Complementary and alternative therapies have become more widely used over the past two decades, but many practitioners in the United Kingdom are largely unregulated. One of the recommendations of last year's report on complementary and alternative medicine by the House of Lords Select Committee on Science and Technology was that “in order to protect the public, professions with more than one regulatory body make a concerted effort to bring their various bodies together and to develop a clear professional structure.”1 That some health professions remain unregulated in a developed country seems extraordinary, and I shall review how this situation has arisen before considering the prospects for change.

In the United Kingdom the common law right to choose one's own treatment for illness has been barely constrained by law.2 It is thus legal for practitioners to set themselves up in a wide variety of healthcare professions, as long as they do not claim to be registered medical practitioners and do not practise protected disciplines such as dentistry, midwifery, and veterinary medicine or supply medicines limited to prescription. By contrast, in most other European Union countries, as well as the United States, there are few healthcare activities that are allowed without state authorisation. Acupuncturists, herbalists, osteopaths, and naturopaths have been prosecuted for practising without medical qualifications, and the technical illegality of much complementary practice has meant that it has been pursued informally and disparately, with less opportunity for professional organisations to develop. The increasing demand for alternative health care across the developed world has, therefore, sometimes been met by practitioners outside the law and without recognisable training qualifications, professional standards, or insurance.