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, matters related to renewal of practising certificates and 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 a view to facilitating CME for CMPs, the CMPB has published the Newsletter and arranged for a quiz on the practice of Chinese medicine to be featured in every December issue. CMPs are invited to answer the questions and earn CME points. Since the first publication of the CME Quiz in late 2011, the support and responses from registered CMPs have been overwhelming and encouraging. By reading the Newsletter, CMPs 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 registered CMPs is most welcome.
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 in a timely manner.
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 standards on prescribing medicines, reporting court convictions to the CMPB, and issuance of sick leave certificates etc. This issue also includes the number of disciplinary cases in 2017 for the attention of all CMPs.
Information about the research results of "Identification of Easily Confused Species of Chinese Materia Medica in Hong Kong by Macroscopic and Microscopic Characteristics Project", "Promotion of Traditional Chinese Medicine in China - Hong Kong Programme" and "Elderly Health Care Voucher Scheme" are also provided in this issue. Further details can be found in the following pages.On behalf of the CMPB, may I wish all CMPs all the best and good health in the coming year.
Ms WONG Yu-yeuk
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.
The Clinical Examination of the 2018 CMPs Licensing Examination was conducted in August 2018. A total of 794 candidates attended the Clinical Examination, of which 302 candidates (38%) passed the Clinical Examination.
The Written Examination and the Clinical Examination of the 2019 CMPs Licensing Examination will be conducted in June and August 2019 respectively. The application period for non-listed CMP persons started on 17 September and ended on 31 October 2018, whereas the deadline for submitting applications for listed CMPs and repeaters is 29 March 2019. The CMPB has notified all qualified listed CMPs by mail the enrollment period for taking the examination.
As at 15 November 2018, there were 7,407 registered CMPs, 37 CMPs with limited registration and 2,610 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 16 July to 15 November 2018, 1,117 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.
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.
The CME system has been implemented since 28 February 2005. Six CME reviews were conducted in end 2005 and 2006, early 2009, 2012, 2015 and 2018 respectively. The report period of the sixth review was from 1 January 2015 to 31 December 2017 (36 months in total). The CMPB has completed the sixth review and review results are enclosed in Appendix I.
With a view to encouraging CMPs to read the Newsletter and facilitating CME for CMPs, the CMPB has arranged for a Quiz with ten questions on the practice of Chinese medicine to be featured in every December issue for CMPs to participate and earn CME points. These ten questions are based on the content of Issue 48 to 50 in 2018.
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 2018 is attached at Appendix II 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 15 February 2019. 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).
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 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: Room 2201, 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 July to 15 November 2018 on one registered CMP and one listed CMP who were convicted of offences punishable with imprisonment and/or alleged breaching the Codes. The registered CMP and listed CMP were found guilty after inquiries. Upon inquiry, the CMPB warned and removed the name of one registered CMP for 3 months but with a suspension of 24 months. In addition, the CMPB put the decision for one listed CMP on record for future reference.
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.
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 the prescriptions were found against the principle by which medicines are combined or compatibility of Chinese medicine principle or a CMP prescribes inappropriately with excessive dosages or excessive number of medicines without referring to any therapeutic principles, treatment methods, treatment priorities, the treatment of patients would be adversely affected. If the CMPB considers a CMP has not provided adequate treatment to his patients according to their medical conditions or 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 and the CMPB will take disciplinary actions in accordance with the Codes.
Furthermore, all CMPs must make safety their first priority in prescribing medicines especially when toxic Chinese herbal medicines are prescribed. 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. 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.
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.elegislation.gov.hk/eng/index.htm). If any listed CMP is found for prescribing Chinese herbal medicines specified in Schedule 1, the CMPB will process the case seriously.
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.
Issuance of sick leave certificates
Registered CMPs are medical professionals with legal status. Sick leave certificates issued by registered CMPs are legally recognised under the Employment Ordinance, which was amended in the end of 2006. The CMPB has compiled "Reference Guide on the Issuance of Sick Leave Certificates by Registered CMPs" (the Guide), which includes diseases commonly encountered by CMPs in Hong Kong and the respective recommended number of days of sick leave, and acts as a general reference for registered CMPs on the issuance of sick leave to be fallen into reasonable standards of conduct expected among their professional colleagues. CMPs should issue appropriate sick leave certificates on the basis of their personal professional judgment and the particular circumstances of individual patients. If any discrepancy between an issued sick leave certificate and the Guide that leads to a complaint against a registered CMP, the registered CMP concerned has the responsibility to explain how he/she has exercised professional judgment in issuing the respective sick leave certificate and the relevant circumstances.
The CMPB reminds all CMPs not to issue professional documents or certificates which are untruthful or misleading when issuing sick leave certificates and receipts of consultation fees; otherwise, the CMPB shall handle the case strictly in accordance with the disciplinary procedures specified under the CMO.
In 2017, a total of 161 disciplinary cases were received by the CMPB, the details of the disciplinary figures are listed as follow:
The CMPB held 15 inquiries in 2017 in accordance with sections 91 and 98 of CMO, involving 14 CMPs. The outcomes of the inquiries are as follow:
Chinese Materia Medica ("CMM") sold in Hong Kong are sometimes confused with species of another, generally because of their similarity in appearances, names, etc. Such confusion in CMM may affect their efficacy and even cause adverse reactions. Based on the current market conditions and the advancements in identification technology, the Government Chinese Medicines Testing Institute ("GCMTI") commenced a research titled "Identification of Easily Confused Species of CMM in Hong Kong by Macroscopic and Microscopic Characteristics Project" ("the Research ") in early 2018. The Research endeavours to strengthen the trade and the public’s ability to differentiate CMM species, to ensure the safety and quality of Chinese medicines, and to promote the development of the Chinese medicines testing and certification sector as well as the international trade in Chinese medicines.
