It is the third month of Ren Chen Year of the Dragon. Spring is just around the corner. On behalf of the Chinese Medicine Practitioners Board (PB), I wish all Chinese medicine practitioners (CMPs) would work together to perform the practice of traditional Chinese medicine in order to achieve the best medical ethics in clinical settings.
Since the PB implemented the system of Continuing Education in Chinese Medicine (CME) for the registered CMPs in February 2005, the registered CMPs have all along rendered unfailing support and active participation. Hence, the system is smoothly launched. Through continuing education, the registered CMPs are able to keep on upgrading their professional knowledge and skills.
Both of the accredited "CME Programme Providers" and institutions providing individual CME programmes have organised professional, quality programmes that meet the needs of CMPs in practising the Chinese medicine. Certificates were issued impartially to participating CMPs, and records of attendance and CME points were maintained. On behalf of the PB, I would like to express my sincere gratitude and appreciation to these providers and institutions for their hard work.
Thank to the efforts and contributions made by the above providers and institutions, the local CME programmes for CMPs not only win the recognition of the local trade of CMPs, but also the applauses from CMPs in the Mainland. At present, there are over 6,000 registered CMPs in Hong Kong. As most of the CMPs are able to meet the requirements of CME, the confidence of the public is strengthened on patronising the Chinese medicine service.
I hope that all registered CMPs will adhere to the requirements of CME and keep themselves abreast of the latest development and knowledge of the profession, so that their professional standard will never lag behind.
To encourage the CMPs reading the Newsletter of the PB (Newsletter), the CME Quiz set by the PB for awarding CME points was published for the first time in the previous issue of the Newsletter. It is encouraging to find that the CME Quiz was well received by the registered CMPs. The correct answers of the CME Quiz are attached to this issue of the Newsletter for CMPs' reference. The next CME Quiz will be published in the year-end issue of the Newsletter.
This issue of Newsletter mainly reports the work of the PB in the past four months, including the CMPs Licensing Examination, renewal of practising certificates and CME for registered CMPs, and the results of the disciplinary inquiries conducted by the PB. CMPs are reminded to display the "Practising Certificate of Registered Chinese Medicine Practitioner" / "Notification to Listed Chinese Medicine Practitioner" at their clinics, and comply with the relevant requirements on the issuance of prescriptions to patients and information contained on the signboards in the Codes of Conduct1 for CMPs.
In addition, all CMPs should read the topics of this issue, including the relevant arrangements made for the Chinese medicines traders (CM traders) on the use of their residential address as the address of the premises specified in their licence, prevention of poisoning from two rarely-seen aconitum alkaloid, the commencement date of the provisions on regulating the claims for orally consumed health products in the Undesirable Medical Advertisement (Amendment) Ordinance and the information about the amendments on the highest income level of MPF contribution.
The practising certificates of over 1,400 registered CMPs in this cycle will expire by the end of June this year. The PB has issued a letter to inform the CMPs of the arrangement on submission of application for renewal of practising certificate. The PB would like to urge all CMPs to make efforts to upgrade their professional knowledge and skills as well as keep on receiving the continuing education so as to maintain the high professional standard.
I wish you good health and happiness in daily life!
Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board
1 Codes of Practice refer to the Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong and Code of Conduct for Listed Chinese Medicine Practitioners
At the end of March 2012, there were 6,399 registered CMPs, 71 CMPs with limited registration, and 2,743 listed CMPs.
The application for sitting the 2012 CMPs Licensing Examination for non-listed CMPs was closed in late October 2011 and that for listed CMPs and repeaters was closed on 30 March 2012.
The Paper 1 and Paper 2 of the Written Examination of the 2012 CMPs Licensing Examination will be conducted on 12 June and 14 June 2012 respectively. In the event of bad weather, the examination will be postponed to 16 June 2012. The clinical examination is scheduled to be held between 1 August and mid-August 2012.
Candidates should receive the admission form and the "Guidelines for Candidates" one week prior to the examination. They may contact the Secretariat of the Chinese Medicine Council of Hong Kong (CMCHK) if they do not receive the above-mentioned documents on time.
