This issue of Newsletter mainly reports the work of the Chinese Medicine Practitioners Board (PB) in the past four months, including the conduct of the Chinese Medicine Practitioners (CMPs) Licensing Examination, renewal of practising certificates of registered CMPs and their continuing education, results of disciplinary inquiries and matters requiring the attention of CMPs.
To encourage the CMPs in reading the Newsletter, the PB publishes the Continuing Education in Chinese Medicine (CME) Quiz, the content of which is relating to the practice of Chinese medicine, along with the Newsletter in December each year. Since the first CME Quiz was published at the year end of 2011, responses from registered CMPs have been encouraging. The CME Quiz of 2013 is attached to this issue of Newsletter. The PB encourages keen participation in this year’s quiz, as CMPs can acquire both the latest knowledge of the profession and CME points through reading the Newsletter.
Regarding disciplinary inquiries, the PB reminds all CMPs to take note of the standards on prescribing medicines, the use of an alias in the practice and the requirement of reporting court convictions to the PB. This issue of the Newsletter also contains the number of disciplinary cases in 2012. For details, please refer to the content.
In addition, the PB also urges all CMPs to pay special attention to incidents concerning China Food and Drug Administration cracking down on illegal dyeing of processed herbal medicines and the points-to-note for CMPs entrusting local manufacturers to manufacture proprietary Chinese medicines as published in this issue of the Newsletter.
Apart from the content above, this issue also includes information on the WHO Traditional Medicine Strategy: 2014-2023, the Co-operation Agreement on Chinese Medicine (renewed in 2013) signed between the Food and Health Bureau and the State Administration of Traditional Chinese Medicine, and the updated version of "HIV Infection and the Health Care Workers – Recommended Guidelines" issued by the Hong Kong Advisory Council on AIDS for information of CMPs.
On behalf of the PB, I wish all CMPs good health and happiness in the year to come.
Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board
The Clinical Examination of the 2013 CMPs Licensing Examination was conducted in August 2013. A total of 445 candidates attended the Clinical Examination, and 200 candidates (44.9%) passed the Clinical Examination.
The Written Examination and the Clinical Examination of the 2014 CMPs Licensing Examination will be conducted in June and August 2014 respectively. The application period for non-listed CMP persons started on 17 September 2013 and ended on 31 October 2013, whereas the deadline for submitting applications for listed CMPs and repeaters is 28 March 2014. The PB has notified all qualified listed CMPs by mail the enrollment period for taking the examination.
As at December 2013, there were 6,737 registered CMPs, 61 CMPs with limited registration and 2,715 listed CMPs.
Pursuant to section 76 of the 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 CME requirements determined by the PB. From Aug to November 2013, 576 registered CMPs were allowed to renew their practising certificates. All registered CMPs should report promptly to their CME Administrators their new CME cycles, required CME points, and the validity period of their practising certificates.
Apart from section 76 of the CMO, registered CMPs should, according to the Codes1, hold valid practising certificates to practise Chinese medicine. Any cases of violation shall be handled strictly by the PB in accordance with disciplinary procedures. Moreover, the CMO also stipulates that if a registered CMP practises Chinese medicine without obtaining a valid practising certificate for a period exceeding six months since the expiry of his/her practising certificate, the PB may order the removal of his/her name from the Register in accordance with section 56(1)(d) of the CMO.
1 The Codes refer to the Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong and the Code of Conduct for Listed Chinese Medicine Practitioners.
To encourage the CMPs in reading the newsletter, ten questions, based on the content of the three issues of Newsletter of the year, will be published in the December issue every year. Two CME points would be awarded for successful attempt of six or more questions. The ceiling of CME points obtained through CME Quiz within each three-year cycle is 10% of the 60 CME points required in the same cycle, i.e. six points per cycle. The accumulated CME points obtained through CME Quiz and other self-study activities should not exceed 30 points per cycle.
The CME Quiz of 2013 is attached at Appendix 1 of this issue of Newsletter. Registered CMPs may send the completed answer sheet to their respective CME Administrators by fax or by mail on or before 6 February 2014. The CME Administrators will assess and record the CME points awarded for the registered CMPs. No CME points would be awarded for any late submission.
The Secretariat of the Chinese Medicine Council of Hong Kong (CMCHK) will not relay the answer sheets to the CME administrators for any CMPs. To avoid delay, CMPs are reminded to submit the completed answer sheets directly to their CME Administrators.
CMPs are welcome to read the previous issues of the Newsletters in the CMCHK homepage (http://www.cmchk.org.hk).
The PB held disciplinary inquiries from August to November 2013 for three registered CMPs and three listed CMPs who were alleged breaching the Codes and/or convicted of an offence punishable with imprisonment. The CMPs concerned were found guilty after the inquiries. The PB ordered to remove the name of one registered CMP for three months; to reprimand one registered CMP and to warn another registered CMP; to remove the name of one listed CMP and put the decision for two listed CMPs on record for future reference.
Summing up the above cases, the PB reminds all CMPs to take note of the following issues.
