BOWEN PROFESSIONAL FORUM
 

Regulation

Simple Guide to Regulation

1. Why is regulation necessary?

2. What are the benefits of regulation?

3. What are the options for Regulation?

4. What is the difference between Statutory Self Regulation (SSR) and Voluntary Self Regulation (VSR)?

5. Why has Statutory Self Regulation been ruled out?

6. What are other groups doing?

7. What are the options for Voluntary Self Regulation?

8. What are the benefits of the Federal Structure?

9. What does the Bowen Forum recommend?

10. How much will it cost me?

11. Why can’t my Association regulate me?

12. What is the process leading to Voluntary Self Regulation?

13. How long will it take to set up a regulatory body?

14. Please can you describe how a regulator fits in with the existing professional associations?

15. Do I have to be registered with the regulating body to practise Bowen?

16. Can I be registered, if I am not a member of an Association?

17. Will regulation benefit professional practice?

18. What will happen to existing Bowen membership associations once VSR is in place?

 

Q. Why is regulation necessary?

Regulation is necessary for the protection of patients and the general public. This position was endorsed by the House of Lords Select Committee report in November 2000 on complementary medicine which called for the regulation of therapies including Bowen and most other common therapies. The Bowen Forum is working with the Prince’s Foundation for Integrated Health (PFIH) in exploring the options for regulation.

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Q. What are the benefits of regulation?

Firstly it provides public protection and safety. At present anyone can set himself or herself up as a Bowen Therapist or can practice Bowen under Common Law, even if they have only done a weekend course or read a book, or not even that! The public needs to have confidence that when they engage the services of an Bowen Therapist, that the therapist has met the required standards of training; is insured; has an enforceable Code of Ethics, Conduct and Disciplinary Procedures applying to them; and updates their knowledge regularly and that there is redress for the patient should there be a problem.

Secondly, only through having a regulated profession will Bowen achieve the credibility and status necessary for doctors to refer patients on a widespread basis. Regulation will hopefully result in increased access to the therapy, including through the NHS. The CNHC is already in discussions with health insurance companies who are interested in covering treatments by therapists regulated by the CNHC.

Thirdly it protects qualified practitioners from having their position undermined and the therapy’s status discredited by unqualified people claiming to have the expertise to practice on the same basis. Also prospective students of Bowen will be protected from those who may run courses which do not provide adequate training.

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Q. What are the options for Regulation?

The three options are to do nothing, to set up a system of Voluntary Self Regulation, or to be regulated under a system of Statutory Self Regulation, as are other health professions such as Doctors and Osteopaths.

The Bowen Forum believes that doing nothing is not in the interests of either Bowen therapists or the general public, and is working towards establishing a system of Voluntary Self Regulation.

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Q. What is the difference between Statutory Self Regulation (SSR) and Voluntary Self Regulation (VSR)?

Voluntary Self Regulation ideally involves an independent regulatory body which:

  • Maintains a register of individual practitioners
  • Sets educational standards and an independent accreditation system
  • Requires professional competence among its registrants through a programme of continuing professional development
  • Provides codes of conduct, ethics and practice
  • Has in place a complaints mechanism for members of the public
  • Has in place a fitness to practice procedure that is accessible to the public
  • Requires registrants to have adequate professional indemnity insurance
  • Has the capacity to regulate the whole profession
  • Includes lay representation on the executive council

Statutory Self Regulation provides for many of the functions of a self-regulatory system but also has the following features:

  • Legal Protection of title for therapists
  • The establishment by law of single definitive register of practitioners
  • Legal underpinning of disciplinary procedures and sanctions
  • External appointment of members of the governing council

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Q. Why has Statutory Self Regulation been ruled out?

Following the House of Lords’ Sixth Report on Science and Technology, Acupuncture and Herbal Medicine will be regulated by statute, in a similar way to Osteopathy and Chiropractic. However, the Government has no current plans to extend statutory regulation to other complementary therapies. It believes that regulation should be proportionate to the risk involved, and the complementary therapies in Group 2 & 3 of the report are deemed to be less invasive than the therapies in Group 1, which include osteopathy and herbal medicine. It expects unregulated CAM professions to develop their own unified systems of Voluntary Self Regulation. If these professions then wish to pursue statutory regulation, they will need to persuade the Government that there are particular risks to patients that voluntary regulation cannot address.

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Q. What are other groups doing?