In accordance with section 76 of the Chinese Medicine Ordinance (CMO), a registered CMP must apply for a valid practising certificate before he/she is allowed to practise Chinese medicine in Hong Kong. The usual validity period of a practising certificate is three years. Before a registered CMP is issued with the renewed practising certificate, he/she must fulfill the requirements of continuing education in Chinese medicine, as determined by the PB. From December 2011 to March 2012, 1,349 registered CMPs renewed their practising certificates. All registered CMPs must report promptly to their "CME Administrators" their new CME cycles, required CME points, and the valid period of their practising certificates.
In accordance with the CMO, if a registered CMP practises Chinese medicine without obtaining a valid practising certificate over a period exceeding six months since the expiry of his/her practising certificate, the PB may act in accordance with section 56(1)(d) of the CMO, to order the removal from the Register the name of that registered CMP.
According to Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong, registered CMPs must display his/her practising certificate at a conspicuous place in the clinic. If a registered CMP practises at more than one clinic, his/her practising certificate must be displayed at each clinic. The registered CMP can decide on either displaying the original copy or the certified true copy issued by the CMCHK Secretariat, of his/her practising certificate. The application fee for each "Certified True Copy of Practising Certificate for Registered Chinese Medicine Practitioner" is HK$125.
Regarding listed CMPs, according to Code of Conduct for Listed Chinese Medicine Practitioners, the Notification of Listing of a listed CMP (Notification) must be displayed at a conspicuous place in the clinic. If a listed CMP practises at more than one clinic, he/she can decide on either displaying the original copy or the certified true copy issued by the CMCHK Secretariat, of his/her Notification. The application for "Certified True Copy of Notification to Listed Chinese Medicine Practitioner" is free of charge.
For details and making appointment of the application of the above-mentioned certified true copies, please contact the Secretariat of CMCHK at 2121 1888.
To encourage the CMPs reading the Newsletter, the PB has decided in 2011 to introduce the CME Quiz to registered CMPs. Ten questions, based on the content of the three issues of Newsletter of the year, will be published in the December issue every year.
The first CME Quiz was published in the previous issue of the Newsletter and it was well-received by the registered CMPs. The correct answers are attached to this issue at appendix for CMPs' reference.
The next CME Quiz will be published in the December issue of the Newsletter this year. All registered CMPs please note that the completed answer sheet should be sent to their "CME administrator" by fax or by post on or before the specific deadline for assessment and record of the CME points to be awarded. CME points will not be awarded to the registered CMPs if they fail to send the answer sheet to their "CME administrator" before the specific deadline. To avoid delay, all registered CMPs are advised to send the completed answer sheet directly to their "CME administrator". All registered CMPs please also note that under the above arrangement, the Secretariat of the CMCHK will not redirect the answer sheets to the "CME administrators" for any individual CMPs.
The PB held disciplinary inquiries from December 2011 to March 2012 for four registered CMPs and three listed CMPs who were suspected to breach the Codes of Conduct or convicted of an offence punishable with imprisonment. After inquiries, all the seven CMPs were found guilty by the PB except one registered CMP. The PB ordered to remove the name of one registered CMP; to remove the name of one registered CMP for six months and suspend its application for 24 months; to warn one registered CMP and to record the results of inquiry of three listed CMPs for future reference.
Summing up the cases, the PB reminds all CMPs to take note of the following issues.
According to section 2 of Part 3 of the Codes of Conduct 2, a CMP should be professionally responsible to his patients, explain patiently to patients their medical conditions, methods of treatment and the precautions in taking drugs, and diligently improve his professional knowledge and skills so as to maintain high professional standards in providing medical service to patients. If the PB considers that a CMP has not provided adequate treatment to his patients according to their medical conditions or the prescription issued is well below the professional standard of CMP, the CMP concerned may have breached the above-mentioned Codes.
The PB also noticed that there were CMPs failing to issue prescriptions to their patients and would like to remind all CMPs that patient has the rights to know clearly the details of the Chinese herbal medicines being prescribed. In case of any medical incident, medical professionals whom the patient is referred to can make use of the prescription to take immediate follow up actions so as to maintain the benefits of the patient. The Codes of Conduct also state that the contents written on the prescription issued by CMP must be clear and easily legible. In addition, prescription must include the names of all Chinese herbal medicines; their dosages; number of times for re-dispensing; method of use of the medicines; name, address, contact telephone number and signature of the CMP and the issue date of the prescription.