Reporting Court Convictions to the PB
According to the Codes, if a CMP has been convicted of an offence punishable with imprisonment in Hong Kong or elsewhere (irrespective of whether a prison term is imposed or not), he/she must report to the PB immediately, specifying the case number, date of conviction, venue, offence and sentence to the PB. If the CMP concerned fails to do so, the PB will take disciplinary actions in accordance with the Codes.
Standards on Prescribing Medicines
It is stipulated in the Codes that a CMP shall issue prescriptions which conform with professional standards and shall not prescribe excessive or inappropriate medicines. If a CMP prescribes inappropriately with excessive dosages or excessive number of medicines without referring to any therapeutic principles, treatment methods, treatment priorities, or against the principle by which medicines are combined, the treatment of the patients would be adversely affected.
In addition, the PB reminds all listed CMPs that, according to section 109 of the CMO, only registered CMPs are permitted to prescribe Chinese herbal medicines specified in Schedule 1. For details of the provision and the schedule, please visit this website (http://www.legislation.gov.hk/blis/eng/index.html).
Use of an Alias in the Practice of Chinese Medicine
CMPs are required to use the name recorded in the list/register of CMPs2 when providing practicing information to the public, failing which, they may contravene the Codes and may be investigated by the police for the suspected unlawful practice of medicine.
The PB reiterates that CMPs who intend to use an alias should register with the Immigration Department and submit the "Certificate of Registered Particulars" issued by the Immigration Department to the PB for acceptance, before using an alias in their practice. CMPs who have completed the alias registration procedures can either use the name recorded in the list/register of CMPs and/or the alias in their practice.
If CMPs use unregistered alias in their practice without the PB’s acceptance, the PB will handle these cases in accordance with the disciplinary procedures.
2 List/register of CMPs refer to List of CMP and Register of CMP maintained by the PB under CMO respectively.
In 2012, a total of 225 disciplinary cases were received by the PB, the details of the disciplinary figures are listed as follow:
The PB held 21 inquiries in 2012 in accordance with section 91 and 98 of CMO, involving 16 CMPs. The details of the inquiry results are as follow:
CMPs entrust local manufacturer of pCm to manufacture pCm must meet the requirements of section 37 of the Chinese Medicines Regulation (the Regulation) (Cap. 549F). Section 37 reads as follows:
Sections 119 (provision on mandatory registration of pCm) and 144 (provision on requirements for package inserts of pCm) of the CMO shall not apply in respect of a pCm if-
the medicine is manufactured-
in the premises in respect of which a manufacturer licence is in force; and
by or under the supervision of a responsible person in accordance with a prescription given by a registered or listed CMP;
the medicine is-
for internal application or both internal and external application, and the medicine is to be administered or supplied to the patient to whom the prescription is given and who is under the direct care of the CMP; or
for external application only, and the medicine is to be administered or supplied to a patient or patients under the direct care of the CMP; and
the Chinese Medicines Board has received from the manufacturer, at least one working day before the day on which the manufacturing process of the medicine begins, a written notification including the particulars set out in subsection (2) and being accompanied by an undertaking referred to in subsection (3).
A notification referred to in subsection (1)(c) shall include-
the quantity of the medicine to be manufactured;
the names and quantities of each ingredient listed in the prescription;
its dose form;
the name and address of the registered or listed Chinese medicines practitioner; and
the date on which the CMP entrusts the manufacturer to manufacture the pCm.
A notification referred to in subsection (1)(c) shall be accompanied by a written undertaking given by the registered or listed CMP to the manufacturer, stating that the medicine will only be administered or supplied to-
(in the case where the medicine is for internal application or both internal and external application) the patient to whom the prescription is given and who is under his direct care; or
(in the case where the medicine is for external application only) a patient or patients under his direct care.
CMP are reminded that according to the above provision, the involved pCm must be manufactured by or under the supervision of a responsible person of the entrusted licensed manufacturer in accordance with a prescription (See Appendix 2) given by a registered or listed CMP. If the pCm involved fulfills part (1)(b)(i) above, the medicines is to be administered or supplied to an identifiable patient to whom the prescription is given and who is under the direct care of the CMP. The manufacturer must manufacture pCm according to the prescription given by the CMP to that identifiable patient. In addition, if the pCm involved fulfills part (1)(b)(ii) above, the medicines can be administered or supplied to a patient or patients under the direct care of the CMP.
Manufacturer entrusted shall possess appropriate techniques and knowledge in manufacturing concept, method and quality control, etc. of manufacturing pCm, and have been authorised to handle the dose form and process so entrusted, in order to ensure that the pCm manufactured meet the requirements in safety, quality and efficacy, as well as that of laws. The label of pCm so manufactured must also fulfill requirements stipulated under section 143 of the CMO, and sections 25 and 26 of the Regulation. Details of the provisions under the CMO and Regulation can be found in the following webpage: http://www.legislation.gov.hk/eng/home.htm.
Please also be reminded that the entrusted manufacturer must comply with the requirement in submitting relevant documents to the Chinese Medicines Board under the CMCHK at least one working day before the day on which each manufacturing process of entrusted pCm begins, and retain relevant documents and records properly. CMP may deliberate with individual manufacturer on manufacturing method and requirements of pCm, if he/ she wishes to do so.
