This issue of the Newsletter mainly reports on the work of the Chinese Medicine Practitioners Board ("CMPB") in the past four months, including the Chinese Medicine Practitioners Licensing Examination, renewal of practicing certificates and continuing education in Chinese medicine ("CME") for registered Chinese medicine practitioners ("CMPs"), adjustment to the prescribed fees for registration of CMPs and related matters, findings of disciplinary inquiries, and reminders for CMPs from the CMPB.
With a view to encouraging CMPs to read the Newsletter, the CMPB has arranged for a Quiz on the practice of Chinese medicine to be featured in every December issue for CMPs to earn CME points. Since the first publication of the CME Quiz in late 2011, the responses and support from registered CMPs have been overwhelming. Reading the Newsletter helps gain not only the latest information on the Chinese medical profession, but also CME points. The CME Quiz for this year is enclosed herewith and active participation of CMPs is most welcome.
On the other hand, the Government has conducted a review of the Chinese Medicine Practitioners (Fees) Regulation early this year. Following the scrutiny of the proposed fee adjustment and the subsequent passage of the Chinese Medicine Practitioners (Fees) (Amendment) Regulation 2015 by the Legislative Council, the new rate of the fees will take effect from 1 January 2016. Please refer to the main text of this issue for details.
With regard to disciplinary inquiries, CMPs are specifically reminded to take heed of matters, including their professional responsibilities in dispensing Chinese medicines, requisite information in the prescriptions, reports of offences committed to the CMPB, issue of professional documents or certificates and standards on prescribing medicines. As for the number of disciplinary cases in 2014, you may wish to refer to the main text.
Also featured in this issue are the arrangements after the deadline for submission of product specification documents and general stability test reports for application of transitional registration of proprietary Chinese medicine ("pCm"). Please refer to the content for details.
On behalf of the CMPB, may I wish all CMPs all the best and good health in the coming year.
Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board
The Clinical Examination of the 2015 CMPs Licensing Examination was conducted in August 2015. A total of 492 candidates attended and 211 candidates (42.9%) passed the Clinical Examination.
The Written Examination and the Clinical Examination of the 2016 CMPs Licensing Examination will be conducted in June and August 2016 respectively. The application period for non-listed CMP persons started on 16 September and ended on 30 October 2015, whereas the deadline for submitting applications for listed CMPs and repeaters is 31 March 2016. The Practitioners Board has notified all qualified listed CMPs by mail the enrollment period for taking the examination.
As at the end of October 2015, there were 7,057 registered CMPs, 60 CMPs with limited registration and 2,662 listed CMPs.
Pursuant to section 76 of the Chinese Medicine Ordinance ("CMO"), registered CMPs must obtain valid practising certificates before they are allowed to practise Chinese medicine in Hong Kong. The usual validity period of a practising certificate is three years. Registered CMPs should fulfill the CME requirements prescribed by the CMPB before they can renew their practising certificates.
From August to October 2015, 577 registered CMPs renewed their practising certificates. All registered CMPs who have their practising certificates renewed should report promptly to their CME Administrators their new CME cycles, required CME points and the validity period of their practising certificates.
The CMO also stipulates that if registered CMPs practise Chinese medicine without obtaining valid practising certificates for a period exceeding six months since the expiry of their practising certificates, the CMPB may order removal from the Register the name of those registered CMPs in accordance with section 56(1)(d) of the CMO.
Apart from the CMO, the Codes also stipulate that registered CMPs should be holders of valid practising certificate to practise Chinese medicine. The CMPB will process violation cases seriously in accordance with the procedures stipulated under the CMO.
To encourage the CMPs in reading the newsletter, ten questions, based on the content of the three issues of the 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 2015 is attached at the APPENDIX of this issue of the Newsletter. Registered CMPs may send the completed answer sheet to their respective CME Administrators by fax or by mail on or before 5 February 2016. 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 registration system for CMPs has been implemented since 2000. Under the CMO, the CMPB shall, in performing statutory functions related to the registration of CMPs and the Licensing Examination, charge the prescribed fees as stipulated in the Chinese Medicine Practitioners (Fees) Regulation at levels sufficient to achieve full-cost recovery.
