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.
In accordance with the Chinese Medicine Ordinance ("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. All registered CMPs are hereby reminded to take note of the validity of their practising certificate and submit a renewal application to the CMPB according to the schedule. Any registered CMPs who have decided not to renew their practising certificate should complete the "Notice of Non-renewal of Practising Certificate" attached to this issue and return it to the Secretariat of the Chinese Medicine Council of Hong Kong ("CMCHK").
With regard to disciplinary inquiries, CMPs are specifically reminded not to dispense western medicines, they should observe the requirements stipulated in the CMO and the Codes, namely their professional responsibilities, points to note on keeping, preparing and handling Chinese medicines in the Chinese medicine clinics, handling of patients' personal data and change of name or use of an alias in their practice etc.
The Apology Ordinance ("the Ordinance") (Cap. 631) has come into effect on 1 December 2017. Under the Ordinance, the CMPB will not admit any apologies (including statements of fact contained therein) as evidence to the prejudice of a CMP being charged. Further details can be found in the following pages.
Information about the Health Manpower Survey conducted by the Department of Health is provided in this issue. Last but not least, answers of the 2017 CME Quiz for awarding CME points through reading the Newsletter are attached to this issue for CMPs' reference.
On behalf of the CMPB, may I wish all CMPs all the best and good health.
Ms WONG Yu-yeuk
Chairman of the Chinese Medicine Practitioners Board
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.
The application for sitting the 2018 CMPs Licensing Examination for non-listed CMPs was closed in late October 2017 and that for listed CMPs and repeaters was closed on 29 March 2018.
The Paper 1 and Paper 2 of the Written Examination of the 2018 CMPs Licensing Examination will be conducted on 5 and 7 June 2018 respectively. In the event of bad weather, the examination on 5 and 7 June 2018 will be postponed to 11 and 13 June 2018 respectively. The Clinical Examination is scheduled to be held between 1 August and Mid-August 2018.
Candidates should receive the admission forms and the Guidelines for Candidates one week prior to the examination. They may contact the Secretariat of the CMCHK at 2121 1888 if they do not receive the above-mentioned documents on time.
As at 15 March 2018, there were 7,417 registered CMPs, 35 CMPs with limited registration and 2,618 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 December 2017 to 15 March 2018, 240 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, required CME points and the validity period of their practising certificates.
Any registered CMPs who have decided not to renew their practising certificate but have not yet returned the "Notice of Non-renewal of Practising Certificate" (Appendix 1) should complete the said Notice and return it to the Secretariat of the CMCHK (Address: 22/F, Wu Chung House, 213 Queen's Road East, Wan Chai, Hong Kong / Fax no.: 2121 1898/ E-mail: email@example.com) as soon as possible for record.
The CMPB hereby reminds that:
if a registered CMP has decided not to renew his current practising certificate, he must stop practicing Chinese medicine upon expiry of the certificate. Otherwise, he will contravene section 76(1) of the CMO.
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.
To encourage CMPs in reading the Newsletter, the CMPB endorsed in 2011 the introduction of the CME Quiz. 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 if successful attempt of six or more questions.
The correct answers of the 2017 CME Quiz are attached to this issue of Newsletter at Appendix II for CMPs' reference. The 2018 CME Quiz will be published in the December issue of the Newsletter this year.
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 CMPs. 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 registered addresses (i.e. practising addresses). 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 III, and send it to the Secretariat of the CMCHK (Address: 22/F, Wu Chung House, 213 Queen's Road East, Wan Chai, Hong Kong / Fax no.: 2121 1898/ E-mail: firstname.lastname@example.org).
The CMPB held disciplinary inquiries from 16 November 2017 to 15 March 2018 on three registered CMPs who were alleged breaching the Code of Professional conduct for Registered CMP in Hong Kong. Three registered CMPs were found guilty after inquiries. One registered CMP concerned was involved in two cases of disciplinary inquiry. Upon inquiry, the CMPB removed the name of the CMP for 6 months with a suspension of 24 months, and reprimanded the CMP for the first case. As for the second case, the CMPB removed the name of the CMP for 24 months and reprimanded the CMP. In addition, the CMPB warned and removed the name of one registered CMP for 1 month with a suspension of 12 months and reprimanded one registered 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
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 for 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 Chinese herbal medicines ("Chm") or proprietary Chinese medicines ("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 whilst they should keep the receipts in order to trace the sources of the Chm and pCm. 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.
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.
According to the provisions of section 2 of Part III of the Codes, CMPs shall be professionally responsible to their patients. They should explain patiently 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 contravened the above-mentioned provisions of the Codes.
