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  • 1.               EUROPEAN CHIROPRACTORS´ UNION The Glasshouse 5a Hampton Hill Road Hampton Middlesex TW12 1JN     Page  |  1  
  • 2.      Index:     Page  No    Summary  of  the  legal  and  regulatory  situation  for  Chiropractic  in  Europe 3-­‐4  Legal  regulations  relating  to  Chiropractic   5-­‐7  Legal  regulation  of  Chiropractors  in  Denmark   8-­‐9  Legal  regulation  of  Chiropractors  in  Great  Britain   10  Legal  regulations  in  Norway   11-­‐27  Legal  regulations  in  Sweden   28  Legal  regulations  in  Switzerland   29  European  Chiropractors’  Union  Constitution   30-­‐35  ECCE  Constitution   37-­‐45  Bylaws  of  the  European  Academy  of  Chiropractic   46-­‐49  Institutions  holding  Accredited  status  with  the  ECCE   50-­‐53  Letter  from  the  ENQA  to  President  of  the  ECCE   54-­‐55 Page  |  2  
  • 3.    A  summary  of  the  legal  and  regulatory  situation  for  chiropractic  in  Europe.  Norway:  Licensed  as  an  independent  health  profession  since  1988  Title  protection.  All  patients  are  partially  reimbursed  by  the  state  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractors  can  refer  patients  for  x-­‐rays,  MRI,  CT  scans,  ultrasound  diagnostic.  Chiropractors  can  refer  patients  to  a  medical  specialist.  Chiropractors  can  refer  patients  to  physiotherapy.  Chiropractors  can  sick  leave  their  patients  up  to  12  weeks.  The  patient’s  right  to  have  reimbursed  travel  expenses  when  going  for  chiropractic  treatments,  are  regulated  by  law.  The  Government  has  established  a  fund  for  post  graduate  education  for  chiropractors.  The  Government  gives  financial  support  for  the  infrastructure  of  chiropractic  research.  Most  insurance  companies  fully  reimburse  chiropractic  treatment.    Sweden:  Licensed  as  an  independent  health  profession  since  1989  Title  protection  All  patients  who  seek  a  chiropractor  with  care  contract  are  reimbursed.    Denmark:  Licensed  as  an  independent  health  profession  since  1991  Title  protection  Chiropractors  have  the  legal  right  to  take  their  own  X-­‐rays.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound.  Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  All  patients  are  partially  reimbursed  by  the  state.  Most  insurance  companies  fully  reimburse  chiropractic  services.  The  Government  has  established  a  fund  for  post  graduate  education  for  chiropractors.  The  Government  support  chiropractic  research.   Page  |  3  
  • 4.    A  chiropractic  education  has  been  established  under  the  medical  faculty  at  the  University  of  Southern  Denmark  in  Odense.    United  Kingdom:  Licensed  and  regulated  as  an  independent  health  profession  since  1994.  Title  protection  Chiropractic  is  one  of  only  eight  independently  regulated  health  professions  in  the  UK  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractic  education  is  provided  by  the  University  of  Bournemouth  (Angle  European  College  of  Chiropractic),  the  University  of  Glamorgan  (Welsh  Institute  of  Chiropractic)  and  the  McTimoney  College  of  Chiropractic.    Switzerland:  Licensed  as  an  independent  health  profession.  Licensed  as  one  of  five  medical  professions.  (Medicine,  dentistry,  veterinary  medicine,  pharmacy  and  chiropractic)  Title  protection  All  patients  are  partially  reimbursed  by  the  state  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractors  have  limited  prescription  rights.  (Painkillers  and  anti-­‐inflammatory  drugs)  Chiropractors  can  refer  patients  for  x-­‐rays,  MRI,  CT  scans,  ultrasound  diagnostic.  Chiropractors  can  refer  patients  to  a  medical  specialist.  Chiropractors  can  refer  patients  to  physiotherapy.  Chiropractors  can  sick  leave  patients.  Most  insurance  companies  fully  reimburse  chiropractic  treatment.  A  chiropractic  education  has  been  established  under  the  medical  faculty  at  the  University  of  Zürich.         Page  |  4  
  • 5.     LEGAL  REGULATIONS  RELATING  TO  CHIROPRACTIC   Denmark¸  Great  Britain,  Norway,  Sweden,  Switzerland      DENMARK  Authorization  Chiropractors  have  been  authorized  in  Denmark  since  1991.    Chiropractors  are  granted  authorization  from  the  National  Board  of  Health  after  completing  a  five-­‐year  Master’s  Degree.  The  authorization  gives  the  right  to  practice  in  subordinate  positions  in  hospitals  or  clinics  under  the  supervision  of  a  chiropractor  with  authorization  to  practice  independently.  Authorization  to  practice  independently  is  issued  by  the  National  Board  of  Health  after  an  additional  one-­‐year  practical  training  (internship).  The  Law  of  autorisation:  (Bekendtgørelse  af  lov  om  autorisation  af  sundhedspersoner  og  om  sundhedsfaglig  virksomhed)    The  Law  of  Permission  to  Practice  Independently  as  a  Chiropractor:    (Bekendtgørelse  om  tilladelse  til  selvstændigt  virke  som  kiropraktor)    National  Board  of  Health  Practicing  in  Denmark  The  Law  that  regulates  chiropractic  in  Denmark  is  called  ‘Bekendtgørelse  om  kiropraktorvirksomhed’:  In  Denmark  there  is  direct  access  for  patients  to  chiropractors  so  there  is  no  need  for  a  medical  referral  prior  to  this.  The  right  of  direct  access  for  patients  is  regulated  through  the    National  Law  of  Health  (Sundhedsloven):    Chiropractors  have  the  right  to  diagnose  patients  independently  and  no  medical  referral  is  required  as  a  condition  for  grants  from  the  National  Health  Service.    Through  their  training  chiropractors  achieve  competences  within  the  medical  imaging  field,  and  all  practicing  chiropractors  have  access  to  X-­‐ray  facilities.    Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound  (take  and  read).    National  Health  Insurance  According  to  the  Act  on  National  Health  Insurance  patients  are  reimbursed  for  some  of  their  expenses  in  connection  with  chiropractic  examination  and  treatment  through  the  National  Health  Insurance.    In  average  the  patients  pay  approximately  80%  of  the  expenses  for  chiropractic  treatment  and  have  20%  of  the  expenses  reimbursed  by  the  National  Health  Insurance.    GREAT  BRITAIN  The  Chiropractors  Act  1994  is  the  relevant  legislation  in  the  UK.  Prior  to  this,  the  chiropractic  profession  was  self-­‐regulated  but  the  passing  of  the  Act  provided  for  the  establishment  of  a  statutory  regulator,  the  General  Chiropractic  Council,  which  is  responsible  for  regulating  and  developing  the  chiropractic  profession.  The  GCC  publishes  a  Code  of  Practice  and  Standard  of  Proficiency  which  sets  out  the  standards  of  conduct  and  practice  required  for  safe  and  competent  practice.    Legislation  for  chiropractors  in  the  UK  means  that  it  is  a  criminal  offence  for  anyone  to  call  themselves  a  chiropractor  unless  they  are  registered  with  the  GCC.  Chiropractic  is  one  of  one  of  only  eight  independently  regulated  health  professions  in  the  UK,  the   Page  |  5  
  • 6.    ninth  covering  a  further  19  professions.  An  over-­‐arching  regulator,  the  Council  for  Healthcare  Regulatory  Excellence,  oversees  the  performance  of  the  UK  health  regulators.    The  UK  legislation  on  chiropractic  largely  mirrors  that  for  other  UK  statutorily-­‐regulated  professions.  It  is  regarded  as  sound  legislation,  but  in  keeping  with  all  other  regulators  it  will  be  subjected  to  review  within  the  next  few  years.  There  is  a  Law  Commission  inquiry  looking  at  all  regulators  and  their  relative  fitness  for  purpose;  reform  is  likely  as  part  of  the  current  Government’s  agenda  for  change.    It  is  mandatory  for  chiropractors  to  undertake  a  minimum  of  30  hours  continuing  professional  development  each  year.  This  is  regularly  audited  by  the  GCC.  The  Department  of  Health  has  indicated  that  it  will  be  asking  the  regulators  to  introduce  a  scheme  of  revalidation  as  part  of  its  reform  of  the  UK  Health  Service.    Chiropractic  education  in  the  UK  is  delivered  by  three  GCC-­‐accredited  educational  providers:  the  Anglo-­‐European  College  of  Chiropractic,  the  Welsh  Institute  of  Chiropractic  and  the  McTimoney  College  of  Chiropractic,  all  of  whom  deliver  Masters  level  awards.  The  first  two  of  these  institutions  also  enjoy  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.    The  British  Chiropractic  Association  is  the  largest  member  of  the  European  Chiropractors’  Union  and  has  around  1350  members.  There  are  in  total  approximately  2700  registered  chiropractors  in  the  UK,  the  balance  being  represented  by  three  other  associations.  Its  President  is  Richard  Brown,  who  is  also  the  Secretary  of  the  European  Chiropractors  Union.  The  BCA  is  a  stakeholder  in  the  CEN  standardisation  process  currently  developing  a  standard  for  the  services  of  chiropractors.      NORWAY  Chiropractors  have  been  authorised  in  Norway  since  1989.  A  new  law  was  passed  in  1999,  Act  of  2.  July  1999,  no  64  relating  to  Health  Personnel  etc.  (The  Health  Personnel  Act)  that  applies  to  all  groups  of  authorized  health  professions  including  chiropractors.  Title  protection  follows  with  authorization  as  stated  in  §  74.  English  translation  Authorization  requirements  are  defined  in  the  same  act  (§  48.)  and  is  education  from  an  ECCE/CCEI-­‐accredited  institution  followed  by  a  one  year  internship  (§  76.).  Rules  and  regulations  for  the  internship  year  are  given  in  FOR  2000-­‐12-­‐21  nr  1382  from  the  Department  of  Health  and:  IK-­‐10/2001  from  the  Norwegian  Board  of  Health  Supervision.  The  chiropractors  are  responsible  for  their  own  diagnosis  and  treatment  based  on  the  general  principle  of  responsible  conduct  as  defined  in  the  Act  §4.  All  patients  are  entitled  to  partial  reimbursement  for  chiropractic  care  (limited  to  14  treatments  per  year)  and  can  seek  care  directly  (no  medical  referral  necessary).  Chiropractors  can  prescribe  sick  leave  (up  to  twelve  weeks  and  limited  to  musculoskeletal  conditions),  and  refer  to  hospitals,  medical  specialists,  physiotherapy  and  diagnostic  imaging  including  CT-­‐  and  MRI-­‐scans.  All  services  referred  to  above  within  the  national  health  system  are  reimbursed  on  equal  terms  as  medical  referrals.      The  regulations  and  requirements  for  the  chiropractor  to  execute  the  rights  above  are  defined  in  FOR  2005-­‐12-­‐21  nr  1668.  Chiropractors  are  also  allowed  to  take  their  own  x-­‐rays,  but  National  Insurance  does  not  reimburse  this.  This  activity  is  regulated  by  the  National  Radiation  Protection  Agency.  Patient  safety  and  protection  is  regulated  by  law  and  chiropractors  were  included  together  with  all  other  authorized  private  practitioners  by  revision  Pasientskadeloven  from  2009  and  at  the  same  time  included  in  the  National  patient  accident  insurance  pool  (NPE).        SWEDEN  Chiropractors  have  been  licensed  in  Sweden  since  1989.    All  authorised  health  personnel  today  adhere  to  one  law.  The  law  on  patient  safety  passed  in  2010.  The  law  includes  a  title  protection  for  chiropractors.   Page  |  6  
  • 7.    There  is  no  specific  law  for  chiropractic.  Chiropractors  are  primary  caregivers,  responsible  for  diagnosis  and  treatment  and  should  like  all  other  licensed  health  professionals  adhere  to  evidence  based  care  according  to  the  law.  The  law  on  patient  safety:  The  National  Agency  for  Health  and  Social  Welfares  Directive  on  patient  safety,  Patientsäkerhetsförordningen  (2010:1369),  regulates  the  required  professional  qualification  for  chiropractors.  The  minimum  requirement  is  a  four  year  degree  and  one  year  practical,  supervised  training  according  to  4§  chapter  3.  See  Patientsäkerhetsförordningen  (2010:1369),  3  Kap  4§:    Tobias  Lauritsen  President,  Swedish  Chiropractic  Association      SWITZERLAND  The  Chiropractic  profession  is  regulated  on  a  federal  and  a  cantonal  level.    Federal  legislation  Federal  law  on  education,  postgraduate  and  continuing  education  and  professional  activity  of  the  MDs,  the  dentists,  the  DCs,  the  pharmacists  and  the  veterinarians  (MedBG/LPMéd).    Chiropractic  treatments  are  reimbursed  by  the  social  insurances.  Sickness  insurance:  Accident  insurance  Radioprotection:    Cantonal  legislation  There  are  26  cantons;  each  canton  has  its  own  regulation.       Page  |  7  
  • 8.    Dansk  Kiropraktor  Forening      LEGAL  REGULATION  OF  CHIROPRACTORS  IN  DENMARK  Authorization  Chiropractors  have  been  authorized  in  Denmark  since  1991.  Chiropractors  are  granted  authorization  from  the  National  Board  of  Health  after  completing  a  five-­‐year  Master’s  Degree.  The  authorization  gives  the  right  to  practice  in  subordinate  positions  in  hospitals  or  clinics  under  the  supervision  of  a  chiropractor  with  authorization  to  practice  independently.  Authorization  to  practice  independently  is  issued  by  the  National  Board  of  Health  after  an  additional  one-­‐year  practical  training  (internship).  The  Law  of  autorisation:      (Bekendtgørelse  af  lov  om  autorisation  af  sundhedspersoner  og  om  sundhedsfaglig  virksomhed)  The  Law  of  Permission  to  Practice  Independently  as  a  Chiropractor:  (Bekendtgørelse  om  tilladelse  til  selvstændigt  virke  som  kiropraktor)  National  Board  of  Health  Practicing  in  Denmark  The  Law  that  regulates  chiropractic  in  Denmark  is  called  ‘Bekendtgørelse  om  kiropraktorvirksomhed’:  In  Denmark  there  is  direct  access  for  patients  to  chiropractors  so  there  is  no  need  for  a  medical  referral  prior  to  this.  The  right  of  direct  access  for  patients  is  regulated  through  the  National  Law  of  Health  (Sundhedsloven):  Chiropractors  have  the  right  to  diagnose  patients  independently  and  no  medical  referral  is  required  as  a  condition  for  grants  from  the  National  Health  Service.  Through  their  training  chiropractors  achieve  competences  within  the  medical  imaging  field,  and  all  practicing  chiropractors  have  access  to  X-­‐ray  facilities.  Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound  (take  and  read).  National  Health  Insurance  According  to  the  Act  on  National  Health  Insurance  patients  are  reimbursed  for  some  of  their  expenses  in  connection  with  chiropractic  examination  and  treatment  through  the  National  Health  Insurance.  In  average  the  patients  pay  approximately  80%  of  the  expenses  for  chiropractic  treatment  and  have  20%  of  the  expenses  reimbursed  by  the  National  Health  Insurance.  The  Law  that  regulates  the  subsidy  to  chiropractic  treatment  is  called  ’Bekendtgørelse  om  tilskud  til  kiro-­‐  praktisk  behandling  i  praksissektoren’:­‐  dokument-­‐  er/Praksisomr%c3%a5det/Bekendtg%c3%b8relse%20om%20tilskud%20til%20kiropraktisk%20behandling%20i%20pra  ksissektoren.mht   Page  |  8  
  • 9.    The  DCA  and  the  National  Health  Insurance  negotiate  the  agreement  every  3  years.  The  Danish  Chiropractic  Education  at  University  of  Southern  Denmark  The  University  of  Southern  Denmark  is  the  only  educational  institution  in  the  Nordic  countries  with  a  graduate  program  in  clinical  biomechanics  (chiropractic).  The  full  study  program  consists  of:  •      a  3  year  bachelor  program  •      a  2  year  graduate  program  (following  the  BA  program)  •      a  house  year  (following  the  graduate  program)  About  half  of  the  students  come  from  Denmark  while  the  other  half  come  from  the  other  Nordic  countries.  The  education  enjoys  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.  The  Danish  Chiropractic  Education  at  University  of  Southern  Denmark:  The  Danish  Chiropractic  Association  (DCA)  The  DCA  was  established  in  1925.  Today  the  association  represents  almost  700  members  who  are  working  as  chiropractors  in  Denmark  or  are  studying  chiropractic.  Since  2006  the  chairman  of  the  board  of  the  DCA  has  been  Peter  Kryger-­‐Baggesen.   Page  |  9  
  • 10.    Chiropractic:  the  UK  legislative  position      The  Chiropractors  Act  1994  is  the  relevant  legislation  in  the  UK.  Prior  to  this,  the  chiropractic  profession  was  self-­‐regulated  but  the  passing  of  the  Act  provided  for  the  establishment  of  a  statutory  regulator,  the  General  Chiropractic  Council,  which  is  responsible  for  regulating  and  developing  the  chiropractic  profession.  The  GCC  publishes  a  Code  of  Practice  and    Standard  of  Proficiency  which  sets  out  the  standards  of  conduct  and  practice  required  for  safe  and  competent  practice.    Legislation  for  chiropractors  in  the  UK  means  that  it  is  a  criminal  offence  for  anyone  to  call  themselves  a  chiropractor  unless  they  are  registered  with  the  GCC.  Chiropractic  is  one  of  only  eight  independently  regulated  health  professions  in  the  UK,  the  ninth  covering  a  further  19  professions.  An  over-­‐arching  regulator,  the  Council  for  Healthcare  Regulatory  Excellence,  oversees  the  performance  of  the  UK  health  regulators.    The  UK  legislation  on  chiropractic  largely  mirrors  that  for  other  UK  statutorily-­‐regulated  professions.  It  is  regarded  as  sound  legislation,  but  in  keeping  with  all  other  regulators  it  will  be  subjected  to  review  within  the  next  few  years.  There  is  a  Law  Commission  inquiry  looking  at  all  regulators  and  their  relative  fitness  for  purpose;  reform  is  likely  as  part  of  the  current  Government’s  agenda  for  change.    It  is  mandatory  for  chiropractors  to  undertake  a  minimum  of  30  hours  continuing  professional  development  each  year.  This  is  regularly  audited  by  the  GCC.  The  Department  of  Health  has  indicated  that  it  will  be  asking  the  regulators  to  introduce  a  scheme  of  revalidation  as  part  of  its  reform  of  the  UK  Health  Service.    Chiropractic  education  in  the  UK  is  delivered  by  three  GCC-­‐accredited  educational  providers:  the  Anglo-­‐European  College  of  Chiropractic,  the  Welsh  Institute  of  Chiropractic  and  the  McTimoney  College  of  Chiropractic,  all  of  whom  deliver  Masters  level  awards.  The  first  two  of  these  institutions  also  enjoy  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.    The  British  Chiropractic  Association  is  the  largest  member  of  the  European  Chiropractors’  Union  and  has  around  1350  members.  There  are  in  total  approximately  2700  registered  chiropractors  in  the  UK,  the  balance  being  represented  by  three  other  associations.  Its  President  is  Richard  Brown,  who  is  also  the  Secretary  of  the  European  Chiropractors  Union.  The  BCA  is  a  stakeholder  in  the  CEN  standardisation  process  currently  developing  a  standard  for  the  services  of  chiropractors.       Page  |  10  
