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Consultation on the regulation of occupations: National Action Plans of the Member States and regulatory proportionality

European Osteopaths, Osteopathes de France and Aujourd’hui Santé Ostéopathie (association of patients) responded this summer to a consultation issued by the European Commission.


On 28 October 2015, the European Commission adopted a strategy for the Single Market for Goods and Services.
This strategy defines measures to develop this single market, in particular by improving the regulation of professional services.
In a recent mutual evaluation exercise, Member States had to examine their regulatory regimes for the professions and demonstrate that they fulfilled legitimate public interest objectives.
They had to present National Action Plans (NAPs) indicating how they expected to ensure the maximum effectiveness of their regulation, for both professionals and consumers.

The Commission wanted to know our opinion on the quality and usefulness of the NAPs and, in particular, how the proportionality of occupational regulation is assessed.
Proportionality means that a national regulation and its enforcement mechanism must be balanced in the public interest and that it cannot lock a profession for protectionist or corporatist purposes beyond the simple objective of Public interest.
The results will be analyzed and incorporated into a report submitted to the Parliament and the European Council in January 2017, setting out guidelines on country and occupational reforms and an analytical framework proposing a more inclusive approach to the assessment of proportionality.

The three associations from a common perspective responded on the profession of osteopath to this consultation after an interview with the service of the liberal professions of the French Ministry of Finance.

Recognition of osteopathy in all Member States. Parliamentary question from Spain.

Question: (Carolina Punset (ALDE) , Javier Nart (ALDE) ) SPAIN

Osteopathy is an independent health and first aid profession that is recognised as such in a number of EU countries. The academic, professional and ethical criteria that apply to osteopathy are set out in European Standard EN 16686:2015 on ‘Osteopathic healthcare provision’. However, the profession is not yet properly regulated in some Member States, including Spain.

It is clear, in the light of the foregoing, that where osteopathy is concerned, Spain is failing to comply with Directive 2005/36/EC on the recognition of professional qualifications, and Directive 2014/54/EU on freedom of movement for workers, in that it does not allow osteopathy professionals who have received proper training in other countries to work on an equal footing in Spain.

This unsatisfactory situation has a bearing on both patient safety and on osteopathy professionals’ rights as regards recognition and freedom of movement in EU countries.

Is the Commission going to take action in response to this failure to guarantee patient safety and uphold the rights of osteopathy professionals throughout the EU?

Answer given by Ms Bieńkowska on behalf of the Commission:

According to the Commission’s data base, the profession of osteopathy is not regulated in most Member States, including Spain. The directive 2005/36/EC on the recognition of professional qualifications(1) does also not foresee that certain profession have to be regulated. Instead, Member States which regulate a given profession must recognise education, training and work experience in other Member States under the relevant procedures.

As there is no harmonisation on the profession of osteopathy in Europe, the Member States are free to determine which activities they foresee for this profession. Thus, the training requirements and the reserved activities for this profession may differ from country to country. As a consequence, Spain can, for example, reserve some activities that osteopaths do in other Member States for other professions on its territory. This is in line with EC law, as long as it meets the requirements of the principle of proportionality and non-discrimination.

(1) Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications, OJ L 255, 30.9.2005, p. 22.


See this article on the Commission’s website.


Thierry Camail and Renaud Leclerc were present at the General Assembly of CEPLIS on November the 21st 2016 in the European Parliament in Brussels.
CEPLIS present a new booklet
Common Values for Professionals within Europe (June 2016).
You can find the text in English, French, Spanish, Italian, Croatian, German and Romanian

CEN European standard and osteopathy. Parliamentary question.

The European Commission through Mr Andriukaitis responded to a parliamentary question bearing on the CEN european standard related to the profession of Osteopath (CEN/TC 414).
Important elements induced by the response :
– the European Standardization Committee (CEN) is an independent entity defining voluntary european standards at the request of standardization national organizations, independent as well.
– it is often difficult to know to what extent such standards are implemented in the domestic market.
– each member state is free to define its health policy and the recognition of a profession.
Therefore, European standards have no impact on the health policy of each country.
The Commission did not wish to respond to the question as to whether the United Kingdom was an example to be followed.
A few precisions :
A standard is designed within a standatdization entity, a profit-making company and does not arise in any way from the administration or the government.
A standard is, by nature, of voluntary compliance, only the one who decides to comply with it is compelled to respect it :
– respect the requirements provided for in the standard,
– comply or not with the recommendations of this standard.
If you wish to learn about standard CEN/TC 414, please visit the website of your standardization national entity :
and pay the requested amount of money (for example 75€ in Belgium, 88€ in Austria, France 90€, Switzerland 87CHF…).
Then, such as is specified from the very first page, this document is intended for an exclusive use and not for a collective use and any copy, even a partial one is prohibited.
Another important detail is that national regulations always prevail upon the standard.