All of the main healthcare professions are regulated by statute, and statutory regulators include the General Medical Council (Doctors), the Nursing and Midwifery Council, the Health Professions Council (13 professions, including physiotherapists, radiographers and dieticians), the General Osteopathic Council, and the General Chiropractic Council. Acupuncture and Herbal Medicine are working towards Statutory Self Regulation. See the links page.

There are other healthcare groups, such as the United Kingdom Council for Psychotherapy, which have established systems of VSR.

The therapies that are working with PFIH towards Voluntary Self Regulation are:
Alexander Technique, Aromatherapy, Bowen, Yoga Therapy, Homeopathy, Cranio Sacral, Massage Therapy, Naturopathy, Nutritional Therapy, Reflexology, Reiki and Shiatsu. 
Of these, Aromatherapy set up its own shadow regulatory council at the beginning of 2007, but this was disbanded later in 2007. All were represented on the working party which was looking into the options for a federal regulatory body, but the Reiki body has decided that federal regulation is not appropriate for Reiki.

Some of the Reflexology associations have set up a regulatory body known as the General Regulatory Council for Complementary Therapies (GRCCT), but this body is not supported either by PFIH or by the Department of Health, and in our view it is not sufficiently independent of the professions to be able to act in the best interests of the general public. It is not possible to register as a Bowen therapist with the GRCCT.

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Q. What are the options for Voluntary Self Regulation?

The two options are either that a therapy sets up its own regulatory body, or that several therapies together set up a federal regulatory body which regulates all of them.  The federal structure was proposed in Professor Julie Stone’s report “Development of Proposals for a Future Voluntary Regulatory Structure for Complementary Healthcare Professionals” in September 2005, and is PFIH’s recommended option.  There was a consultation held in 2006, which was co-ordinated by PFIH, and of the 438 responses received, 68% agreed with the principle of establishing a federal regulatory body.

Examples of stand-alone regulatory bodies are the General Osteopathic Council, the General Chiropractic Council, and the United Kingdom Council for Psychotherapy. The two examples of federal regulatory bodies are the Nursing and Midwifery Council (NMC) and the Health Professions Council (HPC). However, these are both regulated by statute; there are no other examples of a federal structure for VSR.

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Q. What are the benefits of the Federal Structure?

The advantages and disadvantages of each option are set out in detail in Part 3 of Professor Stone’s report. The main reasons why PFIH recommends the federal structure are set out in section 3.1 of the 2006 Consultation document:

  • It would provide one point of contact for the public, and is the most effective way for ensuring public protection.
  • It would provide better name recognition, and therefore be more likely to become synonymous with quality in complementary healthcare.
  • It would allow for harmonisation of standards across different professions, while still allowing for diversity.
  • Individual professions would be able to maintain significant professional autonomy within a federal structure.
  • Economies of scale will lead to a reduced fee for practitioners.
  • A federal structure can better address the needs of ‘multi-disciplinary’ practitioners.
  • A single regulator would have more weight in negotiations with statutory regulators, insurance companies and consumer organisations.
  • A federal structure could provide opportunities for an enhanced role for the Professional Associations.
  • A federal model is consistent with current thinking in healthcare regulatory excellence.

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Q. What does the Bowen Forum recommend?

The Forum believes that the federal structure is the most appropriate structure for VSR. As one of the smaller therapies Bowen stands to gain most from the economies of scale that are offered by the federal structure. The Bowen Forum responded to the 2006 consultation, and supported the idea of having a federal regulator. The Bowen Forum was involved in the Federal Working Group which agreed the structure of the Complementary & Natural Healthcare Council (CNHC), and is working towards setting the final standards for Bowen which will allow Bowen therapists to be regulated through the CNHC.

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Q. How much will it cost me?

The costs of administering the eventual register and running the regulatory body will be funded through a registration fee for regulated therapists. At this stage, these costs are not certain, because the CNHC has not been established yet, and we do not know how many therapists will opt to be regulated by it. The costs of running a regulatory body must not be underestimated, but if they can be spread over 30,000 complementary therapists instead of just 1,000 Bowen Therapists it is hoped that registration fees can be kept to an acceptable level. The figures used in the business plan presented to the Department of Health were £45 for the first therapy, £30 for the second and £25 for the third, with fees being capped at £100 even if more than 3 therapies are registered.

During this exploratory phase of the VSR process, the Bowen Forum is largely funded by PFIH, and the membership associations have been contributing up to £4 per member. In 2008 the contribution from professional associations was £1 per member. 

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Q. Why can’t my Association regulate me?

The fundamental reason is that a regulator is there to protect the general public, whereas a professional association exists to support its members. There would be a conflict of interest if the associations tried to perform both roles.