  • 11.       Norwegian  Law:  Extracts  concerning  the  practise  of  chiropractic  and  chiropractors.       Act  Relating  to  Health  Personnel  etc.  (Health  Personnel  Act).  DATE:   ACT-­‐1999-­‐07-­‐02-­‐64    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  Services)    ENTRY  INTO  FORCE:  2001-­‐01-­‐01,  Royal  decree,  2000-­‐04-­‐14    LAST  AMENDED:   ACT-­‐2003-­‐08-­‐29-­‐87  of  2003-­‐09-­‐01    AMENDING:    ABBREVIATION:   Health  Personnel  Act  -­‐  hlspl.      Chapter  9.  Conditions  for  authorisation,  licensing  and  certificate  of  completion  of  specialist  training  §  48.  Authorisation                  The  authorisation  system  under  this  act  covers  the  following  categories  of  health  personnel:     a)  Emergency  medical  technician   b)  Pharmaceutical  technician   c)  Audiologist   d)  Medical  laboratory  technician   e)  Occupational  therapist   f)  Pharmacist     g)  Chiropodist   h)  Physiotherapist   i)  Medical  secretary   j)  Auxiliary  nurse   k)  Midwife     l)  Chiropractor   m)  Clinical  nutritionist     n)  Doctor   o)  Care  worker   p)  Optician   q)  Prosthetist   r)  Orthoptist     s)  Perfusionist   t)  Psychologist   u)  Radiographer   v)  Nurse   w)  Dental  secretary   x)  Dentist   y)  Dental  nurse   z)  Dental  technician   æ)  Social  educator   Page  |  11  
  • 12.                  The  right  to  authorisation  upon  application  is  granted  to  anyone  who:     a)  has  passed  the  examination  in  the  relevant  subject  at  a  Norwegian  university,  technical  college  or  advanced  occupational   training,     b)  Has  completed  the  practical  training  laid  down  by  the  Ministry  in  the  regulations,     c)  is  under  the  age  of  75,  and   d)  Who  is  not  unfit  for  the  profession?                  The  right  to  authorisation  upon  application  is  also  granted  to  anyone  who:     a)  Has  a  foreign  examination  qualification  which  is  recognised  as  equivalent  to  the  corresponding  Norwegian  examination,     b)  Has  a  foreign  qualification  which  is  recognised  under  an  agreement  on  reciprocal  approval  under  §  52,  or     c)  Has  otherwise  demonstrated  that  he/she  possesses  the  necessary  skills.     The  Ministry  may  in  its  regulations  specify  that  the  categories  of  health  personnel  that  are  not  covered  under  section  1  may   be  granted  authorisation  on  application.  The  decision  will  place  particular  emphasis  on  considerations  of  patient  safety,  the   content  and  purpose  of  training,  the  extent  to  which  the  profession  is  practiced  independently  and  considerations  of   harmonisation  with  other  countries.     The  Ministry  may  in  its  regulations  specify  additional  requirements  for  the  authorisation  of  individual  groups  of  health   personnel,  for  example  that  the  requirements  shall  also  apply  to  those  who  already  have  authorisation  or  official  certification   at  the  time  the  regulations  come  into  force.    Amended  by  Act  of  21  Dec  2000  no.  127  (in  force  1  Jan  2001  pursuant  to  Decree  of  21  Dec  2000  no.  1359).    §  49.  Licence       Health  personnel  who  are  not  entitled  to  authorisation  under  §  48,  may  be  granted  a  licence  on  application.  Licences  may   only  be  granted  to  health  personnel  that  are  considered  suitable  with  regard  to  the  type  and  scope  of  the  licence.                Licences  may  also  be  granted  to  health  personnel  with  foreign  qualifications  which  are  recognised  under  the  agreement  on   reciprocal  approval  pursuant  to  §  52.                  The  licence  may  be  restricted  in  time,  to  a  specific  position,  to  certain  types  of  health  care  or  otherwise.                The  Ministry  may  set  more  specific  requirements  for  obtaining  a  license  and  the  conditions  attached  to  it,  including  a   provision  that  the  requirements  shall  apply  to  those  already  holding  a  license  at  the  time  these  regulations  come  into  force.    §  50.  Border  license     Public  employees  and  authorised  health  personnel  in  Sweden  and  Finland  working  along  the  border  with  Norway  may   practice  their  profession  in  Norwegian  local  authorities  along  the  border  without  Norwegian  authorisation  or  licensing  under   §§  48  and  49.    §  51.  Conditions  governing  the  certificate  of  completion  of  specialist  training                The  Ministry  may  stipulate  requirements  concerning  the  conditions  for  approval  of  authorised  health  personnel  as  specialists   within  a  defined  section  of  the  specialist  health  area,  including  a  provision  that  the  requirements  shall  apply  to  those  who   already  hold  a  certificate  of  completion  of  specialist  training  when  these  regulations  come  into  force.    §  52.  International  agreements     On  the  basis  of  mutual  approval  agreements  with  other  countries,  authorisation,  licenses  and  certificates  of  completion  of   specialist  training  may  be  granted  to  foreign  citizens.     The  Ministry  may  in  its  regulations  make  further  provisions  to  supplement  section  1,  and  may  in  this  connection  set  special   conditions  for  approval  which  are  necessary  in  order  to  comply  with  international  agreements.         Page  |  12  
  • 13.      2.      OF  2000-­‐12-­‐21  no  1385:  Regulations  concerning  patient  records  DATE:  FOR-­‐2000-­‐12-­‐21-­‐1385    DEPARTMENT:HOD  (Ministry  of  Health  and  Care  Services)    DEPT/OFFICE:  Health  department    PUBLISHED:In  2000  3107  (Comments)    ENTRY  INTO  FORCE:2001-­‐01-­‐01    LAST  AMENDED:  FOR-­‐2003-­‐02-­‐25-­‐232  of  2003-­‐03-­‐03    AMENDING:  VALID  FOR:  Norway    AUTHORITY:  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§40,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§42,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§43,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§45,  ACT-­‐1999-­‐07-­‐02-­‐61-­‐§3-­‐2,  ACT-­‐1982-­‐11-­‐19-­‐66-­‐§1-­‐3a,  ACT-­‐1983-­‐06-­‐03-­‐54-­‐§1-­‐3a,  ACT-­‐1999-­‐07-­‐02-­‐63-­‐§5-­‐1  Provisions  concerning  patient  records.  §  4.  (Record  system)    Practices  where  healthcare  is  provided  must  set  up  a  patient  record  system.  The  system  must  operate  in  a  way  which  ensures  that  requirements  established  in  or  in  support  of  the  law  can  be  met,  including  rules  on:     a)  right  to  view  records  cf.  Health  Personnel  Act  §  41  and  Patients’  Rights  Act  §  5-­‐1,     b)  Access  to  and  disclosure  of  records,  cf.  Health  Personnel  Act  §  25  and  §  45  and  the  Patients’  Rights  Act  §  5-­‐3,     c)  Reporting  obligations  and  obligation  of  information,  cf.  Health  Personnel  Act  Chapter  6  and  7,     d)  Drafting  of  the  record,  cf.  Health  Personnel  Act  §  39  Section  2,     e)  Correction  and  deletion,  cf.  Health  Personnel  Act  §  42,  §  43  and  §  44  and     f)  Security  against  access  by  unauthorised  persons,  cf.  Health  Personnel  Act  Chapter  5,  including  secure  safekeeping,  cf.   Health  Personnel  Act  §  21.         Page  |  13  
  • 14.    3.         Act  relating  to  Social  Insurance  (Social  insurance  Act).      DATE:   ACT-­‐1997-­‐02-­‐28-­‐19    DEPARTMENT:   AID  (Ministry  of  Labour  and  Social  Inclusion)    PUBLISHED:    ENTRY  INTO  FORCE:  1997-­‐05-­‐01    LAST  AMENDED:   ACT-­‐2005-­‐12-­‐21-­‐127  of  2006-­‐01-­‐01    AMENDING:    ABBREVIATION:   Social  insurance  law  -­‐  ftrl.    Chapter  5.  Benefits  in  health  services                    Provisions  concerning     -­‐  Aims  are  in  §  5-­‐1     -­‐  Membership  in  §  5-­‐2     -­‐  Upper  expenditure  limit  for  individual  contribution  in  §  5-­‐3     -­‐  Cover  for  cost  of  examination  and  treatment  in  §§  5-­‐4  to  5-­‐12     -­‐  Support  for  birth  outside  institutions  in  §  5-­‐13     -­‐  Cover  for  expenditure  on  medication  etc.  in  §  5-­‐14     -­‐  Cover  for  the  costs  of  important  drugs  which  are  also  used  in  hospital,  in  §  5-­‐15     -­‐  Fixed  salary  subsidy  are  in  §  5-­‐21     -­‐  Contributions  in  §  5-­‐22     -­‐  Exceptions  for  military  personnel  in  §  5-­‐23     -­‐  Benefits  for  health  services  abroad  in  §  5-­‐24     -­‐  Benefit  in  the  event  of  occupational  injury  in  §  5-­‐25     -­‐  Benefits  for  sickness  which  arose  in  the  period  during  which  there  was  no  right  to  benefit,  in  §  5-­‐26.    Amended  by  acts  of  14  June  2002  no.  22,  28  June  2002  no.  52  (in  force  1  July  2002  under.  Decree  28  June  2002  no.  692),  20  Dec.  2002  no  100  (in  force  1Jan  2003  under.  Decree  20  Dec  2002  no.  1804),  20  June  2003  no.  45  (in  force  1  July  2003  under.  Decree  20  June  2003  no.  712),  28  Nov  2003  no.  96  (in  force  1  Jan  2004),  21  Dec  2005  no.  127  (in  force  1  Jan  2006).    §  5-­‐8.  Physiotherapy     The  insurance  system  pays  benefit  to  cover  the  cost  of  examination  and  treatment  by  physiotherapists.     Benefits  for  physiotherapy  are  only  granted  if  the  physiotherapist  has  an  agreement  on  operating  subsidies  with  the  local   authority,  see  Municipal  Health  Services  Act  §  5-­‐1.     The  right  to  benefit  is  conditional  upon  the  member  being  referred  by  a  doctor,  chiropractor  or  manual  therapist.  The   referral  requirement  does  not  apply  to  examination  and  treatment  by  a  manual  therapist.  The  treatment  must  be  of   considerable  importance  for  the  member’s  illness  and  ability  to  function.                  The  benefit  is  paid  on  the  basis  of  fixed  rates.     The  Ministry  establishes  regulations  concerning  benefits  pursuant  to  this  paragraph,  including  regulations  governing   contributions  for  combined  measures  by  physiotherapists,  and  it  may  in  its  provisions  make  exceptions  which  widen  the   circle  of  physiotherapist  under  Section  2.     Page  |  14  
  • 15.    Amended  by  Act  of  19  June  1997  no.  87  (in  force  1  July  1998  under  Decree  19  June  1997  no.  617),  21  Dec  2001  no.  118,  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).    §  5-­‐9.  Treatment  by  chiropractors                The  insurance  system  provides  benefit  to  cover  the  cost  of  examination  and  treatment  by  chiropractors.                The  treatment  must  be  of  considerable  importance  to  the  member’s  ability  to  function.                The  benefit  is  paid  on  the  basis  of  fixed  rates.                The  Ministry  establishes  regulations  concerning  benefits  pursuant  to  this  paragraph,  including  regulations  governing   contributions  for  combined  measures  by  chiropractors.    Amended  by  Act  of  19  Dec  2003  no.  135  (in  force  1  Jan  2004),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).    Chapter  8.  Sickness  benefit        Provisions  concerning   -­‐  Aims  are  in  §  8-­‐1     -­‐  General  conditions  for  the  right  to  sickness  benefit  in  §§  8-­‐2  to  8-­‐9     -­‐  The  basis  for  sickness  benefit  in  §  8-­‐10     -­‐  Sickness  benefit  days  in  §§  8-­‐11  and  8-­‐12     -­‐  Scaled  sickness  benefit  in  §  8-­‐13     -­‐  Subsidies  for  work-­‐related  travel  in  §  8-­‐14     -­‐  Sickness  benefits  for  employees  in  §§  8-­‐15  to  8-­‐33     -­‐  Sickness  benefits  for  self-­‐employed  traders  are  in  §§  8-­‐34  to  8-­‐37     -­‐  Sickness  benefits  for  freelancers  in  §§  8-­‐38  and  8-­‐39     -­‐  Sickness  benefits  for  members  with  combined  incomes  in  §§  8-­‐40  to  8-­‐43     -­‐  Sickness  benefits  for  special  groups  in  §§  8-­‐44  to  8-­‐47     -­‐  The  relationship  with  other  social  insurance  payments,  etc,  in  §§  8-­‐48  to  8-­‐52     -­‐  Sickness  benefit  during  a  stay  in  an  institution  in  §§  8-­‐53  and  8-­‐54     -­‐  Sickness  benefits  in  the  event  of  occupational  injury  in  §  8-­‐55.    §  8-­‐1.  Aim   The  aim  of  sickness  benefit  is  to  compensate  professionally  active  members  who  are  unable  to  work  because  of  sickness  or   injury,  for  loss  of  occupational  earnings.    §  8-­‐7.  Documentary  evidence  of  incapacity  to  work     To  qualify  for  sickness  benefit  the  member  must  have  his  incapacity  to  work  supported  by  a  doctor’s  certificate.  This  does   not  apply  during  the  qualifying  period  covered  by  the  employer,  when  the  employee  is  entitled  to  use  self-­‐certification,  see   §§  8-­‐18,  8-­‐19  and  8-­‐23  to  8-­‐27.     The  doctor’s  certificate  cannot  be  accepted  for  the  period  before  the  member  was  examined  by  the  doctor  (time  reported   sick).  A  doctor’s  certificate  for  the  period  before  the  member  consulted  a  doctor  may  nevertheless  be  accepted  if  the   member  has  been  prevented  from  consulting  a  doctor  and  it  is  agreed  that  he  or  she  has  been  unfit  for  work  from  an  earlier   date.     The  assessment  of  incapacity  to  work  shall  be  based  on  a  functional  assessment.  The  doctor  shall  in  all  cases  assess  whether   the  member  can  go  to  work  or  engage  in  a  work-­‐related  activity.  The  doctor  and  other  health  personnel  undertake,  in   collaboration  with  the  employee  and  if  applicable  the  employer,  to  provide  a  detailed  assessment  of  the  employee’s  ability   to  function.     Page  |  15  
  • 16.     A  doctor’s  certificate  must  be  submitted  no  later  than  eight  weeks  from  the  commencement  of  the  period  of  incapacity  to   work  during  which  the  member  has  not  performed  any  work-­‐related  activity.    In  order  for  the  member  to  receive  payment  of   sickness  benefits  the  doctor’s  certificate  must  demonstrate  that  there  are  medical  reasons  preventing  performance  of  a   work-­‐related  activity.  The  statement  must  contain  a  report  of  the  future  treatment  programme  and  an  assessment  of  the   likelihood  of  the  person  being  able  to  resume  his  previous  job  or  do  other  work.     Sickness  benefit  may  however  be  paid  without  a  doctor’s  certificate  referred  to  in  section  four     a)  If  the  member  has  been  admitted  to  a  health  institution,     b)  If  the  suffering  is  so  serious  that  the  member  cannot  be  expected  to  be  fit  for  work  again,  or     c)  If  the  member  is  expected  to  be  pronounced  fit  within  a  short  period.                  For  a  member  without  an  employer  to  continue  to  qualify  for  payment  of  sickness  benefit,  the  local  national  insurance  office   th must,  no  later  than  the  end  of  the  12  week  of  incapacity  to  work,  assess  whether  the  medical  conditions  for  entitlement  to   sickness  benefit    have  been  met,  and  whether  there  is  a  need  for  medical,  occupational  or  other  action.  In  such  a  case  the   local  national  insurance  office  must  make  a  decision  in  writing  concerning  the  continued  right  to  sickness  benefit.  Exceptions   to  these  provisions  may  be  made  in  the  cases  referred  to  in  section  5.                  As  soon  as  possible  and  no  later  than  12  weeks  from  the  commencement  of  the  period  of  incapacity  to  work,  during  which   an  employee  who  is  registered  sick  has  not  performed  any  work-­‐related  activity,  the  local  national  insurance  office  shall   obtain  a  follow  up  plan,  except  when  such  a  plan  is  accepted  to  be  clearly  unnecessary,  cf.  §  25-­‐2  and  Working  Environment   Act  §  4-­‐6  Section  3.                  The  local  national  insurance  office  shall  as  soon  as  possible  assess  whether  occupational  rehabilitation  is  to  be  provided  if   internal  company  measures  are  not  forthcoming,  or  if  the  member  does  not  have  employment.  An  assessment  of  this  nature   shall  be  completed  by  the  end  of  the  period  of  sickness  benefit  at  the  latest.                  The  Ministry  may  establish  regulations  concerning  exceptions  to  the  condition  for  a  doctor’s  certificate  in  Section  1  for  a   limited  period,  if  evidence  of  the  incapacity  to  work  has  been  provided  by  a  statement  from  other  health  personnel.    Amended  by  Acts  of  22  March  2002  no.  7  (in  force  1  July  2002),  19  Dec  2003  no.  135  (see  III  thereof,  in  force  1  Jan  2004),  18  June  2004  no.  41  (in  force  1  July  2004),  17  June  2005  no.  62  (in  force  1  Jan  2006  under  Decree  17  June  2005  no.  609),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).         Page  |  16  
