peter conway the herbalist
Herbal Medicine in Crisis: the Government must act NOW to protect patients
People are often surprised to hear that herbal medicine practitioners such as myself are not subject to statutory regulation (the “statutory” bit is really important as we will see). This type of regulation would mean that only those who have followed a course of training approved and regulated by the Government would be entitled to call themselves a herbal practitioner. The current absence of such regulation means that anyone can pose as a herbalist if they so wish. This situation is unacceptable as it means that it is difficult for patients to recognise appropriately qualified herbal professionals and therefore exposes them to avoidable risk. It also means that if any harm arises from a herbal treatment the patient has no powerful state regulator to complain to, and there is no single central register from which a dangerous practitioner can be struck off.
I have been involved in campaigning for statutory regulation in order to improve standards in herbal practice and public protection for over 10 years, including sitting on Government committees investigating this issue.
It is now extremely urgent that the Government finally resolves to statutorily regulate herbal practitioners for another pressing reason.
In April 2011 a European law called the Traditional Herbal Medicinal Products Directive (THMPD) will be implemented. Although justifiably aimed at improving the scrutiny and quality of herbal medicinal products unfortunately its requirements are excessively stringent and expensive, to such an extent that a large number of herbal medicine suppliers have been unable to meet its requirements and consequently it now seems likely that huge numbers of currently available herbal products will be taken off the shelves and be made illegal in April THIS YEAR!
It is certainly the case that some herbal products currently freely available are of poor quality and it will be good to see these go. However, many products of excellent quality are also likely to disappear. One huge risk is that people will be forced to buy herbal remedies online and that some of these, completely unregulated, may be dangerous.
In my practice I only use suppliers who manufacture herbal medicines of the highest quality, most of these are produced to Good Manufacturing Practice standards (GMP – the standard that conventional pharmaceuticals are produced to). Most of my suppliers are relatively small firms however, with nothing remotely like the resources of pharmaceutical companies, and some of them will not be able to meet the costs of the THMPD – even though they currently produce excellent quality herbal medicines. An additional problem is that some of the products they make, and on which my patients rely, will be ineligible for consideration for licensing because they fall outside of the narrow limits set by the THMPD.
All this adds up to posing a huge threat to the wellbeing of patients who rely upon herbal medicine. BUT! there is a solution that you can help bring about.
If herbal practitioners are awarded statutory regulation then we will be recognised as “authorised health professionals” under the main EU medicines directive and will consequently be able to continue to access the full range of herbal medicines. This will mean that herbal patients will continue to be able to be prescribed the herbal medicines upon which they depend and that high quality specialist herbal suppliers will be able to stay in business.
If you value access to professionally prescribed herbal medicine then please read on to discover how you can help to protect your right to choose the type of medicine you want.
The Government are due to decide on the nature of regulation that herbalists should be subjected to very soon – perhaps as soon as the end of January and certainly before April. Any regulation that is not “statutory” will be meaningless and will not protect access to a full range of high quality herbal medicines. The Department of Health’s own investigation (6) recommended that herbalists should be statutorily regulated by the Health Professions Council (HPC) and the HPC has written to the Secretary of State for Health saying it is ready to undertake this initiative as soon as the Government gives the go-ahead. SO WHAT EXACTLY IS THE PROBLEM? Please write URGENTLY to your MP and additionally to the people below to ask that the government act NOW to statutorily regulate herbal practitioners.
Find your MP by clicking here.
Please also write to:
Mark Prisk MP
Minister of State
Department of Business, Innovation & Skills
1 Victoria Street
London SW1H 0ET
Anne Milton MP
Parliamentary Under Secretary of State (Public Health)
Richmond House
79 Whitehall
London
SW1A 2NS
TOGETHER WE CAN SAFEGUARD YOUR RIGHT TO OBTAIN THE HERBAL MEDICINES YOU WANT
THANK YOU FOR YOUR SUPPORT
Further Detailed Background Information:
In 2000 the House of Lords Select Committee for Science & Technology Report on Complementary and Alternative Medicine (1) recommended that herbal medicine practitioners should become statutorily regulated and the Labour Government accepted the Committee’s advice (2).
In the ten years since the House of Lords Report was published a number of other reports have been published which have influenced the progress of the herbal profession towards achieving statutory regulation, including the Herbal Medicine Regulatory Working Group Report of 2003 (3). Following these reports a series of delays in progress occurred as herbal practitioners were asked by the Department of Health to await the outcomes of broader reports which might influence health care regulation policy more widely. Most notable amongst these latter documents are the White Paper Trust, Assurance and Safety: the Regulation of Health Professionals in the 21st Century (4) and the Report of the Working Group on Extending Professional Regulation (5).