At the moment the professional associations maintain a register of adequately qualified practitioners who are up to date with CPD requirements. This is a form of voluntary self-regulation, but the Government has expressed its desire that in the future there should be an overarching body for each therapy which maintains a single register of suitably qualified practitioners in order to cut out the confusion and complications for public understanding. This way, all Bowen practitioners will have the same level of qualifications etc. and will satisfy the same requirements, whilst still being free to belong to the Association which has the characteristics they prefer.

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Q. What is the process leading to Voluntary Self Regulation?

The Bowen Forum is the body that is preparing for regulation. All Bowen membership organisations have been invited to participate in the Forum. There is an independent lay chair (Jenny Gordon) and another lay member on the committee who serves on the Education sub-group. The Forum is an interim body to represent Bowen therapists during the process of setting up the eventual regulatory body. This process involves discussions with PFIH and all the other therapies involved in the Federal Working Group.

The Group will consult widely on all its proposals before final decisions are made.

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Q. How long will it take to set up a regulatory body?

Creating a federal body is a significant task, and more complicated than setting up a single regulatory body.  However, the CNHC has already been established as the regulatory body holding the register of therapists and it is hoped that the first therapies will be regulated from January 2009, even though Bowen will not be regulated by it until mid 2009.

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Q. Please can you describe how a regulator fits in with the existing professional associations?

It is important to understand the difference between the regulator, the professional associations and the training establishments. All are independent of each other, and each has a specific role, as follows (a diagram of a possible structure is included elsewhere in this section):

1. Regulator:

A single Federal Regulatory Council (FRC) regulating complementary therapies. Includes an over-arching Council  and various profession-specific boards (PSBs)

A not for profit body, which covers its costs by charging registration fees to therapists.

Functions:

  • Keeps a register of individual practitioners, available to the public.
  • Determines standards of education and training for admission to practise.
  • Represents the public in any fitness to practise enquiries

2. Professional Associations

Examples: BA( UK ), BTER

Membership bodies of therapists, which represent members’ interests.

Not for profit bodies, which cover their costs by charging membership fees to members.

Functions:

  • Promote and market Bowen
  • Advise on the development of educational and practice standards
  • Encourage and facilitate research and development
  • Support members in any fitness to practise enquiries
  • Provide opportunities for continuing professional development
  • Networking and regional groups
  • Provide membership services (e.g. insurance information)
  • Provide therapy clothing and equipment
  • Provide support to members in developing their practice and business opportunities

3. Training Establishments

Examples: Bowen Training ( UK ), European College of Bowen Studies.

Trainers offering courses in Bowen to new students or as CPD to existing practitioners.

Profit making businesses.

Functions:

  • Provision of Bowen training to meet the required standards for registration.

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Q. Do I have to be registered with the regulating body to practise Bowen?

No, this is voluntary self regulation and it is up to individual practitioners, but it is advisable to do so. More and more the public are asking the question “Do you belong to a Regulating body?” when they call to talk to you before booking an appointment and this is a sign of the times. The public are being educated about complementary therapies and soon they will see non-registration as suspect. Clinics may in future decide only to work with registered therapists, and the UK Government or the European Parliament may at some stage decide that statutory self regulation of all complementary therapies is required.

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Q. Can I be registered, if I am not a member of an Association?

Yes, you can, provided that you meet the required standards. The professional associations are there to represent and to support their members, and membership of a professional association will remain optional. However, if you are not a member of a professional association, it means that you are not furnished with information about your profession regularly, and at worst it could mean that you have nobody to represent you during a complaint or fitness to practice enquiry.

Joining a professional association makes you more of a professional in your field, and could result in a lower fee being payable to the regulator.  Also, it may be that a member of the public will have to approach the member associations to search for a practitioner near them; it may be that the regulating body's register can only be used to check the status of a particular therapist.

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Q. Will regulation benefit professional practice?

Yes, because not only will the public have confidence in a qualified Bowen Therapist but also it may enable the profession to be accepted and integrated into conventional health care, especially if we are eventually statutory regulated. Healthcare providers prefer to work with regulated professionals.

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Q. What will happen to existing Bowen membership associations once VSR is in place?

Existing associations will not only continue but could become even stronger. This has been found to be the case for some other professional bodies following statutory self regulation. The new Federal Regulatory Council will be established to administer regulation and the register. It will not be a membership body and will not be able to represent Bowen Therapists. The membership associations will be responsible for ensuring that members’ training meets the criteria required for entry to the register and that training colleges are accredited and inspected regularly.

 

[Regulation]
 
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