After the fee adjustment in 2006, the Government has conducted a review of the costs early this year and proposed adjustment to some of the fees. Following the scrutiny of the proposed fee adjustment and the subsequent passage of the Chinese Medicine Practitioners (Fees) (Amendment) Regulation 2015 by the Legislative Council, the new rate of the fees will take effect from 1 January 2016 as follows:
The CMPB held disciplinary inquiries from August to November 2015 on seven registered CMPs and one listed CMP who were convicted of an offence punishable with imprisonment and/or alleged breaching the Codes1. Seven registered CMPs and one listed CMP were found guilty after the inquiries. The CMPB reprimanded and removed the name of a registered CMP for 24 months; removed the name of three registered CMPs for 2 to 6 months with a suspension of 18 to 24 months and also reprimanded one of the above-mentioned registered CMP; reprimanded three registered CMPs and removed the name of one listed CMP.
Summing up the above cases, the CMPB reminds all CMPs to take note of the following issues:
Professional Responsibility in Prescribing Chinese Medicines
According to section 158 of the CMO, a CMP who practise Chinese medicine to a patient under his direct care and dispense on a prescription given by him and at the premises where he practices, application to Chinese Medicines Board ("CMB") under CMC for applying certificate of sale of proprietary Chinese medicines can be exempted.
A CMP must be professionally responsible for the Chinese medicines prescribed directly by him-/herself or by dispensers and other staff under his/her supervision to patients under his/her care. The CMPB also appeals to CMPs to purchase medicines from licensed wholesalers of proprietary Chinese medicines or Chinese herbal medicines with good reputation. No medicines of unclear or unreliable sources should be purchased.
If a CMP has done something which has fallen short of the standards of conduct expected among members of his/her profession, it could be regarded as professional misconduct and the CMPB and its Disciplinary Committee will handle such cases strictly.
Information that must be included in prescriptions
The CMPB has noticed that there are CMPs who did not list out the names of Chms medicines based on the names in the Schedules of the CMO in their prescriptions. According to the provisions of the Codes, the names of all Chms should be based on the names in the Schedules of the CMO. Names of Chms not listed in the Schedules should be based on the names in the "Pharmacopoeia of the People's Republic of China" (《中華人民共和國藥典》), the "Chinese Materia Medica", (written by XU Guojun, etc.) (《中國藥材學》(徐國鈞等著)), the "Dictionary of Chinese Herbal Medicines" (《中藥大辭典》) or the "Chinese Herbal Medicines" (《中華本草》). Regarding the information that must be included in the issued prescriptions, CMPs could take reference from the Codes.
All CMPs are reminded again that patients have the right to know clearly the details of the Chinese medicines being prescribed. In case of any medical incident, medical professionals can make use of the prescription to initiate investigation and take immediate follow up actions for the best benefit of patients.
Reporting Court Convictions to the CMPB
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 CMPB within 28 days, specifying the case number, date of conviction, venue, offence and sentence. If the CMP concerned fails to do so, the CMPB will take disciplinary actions in accordance with the Codes.
Issue of Certificates
When CMPs issue sick leave certificates and medical receipts, they should be mindful not to issue professional documents which are untruthful or misleading. The Reference Guide on Issuance of Sick Leave Certificate by Registered CMPs also clearly stipulates that CMPs should never issue retrospective sick leave certificates (the sick leave certificates can only be issued on the same day of the treatment). Apart from being subject to criminal liabilities, any CMP reported to have violated the above regulations is also guilty of misconduct in a professional respect.
According to the provisions of section 2 of Part III of the Code, CMPs have a professional responsibility to patients. They should patiently explain to patients their medical conditions, methods of treatment and the precautions in taking drugs. They should diligently improve their professional knowledge and skills, so as to maintain high professional standards in providing medical service to patients. If the CMPB considers that a CMP, in the course of conduct of his profession, has conducted himself in a way which has fallen short of the reasonable standards of conduct expected among his professional colleagues, the CMP may have committed the above-mentioned provisions of the Code.
There was a recent disciplinary case where a CMP performed acupuncture treatment on a patient in the bathroom. The approach and location of the treatment both fell short of the standards expected among the profession. CMPs are hereby reminded to treat patients in a prudent and cautious manner and avoid committing professional misconduct.
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 patients would be adversely affected.