According to section 6(2)(a)(ii) of Part 3 of the Code of Professional Conduct for registered CMPs, signs and signboards exhibited to the public to signify his practice may only contain the following information: (1) name of the registered CMP or the name by which his practice is known, in Chinese and English; (2) gender of the registered CMP; (3) language(s)/dialect(s) spoken by the CMP; (4) Chinese title of "香港中醫藥管理委員會註冊中醫", "香港中醫藥管理委員會註冊中醫師", "註冊中醫" or "註冊中醫師" or English title of "registered Chinese medicine practitioner of the Chinese Medicine Council of Hong Kong" or "registered Chinese medicine practitioner" with one of the streams of practice "General Practice", "Acupuncture" or "Bone-setting" put in a bracket at the end of the title; (5) academic titles and practicing qualifications allowed by the PB. (Academic titles and practicing qualifications that could be exhibited must follow the restrictions set out in Appendix I of the Code); (6) emergency service and emergency contact telephone number of the CMP; (7) an indication of the location of the CMP's clinic in the building; and (8) consultation hours.
For listed CMPs, in accordance with section 6(2)(a)(ii) of Part 3 of the Code of Conduct for listed CMPs about signs and signboards exhibited to the public to signify his practice, all the points are the same except point (4) which is different from the above-mentioned regulations on registered CMPs. Instead, listed CMP can use Chinese title of "中醫" or "中醫師" or English title of "Chinese medicine practitioner" on his signs and signboards.
If the information published on the signs and signboards of a CMP has contravened the Codes, the PB may, at its discretion, decide to make any disciplinary order against the CMP concerned according to section 98(3) (for registered CMPs) or section 91(2)(a) (for listed CMPs) under the CMO.
2 Codes of Conduct refer to the Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong and Code of Conduct for Listed Chinese Medicine Practitioners
Some CMPs made enquiries on the contents of the previous issue of the Newsletter about including the patient's HKID number when they issue the receipt of consultation to patients. CMPs please note that the contents are quoted from the Reference Guide on Issuance of Sick Leave Certificate by Registered CMPs (the Reference Guide). After seeking legal advice once again, it is confirmed that the requirement of recording the patient's HKID number on the receipt of consultation in the Reference Guide does not go against other legislation. For the details of the Reference Guide, please browse CMCHK's website at http://www.cmchk.org.hk/cmp/ eng/#main_public05.htm.
The Department of Health (DH) has received in the recent six months notification from the Hospital Authority of Hong Kong about two cases of poisoning caused by two rare aconitum alkaloids: Yunaconitine and Crassicauline A. Owing to occurrence of such cases previously, CMPs and CM traders are alerted again.
The above aconitum alkaloids are particularly potent. Poisoning by which can lead to clinical features similar to those caused by other aconitum alkaloids, namely, perioral numbness, shortness of breath, palpitations and even breathing difficulties and cardiac arrhythmia which are life-threatening. Chinese medicinal plants known to contain the above two alkaloids are limited to only a few and include Radix Aconiti Austroyunnanensis (小 黑 牛), Radix Aconiti Forrestii (黃 草 烏) and Radix Aconiti Sungpanensis (火 焰 子). These are known to be rarely, if ever, used in Hong Kong.
An extra boiling process for at least 1.5 to 2 hours is necessary in preparing commonly used aconitum alkaloid containing Chinese medicines such as processed Radix Aconiti (製 川 烏), processed Radix Aconiti Kusnezoffii (製 草 烏) and processed Radix Aconiti Lateralis (製 附 子), in order to reduce the aconitum alkaloid content so as to reduce its toxicity. According to the Pharmacopeia of the People's Republic of China 2010, the recommended dosage for processed Radix Aconiti (製 川 烏) and processed Radix Aconiti Kusnezoffii (製 草 烏) is 1.5 grams to 3 grams (i.e. 0.5 - 1 mace) and that for processed Radix Aconiti Lateralis (製 附 子) is 3 grams to 15 grams (i.e. 1 - 5 mace). They should be used cautiously on susceptible persons such as pregnant women and those with chronic diseases.
CMPs and CM traders should be on the alert and should only purchase from suppliers with good reputation. Good documentation of transaction records should be maintained. Never purchase Chinese medicines from unknown source. CMPs are reminded that extra attention should be paid when handling and storage of poisonous medicines to avoid contamination. DH should be notified promptly in case of suspected poisoning cases.
