This issue of the Newsletter mainly reports on the progress of work of the Chinese Medicine Practitioners Board ("CMPB") in the past four months, which includes the Chinese Medicine Practitioners Licensing Examination, renewal of practising certificates, Continuing Education in Chinese Medicine ("CME") for registered Chinese medicine practitioners ("CMPs") and findings of disciplinary inquiries. Some requirements under the Codes1 are also highlighted in this issue for the attention of CMPs.
With regard to disciplinary inquiries, CMPs are specifically reminded not to dispense western drugs, they should observe the requirements stipulated in the Chinese Medicine Ordinance ("CMO") and the Codes, namely their professional responsibilities, standards for prescribing medicines, practice advertising, information in the prescriptions and reports of offences committed to the CMPB.
On 10 January 2017, the Chinese Medicine Council of Hong Kong (CMCHK) established a Health Committee under the CMPB. The Committee mainly handles the cases specifically related to medical grounds, evaluate if the registered CMPs with medical problems are fit to continue practising Chinese medicine, and make recommendations to the CMPB in this regard.
In addition, a questionnaire on the Health Manpower Survey conducted by the Department of Health (DH) is also attached to this issue of the Newsletter. The aim of the survey is to collect information on the manpower and employment status of practising CMPs in Hong Kong. CMPs are invited to complete the questionnaires and return it to the DH direct.
On behalf of the CMPB, may I wish all CMPs all the best and good health.
Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board
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.
Paper 1 and Paper 2 of Part I Written Examination of the 2017 Chinese Medicine Practitioners Licensing Examination were conducted on 6 June and 8 June respectively. The Clinical Examination (Part II) was conducted from 1 August to mid-August. A total of 486 candidates sat for the Written Examination (including Paper 1 and Paper 2) and 360 candidates (74.1% of candidates) passed the Written Examination.
The CMPB will publish the Candidates' Handbook for the 2018 CMPs Licensing Examination and disseminate in September 2017 the details of taking the 2018 CMPs Licensing Examination. Please take notice of the announcements on the CMCHK homepage (http://www.cmchk.org.hk).
As at 31 July 2017, there were 7,244 registered CMPs, 41 CMPs with limited registration and 2,636 listed CMPs.
Pursuant to section 76 of the CMO, registered CMPs must hold 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 1 April to 31 July 2017, 222 registered CMPs had their practising certificates renewed. All registered CMPs who have their practising certificates renewed should report promptly to their CME Administrators their new CME cycles, the CME points required, and the validity period of their practising certificates.
The CMPB reminds that, in accordance with section 56(1)(d) of the CMO, if registered CMPs practise Chinese medicine without 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.
It is specified in the Application Form for Registration as Registered Chinese Medicine Practitioner and Practising Certificate that registered CMPs must provide their practising address as the registered address. For those who practise at more than one location, their principal practising address should be provided as the registered address.
In accordance with sections 52 and 53 of the CMO, registered address shall be recorded in the Register of Chinese Medicine Practitioners. The Registrar shall publish in the Gazette once every 12 months the names, registered addresses and qualifications of all registered CMPs listed in the said Register. Such information will also be published in the website of the CMCHK.
In addition, the CMPB shall arrange to publish in the Gazette from time to time the list of listed CMPs under section 90(6) of the CMO. Such information will also be published in the website of the CMCHK.
To ensure that members of the public can verify the qualifications of CMPs from the Gazette or the website of the CMCHK, both registered and listed CMPs are required to update the CMCHK on their practising address. CMPs who wish to change their personal particulars should complete the form, namely "Change of Personal Particulars of Chinese Medicine Practitioners", enclosed at the APPENDIX, and send it to the Secretariat of the CMCHK by post (Address: 22/F, Wu Chung House, 213 Queen’s Road East, Wan Chai, Hong Kong) or by fax (Fax no.: 2121 1898).
The CMPB held disciplinary inquiries from 16 March to 15 July 2017 on three registered CMPs and one listed CMP who were convicted of an offence punishable with imprisonment and/or alleged breaching the Codes. The three registered CMPs and one listed CMP were found guilty after inquiries. The CMPB warned and removed the name of one registered CMP for 6 months with a suspension of 24 months; warned and removed the name of one registered CMP for 2 months with a suspension of 24 months; warned one registered CMP 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.
