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Britain To Tighten Laws On Herbal Medicine

by Gopalan on Apr 4 2010 9:24 AM

Britain is likely to crack down on shops and clinics selling herbal and Chinese medicine.

Health Secretary Andy Burnham has indicated that practitioners supplying unlicensed medicines may have to register with the Complementary and Natural Healthcare Council.

He stated - 'Emerging evidence clearly demonstrates that the public needs better protection, but in a way that is measured and does not place unreasonable extra burdens on practitioners.

'I am therefore minded to legislate to ensure that all practitioners supplying unlicensed herbal medicines to members of the public in England must be registered with the Complementary and Natural Healthcare Council (CNHC).

'I believe that the introduction of such a register will increase public protection, but without the full trappings of professional recognition which are applied to practitioners of orthodox healthcare.

'I will be considering the similar measures we need to put in place to afford an appropriate level of protection for people using acupuncture treatments.

'I will be discussing this with Ministers in Scotland, Wales and Northern Ireland, as the regulation of these groups is devolved and they are currently considering the consultation responses. A full joint response will be published in due course.'

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The Health Secretary also called on the NHS in England to take part in a pilot scheme to assess the feasibility and benefits of providing access to patients for certain forms of complementary and alternative medicine for the treatment of chronic low back pain.

Primary Care Trusts will be invited to participate in the pilot to help determine whether these therapies can be effectively integrated as part of NHS primary care management of these patients.      

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In consultation with their GP, patients will be able to choose their preferred therapy in line with NICE guidance on treatment of low back pain, which supports use of acupuncture and manual therapy for this condition.  

A recent observational study from Northern Ireland suggested that access to CAM not only improved patient wellbeing but also saved NHS costs through reduced consultations.

The pilot in England will be undertaken within the framework of a rigorous independent evaluation which will be led by the National Institute for Health Research (NIHR) National School for Primary Care Research and designed to deliver a high standard of evidence.  

Andy Burnham said:

'Low back pain affects 7 out of 10 people at some time in their lives. This pilot and its evaluation will provide us with good evidence about the benefits for patients and value to the NHS of extending the treatment choices available for the management of a disabling and costly condition.'

He has not yet decided whether to regulate acupuncture treatment.

Meantime The National Institute of Medical Herbalists is urging the Andy Burnham not to abandon Statutory Regulation of Herbal Medicine at any cost.

Referring to moves for a ‘light touch licensing’ scheme instead, NIMH President Jane Gray said: 

“I appeal to Andy Burnham to honour commitments made by the government over ten years that statutory regulation would go ahead.  Any other outcome will place the public at considerable risk.  Failure to properly regulate medical herbalist practitioners would represent an abdication of responsibility by the government, and by Mr Burnham’s department in particular.  This is because light touch just means a register with nothing else attached to it.  It is not regulation in any sense as it implies no standards of education, continuing professional development, ethics, disciplinary process etc.”

NIMH is a member association of the European Herbal and Traditional medicine Practitioners Association (EHTPA) which has produced a joint statement on the circulating rumours:

“Two rumours that have come to the attention of EHTPA which have given cause for concern.

The first is the suggestion that herbal practitioners are against statutory regulation. This is completely unfounded. The professional associations within the EHTPA solidly support statutory regulation. There are a very small number of herbalists who oppose statutory regulation and have initiated petitions and writing campaigns that have almost exclusively been supported by members of the public (not herbal practitioners) who oppose statutory regulation in principle since they believe (mistakenly) that this will reduce their access to the herbs they currently enjoy. The opposite is actually true - statutory regulation is the only means by which the public can continue to access the herbal medicines they depend upon to support their health.

The second rumour is that Secretary of State Andy Burnham is considering abandoning statutory regulation in favour of a "light touch licensing scheme". Such a decision would be disastrous for herbal medicine users and for herbal practitioners. Only statutory regulation can achieve the following goals:

Provide a high level of public protection by raising standards in herbal practitioner education and practice and by making practitioners fully accountable for their actions
Protect the title of "herbalist" so that the public are able to identify bona fide practitioners
Provide a credible register of herbal practitioners
Establish herbal practitioners as "authorised healthcare professionals" so that they can continue to access a full range of herbal medicine products following the introduction of the Traditional Herbal Medicinal Products Directive (THMPD) in 2011. Failure to achieve this status would reduce public access to herbal products on which their health depends, threaten the viability of herbal manufacturers and herbal practices and give the Medicines and Healthcare products Regulatory Agency (MHRA) an almighty problem in trying to devise a new form of herbal medicines regulation in the UK to deal with the crisis that would result from failure to statutorily regulate
Achieve parity between herbal practitioners and other complementary and alternative medicine (CAM) practitioners who are currently statutorily regulated (osteopaths and chiropractors). Failure to statutorily regulate would create a two-tier system where some CAM practitioners are statutorily regulated whilst others are not. Such a situation cannot be justified and would only serve to confuse the public and undermine their confidence in a "light touch licensing scheme"
Ensure that ethnic groups in the UK who rely upon traditional medicine practices such as Chinese Herbal Medicine continue to have access to the healthcare option of their choice

A "light touch licensing scheme" will not achieve these goals and is therefore totally inappropriate. The inadequacy of such a scheme should be particularly clear in the light of the recent tragic case of a patient who developed renal cancer after taking a herbal medicine product containing aristolochic acids - only statutory regulation would have prevented this case.

Regulators recently issued warnings about herbal products containing aristolochia, a banned toxic and carcinogenic plant derivative. Packs of the herbal medicine Jingzhi Kesou Tan Chuan Wan are thought to be circulating despite a recall by the distributor.

Edzard Ernst, Professor of Complementary Medicine at the University of Exeter’s Peninsula Medical School, said that he had some concerns about the proposals. “All healthcare professionals regulated in the UK have the proviso that they administer evidence-based medicine. If there is an exemption for those providing herbal medicines it would set a double standard that could be very detrimental.”

Even otherwise there is another problem facing traditional medicine practitioners. From April 2011, a new EU law will mean that even fully qualified Chinese medicine practitioners will lose access to the majority of the herbs and medicines on which they rely. Many herbs and medicines will only be available to industrial medical professionals who are regulated by the government, such as GPs. Many practitioners will go out of business, and many patients will not be able to receive the treatment that they need. The government can prevent this by granting statutory regulation to Chinese medicine practitioners.



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