The Research has been examined and endorsed by the Advisory Committee of the GCMTI and the Chinese Herbal Medicines Task Force. The selection of CMM species into the Research will be performed according to the suggestions of the industry and the actual market situation, followed by the publication of such results by phases in form of monographs. The first module of results was released on 19 July 2018, covering the following CMM:
The 3 main characteristics of the Research are:
In parallel to the release of the first module of results, we have organised related publicity and educational activities for CMPs, Chinese medicine traders, research and testing institutions, as well as staff of the Hospital Authority Tripartite Chinese Medicine Centre for Training and Research.
Among these activities, the Sharing Session on "Identification of Easily Confused Species of CMM in Hong Kong by Macroscopic and Microscopic Characteristics" was an accredited CME programme for registered CMPs. Besides the sharing of research contents by an expert during this sharing session, there was a concurrent workshop in which participants took part to learn differentiating the easily confused species of CMM from one another. Below are the highlights of the activities:
Sharing Session on "Identification of Easily Confused Species of CMM in Hong Kong by Macroscopic and Microscopic Characteristics"
Sharing Session on "CMM Testing Technologies"
Exchange Session cum Training Class on "CMM Authentication and Testing Technologies"
The GCMTI will continue releasing results to the public and organising publicity and educational activities in relation with the Research. For information on the 5 pairs of CMM in the first module, please scan the QR codes below or visit the following websites:
Promotion of Traditional Chinese Medicine in China, with the theme of promoting Chinese medicine health culture and enhancing public health literacy, is a nation-wide touring campaign initiated by some 20 Mainland government bodies including the National Administration of Traditional Chinese Medicine ("NATCM") to promote the popularization of scientific use of traditional Chinese medicine. As one of the stops in the tour, Hong Kong launched the Hong Kong Programme on 25 October 2018. The Hong Kong Programme was jointly organised by the NATCM, the Food and Health Bureau ("FHB") and the Department of Health ("DH"), aiming to increase public understanding of Chinese medicine and promote its wider use in the community.
The Hong Kong Programme was kicked off in a launching ceremony officiated by Professor Yu Yanhong, the Party Group Member of the National Health Commission cum Party Secretary and Vice Commissioner of the NATCM; Professor Tan Tieniu, the Deputy Director of the Liaison Office of the Central People’s Government in the HKSAR; Ms Elizabeth Tse, the Permanent Secretary for Food and Health (Health); Dr Constance Chan, the Director of Health; Mr Xu Qingfeng, the Director of the Traditional Chinese Medicine Bureau of Guangdong Province; and Professor Lee Chack-fan, the Chairman of the CMCHK, with as many as 770 people attended the ceremony. The Hong Kong Registered Chinese Medicine Practitioners Association provided free Chinese medicine consultation services on the spot, benefiting over 150 citizens. The next day after the ceremony (i.e. 26 October 2018), the FHB signed a co-operation agreement on Chinese medicine with the NATCM to further promote the development of Chinese medicine in the two places.
Subsequently, 47 Chinese medicine-related organisations actively supported the programme by organising nearly 100 events with over 200 sessions in various districts in Hong Kong within a period of 2 months or so to promote the popularization of scientific use of traditional Chinese medicine. The programme ended on 31 December 2018.
Guests officiating the launching ceremony of Promotion of Traditional Chinese Medicine in China - Hong Kong Programme
Group photo at the launching ceremony of Promotion of Traditional Chinese Medicine in China - Hong Kong Programme
The Elderly Health Care Voucher ("EHV") Scheme was launched in 2009 to subsidise eligible elderly persons to use private primary healthcare services in the private sector, including Chinese medicine services. As of the end of September 2018, nearly 2,700 registered CMPs have enrolled in the EHV Scheme and over 1.13 million eligible elders (accounting for about 90% of the total eligible elderly population) have used EHVs.
Although the procedures for making voucher claims for elders are simple, the enrolled CMPs must pay attention to the requirements of the EHV Scheme, e.g. elders must receive the healthcare services provided by the enrolled CMPs in person before they can use their vouchers to settle the fees. EHVs can neither be used for pre-paid healthcare services nor for the sole purchase of products such as health products, dried seafood, etc. Otherwise, the voucher claims will not be reimbursed by the Government or the CMPs concerned will be disqualified from participating in the EHV Scheme.
Besides, the enrolled CMPs are responsible for the safekeeping of the authentication token for accessing the eHealth System (Subsidies). While they can delegate staff in their medical organisations to enter the data to make voucher claims through "Data Entry Accounts" on their behalf, they are still liable for all the claims made under their "Enrolled Health Care Provider Accounts". It is therefore in the enrolled CMPs’ own best interests to neither allow other persons to use their "Enrolled Health Care Provider Accounts" nor their authentication token for accessing the eHealth System (Subsidies) to make voucher claims for healthcare services which they have not provided or are not professionally responsible for.
For details of the EHV Scheme, examples of improper voucher claims and the advices provided by the DH, please refer to the leaflet (Appendix IV) as enclosed to this issue. In case of any enquiry on the EHV scheme, please contact the Health Care Voucher Unit of the DH at 3582 4102.
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 CMPB. 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 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: email@example.com
Service Hours: Monday to Friday: 9:00 am to 5:30 pm
Closed on Saturdays, Sundays and Public Holidays