Chinese Medicine Practitioners Must Not Prescribe Western Medicines
The DH has recently been investigating a number of suspected cases of undeclared Western drug ingredients detected in cream products prescribed by three registered CMPs causing adverse reactions in patients. The Government Laboratory has confirmed that the cream samples contain steroids, antibiotics and antifungals which are Western medicines. Highly concerned about the incidents, the DH has taken initiative to follow up the cases and referred them to the CMCHK for consideration of disciplinary actions. The DH has written to all local CMPs on 27 June 2017 and 19 July 2017 alerting them to the issue of prescription of Western medicines. A briefing for representatives of Chinese medicine associations has also been held on 19 July 2017 to report the latest situation and concern of the public. In addition, the DH has arranged for staff to explain to CMPs attending Chinese medicine courses organised by Continuing Education in Chinese Medicine Programme Providers that no proprietary Chinese medicines ("pCm") adulterated with Western drug ingredients should be prescribed to patients, and they should be aware of the relevant requirements stipulated in the Laws of Hong Kong and the Codes for CMPs.
In view of the above incidents, the CMPB reminds all CMPs not to prescribe any Chinese herbal medicines ("Chm") or pCm adulterated with Western drug ingredients to patients. Illegal sale or possession of Part 1 poisons are criminal offences under the Pharmacy and Poisons Ordinance (Cap. 138), and offenders are liable on conviction to a maximum fine of $100,000 and to imprisonment for up to 2 years on each count. Moreover, illegal sale and possession of antibiotics are prohibited under the Antibiotics Ordinance (Cap. 137), and offenders are liable on conviction to a maximum fine of $30,000 and to imprisonment for up to 1 year on each count.
Under the Codes, CMPs are required to prescribe Chm or pCm to patients on the basis of principles of the Traditional Chinese Medicine. The CMPB considers that CMPs must know clearly the ingredients of the medicines prescribed to patients, be conversant with the professional requirements stipulated in the Codes, and have a thorough understanding of the medicines allowed to be prescribed by them under local laws. In this connection, CMPs are required to deal with reputable licensed Chinese medicine traders and prescribe medicinal products which are safe and effective for treating patients. They must not purchase Chm or pCm with unknown ingredients or from doubtful sources. All CMPs are also specifically reminded that in accordance with section 158(6)(a) of the CMO, the requirements for pCm to be registered and a person who manufactures pCm to apply for a manufacturer licence in pCm may be exempted for pCm compounded by or under the supervision of a CMP at the premises where he practises if, and only if, such pCm is being used for the purpose of administering or supplying to a patient under his direct care. Yet, CMPs are still rested with the professional responsibility to ensure the safety, quality and efficacy of the pCm compounded.
As CMPs prescribing herbal medicine which contains Western medicine to patient not only violates the laws and endangers public safety, it also has an adverse effect on the image of the Chinese medicine profession, the CMPB would like to restate that all CMPs should observe relevant regulations stated in the Codes at all time, i.e. CMP should adopt treatment methods on the basis of principles of the Traditional Chinese Medicine in prescribing Chm or pCm and shall not use any Western medicines. If any CMP is convicted for prescribing medicines adulterated with Western drug ingredients, the CMPB will process the case seriously in accordance with the disciplinary procedures stipulated under the CMO.
There was a recent disciplinary case where a CMP disregarded his professional responsibility to a patient suffered from pneumohaemothorax which was caused during his acupuncture treatment. All CMPs are hereby reminded to exercise caution when treating patients to avoid injuries and serious medical incidents.
According to the provisions of section 2 of Part 3 of the Codes, CMPs shall be professionally responsible to their patients by diligently improving 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 contravened the above-mentioned provisions of the Codes.
Furthermore, in accordance with section 2(5) of Part 3 of the Codes, CMPs should make medical referrals when necessary, and the registered medical professionals to whom a patient is referred should be able to provide the required treatment according to the diagnosis. The CMPB reminds all CMPs to make appropriate referral of patients when necessary and choose the medicines or apparatus that best serve the medical interest of patients according to his independent professional judgment.
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.