  • 17.         Act  relating  to  Patients’  Rights  (Patients’  Rights  Act).      DATE:   ACT-­‐1999-­‐07-­‐02-­‐63    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  Services)    ENTRY  INTO  FORCE:   2001-­‐01-­‐01,  2001-­‐07-­‐01    LAST  AMENDED:   ACT-­‐2005-­‐12-­‐21-­‐125  from  2006-­‐01-­‐01    AMENDING:    ABBREVIATION:   Patients’  Rights  Act  -­‐  pasrl.      Chapter  2.  Right  to  healthcare  and  transport    Heading  amended  by  Act  28  Nov  2003  no.  96  (in  force  1  Jan  2004).    §  2-­‐2.  Right  to  assessment     Patients  who  are  referred  to  a  hospital  or  specialist  outpatients’  department  covered  by  §  2-­‐4,  are  entitled  to  have  their   health  condition  assessed  within  30  working  days  from  when  the  referral  is  received.    The  need  for  healthcare  must  be   assessed  and  information  must  be  provided  about  when  provision  of  the  treatment  can  be  expected.     An  assessment  must  be  made  as  to  whether  the  patient  has  a  right  to  specialist  health  services  referred  to  in  §  2-­‐1  section  2   and,  if  applicable,  a  time  limit  should  be  set  as  referred  to  in  the  second  point  of  the  same  section.  Patients  who  have  such  a   right  must  be  informed  of  this  and  the  time  limit.  In  the  notification  the  patient  must  also  be  given  details  about  right  of   appeal,  appeal  time  limits  and  details  of  the  appeals  procedure.  The  referring  authority  must  also  be  informed.     The  assessment  must  be  conducted  on  the  basis  of  the  referral.  If  necessary  supplementary  information  shall  be  obtained  or   the  patient  shall  be  called  in  for  examination.     If  a  serious  or  life-­‐threatening  illness  is  suspected,  the  patient  has  the  right  to  an  earlier  assessment.    Amended  by  acts  12  Dec  2003  no.  110  (in  force  1  Sep  2004  under.  Decree  19  March  2004  no.  540),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under.  Decree  21  Dec  2005  no.  1606).    ·∙                Regulation  21.12.2005  concerning  benefit  to  cover  of  the  cost  of  treatment  by  chiropractors  (NY).  Regulation  concerning  benefit  to  cover  of  the  cost  of  treatment  by  chiropractors    Laid  down  by  the  Ministry  of  Health  and  Care  Services  21.  December  2005  pursuant  to  the  act  of  28.  February  1997  no.  19  on  social  insurance  §  5-­‐9  section  4,  §  22-­‐2  section  2.  Chapter  I  Regulations  §  1.  The  insurance  system  pays  benefit  to  cover  the  cost  of  examination  and  treatment  by  a  chiropractor  for  illnesses,  injury  or  disability  which  entitles  the  member  to  benefit  under  the  Social  Insurance  Act,  Chapter  5.  The  treatment  must  be  of  considerable  importance  to  the  member’s  ability  to  function.  §  2    Benefit  is  only  granted  if  the  treating  person  has  authorisation  as  a  chiropractor  under  the  Act  of  2.  July  1999  no.  64  concerning  health  personnel  etc.  §  48,  or  approval  under  previous  regulations,  cf.  health  personnel  act  §  76  section  2  or  an  internship  (turnus)  licence  as  a  chiropractor  in  accordance  with  the  regulation  of  21.  December  2000  no.  1382  concerning  practical  training  (internship)  for  health  personnel  Chapter  1  and  6.   Page  |  17  
  • 18.    In  order  to  be  able  to  refer  to  a  specialist  doctor  and  physiotherapist  and  to  be  able  to  provide  documentary  evidence  of  incapacity  to  work  up  to  8  weeks,  it  is  a  condition  that  the  chiropractor  or  the  holder  of  an  internship  licence  as  a  chiropractor  has  the  necessary  skills  in  social  insurance  subjects  etc.  The  Ministry  will  establish  specific  requirements  regarding  the  content  and  scope  of  training.  §  3    The  insurance  system  pays  benefit  for  treatment  by  chiropractors  according  to  the  rates  in  §  7.  Benefit  is  paid  for  up  to  14  treatments  per  patient  per  treatment  year.  §  4  If  the  member  is  unable  to  get  to  the  place  of  treatment  on  account  of  his  condition  of  health  the  local  authority  will  cover  the  chiropractor’s  travel  expenses  under  the  Act  of  19.  November  1982  no.  66  on  Municipal  health  services  §  5-­‐1  sections  3  and  4.  §  5  The  insurance  service  may  enter  into  an  agreement  with  chiropractors  concerning  direct  settlement  with  the  insurance  scheme,  cf.  Social  Insurance  Act  §  22-­‐2  section  2.  The  benefit  is  then  paid  direct  to  the  chiropractor,  who  is  not  then  entitled  to  charge  the  member  for  parts  of  the  fee  covered  by  the  insurance  system.  The  National  Insurance  Administration  has  established  specific  rules  concerning  direct  settlement.  §  6    The  claim  for  benefit  to  cover  the  cost  of  treatment  by  a  chiropractor  must  be  accompanied  by  a  receipted,  itemised  invoice  from  the  chiropractor.  As  well  as  the  diagnosis  for  the  treatment  carried  out,  the  invoice  must  also  contain  all  the  information  which  is  required  to  decide  the  claim.  The  chiropractor  must  issue  the  invoice  on  a  form  stipulated  by  the  National  Insurance  Administration.  Claims  submitted  electronically  must  be  structured  in  accordance  with  the  file  format  set  by  the  National  Insurance  Administration.  §  7  Rates  K1.  Examination  upon  commencement  of  a  course  of  treatment     100  kroner.    K2.  Treatment  by  a  chiropractor,  per  time         50  kroner  Notes  to  rates  K1  and  K2:    Rate  K1  and  K2  may  not  be  combined  in  the  same  consultation.  Rate  K1  may  only  be  applied  once  per  series  of  treatment.  Series  of  treatment  means  the  number  of  consultations  which  are  required  for  the  same  illness/injury/disability.  The  rates  may  be  activated  a  total  of  14  times  per  patient  per  treatment  year.  K3a.  Indemnification  for  consultations  including  travel  time  when  the  chiropractor  works  in  conjunction  with  other  health  and  social  services  staff  as  part  of  a  treatment  or  rehabilitation  programme  for  individual  patients,  including  working  in  the  base  team.  The  rate  also  covers  practice  costs.  The  rate  cannot  be  used  in  conjunction  with  internal  collaboration  in  inter-­‐disciplinary  medical  centres  etc.  The  rate  cannot  be  used  as  payment  for  regular  collaboration  meetings,  unless  the  collaboration  relates  to  actual  patients.  Collaboration  may  include  diagnosis,  charting  of  rehabilitation  requirements,  drawing  up  and  following  of  the  rehabilitation  schedule,  assessment  of  level  of  function,  adaptation  of  the  environment  etc.  The  rate  is  calculated  for  the  entire  consultation/travel  time,  not  per  patient.  Reimbursement  of  travel  can  be  also  claimed  under  the  regulation  concerning  cover  of  transport  costs  of  health  personnel  in  connection  with  travel  to  conduct  an  examination  or  treatment.  The  rate  may  also  be  applied  when  the  consultation  is  conducted  over  the  telephone.    The  consultation  must  be  scheduled.  Per  half  hour  commenced       240  kroner  K3b.  Later  per  half  hour  commenced         240  kroner       Page  |  18  
  • 19.    K4.  Telephone  conversations/written  communications  about  individual  patients  with  doctors,  physiotherapists  in  specialist  health  services,  chiropractors  in  specialist  health  services,  community  health  and  social  services  and  company  health  services.  The  rate  may  not  be  used  for  communication  with  the  referring  therapist  upon  commencement  of  the  series  of  treatment.                                                     40  kroner  §  8  Grant  for  common  use  by  chiropractors  The  insurance  system  pays  a  grant  corresponding  to  1.5  per  cent  of  the  insurance  scheme  expenditure  on  treatment  with  chiropractors  to  the  fund  for  further  and  subsequent  training  of  chiropractors.  The  grant  is  paid  by  the  National  Insurance  Administration  to  the  Norwegian  Chiropractors  Association  for  an  appropriate  amount  every  quarter  with  a  final  settlement  at  the  end  of  the  year.  §  9  Entry  into  Force  The  regulation  comes  into  effect  on  1.  January  2006.  As  from  the  same  date  the  regulation  of  18.  April  1997  no.  331  concerning  benefit  to  cover  the  cost  of  treatment  by  chiropractors  is  revoked.       Page  |  19  
  • 20.        FOR  2003-­‐12-­‐19  no  1728:  Regulation  on  the  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  an  examination  or  treatment.  DATE:   FOR-­‐2003-­‐12-­‐19-­‐1728    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  services)    DEP/OFFICE:   Health  service  Department.    PUBLISHED:   In  2003  volume  18    ENTRY  INTO  FORCE:   2004-­‐01-­‐01    LAST  AMENDED:    AMENDING:   FOR-­‐1997-­‐03-­‐11-­‐215    VALID  FOR:   Norway    AUTHORITY:   ACT-­‐1982-­‐11-­‐19-­‐66-­‐§5-­‐1,  ACT-­‐1999-­‐07-­‐02-­‐61-­‐§2-­‐1a  CONTENTS  Regulation  concerning  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  and  treatment.            §  1.  Scope            §  2.  Conditions  of  cover          §  3.  Ambulatory  health  service  in  Finnmark            §  4.  Calculation  of  cover  of  cost  of  transport            §  5.  Fixed  transport  supplement            §  6.  Entry  into  force    Regulation  concerning  the  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  or  treatment.    Laid  down  by  the  Ministry  of  Health  19.  December  2003  pursuant  to  the  act  of  19.  November  1982  no.  66  on  municipal  health  services  §  5-­‐1  section  4  and  the  act  of  2.  July  1999  no.  61  on  specialist  health  services  etc.  §  2-­‐1a  section  4    §  1.  Scope                The  Local  Authority  covers  the  transport  costs  of  health  personnel  when  health  personnel  have  to  travel  to  patients  to  conduct  examinations  or  treatment  for  which  benefit  is  granted  under  the  Social  Insurance  Act  Chapter  5.  This  does  not  however  apply  to  the  transport  costs  of  specialists  who  have  operational  agreements  with  regional  health  authorities  cf.  section  2.  The  local  authority  will  also  cover  the  cost  of  transport  if  the  treatment  is  given  by  employees  of  the  local  authority  health  service,  including  home  nursing,  first  aid  clinic  and  family  welfare  office.                  The  regional  health  authority  covers  transport  costs  for  health  personnel  employed  by  the  regional  health  authority,  including  specialists  who  have  operational  agreements  with  the  regional  health  authority  cf.  Social  Insurance  Act  §  5-­‐4  and  §  5-­‐7.    Provision  concerning  exceptions  from  the  condition  for  a  doctor’s  certificate  when  chiropractors  and  manual  therapists  certify  incapacity  to  work  in  a  statement  Laid  down  by  the  Ministry  of  Labour  and  Social  Affairs  21.  December  2005  by  virtue  of  the  law  of  28.  February  1997  no.  19  concerning  Social  Insurance  §  8-­‐7  section  9  §  1  Right  to  certify  incapacity  to  work  Chiropractors  wishing  to  certify  incapacity  to  work  must  have  authorisation  under  the  Health  Personnel  Act  §  48  or  approval  under  former  regulations,  cf.  Health  Personnel  Act  §  76  section  2.  Those  holding  an  internship  license  as  a  chiropractor,  cf.  regulation  of  21.  December  2000  no.  1382  concerning  practical  training  (internship)  for  health  personnel  Chapter  1  and  6,  may  also  certify  incapacity  to  work.     Page  |  20  
  • 21.    Physiotherapists  wishing  to  certify  incapacity  to  work  must  have  authorisation  under  the  Health  Personnel  Act  §  48  or  approval  under  former  regulations,  cf.  Health  Personnel  Act  §  76  section  2,  and  a) Have  passed  an  examination  in  clinical  master  study  in  manual  therapy  for  physiotherapists  at  a  Norwegian  university  or   equivalent,  or  b) Be  approved  for  use  of  A8  tariff  -­‐  Manual  therapy  -­‐  and  have  passed  an  examination  in  differential  diagnostics,  laboratory   analysis  and  training  in  radiology  equivalent  to  Norwegian  master  training.  Physiotherapists  who  certify  incapacity  to  work  are  referred  to  as  manual  therapists  in  the  regulation.  Chiropractors  and  manual  therapists  wishing  to  certify  incapacity  to  work  must  have  completed  training  in  insurance  related  subjects  etc.  the  Ministry  of  Health  and  Care  Services  will  establish  more  specific  rules  concerning  the  scope  of  the  training.  §  2  Declaration  of  incapacity  to  work  The  condition  in  the  Social  Insurance  Act  §  8-­‐7  concerning  a  doctor’s  certificate  for  the  right  to  sickness  benefit  does  not  apply  if  the  incapacity  to  work  is  certified  by  a  statement  from  a  chiropractor  or  manual  therapist.  An  equivalent  exception  is  made  t o  the  condition  for  a  certificate  from  a  doctor  in  §  8-­‐4  section  2,  b).  Nos.  1  and  2  only  apply  to  illness  or  injuries  which  are  directly  connected  to  the  muscle  and  skeleton  system.  The  regulations  in  the  Social  Insurance  Act  §  8-­‐7  section  2  and  3  apply  accordingly  to  declarations  from  chiropractors  and  manual  therapists.  The  declaration  referred  to  in  section  1  may  not  continue  for  a  continuous  period  of  more  than  eight  weeks  from  the  first  day  of  sick  leave.    With  the  consent  of  the  member  a  copy  of  the  declaration  issued  in  accordance  with  section  1  is  sent  to  the  member’s  doctor  at  the  same  time  as  to  the  local  national  insurance  office.  If  a  member  is  unfit  for  work  for  more  than  six  weeks,  the  chiropractor  or  manual  therapist  shall  inform  the  member  that  incapacity  for  work  for  more  than  eight  weeks  must  be  certified  by  a  doctor.  In  such  cases  the  chiropractor  or  manual  therapist  shall,  after  obtaining  the  member’s  consent,  send  the  details  of  the  treatment  performed  to  the  member’s  doctor.    The  Social  Insurance  Act  §  21-­‐4  section  2,  no.  3  on  the  obligation  of  information  in  the  doctor’s  certificate  concerning  sick  leave,  where  an  illness  or  injury  may  have  a  connection  with  the  work  situation  and  §  25-­‐7,  concerning  exemption  from  issuing  doctor’s  certificates,  applies  accordingly  for  chiropractors  and  manual  therapists.  §  3  Supplementary  guidelines  The  National  Insurance  Administration  may  issue  specific  guidelines  for  the  implementation  of  the  regulation,  including  the  illnesses  and  injuries  which  fall  under  §  2  section  1,  no.3,  and  the  application  of  §  2  section  1  in  the  event  of  a  member’s  repeated  incapacity  for  work.  §  4  Entry  into  force  The  regulation  comes  into  force  on  1.  January  2006.         Page  |  21  
  • 22.     FOR  2003-­‐12-­‐19  no  1728:  Regulation  concerning  cover  of  the  cost  of  transport  of  health  personnel       etc.  in  connection  with  travel  to  conduct  examinations  or  treatment.    DATE:   FOR-­‐2003-­‐12-­‐19-­‐1728    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  services)    DEP/OFFICE:   Health  Service  Department.    PUBLISHED:   In  2003  volume  18    ENTRY  INTO  FORCE:  2004-­‐01-­‐01    LAST  AMENDED:    AMENDING:   FOR-­‐1997-­‐03-­‐11-­‐215    VALID  FOR:   Norway    AUTHORITY:   ACT-­‐1982-­‐11-­‐19-­‐66-­‐§5-­‐1,  ACT-­‐1999-­‐07-­‐02-­‐61-­‐§2-­‐1a      CONTENTS  Regulation  concerning  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  or  treatment.            §  1.  Scope            §  2.  Condition  of  cover            §  3.  Ambulatory  health  service  in  Finnmark            §  4.  Calculation  of  the  cover  of  transport  costs            §  5.  Fixed  transport  supplement            §  6.  Entry  into  forceRegulation  concerning  cover  of  the  cost  of  transport  for  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  or  treatment.    Laid  down  by  the  Ministry  of  Health  19.  December  2003  pursuant  to  the  act  of  19.  November  1982  no.  66  concerning  municipal  health  services  §  5-­‐1  section  4  and  the  act  of  2.  July  1999  no.  61  concerning  specialist  health  services  etc.  §  2-­‐1a  section  4.    §  1.  Scope  The  Local  Authority  covers  the  transport  costs  of  health  personnel  when  health  personnel  have  to  travel  to  patients  to  conduct  examinations  or  treatment  for  which  benefit  is  granted  under  the  Social  Insurance  Act  Chapter  5.  This  does  not  however  apply  to  the  transport  costs  of  specialists  who  have  operational  agreements  with  regional  health  authorities  cf.  section  2.  The  local  authority  will  also  cover  the  cost  of  transport  if  the  treatment  is  given  by  employees  of  the  community  health  service,  including  home  nursing,  first  aid  clinic  and  family  welfare  office.    The  regional  health  authority  covers  the  transport  costs  of  health  personnel  employed  by  the  regional  health  authority,  including  specialists  who  have  operational  agreements  with  the  regional  health  authority  cf.  Social  Insurance  Act  §  5-­‐4  and  §  5-­‐7.    §  2.  Conditions  of  cover    If  on  account  of  his  state  of  health  the  patient  cannot  get  to  the  place  of  treatment,  a  person  who  travels  for  the  purpose  of  performing  an  examination  or  treatment  is  entitled  to  cover  of  transport  costs.  Compensation  may  also  be  paid  by  the  local  authority  to  cover  the  travel  expenses  of  doctors  who  travel  to  and  from  regular  places  of  treatment  (subsidiary  clinics)  in  the  districts,  when  these  services  are  organised  by  the  local  authority.  If  the  local  authority  makes  transport  available,  travel  expenses  are  not  covered.    In  the  event  of  travel  by  staff  from  the  family  welfare  office  in  order  to  check  the  environment  in  connection  with  investigations,  treatment  and  advice  at  the  family  welfare  office,  the  local  authority  will  indemnify  half  of  the  calculated  expenses  in  accordance  with  the  national  travel  scale  if  the  medical  director  of  the  family  welfare  office  has  confirmed  the  necessity  for  travel  in  writing.    The  regional  health  authority  may  also  pay  compensation  for  cover  of  travel  expenses  for  specialists  who  have  entered  into  agreements  with  the  regional  health  authority,  for  travel  to  and  from  regular  treatment  centres  within  the  region  (outpatient/Ambulatory  services  etc.)  if  this  arises  pursuant  to  the  agreement  between  the  individual  practitioner  and  the   Page  |  22  