China Food and Drug Administration (CFDA) announced on 15 October 2013 that a special surveillance project on illegal dyeing of processed herbal medicines had started. Certain processed herbal medicines manufactured, transacted or used by relevant units in four provinces, namely, Anhui, Gansu, Guangdong and Sichuan, were sampled for examination. A total of 397 batches of samples had been screened for examination, of which 22 batches were proved to have been dyed and three types of herbs – safflower, Rhizoma corydalis and Stigma Croci – were included. To ensure public safety in the use of medicines, CFDA publicised a list of the processed herbal medicines found to have been dyed and the relevant units involved in their manufacture, transaction and use.
It is a serious illegal act to deceive consumers by dyeing processed herbal medicines, thus jeopardising public safety in the use of medicines. CFDA has instructed food and drug administrations at relevant provincial (regional and municipal) level to investigate the incident that certain processed herbal medicines were proved to have been dyed upon examination and to take appropriate disciplinary actions against the relevant units involved in accordance with the laws and regulations. For details, please visit CFDA’s website (http://www.sda.gov.cn/WS01/CL0051/93277.html).
To safeguard public health and ensure that processed herbal medicines sold in Hong Kong meet the quality and safety standards, CMPs are advised to take caution not to purchase the processed herbal medicines involved in the dyeing problem as mentioned above and check whether the processed herbal medicines being used are involved in the dyeing problem mentioned above. Should the processed herbal medicines purchased are found to be the medicines in question, please stop using them and contact the Department of Health (DH) immediately (telephone no.: 2319 5119).
DH shall follow closely the development of the incident and maintain liaison with CFDA so as to ensure safe use of medicines by the public.
Should you have any enquiries about the contents mentioned above, please contact DH by phone (2319 5119).
All CMPs are advised to take note of the updated version of the "HIV Infection and the Health Care Workers – Recommended Guidelines" ("the Guidelines") issued by the Hong Kong Advisory Council on AIDS ("the Council") in October this year. The Guidelines serve as a practice reference for health care professionals, including CMPs.
Formulated in 1994 and then updated in 2003 by the Council, the Guidelines aim at providing information and guidance for health care workers who have infected HIV.
In view of the expanded knowledge of the field in HIV infection and the understanding of relevant subjects in the territory over the past decade, the Council has reviewed and sought the views of stakeholders, i.e. HIV-related individuals/institutions and various health care sectors (including the Chinese medicine sector) to revise the Guidelines. The updated version was issued in October this year.
The updated version is attached in this issue of the Newsletter (see Appendix 3) for information of CMPs.
The World Health Organization (WHO) launched the WHO Traditional Medicine Strategy: 2014-2023 in Macau on 28 October this year and a three-day meeting (28 to 30 October) was held to formulate a blueprint for the development of Chinese medicine in the coming decade.
There are two main goals of the latest strategy. Firstly, harnessing the potential contribution of traditional medicine to health and secondly, promoting the safe and effective use of traditional medicine. To achieve these goals, the WHO recommended Member States to develop policies and initiatives for regulating Chinese medicine with regard to practical situations and to integrate traditional medicine within local health care systems as appropriate.
The Chinese Medicine Division of the Department of Health, which is the designated WHO Collaborating Centre for Traditional Medicine, has actively supported the WHO in formulating the new strategy. Relevant efforts made include holding three working group meetings in May, November 2012 and April this year respectively, and publishing, distributing and promoting the new strategy. For details, please refer to the website of the Chinese Medicine Division (http://www.cmd.gov.hk).
A co-operation agreement on Chinese medicine (renewed in 2013) was signed in Hong Kong between the State Administration of Traditional Chinese Medicine and the Food and Health Bureau of the Government of the Hong Kong Special Administrative Region on 29 October this year.
The agreement was signed by the Vice Minister of the National Health and Family Planning Commission cum the Commissioner of the State Administration of Traditional Chinese Medicine, Professor Wang Guoqiang and the Secretary for Food and Health, Dr Ko Wing-man.
The agreement was first signed in November 2007, on which the renewed agreement was built. Both sides have reached a consensus of promoting the development of the Chinese medicine in both the Mainland and Hong Kong and further strengthening the co-operation in the area of Chinese medicine.
The PB has not been able to contact some listed CMPs by using the telephone numbers and addresses they provided.
The PB appeals to the following CMPs to contact the Secretariat of the CMCHK (tel. no.: 2121 1888, fax no.: 2121 1898) as soon as possible. If other fellow CMPs happen to keep contact with any of them, please ask them to contact the Secretariat directly so that their contact information can be updated.
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. The form of Change of Personal Particulars of CMPs can be obtained from the Secretariat or downloaded from the CMCHK homepage (http://www.cmchk.org.hk).
Should you have any opinions regarding the content of the Newsletter, please write to the Secretariat by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". Every issue of the Newsletter is uploaded to the CMCHK homepage (http://www.cmchk.org.hk) after publication and those CMPs who are interested may 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