Furthermore, all CMPs must make safety their first priority in prescribing medicines. They should draw reference to the recommended drug dosages stated in the Pharmacopoeia of the People’s Republic of China, and closely monitor for any adverse reactions of patients especially when toxic Chinese herbal medicines are prescribed. CMPs should also give medical instructions in clear written form to ensure that their patients can understand and follow their instructions in preparing and consuming the Chinese medicines. CMPs should also inform their patients of the known possible side effects of the prescriptions, and ask them to seek medical advice promptly if they experience any illness after taking the prescribed medicines.
As stipulated in clause 6(2)(a)(ii) in Part 3 of the Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong, signboards exhibited by a registered CMP 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 allowed by the CMPB (academic titles and practising qualifications that could be exhibited must follow the restrictions set out in Appendix I to 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.
As regards listed CMPs, seven of the requirements for information that may be contained in signs and signboards exhibited at the clinic as stipulated in clause 6(2)(a)(ii) in Part 3 of the Code of Conduct for Listed Chinese Medicine Practitioners are the same as those applicable to registered CMPs, apart from requirement (4) regarding titles, viz. signs and signboards exhibited by a listed CMP may contain the Chinese title of "中醫" or "中醫師" or English title of "Chinese medicine practitioner".
If signboards exhibited by a CMP contain information other than those listed above, the CMP would be considered to have transgressed the relevant code of practice. The CMPB may, in its discretion, take disciplinary actions under section 98(3) (for registered CMPs) or section 91(2)(a) (for listed CMPs) of the CMO.
Information in Prescriptions
The CMPB is concerned that some CMPs have failed to list in their prescriptions all necessary information, including the names and dosages of all Chinese medicines; instructions such as methods of preparation and administration of the medicines as well as number of times for re-dispensing; name, address, contact telephone number and signature of the CMP; and issuing date of the prescription, etc. Under the codes of practice, CMPs are also required to ensure that the issued prescriptions are clear and legible. The CMPB reminds all CMPs again that the above requirements serve to protect the right of the patients to gain full knowledge of all Chinese medicines prescribed. In case of medical incidents, healthcare personnel can initiate prompt investigations and provide follow-up treatments to the patients by making reference to the prescriptions issued, thereby ensuring that the medical interests of the patients are best served.
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.
The CMCHK has established a Health Committee under section 39 of the CMO. The Health Committee was set up on 10 May 2017 and it is composed of 5 CMPs, 4 registered medical practitioners and 2 lay persons. The functions of the Health Committee are to discuss and deliberate on the physical or mental fitness of any registered CMP to practise Chinese medicine, meet with the registered CMP where necessary for assessment, and report the findings of the assessment to the CMPB for its consideration. Members of the Health Committee include Ms CHAU Shuk-ying (Chairman), Dr KWAN Yiu-keung, Dr LAW Chun-bon, Alexander, Mr NG Sze-tuen (CMP), Dr PAN Pey-chyou, Miss TAM Siu-ying, Louisa, Dr WONG Chung-leung, Mr WONG Kwun-ming (CMP), Dr WONG Ming-cheuk, Michael, Mr WONG Wing-ho (CMP) and Ms YEUNG Siu-lin, Teresa (CMP).
Regarding the establishment of a Health Committee for listed CMPs, the CMPB will make a recommendation to the CMCHK after the revision of the Code of Conduct for Listed CMPs is made.
The 2014 Health Manpower Survey conducted by the DH was completed in May 2015. A summary of the findings of the survey is attached to this issue of the Newsletter for information.
A new round of the Health Manpower Survey will be conducted this year. This survey aims at collecting information on the manpower and employment status of healthcare personnel practising in Hong Kong, which will serve as a reference for the Government in health manpower planning. The survey on CMPs has commenced and a questionnaire is enclosed in this issue of the Newsletter for distributing to CMPs. CMPs are advised to return the completed questionnaire to the DH direct. For further information and enquiries, please visit http://www.dh.gov.hk/english/statistics/statistics_hms/statistics_hms.html or contact Health Manpower Unit of the DH 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. 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
24-hour enquiry system: (852) 2574 9999
Fax Number: (852) 2121 1898
E-mail Address: firstname.lastname@example.org
Service Hours: Monday to Friday: 9:00 am to 5:30 pm
Closed on Saturdays, Sundays and Public Holidays