The Ongoing Struggle
Shawn O’Reilly

Executive Director, Director of Government Relations, Canadian Association of Naturopathic Doctors (CAND)

Regulation is always a complicated issue, but when you are a health professional in Canada it becomes even more complex. Health care is a provincial mandate in this country and while the federal government sets national policy for health care and regulates substances such as drugs, therapeutic devices and natural health products, it is the province or territory that decides who does or does not get regulated, who has prescribing rights and dictates Scope of Practice via Colleges set up for each of the regulated health professions.  As a result, regulation of Naturopathic Doctors (NDs) and their Scope of Practice are inconsistent across the country.

Naturopathic Doctors have struggled to obtain and in some cases retain regulation since they first began to practice in Canada back in the early 1900’s. NDs were first regulated in Ontario under the Drugless Practitioners Act of 1925 along with a number of other professions including chiropractors and osteopaths. Individual Naturopathic Acts followed in British Columbia in 1936, Alberta 1940, Manitoba 1946 and Saskatchewan in 1954.

The Acts and accompanying regulations set out what NDs can or cannot do or, in the case of Manitoba and Saskatchewan contain a list of “Prohibited Acts” such as prescribing or administering a drug either externally or internally and directing or prescribing the use of anaesthetics. Practicing surgery or midwifery is also prohibited under the Acts.

Over the years the regulatory framework has fluctuated drastically. Ontario NDs are now the only profession left under the Drugless Practitioners Act. This despite requests for a separate Naturopathic Act that date back to the 1950’s. They have also successfully fought two attempts at de-regulation. Various Ontario Provincial governments have promised to move the NDs under the Regulated Health Professions Act enacted in December of 1993 but four government committees and numerous submissions later this has yet to happen.

Alberta’s Naturopathic Act was repealed in 1986. Happily, Alberta NDs have been successful in ensuring that they will be regulated under the new Health Professions Act enacted in December of 2001 and are in the final stages of the regulatory process. It is expected that their regulations will come into force early in 2005.

In British Columbia, NDs are currently involved in extensive negotiations with the BC Health Ministry with respect to their Scope of Practice which is being seriously challenged. And while Saskatchewan and Manitoba have been able to maintain their Acts they remain vigilant given what has occurred in other jurisdictions. Regulation is an expensive and time consuming procedure and the successes to date are a testament to the NDs and naturopathic associations in Canada who dedicate long hours and financial resources to the cause.

The struggle for recognition and regulation continues at both the provincial/territorial and federal levels. While we still see a great deal of resistance from the conventional medical community, progress is being made at the government level. NDs now sit on government committees and advisory councils, provide input as stakeholders on national health issues and liaise with various government ministries.

Our message is straight forward. Naturopathic Doctors are Primary Health Care providers committed to ensuring that Canadians have the freedom to choose their health care provider and have access to licensed NDs with the proper education and training. It is only through uniformly high standards and regulation that this can truly be accomplished.