  • 23.    regional  health  authority.  The  same  applies  to  health  personnel  employed  in  private  hospitals  who  have  reached  an  agreement  with  the  regional  health  authority,  if  this  is  stated  in  the  agreement  between  the  hospital  and  the  regional  health  authority.    Travel  expenses  are  only  covered  if  the  distance  which  has  to  be  travelled  from  the  place  of  departure  to  the  patient  is  at  least  one  kilometre.  This  limit  does  not  apply  for  immediate  assistance.    §  3.  Ambulatory  health  service  in  Finnmark    In  the  event  of  journeys  to  and  from  regular  treatment  centres  in  Finnmark  the  local  authority  may  in  special  cases  cover  travel  expenses  and  accommodation  for  chiropractors,  physiotherapists  who  specialise  in  manual  therapy  and  physiotherapists  who  specialise  in  psychomotor  treatment  (Ambulatory  health  service).  Cover  for  expenses  are  normally  only  granted  to  practitioners  who  reside  in  Troms  County.  If  there  is  a  lack  of  practitioners  in  this  region,  the  local  authority  may  however  approve  cover  of  expenses  to  be  granted  to  practitioners  who  are  resident  elsewhere.    Cover  for  expenditure  may  only  be  granted  if  the  Ambulatory  health  service  is  approved  and  organised  by  the  local  authority.    Travel  expenses  for  treatment  of  patients  admitted  to  hospital  is  not  covered.  Nor  will  cover  be  granted  for  expenses  of  other  staff  or  for  lease  of  premises  etc.    A  promise  to  cover  expenses  may  be  withdrawn  with  one  month’s  notice.    §  4.  Calculation  of  cover  of  transport  costs    Only  the  cost  of  the  cheapest  mode  of  transport  will  be  covered.  If,  due  to  special  circumstances,  the  person  performing  the  examination  or  treatment  has  incurred  higher  essential  costs,  the  costs  may  be  covered  on  presentation  of  invoice.    The  cover  for  expenses  is  calculated  on  the  basis  of  the  «  Scale  for  domestic  journeys  on  behalf  of  the  State  ».    If  the  practitioner  uses  his/her  own  transport  the  calculation  is  based  on  the  number  of  kilometres  travelled.  In  the  calculation  of  the  distance  the  total  number  of  kilometres  from  the  outward  and  return  journeys  is  rounded  off  to  the  nearest  number  of  full  kilometres.  The  distance  is  calculated  from  the  office  (residence)  of  the  person  performing  the  examination  or  treatment.  If  the  journey  commences  at  a  temporary  place  of  residence,  the  distance  will  be  calculated  from  there,  if  the  distance  from  there  to  the  patient  is  shorter.    If  the  person  concerned  is  called  out  during  a  journey,  the  compensation  is  only  calculated  for  the  extra  distance  which  has  to  be  travelled  to  reach  the  patient  If  the  examination  or  treatment  takes  place  during  a  regular  working  day  journey,  the  distance  is  only  calculated  for  the  number  of  kilometres  which  the  person  in  question  travels  additionally  for  the  examination  or  treatment.  §  5.  Fixed  transport  supplement  If  the  practice  of  the  person  performing  the  examination  or  treatment  is  mainly  in  a  town  or  within  a  densely  built  up  area  in  an  urban  district,  a  fixed  supplement  may  be  paid  instead  of  the  cover  for  expenses  referred  to  in  §  1,  cf.  §  2.  A  fixed  supplement  of  this  nature  can  only  be  calculated  if  a  form  of  transport  is  used.  If  the  conditions  for  payment  of  a  fixed  supplement  are  met,  the  person(s)  conducting  the  examination  and  treatment  will  agree  the  amount  and  specific  conditions  of  the  travel  supplement  with  the  local  authority.  The  fixed  supplement  will  lapse  if  hired  forms  of  transport  (taxis)  are  used  and  the  locally  authority  has  reimbursed  the  costs    §  6.  Entry  into  force  The  regulation  comes  into  effect  on  1.  January  2004.    As  from  the  same  date  the  regulation  of  11.  March  1997  no.  215  concerning  support  for  the  cost  of  travel  in  connection  with  journeys  to  conduct  examinations  or  treatment  is  revoked.     Page  |  23  
  • 24.    Internship  (Turnustjeneste):   FOR  2000-­‐12-­‐21  no  1382:  Regulation  concerning  practical  training  (internship)  for  health       personnel.    DATE:   FOR-­‐2000-­‐12-­‐21-­‐1382    DEPARTMENT:   HOD  Ministry  of  Health  and  Care  Services    DEP/OFFICE:   Health  Dept.    PUBLISHED:   In  2000  3097    ENTRY  INTO  FORCE:  2001-­‐01-­‐01    LAST  AMENDED:   FOR-­‐2003-­‐09-­‐01-­‐1111    AMENDING:    VALID  FOR:   Norway    AUTHORITY:   ACT-­‐1999-­‐07-­‐02-­‐64-­‐§48    CONTENTS  Regulation  concerning  practical  training  (internship)  for  health  staff.    Chapter  1.  General  provisions            §  1-­‐1.  License            §  1-­‐2.  Training  at  the  place  allocated    Chapter  2.    Chapter  3.  Practical  training  (internship)  to  obtain  authorisation  as  a  physiotherapist            §  3-­‐1.  Required  content  of  the  internship            §  3-­‐2.  Approval  of  internship  place            §  3-­‐3.  Instructions            §  3-­‐4.  Completion  of  the  internship            §  3-­‐5.  Exceptions          §  3-­‐6.  Guidelines    Chapter  4.  Practical  training  (internship)  to  obtain  authorisation  as  a  midwife            §  4-­‐1.  Required  content  of  the  internship            §  4-­‐2.  Exceptions  for  candidates  from  other  countries            §  4-­‐3.  Completion  of  the  internship            §  4-­‐4.  Approval  of  internship  place            §  4-­‐5.  Exceptions          §  4-­‐6.  Guidelines      Chapter  5.  Practical  training  (internship)  to  obtain  authorisation  as  an  prosthetist            §  5-­‐1.  Completion  of  the  internship            §  5-­‐2.  Approval  of  the  internship  place            §  5-­‐3.  Required  content  of  the  internship            §  5-­‐4.  Assessment          §  5-­‐5.  Relationship  with  employer            §  5-­‐6.  Exceptions    Chapter  6.  Practical  training  (internship)  to  obtain  authorisation  as  a  chiropractor            §  6-­‐1.  Conditions  of  authorisation            §  6-­‐2.  Exceptions  for  candidates  from  other  countries     Page  |  24  
  • 25.    Chapter  7.  Entry  into  force,  etc.            §  7-­‐1.  Entry  into  force    Regulation  concerning  practical  training  (internship)  for  health  personnel.    Laid  down  by  the  Ministry  of  Health  and  Social  Welfare  21.  December  2000  pursuant  to  the  Act  of  2.  July  1999  no.  64  concerning  health  personnel,  etc.  (Health  Personnel  Act)  §  48  section  2,  b.  Amended  20  Dec  2001  no.  1549,  1  Sep  2003  no.  1111.    Chapter1.  General  provisions    §  1-­‐1.  License     Health  personnel,  who  have  to  complete  practical  training  (internship)  under  this  regulation,  must  have  a  license  (internship   license)  issued  by  the  Norwegian  Directorate  of  Health  and  Social  Welfare  before  the  training  commences.  This  does  not   apply  to  health  personnel  referred  to  in  Chapter  5.    §  1-­‐2.  Training  at  the  place  allocated                  Unless  otherwise  provided  in  this  regulation,  the  training  must  be  completed  at  the  place  allocated  in  order  to  qualify  for  approval  as  practical  training  (internship).    Chapter  6.  Practical  training  (internship)  to  obtain  authorisation  as  a  chiropractor    §  6-­‐1.  Conditions  of  authorisation                  In  order  to  obtain  authorisation  as  a  chiropractor  the  candidate  must  prove  that  he/she  has  completed  the  practical  training  specified  by  the  Directorate  of  Health  and  Social  Welfare.     0   Amended  by  regulation  of  20  Dec  2001  no.  1549  (in  force  1  Jan  2002).    §  6-­‐2.  Exceptions  for  candidates  from  other  countries                    For  candidates  from  other  countries  within  The  European  Economic  Area  (EEA),  who  meet  the  conditions  for  authorisation  as  a  chiropractor  under  the  EEA  treaty,  authorisation  is  granted  in  accordance  with  the  regulation  of  21.  December  2000  no.  1377  concerning  authorisation  etc.  of  health  personnel  under  the  EEA  treaty.    To:   Norwegian  Board  of  Health  Norwegian  Registration  Authority  for  Health  Personnel    Norwegian  Chiropractors  Association     CIRCULAR   IK-­‐10/2001     2000/4933     22.  Oct.  2001    Guidelines  for  practical  training  (internship)  for  chiropractors  1.  Legal  basis  As  a  condition  for  obtaining  authorisation  as  a  chiropractor  the  candidate  must  have  completed  practical  training  in  line  with  the  regulations  specifically  laid  down  cf.  Health  Personnel  Act  §  48  section  2,  b).  Specific  regulations  concerning  practical  training  for  chiropractors  are  stated  in  the  regulation  of  21.  December  2000  no.  1382  concerning  practical  training  (internship)  for  health  personnel.    §  6-­‐1  of  the  regulation  states  that  the  candidate”must  prove  that  he/she  has  completed  the  practical  training  specified  by  the  Norwegian  Board  of  Health.”    The  available  guidelines  establish  specific  requirements  for  the  practical  training.      Candidates  from  other  countries  within  the  EEA  who  meet  the  conditions  for  authorisation  as  a  chiropractor  under  the  EEA  treaty  are  entitled  to  authorisation  without  a  requirement  for  practical  training  cf.  Regulation  of  21.  December  2000  no.  1377  concerning  authorisation  etc  of  health  personnel  under  the  EEA  Treaty.     Page  |  25  
  • 26.      2.  Requirement  of  practical  training  In  order  to  be  granted  Norwegian  authorisation  as  a  chiropractor,  candidates  who  have  passed  the  chiropractor  training  accredited  by  the  European  Council  on  Chiropractic  Education  (ECCE),  must  complete  12  months  practical  training.      In  accordance  with  the  regulation  concerning  practical  training  (internship)  for  health  personnel  §  1-­‐  2  the  training  must  be  completed  at  the  allocated  place  in  order  to  be  approved  as  practical  training.  The  allocated  place  in  this  connection  means  that  the  training  must  be  completed  under  the  professional  guidance  and  supervision  of  authorised  chiropractors.  The  candidates  must  obtain  the  training  place  themselves  and  provide  evidence  that  the  person  concerned  is  given  guidance  by  an  authorised  chiropractor.  The  individual  may  if  necessary  refer  to  the  Norwegian  Chiropractors  Association  for  assistance  concerning  the  training  place.    The  training  should  in  principle  be  completed  in  a  full  time  position.  The  training  may  exceptionally  be  completed  in  a  part  time  position,  but  not  less  than  50  %  time.  The  training  period  must  then  be  extended  accordingly.      The  training  may  be  completed  in  several  training  places,  but  in  no  more  than  three  places.  Training  periods  of  less  than  two  months  will  not  be  counted.  3.  Specific  details  regarding  the  required  content  of  the  training    The  aim  of  the  practical  training  is  for  the  candidate,  through  working  as  a  chiropractor  under  guidance,  to  acquire  the  necessary  experience  and  practical  skills  to  be  able  to  practise  independently  as  a  chiropractor  in  a  proper  manner.      On  completion  of  the  practical  training  the  candidate  must  be  able  to:    Conduct  him/herself  appropriately  and  communicate  with  patients,  relatives  and  other  personnel  involved.    Take  case  notes.    Perform  usual  clinical  investigations.    Conduct  or  refer  to  relevant  image  diagnostic  investigations.    Assess  and  discuss  symptoms,  differential  diagnoses  and  prognoses.    Schedule  further  investigations,  assess  forms  of  treatment  and  decide  indications  and  contra-­‐indications  of  this.    Use  normal  chiropractic  methods  of  treatment.    Carry  out  necessary  and  proper  chiropractor  treatment.    Be  familiar  with  the  normal  procedures  with  reference  to  other  parts  of  the  treatment  chain.    Give  patients  and  if  necessary,  relatives,  adequate  information.    Satisfactorily  complete  medical  records-­‐,  epicrisis  and  other  documentation  work,  including  use  of  various  current  forms,  orders  and  certificates.    Manage  problem  scenarios  which  require  inter-­‐disciplinary  contacts  in  the  form  of  collaboration  meetings,  and  in  this  connection  be  familiar  with  the  partners  in  cooperation  in  the  health  service  and  social  insurance  office.  The  candidate  must  also  demonstrate  knowledge  of  Norwegian  health  and  insurance  legislation,  for  example  have  completed  a  course  in  public  health  work  with  the  District  Medical  Officer         Page  |  26  
  • 27.    4.  License  As  stated  in  the  regulation  concerning  practical  training  (internship)  for  health  personnel  §  1 -­‐1,  chiropractor  candidates  who  are  to  complete  practical  training  must  have  a  licence  (internship  licence)  before  the  training  commences.  Applications  for  a  licence  on  the  established  application  form  are  to  be  sent  to:    Statens  autorisasjonskontor  for  helsepersonell.    Postboks  8053  Dep.  0031  OSLO    Confirmation  of  the  training  place  and  instructor  must  be  enclosed  with  the  application.    5.  Attestation  The  candidate  shall  demonstrate  that  the  practical  training  has  been  completed  in  accordance  with  the  above  requirements.  This  must  be  certified  by  the  instructor  on  a  separate  form  issued  by  the  Statens  autorisasjonskontor  for  helsepersonell  (Norwegian  Registration  Office  for  Health  Personnel).    Aud  Nordal  e.f  Acting  Departmental  Manager  Lotte  Hernæs    Senior  consultant  Copy:  Ministry  of  Health  and  Social  Welfare    Church,  education  and  research  department  District  Medical  Officers       Page  |  27  
  • 28.    Legal  regulation  of  Chiropractors  in  Sweden.      Chiropractors  have  been  licensed  in  Sweden  since  1989.    All  authorised  health  personnel  today  adhere  to  one  law,  The  law  on  patient  safety,  passed  in  2010.  The  law  includes  a  title  protection  for  chiropractors.  There  is  no  specific  law  for  chiropractic.  Chiropractors  are  primary  caregivers,  responsible  for  diagnosis  and  treatment  and  should  like  all  other  licensed  health  professionals  adhere  to  evidence  based  care  according  to  the  law.  The  law  on  patient  safety:  The  National  Agency  for  Health  and  Social  Welfares  Directive  on  patient  safety,  Patientsäkerhetsförordningen  (2010:1369),  regulates  the  required  professional  qualification  for  chiropractors.  The  minimum  requirement  is  a  four  year  degree  and  one  year  practical,  supervised  training  according  to  4§  chapter  3.  See  Patientsäkerhetsförordningen  (2010:1369),  3  Kap  4§:    Tobias  Lauritsen  President,  Swedish  Chiropractic  Association       Page  |  28  
  • 29.    Switzerland    The  Chiropractic  profession  is  regulated  on  a  federal  and  a  cantonal  level.      Federal  legislation  Federal  law  on  education,  postgraduate  and  continuing  education  and  professional  activity  of  the  MDs,  the  dentists,  the  DCs,  the  pharmacists  and  the  veterinarians  (MedBG/LPMéd).      Chiropractic  treatments  are  reimbursed  by  the  social  insurances.  Sickness  insurance:  Accident  insurance  Radioprotection:        Cantonal  legislation  There  are  26  cantons,  each  canton  has  its  own  regulation.       Page  |  29  
  • 30.     EUROPEAN  CHIROPRACTORS’  UNION  Constitution   Revised  at  the  General  Council  Meeting  of  ECU  –  November  2010  1. NAME  AND  OFFICE   The  European  Chiropractors’  Union  (hereinafter  referred  to  as  ECU)  is  a  federation  of  National  Chiropractors’  Associations   with  its  office  at  the  address  of  the  Secretariat.  2. OBJECTS  AND  POWERS    a) The  ECU  is  established  to  promote  and  develop  the  profession  of  chiropractic  in  Europe.  It  shall  achieve  these  objects   by  promoting  and  supporting  research,  education,  political  representation  and  dissemination  of  information.  It   represents  the  whole  of  the  chiropractic  profession  in  Europe  on  a  supranational  level.  b) In  furtherance  of  the  said  objects  but  not  otherwise  the  ECU  may:   (i) Employ  and  pay  any  person  or  persons  to  supervise,  organise  and  carry  on  the  work  of  the  ECU.   (ii) Meet  with  representatives  of  national  governments,  voluntary  organisations,  statutory  authorities  and   individuals  with  the  aim  of  securing  or  developing  legal  recognition  for  chiropractors  as  members  of  a  separate,   distinct  and  independent  healthcare  profession.   (iii) Promote,  support  or  undertake  research,  surveys  or  investigations  that  will  advance  knowledge  and  guide  the   development  of  the  chiropractic  profession.   (iv) Arrange  and  provide  for  or  assist  in  arranging  and  providing  for  the  holding  of  exhibitions,  meetings,  lectures,   classes,  seminars  and  training  courses,  and  to  promote  and  assist  in  the  development  of  Chiropractic  teaching   institutions  in  Europe.   (v) Collect  and  disseminate  information  on  all  matters  affecting  the  said  objects  and  exchange  such  information   with  other  bodies  having  similar  objects.   (vi) Cause  to  be  produced,  published  and  distributed  such  materials  as  shall  further  the  said  objects.   (vii) Purchase,  take,  lease,  hire  or  otherwise  acquire  any  property  and  any  rights  and  privileges  necessary  for  the   promotion  of  the  said  objects  and  construct,  maintain  and  alter  any  buildings  or  erections  necessary  for  the  work   of  the  ECU.   (viii) Make  regulations  for  any  property,  which  may  be  so  acquired.   (ix) Subject  to  such  consents  as  may  be  required  by  law,  sell,  let,  mortgage,  dispose  of  or  turn  to  account  all  or  any  of   the  property  or  assets  of  the  ECU.   (x) Subject  to  such  consents  as  may  be  required  by  law,  borrow  or  raise  money  for  the  said  objects  and  accept  gifts   on  such  terms  and  on  such  security  as  shall  be  deemed  to  be  necessary.   (xi) Raise  funds  and  invite  and  receive  contributions  from  any  person  or  persons  whatsoever  by  way  of  subscriptions   and  otherwise  provided  that  the  ECU  shall  not  undertake  permanent  trading  activities  in  raising  funds  for  the   said  objects.   (xii)  Invest  the  monies  of  the  ECU  not  immediately  required  for  the  said  objects  in  or  upon  such  investments,   security  or  property  as  may  be  thought  fit,  subject  nevertheless  to  such  conditions  as  may  for  the  time  being  be   imposed  or  required  by  law.   (xiii) Do  all  such  other  lawful  things  as  are  necessary  for  the  attainment  of  the  said  objects.  3.     MEMBERSHIP  I)       UNION  MEMBER  (a)     Union  Membership  is  open  to  one  properly-­‐constituted  national  chiropractors’  association  per  European  country.  Such   associations  shall  require  all  full  members  to  be  graduates  of  CCEI-­‐accredited  chiropractic  educational  institutions.  All   Union    Members  shall  have  three  or  more  full  members  who  are  in  residence  and  practice  in  that  country.  (b)   All  applications  for  Full  Union  membership  shall  be  considered  by  the  General  Council  on  receipt  of  a  valid  application   by  the  Executive  Secretary.  Subject  to  satisfying  all  relevant  criteria  for  membership,  the  Executive  Council  shall,  not   less  than  three  months  in  advance  of  the  next  General  Council  meeting,  submit  a  proposal  for  Full  Union  Membership.   Approval  of  applications  shall  be  by  simple  majority  at  the  General  Council  meeting  thereafter.  (c)   Union  Membership  shall  be  open  to  all  European  nations  who  fulfil  the  criteria  for  membership.  These  shall  include,  but   not  be  limited  to,  those  countries  who  are  members  of  the  European  Union    (EU)  and  those  falling  within  the  European   Economic  Area  (EEA).   Page  |  30  