Adverse events should be reported to the Central Notification Office of DH (Website: http://www.chp.gov.hk/files/pdf/hpf-form3-en-20090306.pdf; Tel: 2477 2772, Fax: 2477 2770)
CMPs are invited to pay attention to the following information regarding reporting of Adverse Drug Reaction (ADR). DH encourages health care professionals including doctors, dentists, pharmacists and CMPs to report suspected ADR of their patients. ADR reports can be submitted for all medicines including Chinese herbal medicines, proprietary Chinese medicines and vaccines. The World Health Organization (WHO) defines ADR as a "reaction to drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function." The captioned ADR reporting/monitoring is extremely important for post-marketing drug safety surveillance, corresponding analysis and investigation, preventive and control measures. We count on the cooperation and support of health care professionals in every aspect. Please browse the following website for further details about the reporting: http://www.drugoffice.gov.hk/eps/root/ en/healthcare_providers/ adr_reporting/reporting_guideline.html.
As CMPs may apply for various CM Traders licences, CMPs are reminded, according to the CMO, the premises to which the licence relates shall in all other respects suitable for carrying on a business of Chinese medicines. The Chinese Medicines Board (MB) under the CMCHK having regard to the practice of Chinese medicine and the trader's operating conditions, and after consultation with the Buildings Department, has decided that CM traders are not suitable to conduct business of Chinese medicine in domestic premises. Therefore, the MB will not accept any new application for CM traders licence of which a domestic premises (premises which are constructed or intended to be used for habitation) being the address of operation of Chinese medicine business.
MB having considered a number of licensed Chinese medicine holders are currently engaged in business of Chinese medicines in domestic premises, the traders concerned are allowed to have sufficient time to find and / or relocate to a suitable premises to continue their business. The grace period started from 1 January 2012 until 31 December 2013; or the date when the enforcement authority of the Buildings Ordinance decides to terminate domestic premises being used for commercial purpose, whichever is earlier.
CM traders who operate business of Chinese medicine at domestic premises are hereby reminded to make arrangement of relocation as soon as possible, and apply to the MB accordingly. For detail of application for change of address of premises specified in licences, please refer to the website of the CMCHK (http://www.cmchk.org.hk/pcm/ eng/#main_down01.htm). According to the CMO, any person who operates Chinese medicine business without a licence is an offence and may be prosecuted.
For any enquiry, please call the DH hotline 2319 5119.
The Secretary for Food and Health has appointed 1 June 2012 to be the commencement date of the provisions related to the control of health claims of orally consumed products under the Undesirable Medical Advertisements (Amendment) Ordinance 2005. The Commencement Notice has been published in the gazette on 13 January 2012.
The Undesirable Medical Advertisements Ordinance (Cap. 231) (UMAO) was first enacted in 1953 with the purpose of protecting public health through prohibiting/restricting advertisements which may induce the seeking of improper management of certain health conditions. Under the UMAO, advertisements likely to lead to the use of any medicine, surgical appliance or treatment for the purpose of treating human beings for, or preventing them from contracting listed diseases or conditions or purposes specified in different Schedules of the Ordinance are not allowed.
In view of the ever increasing number of orally consumed products with various health claims on the local market and stakeholders' concern about their impact on public health, the Administration amended the UMAO in June 2005 after careful risk assessment and consultation. The major amendments included:
adding a whole new Schedule 4 on prohibiting/ restricting six groups of health claims by orally consumed products (Table 1),
increasing the penalty for contravention of UMAO from $10,000 to level 5 3 and imprisonment for six months for a first offence; and from $25,000 and imprisonment for one year to level 63 and imprisonment for one year for a second or subsequent offence,
empowering the Director of Health to appoint inspectors to enforce the UMAO, and
amendments to Schedules 1 and 2.
Provisions related to amendments in Schedule 1 and 2 had been implemented since January 2006. The commencement date for the rest of the amendments was proposed to be 1 June 2012 because amongst the latter, there was reliance on the CMO which only came into full implementation from 1 December 2011.
DH has been launching various education and publicity activities for stakeholders since 2005. In particular, a set of guidelines on the Amendment Ordinance has been prepared for the trade and briefings and seminars have been organised to provide platforms for interactive communication between stakeholders and the regulatory authority. For details of the UMAO, the Amendment Ordinance and the guidelines on the Amendment Ordinance, please refer to the website of Drug Office - http://www.drugoffice.gov.hk/eps/root/ en/pharmaceutical_trade/ other_useful_information/umao.html.
