to authorized health professionals, who have previously been registered as alternative practitioners pursuant to §3 of the law. A registered alternative practitioner may be either a person without a healthcare authorization, as well as a person with healthcare authorization."

The scheme is subject to voluntary, industry-administered registration, which means that professional associations must fulfill certain requirements in order to register a member as a registered alternative practitioner (RAB - see below).

Since 2004, this law has made it possible for alternative practitioners to use the  'RAB' title, as long as they belong to a professional association that has been approved by the Danish Patient Safety Authority.

An alternative practitioner can thus only be RAB-registered via their professional association. Read more about the professional associations and what is required of them here: www.srab.dk/english/

 

The most important educational requirements

In order to be RAB-registered, alternative practitioners must, as a minimum, have completed a training that fulfills the educational requirements set by the Patient Safety Authority. The following are the most important requirements:

  • A health-education comprising a minimum of 660 lessons, each of at least 45 minutes duration.
  • The training must include both theory and practice.
  • The training must include a minimum of 250 lessons or lectures covering the primary specialty or therapy.
  • Furthermore, the training must include basic health legislation, clinical training/direct patient contact, psychology, and an introduction to other alternative therapies.
  • Final exams in the basic subjects of anatomy, physiology and pathology are obligatory. The relevant professional association must set the requirements for these exams to ensure that the applicant possesses the necessary professional insight and understanding. If needed, the association may hold the exams themselves.
  • The associating must ensure that the applicant's training is up to date, and that it fulfills the relevant amount of continual professional development.

E-learning can account for a minor part of the education, especially in the academic subjects, but there must always be formal teacher-student relationship. E-learning may account for up to 100% of the academic subjects, but max 33% of the primary discipline, although the proportion may be up to 75% of the academically founded disciplines such as homeopathy, nutritional therapy and naturopathy.

The above is only applicable to the minimum requirements set by law.

 

The most important requirements of the professional associations

  • The association must have a code of conduct for clinical practice.
  • The association must have a complaints procedure, which is satisfactory for all parties.
  • The association must set basic educational and professional requirements for the members that gain permission by the association to use the title 'registered alternative practitioner' (RAB).

More details of the statutory order can be found here https://www.retsinformation.dk/forms/r0710.aspx?id=143297

 

Other relevant legislation

Overview of CAM legislation in Europe: http://nafkam-camregulation.uit.no/country/denmark/

The Danish Health Act https://www.retsinformation.dk/Forms/R0710.aspx?id=130455

Legislation regarding authorization of health professionals and healthcare activities

https://www.retsinformation.dk/Forms/R0710.aspx?id=138178

 

Specifics for acupuncture

From the 1st of January 2007 it has been permitted for everyone, including people without a healthcare authorization, to use needle acupuncture for treatment purposes. A precondition for this is that the treatment does not pose a demonstrable risk to the patient's health.

The changes only apply to needle acupuncture and not to injection of pharmaceutical products, natural remedies, etc, which are still restricted to medical doctors and other health professionals that are permitted by law to perform injections.

 

SRAB: A state-run forum for dialog and bridge-building

SRAB - The Danish Health Authority's Council for CAM - has existed since 1985. The council's task list includes

  • to assist and inspire the Health Authority in matters related to the counseling of other authorities, ministries, institutions, alternative associations etc.
  • to inspire initiatives to launch bridge building projects between the established health care system and alternative practitioners
  • to contribute to and facilitate information regarding CAM to the established health care system and the public
  • to debate the integration of alternative medicine into the established health care system

The council was established after an appeal from the Home Office in the light of increasing public interest in alternative medicine, and in connection with a parliamentary discussion of a proposal for initiatives regarding alternative medicine and healthcare methods.

As a consequence, on the 24 June 1985 the Home Office asked the Health Authority to initiate the establishment of a contact group including alternative practitioner associations and the Health Authority. The group became responsible for facilitating a dialog between established and alternative practitioners, and its responsibilities also included participating in the attempt to further knowledge and understanding of alternative treatment methods.

The contact group was given the name "The Danish Health Authority's Contact Group Regarding Alternative Medicine/Therapy. In at meeting on the 23 April , it was decided to change the name of the group to The Danish Health Authority's Council for Alternative Medicine (SRAB), and this is the origin of the name for this website.  A progress report of the Council's work from 1987-2000 can be found on http://www.sst.dk/publ/Publ2001/statusrapp_alternativbeh/status.html