  • 31.    (d)   Where  the  Constitution  of  any  Union  Member  is  amended  to  permit  membership  to  chiropractors  who  have  qualified   from  an  educational  institution  not  recognised  by  CCEI  or  its  affiliates,  the  General  Council  may  request  in  writing  the   justification  for  such  amendment  and  determine  whether  Union  Membership  may  remain  valid  in  the  circumstances.  (e)   Each  Union  Member  shall  nominate  one  representative  to  sit  on  the  General  Council.  (f)                        Each  Union  Member:   (i)   may  appoint  a  maximum  of  two  observers  to  attend  General  Council  meetings.  Such  observers  shall  not  be   permitted  a  voice  unless  explicitly  requested  by  the  General  Council.   (ii)   may  request  that  an  additional  observer  attend  if  it  is  relevant  to  the  meeting.  (g)   The  General  Council  shall  have  the  right:   (i)   To  approve  and  reject  applications  for  membership,  and   (ii)   For  good  and  sufficient  reason  to  terminate  membership  of  any  Union  Member  provided  that  the  individual   representing  such  Union  Member  shall  have  the  right  to  be  heard  by  the  full  General  Council  before  a  final   decision  is  made.  (h)   Any  member  wishing  to  withdraw  from  membership  must  give  written  notice  to  the  office  of  the  ECU  prior  to  the  30th   day  of  September  in  any  year.    Failing  such  notice  the  per  capita  fee  for  the  ensuing  year  shall  become  due  and  payable.  II)   ASSOCIATE  UNION  MEMBER  (a)   Membership  is  open  to  one  properly  constituted  national  chiropractors’  association  per  country  which  is  not  an  EU   member  and  is  outside  the  European  Economic  Area  (EEA)  that  has  on  its  register  three  or  more  full  members,  who  are   in  residence  and  practice  in  that  country  and  are  graduates  of  colleges  that  meet  CCEI  education  criteria.  (hereinafter   known  as  Associate  Union  Member)  (b)   Applications  for  membership  will  be  approved  by  the  General  Council  by  simple  majority  at  the  next  meeting  following   receipt  of  a  valid  application.  (c)   Where  the  Constitution  of  any  Associate  Union  Member  is  amended  to  permit  membership  to  chiropractors  who  have   qualified  from  an  educational  institution  not  recognised  by  CCEI  or  its  affiliates,  the  General  Council  may  request  in   writing  the  justification  for  such  amendment  and  determine  whether  Associate  Union  Membership  may  remain  valid  in   the  circumstances.  (d)   Each  Associate  Union  Member  shall  nominate  one  representative  to  represent    it  as  an  observer  at  General  Council   meetings.  (e)   Each  Associate  Union  Member:   (i)   may  appoint  a  deputy  from  the  Associate  Union  Member  to  replace  its  appointed  representative  if  the  latter  is   unable  to  attend  any  particular  meeting  of  the  ECU  and   (ii)     may  request  to  have  an  observer  present.    (f)   The  General  Council  shall  have  the  right:   (i)   To  approve  and  reject  applications  for  membership,  and   (ii)   For  good  and  sufficient  reason  to  terminate  membership  of  any  Associate  Union  Member  provided  that  the   individual  representing  such  Union  Member  shall  have  the  right  to  be  heard  by  the  full  General  Council  before  a   final  decision  is  made.  (g)     Any  member  wishing  to  withdraw  from  membership  must  give  written  notice  to  the  office  of  the  ECU  prior  to  the  30th   day  of  September  in  any  year.    Failing  such  notice  the  per  capita  fee  for  the  ensuing  year  shall  become  due  and  payable.  (h)   Associate  Union  Members  may  not  stand  for  election  to  the  Executive  Council.    (i)   Associate  Union  Members  are  permitted  to  speak  to  agenda  items  at  General  Council  meetings  but  have  no  vote.   Page  |  31  
  • 32.      III)     INDIVIDUAL  CHIROPRACTIC  MEMBER    (a)     Chiropractors  in  European  countries  where  there  is  no  Union  Member  of  the  ECU,  may  apply  for  membership  as   Individual  Chiropractic  Members,  and  shall  be  accepted  as  such  on  providing  evidence  of  professional  qualification  and   ethical  standards  to  the  satisfaction  of  the  Executive  Council  of  the  ECU.  (b)     In  the  event  of  a  chiropractors’  association  being  constituted  in  any  country  and  becoming  a  Union  Member  of  the  ECU,   all  Individual  Chiropractic  Members  in  that  country  will  be  required  to  become  members  of  that  national  association,   and  will  be  ineligible  for  Individual  Chiropractic  Membership.  (c)     Any  chiropractor  outside  Europe  may  apply  to  become  an  Individual  Chiropractic  Member  of  the  ECU,  provided  such   chiropractor  is  able  to  prove  he/she  is  a  member  in  good  standing  in  his/her  State  or  National  Association,  should  one   exist.    In  cases  where  no  State  or  National  Association  exists,  the  Executive  Council  shall  use  its  discretion.  (d)     Individual  Chiropractic  Members  may  not  stand  for  election  to  the  Executive  Council.  (e)   Individual  Chiropractic  Members  have  no  vote.  IV)       HONORARY  MEMBER  (a)     The  award  of  Honorary  Membership  of  the  ECU  may  be  proposed  by  the  Executive  Council  and  approved  by  the   General  Council  to  those  individuals  considered  to  have  performed  exceptional  works  on  behalf  of  the  ECU.  Receipt  of   Honorary  membership  shall  exempt  the  Union  Member  to  which  the  individual  belongs  from  paying  the  per  capita  fee   for  that  individual.  (b)     Honorary  Members  may  not  stand  for  election  to  the  Executive  Council.    (c)     Honorary  members  have  no  vote.  4.     HONORARY  OFFICERS  (a)     The  General  Council  shall  elect  and  duly  appoint  all  Honorary  Officers  to  an  Executive  Council.  The  Executive  Council   shall  consist  of  a  President,  First  Vice-­‐President,  Second  Vice-­‐President,  Treasurer  and  Secretary.  Each  term  of  office   shall  run  from  the  date  of  the  Annual  General  Meeting  until  the  same  meeting  two  years  later.  All  Honorary  Officers   shall  be  eligible  for  re-­‐  election  for  a  second  term  of  office  by  simple  majority.  Candidates  seeking  further  terms  of   office  shall  be  required  to  secure  a  75%  majority  of  those  present  and  entitled  to  vote.  (b)     Elections  for  the  offices  of  President,  Second  Vice-­‐President  and  Treasurer  shall  take  place  on  alternate  years  to  the   elections  for  the  offices  of  First  Vice-­‐President  and  Secretary.  (c)     In  the  event  of  any  vacancy  arising  on  the  Executive  Council  outside  of  the  periods  of  election,  the  Executive  Council   shall  have  the  power  to  co-­‐opt  members,  as  they  see  fit,  for  the  remainder  of  the  term  of  office  or  until  the  following   Annual  General  Meeting,  whichever  is  sooner.  (d)     At  the  natural  completion  of  his  term  of  office,  the  President  shall  remain  on  the  Executive  Council  in  the  office  of   Immediate  Past  President  until  the  next  regular  meeting  of  the  General  Council.    (e)             (i)   Only  full  members  of  Union  Members  shall  be  eligible  to  serve  as  Honorary  Officers  or  members  of  the  General   Council.    Nominations  for  Honorary  Officers  must  be  made  by  members  of  the  General  Council  in  writing  or  via   e-­‐mail  and  must  be  received  at  the  ECU  office  at  least  six  weeks  before  the  Annual  General  Council  Meeting.    (ii)   Should  nominations  exceed  vacancies,  election  shall  be  by  ballot.     (iii)   There  must  be  a  secret  ballot  for  each  vacant  post.   (iv)   election  is  by  a  simple  majority.   (v)   In  the  case  of  three  or  more  nominations  for  one  office,  the  nominee  securing  the  least  votes  from  each  round   of  voting  shall  be  eliminated  until  only  two  nominees  remain.  Election  shall  then  be  according  to  a  simple   majority,  unless  one  of  the  nominees  is  seeking  a  third  term  of  office,  whereby  clause  4(a)  shall  be  invoked.    In   Page  |  32  
  • 33.     the  event  that  the  nominee  seeking  a  third  term  of  office  fails  to  achieve  75%  of  the  votes  cast  in  an  election   between  two  nominees,  he  shall  be  eliminated  from  the  ballot.    Where  the  remaining  candidate  does  not   achieve  51%  in  that  same  ballot,  a  further,  final  ballot  shall  be  held  in  which  he  must  achieve  a  simple  majority   of  the  votes  cast.    Failure  to  do  so  will  render  the  election  null  and  void  and  a  further  election  will  be  called  for   the  next  regular  General  Council  meeting.    (vi)   In  the  event  of  a  tied  election  where  only  two  nominees  remain,  the  Executive  Council  shall  adjourn  to   determine  a  casting  vote.  5.     EXECUTIVE  COUNCIL    (a)     Subject  as  hereinafter  mentioned  the  policy  and  general  management    of  the  affairs  of  the  ECU  shall  be  directed  by  an   Executive  Council  which  shall  meet  not  less  than  twice  a  year.    (b)     The  members  of  the  Executive  Council  shall  be  elected  at  the  Annual  General  Council  Meeting  of  the  ECU  in  accordance   with  Clause  4.  (c)   The  Executive  Council  shall  appoint  an  Executive  Secretary  and  when  required  an  Executive  Administrator.  (d)   The  Executive  Secretary  must  request  nominations  from  the  General  Council  for  the  posts  of  Officers  and  circulate  them   with  the  agenda  one  month  before  elections.  (e)     Where  any  member  of  the  Executive  Council  wishes  to  resign  from  office,  his  resignation  must  be  submitted  in  writing   to  the  Executive  Secretary.  Once  accepted  by  the  Executive  Council,  it  shall  not  be  possible  to  rescind  this  resignation.  (f)     The  Executive  Council  shall  appoint  a  Remuneration  Committee  which  shall  determine  the  remuneration  of  the   President,  Executive  Secretary  and  any  other  member  of  staff  who  shall  from  time  to  time  be  appointed  by  the   Executive  Council.  It  shall  also  recommend  to  the  Executive  Council  a  policy  for  the  payment  of  Expenses  and  any  other   Honoraria  to  any  other  member  of  Executive  Council  or  any  other  individual  undertaking  work  on  behalf  of  the  ECU.  (g)     The  proceedings  of  the  Executive  Council  shall  not  be  invalidated  by  any  failure  to  elect  or  any  defect  in  the  election,   appointment,  co-­‐option  or  qualification  of  any  member.    (h)     The  Executive  Council  may  appoint  such  special  or  standing  committees  as  may  be  deemed  necessary  by  the  Executive   Council  and  shall  determine  their  terms  of  reference,  powers,  duration  and  composition.    All  acts  and  proceedings  of   such  special  or  standing  committees  shall  be  reported  back  to  the  Executive  Council  as  soon  as  possible.    (i)     The  Executive  Council  shall  perform  its  duties  in  accordance  with  policies  laid  down  by  the  General  Council.  Any  policy   decisions  made  by  the  Executive  Council  shall  be  subject  to  ratification  by  simple  majority  at  the  following  General   Council  meeting.  6.   MEETINGS  OF  THE  ECU    (a)     Annual  General  Meetings  of  the  General  Council  shall  be  held  at  such  place  and  time  (not  being  more  than  15  months   following  the  preceding  Annual  General  Meeting)  as  the  Executive  Council  shall  determine.  At  least  4  months’  notice   shall  be  given  in  writing  to  Union  Members  and  Associate  Union  Members  by  the  Executive  Secretary.    (b)     An  Extraordinary  General  Council  Meeting  may  be  called  at  any  other  time  by  the  Executive  Council  at  its  discretion  or   by  the  General  Council  after  providing  six  or  more  signatories  of  Union  Members  calling  for  such  a  meeting.  The   Executive  Secretary  shall,  within  28  days,  call  an  Extraordinary  General  Council  Meeting  of  the  ECU.    (c)     Any  decision  of  the  General  Council  may  be  objected  to  by  a  Union  Member  not  represented  at  the  meeting  at  which   the  decision  was  taken.  Any  objection  shall  be  made  within  one  month  of  receipt  of  the  related  Minutes.  The  Union   Member  must  accept  the  majority  decision  pertaining  to  the  matter  at  the  following  meeting  of  General  Council.  7.     RULES  OF  PROCEDURE  AT  ALL  MEETINGS  (a)     Minutes  of  all  General  Council,  Executive  Council  and  sub-­‐committee  meetings  shall  be  kept.  The  Executive  Secretary   shall  be  responsible  for  the  accurate  recording  of  all  proceedings  and  resolutions.  (b)     Save  as  otherwise  herein  provided,  all  questions  arising  at  any  meeting  shall  be  decided  by  a  simple  majority  of  those   present  and  entitled  to  vote.  In  the  case  of  a  tied  vote,  the  Executive  Council  shall  adjourn  and  determine  a  casting   vote.   Page  |  33  
  • 34.    (c)     Minutes  of  all  General  Council,  Executive  Council  and  sub-­‐committee  meetings  shall  be  kept.  The  Executive  Secretary   shall  be  responsible  for  the  accurate  recording  of  all  proceedings  and  resolutions.  (d)     Standing  Orders  and  Rules  -­‐  The  Executive  Council  shall  have  power  to  adopt  and  issue  standing  orders  and/or  Rules  of   the  ECU.  Such  Standing  Orders  and/or  Rules  shall  come  into  operation  immediately  provided  always  that  they  shall  be   subject  to  review  by  the  ECU  in  General  Council  meetings  and  shall  not  be  inconsistent  with  the  provision  of  this   Constitution.  (e)     In  decisions  relating  to  political,  professional  or  electoral  issues  each  Union  Member  representative  disposes  of  one   vote.  (f)       In  decisions  relating  to  financial  issues  each  Union  Member  representative  disposes  the  following  votes  dependent  on   membership  numbers:   Number  of  members                Votes   3  -­‐      30   1   31  -­‐      60   2   61  -­‐      120   3   121  -­‐      200   4   201  -­‐      300   5   301  -­‐      400   6   401  -­‐      500    7   501  -­‐      600   8   601  -­‐      700    9   701  -­‐      800   10  An  additional  vote  would  be  added  for  each  100  members  to  a  maximum  of  no  more  than  one-­‐third  of  total  votes  available.  (g)     Any  country  which  is  the  subject  of  a  financial  proposal  is  excluded  from  voting  on  that  issue.  (h)     Union  Members  shall  submit  notification  of  membership  numbers  to  the  Treasurer  who  will  determine  Union  Member   dues  accordingly.  Votes  on  financial  issues  shall  be  determined  by  reference  to  membership  numbers  and  dues  paid.  (i)     Financial  proposals  for  the  agenda  must  be  submitted  by  the  Union  Member  in  writing  or  by  email  three  months  in   advance  of  the  meeting.    (j)     All  other  proposals  for  the  agenda  must  be  submitted  by  the  Union  Member  in  writing  or  by  e-­‐mail  to  the  Executive   Secretary  six  weeks  prior  to  the  General  Council  meeting.  8.     FINANCE  (a)     All  monies  raised  by  or  on  behalf  of  the  ECU  shall  be  applied  to  further  the  objects  of  the  Association  and  for  no  other   purpose,  provided  that  nothing  herein  contained  shall  prevent  the  payment  in  good  faith  of  reasonable  and  proper   remuneration  to  any  employee  of  the  ECU  or  the  repayment  to  members  of  the  Executive  Council  or  of  any  committee   appointed  under  Clause  5(h)  of  reasonable  out-­‐of-­‐pocket  expenses.  (b)     The  Honorary  Treasurer  shall  keep  proper  accounts  of  the  finances  of  the  ECU.  (c)   The  accounts  shall  be  audited  at  least  once  a  year  by  the  auditor  or  auditors  appointed  at  the  Annual  General  Council   Meeting.    An  Honorary  Officer  is  not  eligible  to  act  as  an  Auditor.  (d)     The  Remuneration  Committee  shall  determine  the  remuneration  of  the  auditors.   Page  |  34  