Subject: Practising as an osteopath in the different Member States and compliance with the CEN European standard

Alongside acupuncture, homeopathy and chiropractic, osteopathy is, in most Member States, a ‘non-conventional’ medicine. In Belgium, for example, osteopathy has been governed by law since 1999, but it has not yet been granted official recognition by the authorities. With debates taking place at national level as to whether osteopathy should be given full conventional medicine status, a standardisation process has been set up at European level in an effort to establish a European standard for ‘services’ in osteopathy (CEN/TC 414).
1. Could the Commission state whether standard CEN/TC 414 is already being applied in some Member States? Is the Commission aware of any cases in which the standard falls foul of specific national rules and regulations?
2. Does the Commission yet have any figures it can share as regards the extent to which the common standard has spread around the Member States, in particular in terms of improvements in osteopathic diagnosis and in the treatments and care provided to patients?
3. From a broader perspective, does the Commission think that the example set by the UK — the first European country to fully recognise osteopathic medicine — is one that the rest of the EU should follow?

Answer given by Mr Andriukaitis on behalf of the Commission

The European Committee for Standardisation (CEN) is an independent body, which develops voluntary European standards at the request of the national standardisation bodies. The European Commission has no competence to monitor the application of CEN standards in the Member States and therefore has no information or figures on the national implementation of the CEN TC/414 for services in osteopathy. Information on whether National Standardisation Bodies (NSBs) list the standard might be available on their websites. Information on the extent to which standards are being used in the market tends not to be available.
The Commission respects the responsibilities of the Member State for the definition of their health policy and for the organisation and delivery of their healthcare in accordance with the Treaty on the Functioning of the European Union. The recognition of osteopathic medicine is a matter for each Member State to decide. Thus every Member State can decide, within the limits of Union law and more particularly proportionality, whether or not to regulate the profession of osteopath in its legal system and how to regulate it.

Regulating the profession of osteopathy. Parliamentary question.

ec_for_fbOn the 6th of June 2016 Philippe Juvin, a Member of the European Parliament (the European People’s Party / Parti Populaire Européen) filed a parliamentary question before the European Commission, following a work with Thierry Camail, the President of European Osteopaths.
We are very grateful to Monsieur Juvin for his help and his cooperation.
The response from the Commission is bringing elements to the matter of osteopathy :
– the profession of Osteopath is not one of the seven professions for which the minimum training requirements have been standardized at the level of the European Union.
– yet, we have the opportunity to introduce common training principles provided that our profession would be regulated in at least a third of the member states.
Such a clear response from the Commission reinforces European Osteopaths in their commitment to help, by any means, the countries of the European Union that do not have any regulation yet, to obtain one.

Subject: Regulating the profession of osteopathy

In 1997 the European Parliament voted on the Lannoye report, which called on Member States to regulate four forms of alternative medicine: acupuncture, homeopathy, naturopathy and osteopathy.
Following that vote, and a WHO report published in 2010, a number of countries (e.g. Belgium, Italy, Portugal and the Netherlands) have started to adopt legislation on osteopathy, while in others (Finland, Iceland, Liechtenstein, Malta, the UK and Switzerland) osteopathy is now regulated. France legalised it in 2002 before bringing in full regulation in 2014.
Many patients are turning to osteopathy more often as one of the various forms of treatment they choose, as it helps improve their health in specific ways.
It would therefore be appropriate to provide a European framework for the regulation of osteopathy, in order to guarantee patients’ safety. There is a need to lay down a definition of the profession and of the skills and qualifications required.
Is the Commission considering establishing a common framework in order to make it possible to lay down uniform requirements for osteopathy training and qualifications, and to ensure that practitioners are able to move freely and practise in all EU Member States?

Answer given by Ms Bieńkowska on behalf of the Commission

The regulation of professions or professional activities is, in principle, up to Member States. Every Member State can decide, within the limits of non-discrimination and proportionality, whether or not to regulate a profession or a professional activity and how to regulate it (including the level and content of the education and training required for access to exercise the profession). There are exceptions to this principle for a limited number of professions(1) for which minimum training requirements have been harmonised at the EU level by Directive 2005/36/EC(2) on the recognition of professional qualifications. The profession of osteopath is not among those seven professions.
Directive 2005/36/EC also foresees the possibility to introduce so called Common Training Principles, which aims to increase the mobility of professionals, for professions fulfilling the criteria of the directive which include for instance the condition that the profession or the education and training leading to the profession should be regulated in at least 1/3 of the Member States.
According to the information of the Commission, the profession of osteopath does not seem to satisfy the abovementioned required condition. As a consequence, at this stage, the Commission does not consider establishing a common European framework of uniform osteopathy training and qualifications requirements.
(1)i.e., doctors, midwives, nurses responsible for general care, dentists, pharmacists, veterinary surgeons and architects.(2)…

Welcome !

We are pleased to welcome you to our new website.

Romanian and French osteopaths gathered to bring a new European association to life. They will be joined by other countries very soon.

Its main goal is to promote the Osteopathic  profession within European bodies through effective lobbying.

Thanks to this website and to our pages on social networks, we will keep you informed of the advances in our work and of the news related to Osteopathy professionals in Europe.

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