All CMPs are hereby reminded to exercise caution when treating patients to avoid injuries and serious medical incidents.
Points to Note on Keeping, Preparing and Handling Chinese Medicines in the Chinese Medicine Clinics
To facilitate management of patients, the enacted CMO provides the following exemptions to CMPs for licensing application and the registration of pCm have -
According to sections 158(2) and (4), a CMP shall be exempted from applying to the Chinese Medicines Board for a retailer license in Chm if the Chm in question are dispensed to a patient under his direct care and on a prescription given by him and at the premises where he practices; and
According to section 158(6)(a), a CMP shall be exempted from applying to the Chinese Medicines Board for a manufacturer license in pCm if a pCm is compounded by or under the supervision of the CMP for a patient under his direct care at the premises where he practices. Moreover, the pCm in question shall be exempted from registration.
In carrying out professional responsibilities, CMPs are required to conform to professional standards, maintain good conduct and be professionally responsible for patients, which includes ensuring the safety and quality of the Chinese medicines dispensed to patients. As such, the CMPB has suggested that appropriate management should be carried out on the pCm dispensed to patients by CMPs, as well as on the relevant personnel, premises, keeping of records, processing of herbal medicines, preparing of pCm and dispensing of Chinese medicines, etc. which are involved in the retail business of Chm, and none of these should be neglected. For instance,
A CMP or a dispenser under his supervision should have knowledge of the processing, authentication and decoction of processed Chm (including the toxic/potent Chm listed in Schedule 1);
Capable of checking the authenticity and quality of the processed herbal medicines when inspection and acceptance is being carried out. Processed herbal medicine found to be counterfeit, of poor quality or not conforming to the stated specifications, such as those showing obvious irregularities, for example, contamination with mildew, infestation by insects, decolourisation, decomposition due to humidity or stickiness etc. or adulterated with impurities should not be accepted, neither should these Chm be dispensed to patients, or used as raw materials for preparing or compounding Chinese medicine preparations for patients;
Store-room of Chm should be kept cool, dry and well ventilated. Relevant facilities should be provided for the control of insects, rodents, mildew, humidity and contamination;
The area, apparatus and staff for preparing or compounding Chinese medicine preparations should meet the hygiene standards to ensure that the finished products are not contaminated in the preparing or compounding process. If there is any doubt about the quality of a finished product, laboratory test should be carried out to ensure that the product concerned is not contaminated.
To protect the health of the public, if Chm have to be dispensed or preparations have to be prepared/compounded by a CMP (or by a personnel under his supervision) for patients under his care in carrying out professional responsibilities, he should comply with the standards of practice and ensure the quality and safety of the Chinese medicines. In addition, in treating high risk patients such as children, elders and patients with impaired immunity, extra caution must be taken and detailed medical advice or instruction be provided. There should be strict requirements for the preparing or compounding of Chinese medicine preparation, including measures for the prevention of cross contamination and bacterial contamination. For instance, the equipment and the surroundings should be thoroughly cleansed; suitable containers should be used for packaging and sealing, etc. Moreover, medical advice should be given to these patients that their Chm (including powder form) or the Chinese medicine preparations must be stored in a dry, cool and clean environment; overstock of medicines must be avoided; expired or contaminated medicines must not be taken, and the Chm to be taken must be decocted as required, etc.
To promote the standards of practice of the Chinese medicines trade, the Chinese Medicines Board has prepared relevant trade guidelines2 to regulate all the aspects involved in operating the Chm and pCm business. The Chinese Medicines Board advises CMPs to refer to the "Practising Guidelines for Retailers of Chinese Herbal Medicines" and "Practising Guidelines for Manufacturers of Proprietary Chinese Medicines" for compliance in their relevant business.
2 The relevant guidelines have been uploaded to the website of the CMCHK (www.cmchk.org.hk).
Handling of patients' personal data by CMPs
The CMPB hereby reminds all CMPs that they shall comply with the Personal Data (Privacy) Ordinance ("PDPO") (Cap. 486) in the collection, holding, use, storage and erasure of their patients' personal data.
The personal data of patients collected by CMPs must be related to the diagnosis and treatment of the patients, and the extent or scope of data so collected should not be excessive to actual needs. CMPs shall collect patients' personal data by legal and fair means, and inform the patients of the purpose of collecting the data and its use. When CMPs collect or process patients' personal data in an open area (e.g. during medical consultations), they shall exercise great caution and take practicable steps to protect the data in order to avoid necessary disclosure to other patients or visitors.