  • 35.    (e)     A  bank  account  shall  be  maintained  in  the  name  of  the  ECU  with  such  bank,  as  the  Executive  Council  shall  from  time  to   time  decide.  (f)     The  Executive  Council  shall  have  the  power  to  appoint  trustees,  when  and  where  necessary  in  countries  where  ECU   funds  have  accumulated.    Three  trustees  shall  be  appointed,  two  to  form  a  quorum.    They  shall  invest  the  ordinary  and   special  funds  of  the  ECU  in  any  of  the  stocks  or  securities  authorised  by  law  for  the  investment  of  trust  funds  in  such   manner,  as  the  Executive  Council  shall  from  time  to  time  direct.  (g)     The  title  to  all  real  or  personal  property  which  may  be  acquired  by  or  on  behalf  of  the  ECU  shall  be  vested  in  a   corporation  lawfully  entitled  to  act  as  Custodian  Trustee  or  in  not  less  than  three  or  more  than  five  individual  persons   (not  being  members  of  the  Executive  Council).  9.     ALTERATIONS  TO  THE  CONSTITUTION  (a)     Any  alteration  of  this  Constitution  shall  be  determined  by  a  two-­‐thirds  majority  of  the  General  Council  present  and   voting  at  the  next  General  Council  meeting.    (b)   Notice  of  any  proposed  alteration  to  this  Constitution  must  be  received  by  the  Executive  Secretary  in  writing  at  least   three  months  before  the  General  Council  meeting  and  submitted  to  the  Union  Members  two  months  before  such   meeting.  10.     DISSOLUTION  (a)    If  the  Executive  Council  by  a  simple  majority  decides  at  any  time  that  it  is  necessary  or  advisable  to  dissolve  the  ECU,  it   shall  call  an  extraordinary  General  Council  meeting,  of  which  meeting  not  less  than  28  days’  notice  stating  the  terms  of   the  Resolution  to  be  proposed  threat  shall  be  given.  If  such  decision  shall  be  confirmed  by  a  two-­‐thirds  majority  of   those  present  and  voting  at  such  meeting  the  Executive  Council  shall  have  power  to  dispose  of  any  assets  held  by  or  on   behalf  of  the  ECU.  Any  assets  remaining  after  the  satisfaction  of  any  proper  debts  and  liabilities  shall  be  given  or   transferred  to  the  Union  Members  in  proportion  to  their  membership.  11.     NOTICES    (a)     Any  notice  may  be  served  by  the  Secretary  on  any  Union  Member  either  personally  or  on  its  appointed  representative   as  the  case  may  be,  by  e-­‐  mail,  or  by  sending  it  through  the  post  in  a  pre-­‐paid  letter  addressed  to  such  Union  Member   at  its  last  known  address,  and  any  letter  so  sent  shall  be  deemed  to  have  been  received  within  ten  days  of  posting.                    ECU  CONSTITUTION  updated  27  November  2010    Previously  Updated  2nd  January  1996,  17th  January  1997,  8th  August  2000,  23rd  June  2003,  16th  December  2003,  27th  May  2004,  3rd  March  2006,  31st  May  2008  &  30th  May  2009       Page  |  35  
  • 36.     EUROPEAN  COUNCIL  ON  CHIROPRACTIC  EDUCATION  CONSTITUTION  Revision  Start  Date:  March  2004  Revision  Complete  Date:  November  2004  Back  Translation  to  English:  Complete  Date:  September  2005  Version  2.1:  November  2006  Version  2.2:  November  2009  ECCE  CONSTITUTION  CONTENTS    1                     TITLE  AND  REGISTERED  OFFICE      2                     PURPOSE    3                     MEMBERSHIP      4                     TERM,  COMMENCEMENT  AND  LOSS  OF  MEMBERSHIP    5   BODIES  OF  THE  ECCE    6   ATTENDANCE  BY  INSTITUTIONS  WITH  CANDIDATE  (for  ACCREDITED)  STATUS    7   OBSERVERS    8   THE  COUNCIL    9   THE  EXECUTIVE  COMMITTEE    10   STANDING  COMMITTEES     10.1   Commission  on  Accreditation     10.2   Quality  Assurance  Committee      11   FINANCE      12   INDEMNIFICATION    13   AMENDMENTS      14   DISSOLUTION    15   INTERPRETATION      VERSION  2.2  Adopted  Council  7  NOVEMBER  2009         Page  |  36  
  • 37.    ECCE  CONSTITUTION  1                        TITLE  AND  REGISTERED  OFFICE     The  title  of  the  organisation  shall  be:  “THE  EUROPEAN  COUNCIL  ON  CHIROPRACTIC  EDUCATION”  hereafter   referred  to  as  “the  Council”.  The  Councils  registered  office  is  in  Aachen,  Germany.  It  is  registered  at  the   Register  of  Associations  (Vereinsregister  73  VR  2732)  of  the  Local  Court  (Amtsgericht)  Aachen  and  bears  the   affix  "e.V."  2                          PURPOSE     The  European  Council  on  Chiropractic  Education  (ECCE)  (the  Council)  is  an  organisation  created  to  pursue  the   following  objectives:     2.1.                 To  encourage  the  highest  possible  standards  in  chiropractic  education  and  training.     2.2                   To  establish  standards  of  excellence  for  the  education  and  training  of  chiropractors  as  safe  and  competent  primary   contact  practitioners.     2.3                   To  foster  academic  environments  in  which  ethically  and  professionally  responsible  future  practitioners  of   chiropractic  can  be  educated  and  trained.     2.4                   To  evaluate  and  accredit  chiropractic  institutions  (and/or  chiropractic  educational  programmes)  according  to,  and   against,  a  pre-­‐determined  and  evolving  set  of  procedures  and  Standards.     2.5                   To  publish  a  list  of  those  institutions  that  deliver  programmes  in  compliance  with  the  Council’s  procedures  and   Standards.     2.6                   To  ensure  that  institutions  holding  Accredited  status  with  the  Council  are  comparable  in  their  educational   programmes  in  achieving  the  core  competencies.     2.7                   To  actively  seek  recognition  of  the  Council  as  the  policy-­‐making  body  for  chiropractic  education  and  training  by  all   relevant  authorities  whether  independent,  national  or  international.     2.8                   To  develop  equivalent  accreditation  agreements  where  appropriate  with  other  co-­‐  operating  accreditation  bodies.     2.9                   The  Council  exclusively  and  directly  pursues  non-­‐profit  objectives  in  accordance  with  the  Section  "Tax-­‐deductible   objectives"  of  the  German  tax  regulations.     2.10               The  Council  is  engaged  altruistically.  It  does  not  pursue  any  own  profit-­‐making  goals.     The  funds  of  the  Council  shall  be  spent  in  accordance  with  the  Constitution  only.  The  members  shall  not  receive   allocations  from  the  Councils  funds.  Expenditure  and  remunerations  must  not  exceed  the  costs  actually  incurred.   They  shall  be  documented  by  the  Councils  accounting  records.  No  person  shall  benefit  from  expenditure  which   are  alien  to  the  purpose  of  the  Council.     3                        MEMBERSHIP     3.1                   The  members  of  the  Council  shall  comply  with  the  Requirements  of  Membership(refer  to  3.3  to  3.6  inclusive),  and   consist  of:     3.1.1             Four  (4)  members  nominated  by  the  European  Chiropractors’  Union  (ECU)  and  elected  by  the  Council.     3.1.2             One  (1)  member  who  is  a  member  of  the  ECU  Executive,  nominated  by  the  ECU  Executive  and  elected  by  the   Council     3.1.3             One  (1)  member  who  is  a  chiropractor,  citizen  and  resident  of  the  country  where  the  Council  is  registered,   nominated  and  elected  by  the  Council.     Page  |  37  
  • 38.     3.1.4             Two  (2)  members  who  are  educationalists  and  who  are  NOT  chiropractors  nominated  by  the  Executive  Committee   and  elected  by  the  Council.     3.1.5            Two  (2)  members  who  are  chiropractors  nominated  by  the  Executive  Committee  and  elected  by  the  Council.     3.1.6             Institutional  members  are  members  that  have  been  accredited  by  the  ECCE.  The  Commission  on  Accreditation   decides  on  the  admission  of  such  members.  Each  institution  member  is  represented  by  one  person  who  is   authorized  to  speak  and  vote  on  its  behalf     3.1.7             Two  (2)  members  nominated  by  the  institutional  members  (3.1.6)  from  the  teaching  or  administrative  staff  of  the   member  institutions  (but  not  more  than  one  of  those  two  members  from  any  one  institution)  and  elected  by  the   Council.     3.1.8            Up  to  Two  (2)  members  who  are  nominated  by  the  Executive  Committee  and  elected  by  the  Council.     3.2                   Vacancies:     3.2.1             Vacancies  occurring  in  the  membership  of  the  Council  shall  be  filled  by  the  constituency  in  which  the  vacancy   occurs.  The  new  member  shall  be  elected  by  the  Council  as  a  new  member  in  line  with  section  4.     3.2.2             There  is  no  obligation  to  fill  vacancies  in  the  membership.     3.3                   Requirements  for  ALL  members  of  the  Council:     Members  of  the  Council  must:     3.3.1             Uphold  the  Constitution,  educational  Standards,  procedures  and  policies  adopted  in  accordance  with  the   Constitution.     3.3.2             Understand,  accept  and  be  bound  by  all  aspects  of  confidentiality  during  and  after  elected  periods.     3.3.3            Have  the  will  and  ability  to  devote  the  time  necessary  to  the  Council’s  activities.     3.3.4             NOT  be  acting  in  an  executive  capacity  in  a  national  professional  chiropractic  organisation/association  or  in  the   ECU  (with  the  exception  of  3.1.2).     3.3.5             NOT  engage  in  activities  which  constitute  a  conflict  of  interest  with  the  Council’s  affairs.     3.3.6             NOT  represent  themselves  as  spokespersons  for  the  Council  without  the  express  authorisation  of  the  President   and/or  the  Executive  Committee.     3.4                   Requirements  for  chiropractic  members  of  the  Council:     In  addition  to  the  requirements  under  3.3,  chiropractic  members  of  the  Council  must  have:     3.4.1             A  total  of  five  years  full-­‐time  practice  of  chiropractic  and/or  teaching  practice  in  a  chiropractic  institution.     3.4.2             Demonstrated  a  record  of  professional  accomplishment.     3.5                   Requirements  for  members  of  the  Council  who  are  NOT  chiropractors:     In  addition  to  the  requirements  under  3.3,  members  of  the  Council  who  are  NOT  chiropractors  must  have:     3.5.1             Demonstrated  an  interest  in  chiropractic  education  and/or  health  care.     3.5.2             Have  experience  in  academic  and/or  accreditation  procedures.     3.6                   Special  Requirements  for  ECU  nominated  members  (3.1.1.)     Page  |  38  
  • 39.     In  addition  to  the  requirements  under  3.3  and  3.4,  members  nominated  by  the  ECU  must  comply  with  ALL  of  the  following:     3.6.1             Be  members  of  the  chiropractic  profession.     3.6.2             NOT  be  voting  members  of  a  governing  body  (or  equivalent)  of  a  chiropractic  education  institution.     3.6.3             NOT  be  members  of  staff  of  a  chiropractic  education  institution.     4   TERM,  COMMENCEMENT  AND  LOSS  OF  MEMBERSHIP     4.1                   Term  and  Commencement     4.1.1             For  members  pursuant  to  sections  3.1.1,  3.1.4,  3.1.5,  3.1.7  and  3.1.8  membership  shall  be  limited  to  a  period  of   four  years  commencing  on  the  first  day  of  January  following  the  annual  meeting  of  the  Council.  Membership  may   be  prolonged  for  a  consecutive  period  of  four  years  if  the  member  is  re-­‐nominated  by  his/her  constituency  and  re-­‐ elected  by  the  Council.     4.1.2             Membership  of  the  members  pursuant  to  sections  3.1.2,  3.1.3  and  3.1.6  shall  be  for  an  indefinite  period  of  time.     4.1.3             All  nominations  for  membership  to  the  Council  must  be  received  (by  the  Executive  Secretary)  at  least  35  days  prior   to  an  election  by  the  Council.     4.2                   Loss  of  membership.  Membership  may  be  terminated  as  follows:     4.2.1             The  member  declares  his/her  resignation,  which  is  possible  without  observing  any  period  of  notice.     4.2.2             Members  with  unlimited  membership  lose  their  membership  if  their  constituency  rescinds  or  withdraws  the   nomination.     4.2.3             Members  of  the  ECU  (3.1.1)  lose  their  membership  if  they  cease  to  fulfil  one  or  more  of  the  requirements  set  forth   in  section  3.6.     4.2.4             In  addition,  a  member  may  be  excluded  if  the  further  requirements  set  forth  in  section  3.3  through  3.6  inclusive  of   the  Constitution  are  no  longer  complied  with  and/or  a  member  infringes  the  purpose  of  the  ECCE  (see  section  2).   The  exclusion  shall  be  decided  upon  by  the  Council.     5                        BODIES  OF  THE  ECCE     5.1                   The  bodies  of  the  ECCE  are:     5.1.1             the  Council;     5.1.2             the  Executive  Committee;     5.1.3             the  Commission  on  Accreditation;     5.1.4             the  Quality  Assurance  Committee.     5.2                   The  Executive  (Committee)  as  defined  by  §  26  German  Civil  Code  consists  of  the  President,  the  Vice-­‐President  and   the  Secretary/Treasurer.     The  ECCE  shall  be  represented  by  two  members  of  the  Executive  Committee  in  legal  and  out  of  court  proceedings;   one  of  the  said  members  shall  be  the  President  or  the  Vice-­‐  President.     6                        ATTENDANCE  BY  INSTITUTIONS  WITH  CANDIDATE  (for  ACCREDITED)  STATUS       One  official  representative  appointed  by  each  institution  holding  Candidate  (for  Accredited)  status  with  the   Council  will  have  the  right  to  attend  and  speak  at  Council  meetings  without  voting  rights.       Page  |  39  
  • 40.     7                        OBSERVERS     7.1                   The  following  categories  of  Observer  may  be  invited  at  the  discretion  of  the  Executive  Committee  to  attend  but   not  vote  at  Council  meetings:     7.1.1             State  licensing  authorities  or  national  or  international  regulatory  authorities  dealing  with  chiropractic  education  in   Europe.     7.1.2             Institutions  with  whom  there  has  been  recent  and  substantial  dialogue  regarding  application  for  (Candidate  for)   Accredited  status.     7.1.3             Members  of  other  Councils  on  Chiropractic  Education  (CCEs)  worldwide  including  the  Council  on  Chiropractic   Education  International  (CCEI).     8                        THE  COUNCIL     The  Council  is  the  supreme  decision-­‐making  authority  of  the  ECCE.     8.1                   Regular  meetings  shall  be  held  at  least  once  a  year  at  such  times  (normally  in  October  or  November)  and  in  such   places  as  determined  by  the  Executive  Committee.     8.2                   Special  meetings  may  be  called  by  the  President,  or  his/her  duly  appointed  designee  (in  writing)  upon  the  written   request  of  a  one-­‐third  majority  of  the  membership  of  the  Council  (excluding  vacancies).     8.3                  All  Council  meetings  shall  be  convened  by  the  Executive  Committee  with  at  least  thirty  (30)  days’  notice  in  writing,   including  the  agenda  and  supporting  papers.     8.4                   Quorum:  Two-­‐thirds  of  the  membership  of  the  Council  (excluding  vacancies)  shall  form  a  quorum.  In  cases  where  a   quorum  is  not  formed,  the  meeting  will  continue  and  make  recommendations  but  not  decisions.  Decisions  arising   from  the  meeting  shall  be  taken  either  at  the  next  meeting  or  by  postal/teleconference  voting.     8.5                   Majority  vote.  In  all  matters  (with  the  exception  of  Amendments  (13)  and  Dissolution  (14))  a  motion  is  carried  by  a   simple  majority  of  those  members  present  at  the  Council  meeting  with  a  show  of  hands  or  by  secret  ballot  as   decided  by  the  Council.  Postal  votes  or  voting  by  proxy  is  NOT  allowed.     8.6                   A  conflict  of  interest  on  the  part  of  a  member  in  any  matter  under  discussion  must  be  declared  by  the  said   member  either  before  or  during  the  meeting.  In  all  cases,  the  member  will  be  excluded  from  the  meeting  for  the   said  matter.       A  perceived  conflict  of  interest  of  any  member  in  any  matter  under  discussion  can  also  be  raised  by  any  member   of  the  Council  either  before  or  during  the  meeting.  If  this  objection  is  supported  by  a  simple  majority  vote,  then   the  said  member  will  be  excluded  from  the  meeting  for  the  said  matter.     8.7                   Consent  to  action  without  meeting:  Exceptionally,  action  may  be  taken  in  writing  without  a  meeting  if  the  action   to  be  taken  is  agreed  in  writing  by  a  two-­‐thirds  majority  of  the  membership  of  the  Council  (excluding  vacancies).     The  written  procedure  shall  be  as  follows:     The  period  of  time  granted  to  the  members  for  reflection  shall  be  four  weeks.  This  time-­‐limit  commences  with  the   announcement  (receipt)  of  the  action  to  be  decided  upon.  The  written  votes  must  be  received  at  the  end  of  the   day  on  which  the  period  of  reflection  expires.  The  written  votes  shall  be  counted  and  the  result  announced  by  the   Executive  Secretary.     Amendments  of  the  Constitution  (13)  and  Dissolution  of  the  Council  (14)  cannot  be  decided  without  a  meeting  of   the  Council.     8.8                   Executive  Secretary:  The  Council  shall  be  serviced  in  its  business  by  the  Executive  Secretary  who  is  in  attendance  at   meetings  without  voting  rights.     Page  |  40  
