Government Regulation of Chiropractors for Consumer Protection against Poor Standards and Malpractice

Ms Poh Li San asked the Coordinating Minister for Social Policies and Minister for Health (a) whether it will consider a regulatory regime for chiropractors practising in Singapore; and (b) how can consumers be protected from poor standards and even malpractice under the current self-regulation model.

The Senior Minister of State for Health (Mr Tan Kiat How) (for the Coordinating Minister for Social Policies and Minister for Health): When it comes to professional regulation, the Ministry of Health's (MOH's) main consideration is the potential risk to patients. In determining the risk levels, we consider factors, such as nature and scale of practice, patient awareness and evidence of adverse outcomes.

As of now, chiropractic services as a form of complementary and alternative treatment are not considered high risk. Hence, our approach is self-regulated through their professional associations. Professional associations set standards for their members and help customers identify practitioners who meet these standards. In addition, chiropractic providers remain subject to laws governing advertising and consumer protection. Where there are allegations of malpractice or negligence causing harm, patients may lodge a complaint with the relevant professional association or pursue civil action.

Notwithstanding the current approach, MOH will continue to monitor developments in the profession and review this position if the risk profile changes.

Mr Speaker: Ms Poh.

Ms Poh Li San (Sembawang West): I thank the Senior Minister of State Mr Tan. I have consulted several patients and chiropractors for their opinions on the need for regulation. I have two supplementary questions.

First, since November 2020, the Chiropractic Association (Singapore) has received reports of at least 61 cases of non-chiropractors misrepresenting themselves as chiropractors. Some of them have caused harm to clients in the process of treatment, while others have been reported for unprofessional misconduct towards female clients. How can consumers be protected against such fraudulent practitioners?

Second, do consumers have a platform to lodge complaints against unprofessional or unethical practices? The context is that since 2015, the Chiropractic Association (Singapore) has received 21 complaints from members of the public against authentic chiropractors, mostly regarding prepaid packages or sub-standard quality treatment.

Mr Tan Kiat How: Sir, I will take both supplementary questions together. Firstly, I must say I understand the concerns from Ms Poh. However, there are two separate issues here. The first issue is the fees and treatment packages. That is primarily a consumer issue. Patients should have clear information on what they are paying for and have avenues for recourse where there is a dispute, including through the Consumers Association of Singapore where appropriate. So, it is a consumer protection issue and there are relevant mechanisms and recourse platforms for those consumers.

The second issue is on patient safety. We take allegations of harm seriously. Based on the evidence we have, the overall risk of harm from chiropractic services remains low. We have not seen major adverse events in Singapore that would warrant statutory registration at this time. But I must remind everyone that self-regulation is not a free pass. We will continue to monitor complaints and adverse outcomes, and if the evidence changes or if the existing safeguards prove inadequate, MOH will review whether stronger regulations are needed.