Moreover, the personal data collected can only be used for the purpose for which it was collected in the first place or other directly related purposes; otherwise, the prior consent of the patients concerned must be sought. According to section 3(2) of the Codes, a CMP shall not misuse or disclose information obtained from his patients and the PDPO shall be complied with when releasing information of patients.
CMPs shall also take all practicable steps to ensure the security of patients' personal data in order to avoid unauthorised or accidental access, processing or erasure of it. Patients have the right to ask CMPs for their own medical records, including medical history, and CMPs are obliged to provide such records to them. However, subject to section 20 of the PDPO, where: (i) a CMP is not supplied with the information that will satisfy him as to the identity of the party requesting for medical records, (ii) compliance with the request is being prohibited under the PDPO or any other ordinance, or (iii) the request is not in writing in the Chinese or English language, he can decline a patient exercising his rights to request for such records. As to whether a fee will be imposed for the provision of copies of medical records to patients, it is left to the discretion of the CMP.
In case of any queries, please contact the Office of the Privacy Commissioner for Personal Data (Tel.: 2827 2827 / E-mail: email@example.com).
If the CMPB considers that a CMP has not complied with the PDPO in processing his patient's personal data and his standard in this aspect is far below that of professional CMPs in general, it may take disciplinary actions against him.
Change of Name of CMPs or Use of Alias in their Practice
CMPs must make sure that their name as recorded in the list/Register of CMPs is used when they practise Chinese medicine, or otherwise they may contravene the Codes and even be investigated by the Police for suspected illegal practice of Chinese medicine.
The CMPB hereby reiterates that CMPs who wish to use an alias in their practice should apply to the Immigration Department ("ImmD") for alias registration and submit the Certificate of Registered Particulars for the CMPB's approval before using the alias. CMPs who have completed the alias registration may use their name as recorded in the list/Register of CMPs and/or their alias in their practice. As for CMPs whose application for alias registration is still being processed by the ImmD, they may only use their name as recorded in the list/Register of CMPs or list their alias alongside their name as recorded in the said list/Register.
CMPs who have been notified by the CMPB of the requirement for alias registration but have not yet filed an application to the ImmD should complete the registration within 12 weeks from the date of notification. CMPs who continue to use their alias in their practice without completing the alias registration may be subject to disciplinary procedures.
Besides, for CMPs who have changed their name, please bring along the original of their deed poll and proof of identity to the Secretariat of the CMCHK for change of personal particulars as soon as practicable.
The Apology Ordinance ("the Ordinance") (Cap. 631) has come into effect on 1 December 2017. Its objective is to promote and encourage the making of apologies with a view to preventing the escalation of disputes and facilitating their amicable resolution.
The Ordinance ensures that the content of an apology will not constitute as evidence of admission of fault or liability to be presented in court in civil proceedings, hence eliminating the obstacles to the making of apologies and encouraging the use of it to resolve disputes early. Under the Ordinance, the CMPB will not admit any apologies (including statements of fact contained therein) as evidence to the prejudice of a CMP being charged. However, upon commencement of disciplinary proceedings (i.e. on receipt of a complaint by the Disciplinary Committee of CMPs), any apologies and statements of fact contained in the submission made by a CMP being charged to the Disciplinary Committee or the CMPB in the disciplinary proceedings, may it be oral or written, are not protected by the Ordinance (i.e. can be adduced as evidence in prosecution). The scope of the Ordinance covers only the apology and the relevant statement of fact made by a defendant to his patient, the patient's family or other persons in connection with the matter outside disciplinary proceedings (i.e. the prosecution cannot adduce the evidence or information in the inquiry). However, if the content of the apology has become an important evidence in the inquiry and public interest is involved, the CMPB may decide whether or not to exercise discretion to admit a statement of fact contained in an apology as evidence under section 8(2) of the Ordinance. Please consult your legal advisor on the details of the Ordinance.
The 2017 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 to formulate long-term policy on health manpower planning and training. The questionnaire has been distributed to all CMPs together with the previous issues of Newsletter. To enhance the response rate of the survey, enclosed please find the reminder and questionnaire to all CMPs from DH. Please return the duly completed questionnaire with the enclosed envelope to the Health Manpower Unit of the DH as soon as possible. For further enquiry, please visit http://www.dh.gov.hk/english/statistics/statistics_hms/statistics_hms.html or contact Health Manpower Unit at 2961 8566.
All CMPs are requested to notify the Secretariat of the CMCHK 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 CMPB. The form of Change of Personal Particulars of CMPs can be obtained from the Secretariat of the CMCHK 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 of the CMCHK 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
Telephone number: (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