  • 41.     8.9                   All  members  shall  have  full  voting  rights.     8.10               At  all  Council  meetings  a  chair  must  be  elected  by  a  simple  majority  of  those  present  at  the  meeting.  The  minutes   of  the  meeting  shall  be  signed  by  the  chair  and  the  Secretary/Treasurer  or  the  delegated  authority  taking  the   minutes.     9                        THE  EXECUTIVE  COMMITTEE     9.1                   Membership  of  the  Executive  Committee  SHALL  BE  NOMINATED  AND  ELECTED  FROM  THE  MEMBERS  OF  THE   COUNCIL.THE  LOSS  OF  MEMBERSHIP  OF  THE  COUNCIL  SHALL  ALWAYS  LEAD  TO  DISMISSAL  FROM  THE  OFFICE  OF   MEMBER  OF  THE  EXECUTIVE  COMMITTEE.     They  are:     •      President   •      Vice-­‐President   •      Secretary/Treasurer   •      Chair  of  the  Commission  on  Accreditation  (CoA)   •      Chair  Quality  Assurance  Committee  (QAC)     9.1.1             The  Chair  of  the  Commission  on  Accreditation  is  not  elected  by  the  Council.     He/She  is  nominated  and  elected  by  the  members  of  the  Commission  on  Accreditation  (section  10.1)  and   appointed  member  of  the  Executive  Committee.  His/Her  office  shall  end  when  he/she  ceases  to  be  Chair  of  the   COA  or  in  the  event  of  his/her  dismissal  by  the  COA.  The  Chair  of  the  COA  cannot  be  dismissed  by  the  Council.     9.1.2             In  the  event  that  the  Chair  of  the  COA  resigns  or  is  dismissed,  the  Vice-­‐Chair  of  the  COA  shall  act  as  interim   member  of  the  Executive  Committee  until  a  new  Chair  of  the  COA  is  elected.     9.1.3             In  the  event  that  the  Chair  of  the  QAC  resigns  or  is  dismissed,  a  member  of  the  QAC  nominated  by  the  QAC  shall   act  as  interim  member  of  the  Executive  Committee  until  a  new  Chair  of  the  QAC  is  elected  by  the  Council.     9.2                   Elections  and  Terms  of  Office     9.2.1             The  members  of  the  Executive  Committee  (with  the  exception  of  the  Secretary/Treasurer  and  the  Immediate  Past   President)  shall  be  elected  to  serve  for  a  period  of  four  years.  The  elections  shall  take  place  at  the  annual  Council   meeting  (normally  held  in  October  or  November).  The  President  and  Vice-­‐  President  may  seek  re-­‐election  for  one   further  period  of  four  years.     9.2.2             The  Secretary/Treasurer  is  nominated  and  elected  annually  by  the  Council  and  has  a  fixed  term  of  office  of  one   year.     9.2.3             The  term  of  office  shall  begin  on  the  first  day  of  January  following  election.     9.3                   Dismissal       Any  member  of  the  Executive  Committee  may  be  dismissed  for  whatever  reason  by  a  two-­‐thirds  majority  vote  of   those  members  present  at  the  meeting  of  the  Council.  The  dismissal  without  meeting  (postal  votes  (8.7))  is  not   allowed.  This  does  not  apply  to  the  Chair  of  the  CoA  who  cannot  be  dismissed  by  the  membership  of  the  Council   (ref.  9.1.1)     9.4                   Vacancies       A  vacancy  in  any  office  because  of  death,  resignation,  or  due  to  loss  of  membership  for  any  other  reason  shall  be   filled  by  an  appointee  of  the  Executive  Committee  until  the  next  annual  meeting  of  the  Council.     9.5                   Office  of  President     9.5.1             The  President  shall  be  the  Principal  Officer  of  the  Council  and  subject  to  its  control.     Page  |  41  
  • 42.     9.5.2             In  general,  he/she  shall  perform  all  duties  appropriate  to  the  office  of  President,  and  such  other  duties  as  may  be   prescribed  to  him/her  by  the  Council  from  time  to  time,  and  under  the  supervision  and  control  of  the  Council.     9.6                   Office  of  Vice-­‐President     9.6.1             In  general,  he/she  shall  perform  all  duties  appropriate  to  the  office  of  Vice-­‐  President  and  have  such  other  duties   and  exercise  such  authority  as  from  time  to  time  may  be  delegated  or  assigned  to  him/her  by  the  President  or  by   the  Council.     9.6.2             In  the  absence  of  the  President,  or  in  the  event  of  his/her  inability  to  act,  or  in  the  event  that  for  any  reason  it   would  be  impractical/inappropriate  for  the  President  to  act,  the  Vice-­‐President  shall  perform  the  duties  of  the   President,  and  when  so  acting  shall  have  all  the  powers  of,  and  be  subject  to  all  the  restrictions  upon,  the   President.     9.7                   Office  of  Secretary/Treasurer     The  Secretary/Treasurer  shall:     9.7.1             Keep  the  Minutes  of  the  meetings  of  the  Council.     9.7.2             Ensure  that  the  members  of  the  Council  are  appropriately  notified  of  meetings.     9.7.3             Have  charge  and  custody  of,  and  be  responsible  for,  all  funds  of  the  Council.     9.7.4             Receive  and  give  receipts  for  fees  and  dues  payable  to  the  Council  from  any  source  whatsoever  and  deposit  all   such  funds  in  the  name  of  the  Council  in  whatever  Bank,  Trust  Company  or  depository  the  Council  shall  elect.     9.7.5             In  general,  perform  all  duties  appropriate  to  the  office  of  Secretary/Treasurer  and  have  such  other  duties  and   exercise  such  authority  as  from  time  to  time  may  be  delegated  or  assigned  to  him/her  by  the  President  or  by  the   Council.     9.8                   The  Immediate  Past  President     9.8.1             The  Immediate  Past  President  shall  act  in  a  consultative  role  (without  voting  rights)  to  the  Executive  Committee   and  may  attend  all  meetings  of  the  Executive  Committee.     9.8.2             He/she  will  serve  in  this  function  for  one  calendar  year  immediately  following  the  end  of  his/her  period  as   President.     9.9                   The  Executive  Committee  shall  have  the  right  to  delegate  representation  tasks  to  the  Executive  Secretary,  who,  in   turn,  shall  be  authorized  to  represent  the  ECCE  in  accordance  with  the  respective  powers  of  attorney  granted  to   him.     9.10               The  Executive  Committee  shall  be  responsible  for:     •      Day-­‐to  day  administration  of  the  Council.   •      Appointment  of  Evaluation  Teams.   •      Correspondence  with  CCEI  and  other  CCEs.   •      Appointment  of  a  representative(s)  to  the  CCEI  (who  may  or  may  not  be  a  member  of  the  Council).   •      Administering  initial  contacts  with  institutions  prior  to  application  for  (Candidate  for)  Accredited  status.   •      Dealing  with  all  queries  (other  than  those  under  the  jurisdiction  of  the  Commission  on  Accreditation)  directed   to  the  Council.   •      Invitation  of  Observers  to  meetings  of  the  Council  (7).   •      Production  of  financial  statements  and  budgets  for  approval  by  the  Council.   •      Production  of  the  Financial  Policy  to  include  annual  dues  and  accreditation  fees  for  approval  by  the  Council.   •      Production  of  an  Annual  Report  on  the  activities  of  the  Council  (ECCE).     9.11            The  President  shall  be  the  Chair  of  the  Executive  Committee  and  have  a  casting  vote  when  appropriate.     Page  |  42  
  • 43.     9.12            The  Executive  Committee  will  normally  meet  three  times  a  year.     9.13            Minutes  of  all  Executive  Committee  meetings  shall  be  submitted  to  the  annual  Council  meeting.         10                  STANDING  COMMITTEES       Committees  of  the  Council  shall  conduct  their  business  in  accordance  with  the  rules  and  regulations  of  the  Council   (8.The  Council).       Members  of  the  Committees  of  the  Council  SHALL  BE  NOMINATED  AND  ELECTED  FROM  THE  MEMBERS  OF  THE   COUNCIL.  THE  LOSS  OF  MEMBERSHIP  OF  THE  COUNCIL  SHALL  ALWAYS  LEAD  TO  DISMISSAL  FROM  THE   COMMITTEES  OF  THE  COUNCIL.     There  are  two  (2)  standing  committees  of  the  Council.  They  are:     10.1               Commission  on  Accreditation       The  COA  is  responsible  for  the  process  and  decisions  of  accreditation  of  chiropractic  institutions  according  to  the   Council’s  accreditation  policies,  procedures  and  educational  Standards.     10.1.1         Membership         Its  membership  consists  of  a  minimum  of  five  (5)  members.         The  following  Council  members  are  NOT  eligible  for  membership  on  the  COA:   •      Institutional  members  (3.1.6)   •      Member  of  the  ECU  Executive  (3.1.2).         Members  are  elected  to  the  COA  by  the  Council  for  a  period  of  three  (3)  years  and  thereafter  for  one  further   period  of  three  (3)  years.         Members’  terms  of  office  shall  begin  on  the  first  day  of  January  following  the  election.         The  President  of  the  Council  is  an  ex-­‐officio  member  of  the  COA  (no  voting  rights).     10.1.2         The  Officers  of  the  COA  are:   •            Chair   •            Vice-­‐Chair   The  Officers  of  the  COA  shall  be  elected  annually  by  and  from  its  membership  at  the  annual  meeting  of  the  COA.         The  Chair  and  Vice-­‐Chair  shall  perform  all  duties  appropriate  to  their  respective  offices  and  such  other  duties  as   may  be  prescribed  from  time  to  time  by  the  COA  and  by  the  Council.         The  Chair  of  the  COA  shall  have  a  casting  vote  when  appropriate.       The  Chair  of  the  COA  or  his/her  duly  appointed  designee,  in  writing,  shall  be  the  official  spokesperson  for  the  COA.     10.1.3         Requirements  for  ALL  Members  of  the  COA  Members  of  the  COA  must:         Have  the  will  and  ability  to  devote  the  time  necessary  to  the  COA  activities.         Not  engage  in  activities  that  constitute  a  conflict  of  interest  with  the  affairs  of  the  COA.         Not  represent  themselves  as  spokespersons  for  the  COA  without  the  express  authorisation  of  the  Chair.         Sign  a  Declaration  of  Confidentiality  covering  all  matters  of  the  COA.   Page  |  43  
  • 44.       10.1.4         Duties  and  Responsibilities         The  COA  is  responsible  for  all  matters  (including  all  correspondence)  pertaining  to  the  accreditation  of  chiropractic   institutions  and  providing  a  list  of  institutions  with  Accredited  status  to  the  Council.         The  COA  shall  apply  and  follow  the  Standards  and  procedures  set  forth  in  the  current  Council’s  publication  entitled   “Accreditation  Procedures  and  Standards  for  Chiropractic  Education”  and  in  such  documents  and  regulations   which  may  be  adopted  by  the  Council.       The  COA  shall  be  responsible  for  all  decisions  on  granting,  revoking  or  refusing  of  any  status  of  accreditation  to  an   institution.       The  COA  shall  be  responsible  for  receipt  and  approval  of  Annual  Monitoring  Reports  from  the  institutions  in  line   with  relevant  policies  and  procedures.     10.1.5         Meetings   Regular  Meetings  shall  normally  be  held  at  least  once  a  year  and  normally  in  conjunction  with  meetings  held  by   the  Council  and/or  the  Executive  Committee.         Special  Meetings  may  be  called  by  the  Chair  of  the  COA  and/or  upon  the  written  request  of  a  one-­‐third  majority  of   the  membership  of  the  COA.         The  time  and  place  for  holding  meetings  shall  be  determined  by  the  Chair  and  notified  to  members  at  least  30   (thirty)  days  beforehand.         Minutes/notes  of  all  COA  meetings  are  for  distribution  to  members  of  the  COA  only.     10.2               Quality  Assurance  Committee     10.2.1         Membership         Membership  consists  of  a  minimum  of  three  (3)  members.      Members  are  elected  to  the  QAC  by  the  Council  for  a  period  of  three  (3)  years  and  thereafter  for  one  further  period   of  three  (3)  years.         Members’  terms  of  office  shall  begin  on  the  first  day  of  January  following  the  election.         A  member  of  the  QAC  is  nominated  and  elected  as  Chair  of  the  QAC  by  the  Council.       The  Chair  is  elected  for  a  period  of  three  (3)  years,  and  thereafter  for  one  further  period  of  three  (3)  years.     10.2.2         Duties  and  Responsibilities       The  QAC  is  responsible  for  continual  review  and  evaluation  of  the  Council’s  policies  and  procedures,  the   Constitution  and  the  Council’s  publication  entitled  “Accreditation  Procedures  and  Standards  for  Chiropractic   Education”  and  such  other  documents  and  regulations  that  may  be  adopted  by  the  Council.     10.2.3         Meetings         Meetings  shall  normally  be  held  once  a  year  and/or  as  directed  by  the  Executive  Committee.   Minutes  and/or  Recommendations  of  all  QAC  meetings  shall  be  submitted  to  the  annual  Council  meeting.           Page  |  44  
  • 45.     11   FINANCE     11.1               The  Council  may  be  supported  financially  by:     •      The  European  chiropractic  profession.   •      The  status-­‐holding  institutions  paying  accreditation  fees  and  annual  dues  according  to  the  Financial  Policy  of   the  Council   •      Donations   •      Public  funding     11.2               The  on-­‐going  budget  will  be  approved  by  the  Council.  Furthermore,  the  Council  will  adopt  a  “Financial  Policy  for   Dues  and  Fees”  setting  forth  the  respective  contribution  for  the  members.     11.3             The  fiscal  year  will  be  the  calendar  year.     11.4.             The  Executive  Committee  will  appoint  professional  accountants  domiciled  in  the  country  of  residence  of  the   Secretary/Treasurer  to  audit  the  accounts.     11.5               Loans     No  indebtedness  shall  be  contracted  on  behalf  of  the  ECCE  unless  this  has  been  approved  by  the  Council.  The   approval  may  be  general  or  limited  to  specific  instances.     12                  INDEMNIFICATION       The  liability  of  members  of  the  Council,  the  Executive  Committee  and/or  employees  and/or  agents  of  the  Council   or  the  Commission  on  Accreditation  shall  be  limited  to  damage  caused  by  deliberate  acts.  In  this  respect,  the   Council  shall  waive  any  claim  of  recourse  vis-­‐à-­‐vis  the  aforementioned  persons  even  in  the  event  of  a  claim  being   asserted  against  the  Council.  The  members  of  the  Executive  Committee  and/or  employees  and/or  agents  shall  be   indemnified  in  this  respect.     13                  AMENDMENTS       This  Constitution  may  be  altered,  amended  or  repealed,  and  new  bylaws  may  be  adopted,  by  the  Council  by   affirmative  vote  of  three-­‐quarters  of  those  members  present  at  the  meeting  at  any  regular  or  special  meeting.     14                DISSOLUTION     14.1             If  and  when  the  Council  shall  realise  that  it  is  not  in  a  position  to  fulfil  its  purpose,  dissolution  of  the  organisation   may  be  considered.     14.2               Dissolution  shall  result  from  a  three-­‐quarters  affirmative  vote  of  those  members  present  at  the  meeting.     14.3               Upon  dissolution  of  the  ECCE,  the  assets  shall  be  used  for  tax-­‐privileged  purposes.    Resolutions  concerning  the   future  use  of  the  assets  may  only  be  carried  out  with  the  consent  of  the  Local  Tax  Office.     15                  INTERPRETATION       The  final  authority  on  interpretation  of  the  Constitution,  and  of  the  Council’s  policies  and  procedures,  of  the   publication  entitled  “Accreditation  Procedures  and  Standards  for  Chiropractic  Education”  and  of  such  documents   and  regulations  that  may  be  adopted  by  the  Council,  is  the  Council.           Page  |  45  
  • 46.     BYLAWS  OF  THE  EUROPEAN  ACADEMY  OF  CHIROPRACTIC       (November  2011)     Article  I   1. Name  and  Office     Name     The  committee,  which  represents  the  academic  arm  of  the  European  Chiropractors’  Union,  shall  be  known  as  the   European  Academy  of  Chiropractic  (hereinafter  referred  to  as  the  EAC).     2. Principal  office  and  other  offices     For  all  correspondence,  the  EAC  shall  utilise  a  nominated  address  of  the  Secretary  General.  The  EAC  shall  maintain   other  office  accommodation  as  may  be  designated  by  the  Governing  Council.     Article  II   Mission  and  Objectives     Mission     The  EAC  exists  to  (a)  facilitate  the  delivery  of  postgraduate  education  (i.e.  Graduate  Education  Programmes  and   continuing  professional  development);  and  (b)  to  promote  and  develop  research  and  researchers  in  Europe.  It  will   achieve  its  aims  by  exposing  chiropractors  to  current  best  practice,  by  stimulating  reflective  learning  and  by  acting   as  a  conduit  for  research  activity.  This  will  help  facilitate  the  delivery  of  safe,  evidence-­‐informed,  optimum   standards  of  care  and  will  positively  impact  on  patients  and  healthcare  in  society.     Objectives     The  objectives  of  the  EAC  shall  include,  but  not  be  limited  to,  the  following:     1.         To  develop,  through  lifelong  learning,  the  key  competencies  of:  expert  performance;  communication;   collaboration;  enhanced  knowledge  through  scholarly  enquiry;  community  awareness;  patient  management  skills;   and  ethical  professionalism.   2.       To  provide  and  coordinate  access  to  high  quality  sources  of  knowledge  and  skills.   3.         To  encourage  and  actively  support  the  acquisition  by  chiropractors  of  higher  level  postgraduate  qualifications  and   EAC  Fellowship  awards.   4.         To  facilitate  the  formation  and  development  of  Graduate  Education  Programmes  (GEP)  by  national  associations.   5.         To  provide  a  platform  to  bring  together  parties  with  a  diversity  of  experience  and  expertise  to  enable  the  sharing   of  best  practice.   6.         To  raise  quality  standards  across  the  profession  and  enhance  chiropractic’s  contribution  to  a  healthier  society  by   facilitating  a  collaboration  of  European  national  chiropractic  associations,  educational  institutions,  researchers  and   postgraduate  educational  providers.   7.         To  promote  chiropractic  research  and  researchers.       Article  III  Governing  Council     The  Governing  Council  (GC)  shall  have  overall  responsibility  for  the  business  affairs  of  the  EAC,  including  matters   relating  to  general  policy,  contracts  and  activities  relating  to  the  furtherance  of  its  stated  objectives.  It  shall  also   from  time  to  time  establish  rules  and  procedures  to  be  implemented  within  the  GC  or  any  of  its  sub-­‐committees  as   may  be  consistent  with  the  stated  objectives  of  the  EAC.       The  Governing  Council  shall  consist  of  seven  members.  All  members  of  the  GC  shall  act  independently  of  any  other   affiliations  or  memberships  of  other  organisations.     The  membership  of  the  GC  shall  comprise  the  following  offices:   • Dean   • Registrar   • Secretary  General  (who  shall  be  the  ECU  General  Secretary)   • Director  of  Academic  Affairs   Page  |  46  