In addition, the CMPB 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).
The CMPB would like to reiterate that according to the Codes, CMPs shall not carry out or participate in any practice advertising works or activities. Practice advertising refers to the adoption of various promotion measures to enhance the popularity of CMPs so as to gain benefits from his business, including the promotion of a CMP, his work or his practice, by himself or others (including his employer). Inappropriate advertising measures include the provision of information to, and soliciting business from the public or his patients. Any information provided by a CMP to the public or his patients must be legitimate, honest, true, not exaggerated, and must not claim superiority over other CMPs, or disparage other CMPs. A CMP who has any kind of professional relationship with an organization, when participating in advertising activities or services of the organization, must exercise due diligence to ensure that the organizations do not advertise in contravention of the principles and rules applicable to CMPs as mentioned above.
1The 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.
In 2014, a total of 361 disciplinary cases were received by the CMPB, the details of the disciplinary figures are listed as follow:
The CMPB held 33 inquiries in 2014 in accordance with sections 91 and 98 of CMO, involving 26 CMPs. The outcomes of the inquiries are as follow:
The CMO was enacted to safeguard public health and safety in 1999 while the Chinese Medicine Council of Hong Kong ("CMCHK"), underpinned by the CMPB and the CMB, was established to formulate and implement measures for regulating CMPs and Chinese medicines. The registration system for pCm was put in place by the CMB in December 2003. Under the system, the applicants should submit their applications to the CMB in accordance with the relevant registration arrangements and requirements, and the CMB will then decide whether the applications should be approved taking into consideration the safety, quality and efficacy of the products. The Department of Health ("DH") provides professional and administrative support to the CMB.
With regard to the history and practical circumstances of pCm sales in Hong Kong, and pursuant to section 128 of the CMO, local manufacturers or local agents (for products manufactured overseas) of all pCms manufactured, sold or supplied for sale in Hong Kong as at 1 March 1999 may apply for transitional registration of their products within the period specified by the CMB. The applicants should submit objective proof to demonstrate that their pCm products meet the criteria for transitional registration. After thorough assessment of the applications, the CMB will issue a "Notice of confirmation of transitional registration of proprietary Chinese medicine" ("HKP") for the products.
Holders of HKP are required to submit documents in respect of the safety, quality and efficacy of their products to the CMB to facilitate the processing of transitional registration to formal registration. A "Certificate of registration of proprietary Chinese medicine" ("HKC") will be issued in respect of products which have been issued with HKP and assessed by the CMB as meeting the registration requirements.
As promulgated by the CMB on 26 June 2013, all holders of HKP must submit product specification documents and general stability test reports of the first batch of products by 30 June 2015. The CMB has written to holders of HKP who failed to submit the said documents/reports or fully justify their non-submission and informed them of the rejection of their applications for registration of pCm. The HKPs concerned are no longer valid and the products must not be supplied or sold commercially. Such products have been removed from the "List of applications for proprietary Chinese medicine registration" (http://www.cmchk.org.hk/pcm/eng/#main_dis.htm) and information of rejected applications has been uploaded onto the "What's New" section (http://www.cmchk.org.hk/pcm/eng/#main_news.htm) on CMCHK's website.
Pursuant to section 119 of the CMO, no person shall sell, import or possess any pCm unless the pCm is registered with the CMB, otherwise that person commits an offence and is liable to a maximum penalty of a fine at level 6 and imprisonment for 2 years. As such, CMPs are requested to take note of the said list of rejected applications for pCm registration. CMPs who have procured such pCms should discontinue their administration and supply, and support the suppliers in handling the products in an appropriate manner.
CMPs in possession of such pCms may send the products to the Chinese Medicine Division of the DH during office hours for arrangement of destruction if necessary (Address: 16/F, AIA Kowloon Tower, Landmark East, 100 How Ming Street, Kwun Tong, Kowloon).
A seminar on the registration of pCm had been held by the CMB and the DH on 2 November 2015, the content of which is available from the website of CMCHK (http://www.cmchk.org.hk/cmp/eng/#main_news.htm).
For enquiries on the above, please call the Chinese Medicines Section, Chinese Medicine Division on 3904 9130.
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 send them to the Secretariat by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". All published Newsletters are 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
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