3 The maximum penalties for level 5 and level 6 are $50,000 and $100,000 respectively.
Table 1: Summary of the six groups of claims to be prohibited/ restricted in the new Schedule 4
The Legislative Council has passed the amendment of the maximum level of relevant income 4 for MPF mandatory contributions, effective 1 June 2012. Key points about the amendment are as below:
For monthly-paid regular employees, the maximum level of relevant income has been amended from $20,000 to $25,000 monthly. The maximum contributions will be adjusted from $1,000 to $1,250 monthly accordingly.
4 "Relevant income" refers to any wages, salary, leave pay, fee, commission, bonus, gratuity, perquisite or allowance (including housing allowance and other housing benefit), expressed in monetary terms, paid by an employer to an employee. It does not include any severance or long service payments under the Employment Ordinance.
CMP sub-directory of the Primary Care Directory is now open for application. Registered CMPs, CMPs with limited registration and Listed CMPs, who are committed to provide directly accessible, comprehensive, continuing and co-ordinated person-centred primary care services are eligible for application. For details, please visit the webpage of Primary Care Office (PCO) (http://www.pcdirectory.gov.hk). In case of enquiries, please contact the PCO (Tel: 3576 3658, Fax: 3583 4549, email: firstname.lastname@example.org).
The representatives from the DH attended the 62nd Session of the WHO Regional Committee for the Western Pacific which was held in Manila, the capital of the Phillipines, from 10 to 14 October 2011.
Member States were invited to consider the Regional Strategy for Traditional Medicine in the Western Pacific (2011~2020) (the Regional Strategy for Traditional Medicine) in the 62nd Meeting. Representatives from different Member States showed their eager support to the Regional Strategy for Traditional Medicine. They generally agreed and appreciated the inclusion of traditional medicine in the 62nd Meeting of the Regional Committee for the Western Pacific.
On the basis of the Regional Strategy for Traditional Medicine, the Regional Committee considered and approved the Resolution on Traditional Medicine to urge the Member States to take action, in accordance with national circumstances, and to include traditional medicine in their health systems so as to advocate the sustainability of the traditional medicine and promote the development of traditional medicine of their nations under the framework of the Regional Strategy for Traditional Medicine. For details, please browse WHO's website (www.wpro.who.int/topics/traditional_medicine/en/).
Registered Chinese Medicine Practitioners
The PB appeals to the following CMP for contacting the Secretariat as soon as possible. If other CMPs have contact with the following CMP, please notify him of the above.
The 2011 Health Manpower Survey conducted by the DH has commenced. This survey aims at collecting information on the manpower and employment status of healthcare personnel practising in Hong Kong, which is essential for reference of health manpower planning.
The questionnaire has been distributed to all CMPs together with the previous issues of Newsletter. It is known that some CMPs have not returned the completed questionnaire yet, enclosed please find the reminder and questionnaire to all CMPs from DH. Please return the duly completed questionnaire to the Health Manpower Unit of the DH as soon as possible.
For further enquiry, please visit http://www.dh.gov.hk/tc_chi/statistics/ statistics_hms/statistics_hms.html or contact Health Manpower Unit at 2961 8566.
All CMPs are requested to notify the Secretariat as soon as possible if there are changes in their registered address, correspondence address, practising address, telephone number, fax number and other personal data which have been previously reported to the PB. Enclosed please find the form for notification of change of personal data. It may also be obtained from the Secretariat if needed.
Should you have any opinions regarding the content of the Newsletter, please send them to the Secretariat by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". All published Newsletters have been uploaded to the CMCHK homepage (http://www.cmchk.org.hk). CMPs are cordially invited to visit the above website.
Chinese Medicine Council of Hong Kong
Room 2201, 22/F, Wu Chung House, 213 Queen's Road East,
Wanchai, Hong Kong
Enquiry telephone: (852) 2121 1888
24-hour enquiry system: (852) 2574 9999
Fax Number: (852) 2121 1898
E-mail Address: email@example.com
Service Hours: Monday to Friday: 9:00 am to 5:30 pm
Closed on Saturdays, Sundays and Public Holidays