  • 47.     • Chair  of  the  ECU  Research  Council   • ECU  President   • ECU  Convention  Director       No  member  of  the  GC  shall  hold  more  than  one  GC  office  at  any  time.       Members  of  the  GC  shall  serve  a  term  of  office  of  two  years.  Members  of  the  GC  may  serve  up  to  three   consecutive  terms  of  office.  Terms  of  office  shall  be  ratified  by  the  ECU  General  Council.       Where  a  vacancy  should  arise  on  the  GC  outside  of  the  normal  periods  of  election,  the  GC  shall  be  empowered  to   co-­‐opt  any  person  it  considers  well-­‐qualified  to  fill  the  office  until  the  next  period  of  election.       Outside  the  regular  periods  of  election,  a  GC  member  may  be  removed  from  office  by  a  two-­‐  thirds  majority  of  the   GC  at  any  Regular  or  Extraordinary  meeting  at  which  a  quorum  of  the  GC  is  present.  In  such  circumstances,  a   member  shall,  no  less  than  28  days  before  the  date  of  the  meeting,  be  provided  with  a  notice  setting  out  the   reasons  for  the  proposal  removal  from  office  and  inviting  the  member  to  attend  the  meeting  and/or  be   represented.       The  GC  shall  from  time  to  time  determine  the  qualifications  and  duties  of  its  members  and  shall  publish  these  on   its  website.       The  GC  shall  be  provided  with  an  Administrator,  appointed  and  employed  by  the  ECU,  whose  duties  shall  be   determined  by  the  GC.  The  EAC  Administrator  should  be  present  at  Regular  or  Extraordinary  meetings  of  the  GC   but  shall  not  have  voting  rights.     Article  IV   o Meetings  of  the  EAC  Governing  Council     o Regular  meetings  of  the  GC  shall  be  held  at  least  once  a  year,  where  possible  to  coincide  with  scheduled   meetings  of  the  ECU  General  Council.  The  Annual  General  Meeting  of  the  EAC  GC  shall  be  held  during  the   ECU  Convention.   o Notice  of  regular  GC  meetings  shall  be  given  at  least  12  weeks  before  the  date  of  the  meetings.  An  agenda   shall  be  circulated  at  least  21  days  prior  to  the  meeting  and  shall  be  provided  to  all  GC  members.     o Extraordinary  meetings  of  the  GC  may  be  conducted  outside  the  normal  scheduled  meeting  times  and  shall   be  convened  at  the  request  of  the  Dean  or  by  three  or  more  members  of  the  GC.  Requests  for   Extraordinary  meetings  should  be  received  by  the  Secretary  General  stating  the  object  of  the  meeting.  GC   members  shall  have  a  minimum  of  14  days’  notice  of  meeting,  which  may  be  conducted  electronically  or  by   telephone  where  possible.     o Meetings  of  the  GC  shall  be  deemed  to  be  quorate  where  four  or  more  members  of  the  GC.  Except  as   otherwise  provided  by  these  Bylaws  or  by  statute,  decisions  of  quorate  GC  meetings  shall  be  adopted  as  if   all  members  were  present.     o Extraordinary  Meetings  of  the  GC  may  be  convened  at  any  time  with  the  consent  of  four  or  more  GC   members,  two  of  whom  shall  be  Executive  Members.  In  such  cases,  the  object  of  the  meeting  shall  be   distributed  in  writing  to  all  members.  Such  meetings  may  be  conducted  in  person,  electronically  or  by   telephone.     o Voting  rights  are  only  permissible  to  those  present  at  meetings  of  the  GC.  Proxy  votes  are  not  permitted.     Article  V   EAC  Subcommittees     The  GC  shall  have  the  power  to  appoint  subcommittees  for  such  purposes  as  it  deems  necessary  to  further  the   objectives  of  the  EAC,  to  transact  EAC  business,  or  for  any  purpose  that  the  EAC  shall  determine  from  time  to  time.       Standing  Committees  of  the  EAC  shall  include  the  following:   • Finance  Committee   • Court  of  Electors   Page  |  47  
  • 48.       Terms  of  reference  and  membership  of  EAC  subcommittees  shall  be  published  and  amended  with  the  agreement  of  the  GC.     Article  VI  Membership     Member  (MEAC).     Upon  successful  application,  full  membership  of  the  EAC  shall  be  granted  to  persons  who  fulfil  any  one  of  the   following  criteria:   • Full  members  of  ECU  Union  Members  and  Associate  Members  which  have  collective  EAC   • membership;   • Full  members  of  ECU  Union  Members  and  Associate  Members  which  do  not  have  collective  EAC  membership;   • ECU  Individual  Members   • Full  time  Faculty  members  of  ECCE-­‐accredited  educational  institutions   • Fellow  (FEAC)       Fellowships  of  the  EAC  may  be  granted  to  members  who  can  demonstrate  to  the  satisfaction  of  the  Court  of   Electors  that  they  have  excelled  in  one  or  more  fields  of  chiropractic.  The  Court  of  Electors  shall  define  and  publish   criteria  for  EAC  Fellowship  against  which  nominations  shall  be  measured.     Founding  Fellow.      A  Fellow  (who  may  not  be  a  chiropractor)  who  was  honoured  by  invitation  when  the  EAC  was   established.  Founding  Fellows  retain  for  life  all  rights  and  privileges  of     Fellowship  and  incur  no  annual  fee.  They  are  entitled  to  use  the  designation  FFEAC.     Honorary  Fellow.  A  Fellow  who  the  EAC  Academic  Board  has  deemed  as  having  excelled  in  either  their   professional  or  academic  career,  or  in  their  work  for  the  EAC.  Honorary  Fellows  shall  enjoy  such  privileges  as  may   be  conferred  upon  them.    An  Honorary  Fellow  shall  enjoy  life  membership  of  the  EAC  and  incur  no  annual  fee.   They  are  entitled  to  use  the  designation  FEAC  (Hon).       Applications  for  Membership  of  the  EAC  may  be  refused  at  the  discretion  of  the  Governing  Council  on   recommendation  of  the  Court  of  Electors.  The  EAC  is  not  required  to  give  reasons  for  refusal  of  membership.     Article  VII   Special  Interest  Groups       Special  Interest  Groups  may  be  established  within  the  EAC  in  response  to  an  identified  need  to  advance  a  specific   area  of  knowledge,  understanding,  skills  and  competency.  They  may  undertake  a  range  of  activities  consistent   with  the  stated  objectives  of  the  EAC.       A  Special  Interest  Group  may  be  formed  on  submission  of  a  satisfactory  written  proposal  and  with  the  approval  of   the  GC  provided  the  following  criteria  are  met:     • Members/Fellows  should  be  full  members  of  the  EAC;   • At  least  three  Fellows  shall  be  members,  one  of  whom  shall  act  as  Chair;   • An  annual  statement  of  activity  shall  be  presented  to  the  GC.     Article  VIII     Termination  of  Membership     EAC  Membership  may  be  terminated  by  the  following  means:  Resignation     Membership  of  the  EAC  may  be  terminated  28  days  following  receipt  of  a  written  statement  of  resignation.     Removal     Membership  of  the  EAC  may  be  terminated  if  a  Member/Fellow  is  removed  from  the  register  of  chiropractors  in   the  country  where  he/she  practised  and/or;  the  Member/Fellow’s  membership  of  his/her  national  association  was   terminated  by  reason  of  conduct  or  practice.       Failure  to  pay  membership  dues       Membership  of  the  EAC  may  be  terminated  if  there  is  a  failure  to  pay  within  60  days  of  being  notified  by  the   Secretary  General  arrears  that  have  been  outstanding  for  a  period  of  12  months  or  greater.         Page  |  48  
  • 49.     Article  IX     Amendments  to  Bylaws     The  EAC  may  from  time  to  time  make,  repeal  or  vary  the  Bylaws.  All  Bylaws  stated  above  will  be  binding  to  all   Members  and  Fellows  for  the  time  they  are  in  force.       The  EAC  GC  may  set  rules  and  regulations  in  relation  to  specific  matters.  Rules  may  relate  to  policy,  procedure,   terms  of  reference  or  membership  of  its  committees.     Article  X  Seal     The  common  seal  of  the  EAC  shall  only  be  used  by  the  authority  of  a  resolution  of  the  Governing  Council  or  of  a   Committee  authorised  for  a  purpose  by  the  GC.  Every  document  to  which  the  common  seal  is  attached  shall  be   signed  by  at  least  two  Fellows,  one  of  whom  shall  be  the  Dean,  and  the  Registrar  or  another  person  so  appointed   for  that  purpose.     Article  XI  Finances     Membership  fees  shall  be  reviewed  from  time  to  time  and  be  set  by  the  Governing  Council.  Fees  shall  be  payable   upon  receipt  of  an  invoice  issued  by  the  EAC.  Any  Member/Fellow  failing  to  pay  fees  shall  be  liable  to  removal   from  the  Register  in  accordance  with  the  provisions  of  Article  VIII  of  these  Bylaws.     Accounts     The  GC  shall  ensure  that  proper  accounts  are  maintained  and  may  delegate  this  task  to  the  Finance  Committee.   The  Finance  Committee  shall  be  chaired  by  the  Dean  who  shall  ensure  that  the  EAC  Accounts  are  accurately   maintained.       The  accounts  shall  be  audited  by  externally  appointed  auditors  on  a  once-­‐yearly  basis.  All  audited  accounts  shall   be  available  to  EAC  Members/Fellows  for  inspection  on  request.  The  EAC  financial  year  ends  on  31  December.       Bank  accounts  holding  funds  belonging  to  the  EAC  shall  be  clearly  designated  as  such.  Funds  in  and  out  of  the   account  shall  be  clearly  recorded  for  the  purposes  of  audit  and  accounting.  The  Finance  Committee  shall   determine  rules  regarding  signatories  and  payment  authorisation.     Article  XII  Indemnity       All  members  of  the  Governing  Council,  appointed  officers,  members  of  EAC  Committees,  agents  or  employed   persons  of  the  EAC  shall  be  indemnified  from  the  assets  of  the  EAC  against  any  liability  incurred  by  them  whilst   acting  in  their  designated  capacity  when  defending  any  allegation  of  improper  conduct  whether  civil  or  criminal,   including  negligence,  default,  breach  of  duty  or  breach  of  trust.     Article  XIII  Dissolution       Upon  dissolution  of  the  EAC,  and  after  having  discharged  all  outstanding  liabilities  to  creditors,  the  Finance   Committee  of  the  GC  shall  arrange  for  all  funds  to  be  transferred  to  the  ECU.                                     Page  |  49  
  • 50.           Institutions  holding  Accredited  Status  with  the  ECCE  This  recognizes  that  an  institution  meets  the  Eligibility  Criteria  for  Accredited  Status,  and  delivers  education  and  training  in  full  compliance  with  the  ECCE  Standards.  Status  is  granted  by  the  Commission  on  Accreditation  of  the  European  Council  on  Chiropractic  Education.      Anglo-­‐European  College  of  Chiropractic    Kenneth  Vall  DC,  FCC,  MA(Ed),  FHEA  Principal  13-­‐15  Parkwood  Road  Bournemouth  Dorset  BH5  2DF  England,  United  Kingdom      Phone:        (+44)  1202  436  200  Fax:              (+44)  1202  436  312  E-­‐mail:  Website:    Accredited  since:  1992  Last  review:  2007  Next  review:  2012    AECC  Evaluation  Team  Report  2007          Durban  University  of  Technology    Junaid  Shaik  M.Tech:  Chiropractic,  MMedSci(SM)  Acting  Head  of  Department  of  Chiropractic  and  Somatology  P.O.  Box  1334  Durban  4001  South  Africa      Phone:        (+27)  31  373  2588  Mobile:              (+27)  832463562  Fax:              (+27)  31  202  3632  E-­‐mail:  Website:    Accredited  since:  2009  Last  review:  2009  Next  review:  2012    DUT  Evaluation  Team  Report  2009         Page  |  50  
  • 51.            Institut  Franco-­‐Européen  de  Chiropratique    Charles  Martin  -­‐  Directeur  24  Blvd.  Paul  Vaillant-­‐Couturier  94200  Ivry-­‐Sur-­‐Seine  France    Phone:        (+33)  1  45  15  89  10  Fax:              (+33)  1  45  15  89  11  E-­‐mail:  Website:      Accredited  since:  1996  Last  review:  2009  Next  review:  2014    IFEC  Evaluation  Team  Report  2009          Syddansk  Universitet  Odense    Henrik  Hein  Lauridsen  Ph.D.  -­‐  Director  of  Studies  Institute  of  Sports  and  Clinical  Biomechanics  University  of  Southern  Denmark  Campusvej  55  DK-­‐5230  Odense  M  Denmark  Email:  Website:    Accredited  since:  1999  Last  review:  2008  Next  review:  Spring  2013      SDU  Evaluation  Team  Report  2008      SDU  Self  Study  Report  2008            University  of  Glamorgan  -­‐  Welsh  Institute  of  Chiropractic    David  Byfield  DC,  BSc,  Mphil  School  of  Applied  Sciences  Pontypridd,  Mid  Glamorgan  CF37  1DL  Wales,  United  Kingdom    Phone:        (+44)  1443  480  480  Fax:              (+44)  1443  482  285  E-­‐mail:  Website:      Accredited  since:  2002  Last  review:  2010  Next  review:  Spring  2015    WIOC  Evaluation  Team  Report  2010                   Page  |  51  
  • 52.    University  of  Johannesburg  -­‐  Faculty  of  Health  Sciences  -­‐  Dept.  of  Chiropractic      Dr.  Chris  Yelverton  MTech  Chiropractic,  ICSSD  Head  of  Department  of  Chiropractic  University  of  Johannesburg  PO  Box  524  Auckland  Park  2006    South  Africa    Phone:        (+27)  11  559  6218  Fax:              (+27)  11  559  6117    E-­‐mail:  Website:    Accredited  since:  2010  Next  review:  Spring  2013    UJ  Evaluation  Team  Report  2010            University  of  Surrey    European  Institute  of  Health  &  Medical  Science  University  of  Surrey  Stag  Hill,  Guildford  Surrey  GU2  5XH  England,  United  Kingdom    Accredited  for  period  2003  -­‐  2006    (Course  Closed)      Institutions  holding  Candidate  for  Accredited  Status  with  the  ECCE    This  recognizes  that  an  institution  complies  with  the  Eligibility  Criteria  for  Candidate  Status  and  is  working  towards  full  compliance  with  the  ECCE  Standards.  The  maximum  period  of  time  that  an  institution  can  hold  Candidate  Status  is  a  total  of  5  years.  This  period  of  time  cannot  be  either  extended  or  renewed.  Candidate  Status  establishes  a  formal  relationship  between  the  Council  and  the  institution.  This  route  to  Accredited  Status  however,  is  NOT  mandatory.        RCU  Escorial  Maria-­‐Cristina    Ricardo  Fujikawa  DC,  MD  Head  of  Studies,  Chiropractic  RCU  Escorial  Maria-­‐Cristina  Paseo  delos  Alamillos  2  E-­‐28200  San  Lorenzo  de  El  Escorial  Madrid  Spain    Phone:        (+39)  918  90  45  45  Ext.  211  E-­‐mail:  Website:    Candidate  Status  since:  Nov.  2008         Page  |  52  
  • 53.          McTimoney  College  of  Chiropractic      for  its  four  year  integrated  Masters  in  Chiropractic  plus  Foundation  Year  programme      Professor  Christina  Cunliffe  PhD  DC  CBiol  FIBiol  FCC  FMCA  MCC  (Paeds)  Principal  McTimoney  College  of  Chiropractic    Kimber  House  1  Kimber  Road  Abingdon  Oxfordshire  OX14  1BZ  England,  United  Kingdom    Phone:        (+44)1235  523336    Fax:                (+44)1235  523576    E-­‐mail:        principal@mctimoney-­‐  Website:  www.mctimoney-­‐    Candidate  Status  since:  May  2010          Barcelona  College  of  Chiropractic    Adrian  Wenban,  B.Sc.,  B.App.Sc.,  M.Med.Sc.,  MACC    Director    Barcelona  College  of  Chiropractic    C/  Mallorca,  364,  2º1ª    08013  Barcelona  Spain    Phone:        (+34)  93  476  53  10      E-­‐mail:    Website:    Candidate  Status  since:  November  2010                                                     Page  |  53  
  • 54.       The  following  is  a  letter  from  ENQA         Timothy  Raven   President   The  European  Council  on  Chiropractic  Education  (ECCE)     Bonn,  27  October  2010       Subject:  ECCE  Full  Membership  in  ENQA       Dear  Timothy  Raven,     I  am  pleased  to  let  you  know  that,  at  its  meeting  of  22  September  2010,  the  Board  of   ENQA  agreed  to  grant  ECCE  Full  membership  of  ENQA  for  five  years  from  22  September   2010.     On  the  basis  of  its  scrutiny  of  the  final  review  report  on  ECCE,  the  ENQA  Board  and  its  Review  Committee  agreed  that  ECCE   met  the  necessary  requirements  for  being  granted  ENQA  Membership.    In  doing  so,  it  considered  that  it  would  be  advisable   to  take  into  consideration  the  panel’s  recommendations,  and  especially  those  included  in  the  Annex  to  this  letter.     The  Board  indicated  that  it  would  wish  to  give  special  attention  to  these  points  at  the  next  re-­‐confirmation  of  membership.     In  addition,  the  ENQA  Board  requests  your  Agency  to  submit,  within  two  years  of  this  decision,    a  progress    report  on  the   actions  ECCE  has  undertaken    to  meet  the  above  recommendations.     If  you  have  any  further  queries,  please  do  not  hesitate  to  contact  me  or  the  ENQA  Secretariat.     Please  accept  my  congratulations  to  ECCE  for  being  granted  Full  Membership  in  ENQA.  With  kind  regards,             Achim  Hopbach   ENQA  President               Page  |  54  
  • 55.     Annex:  Areas  for  development     The  Board  suggests  that  ECCE  should  pay  careful  attention  to  the  following  panel  and  Board’s  recommendations:           ENQA  Criterion  3  –  Resources  (ESG  3.4)     The  panel  recommends  that  ECCE  should  “develop  and  put  in  place  (in  collaboration  with  funders)  a  more  sustainable   administrative  staffing  structure  over  the  next  two  years”.  The  Panel  thought  this  important  in  order  to  meet  anticipated   demand  and  to  expand  some  current  levels  of  activity  (paragraph  49).     ENQA  Criterion  5  –  Independence  (ESG  3.6)     ECCE  operates  within  a  small  community  and  depends  on  a  limited  number  of  active  participants,  which  makes  the  issue  of   independence  difficult.  Therefore,  the  Board  recommends  ECCE  not  to  underestimate  “the  potentially  increased  risks  to   independence  posed  by  the  operation  of  ECCE  within  such  a  relatively  small  community”  as  stated  by  the  panel.     ENQA  Criterion  6  –  External  quality  assurance  criteria  and  processes  used  by  the  members  (ESG  3.7)     The  panel  considers  that  there  is  still  room  for  improvement  concerning  the  student  participation  and  the  definition  of   procedures  with  regard  to  the  Appeal  Committee.  Student  involvement  is  considered  as  a  major  issue  for  the  Board.   Therefore,  ECCE  is  recommended  to  implement  mechanisms  fostering  student  participation.     ENQA  Criterion  7  –  Accountability  procedures  (ESG  3.8)     ECCE  is  encouraged  do  an  effort  in  increasing  its  resources  in  order  to  further  enhance  its  processes  for  forward  planning  and   monitoring  its  own  performance  at  corporate  level.                                                       Page  |  55