In 2008 the Government conducted a further investigation into the regulation of herbalists (by a committee on which I sat) and published its report (6), which recommended that herbal medicine practitioners should be statutorily regulated. This report went out to public consultation but neither the previous Labour, nor the current coalition Government have published the results of that consultation.
Over the course of the last decade a major issue has arisen which has influenced the need for statutory regulation for herbal practitioners. This has to do with the Traditional Herbal Medicinal Products Directive, which will be enforced from April 2011. From that date, if herbal practitioners are not statutorily regulated, we will lose the right to access many of the herbal products that we currently prescribe. This situation will prove disastrous not only for herbal practitioners but more importantly for the many patients who depend on herbal medicine to support their health, the businesses that supply herbal practitioners with products and the many students currently studying for herbal medicine BSc Honours degrees at UK Universities.
In the light of the above there is real urgency in the need for herbal practitioners to obtain statutory regulation in order to ensure the future of this most ancient profession so that patients and the public can continue to exercise their health care choices and access the medicines they rely upon.
It is important to be clear about the story so far:
2000 – House of Lords Report recommends statutory regulation for herbal medicine and acupuncture
2001 – The Government Response accepts this recommendation
2003 – Herbal Medicine Working Group Report published
2004 – Department of Health Consultation on the Working Group Report shows widespread public and professional support for statutory regulation
2005 – Department of Health publishes its report on the Consultation and says that it expects to publish a draft Section 60 Order enabling statutory regulation for consultation later that year
2005 - 2008 Delays in progress justified by the Department of Health on the basis that we are to await the results of other reports that may impact on the regulation of acupuncture and herbal medicine
2008 – The Steering Group (Pittilo) Report is published recommending statutory regulation. The public consultation on this has never been published
2010 – The Labour Government renege on their decade-old promise to statutorily regulate herbal medicine, instead saying they are “minded” to voluntarily regulate. The new coalition Government are not bound by what Labour were “minded” to do and review the situation
It can be easily seen from the above that the Labour Government promised statutory regulation in 2000, then took five years to produce a report, consult on it and organise an action plan for providing statutory regulation. They then failed to deliver the Section 60 Order that was promised and then spent another five years subjecting the herbal profession to unnecessary delays.
The Department of Health and the Government under Labour were inconsistent and laggardly in their handling of this process.
Despite the above, the herbal profession has been very patient and highly co-operative and constructive in working with the Department of Health and the Government over the last decade. I now hope that the coalition Government will make the choice that is evidently the one which will be most in the public interest – namely to statutorily regulate herbalists as rapidly as the legislative process will allow but certainly before April 2011.
Response to critics of herbal statutory regulation:
The Report of the Working Group on Extending Professional Regulation (5) stated that:
“The primary purpose of regulation is to secure safe, effective, high quality, and respectful care for the individuals who depend on health care staff for their health and well-being.”
Some ideological opponents of the regulation of any of the so-called “complementary and alternative medicine” (CAM) professions maintain that statutory regulation amounts to a form of state approval or official legitimisation of practices that these opponents consider to be in some manner inherently illegitimate. This is an erroneous assertion and should not be allowed to obstruct statutory regulation to be enacted in line with its true purpose of providing public protection. The Report of the Working Group on Extending Professional Regulation advised that:
“When considering all the factors at play that drive professional and occupational groups to seek regulation the Working Group recommends that safety of patients and the public, as well as enhancing effective, high quality, and respectful care, are the legitimate benefits to be considered in assessing whether to extend professional and occupational regulation. The Working Group felt that respect, respectability, status and legitimacy was earned from the public rather than conferred by statutory regulation…”
Over the course of the decade since the House of Lords Report on Complementary and Alternative Medicine (1) and the Government Response (2) to it, it has become fashionable in some quarters to attack CAM as part of an ideological assault on forces that are seen to be “anti-science” or “anti-rational.” This is, paradoxically, a non-scientific and non-rational position. “CAM” is not a unified movement but a label applied to a complex social phenomenon, which encompasses a heterogeneous group of practices. Although notionally a “CAM” practice, herbal medicine has a rational pharmacological basis and a surprisingly large scientific evidence base when one allows for the fact that it has until very recently existed outside of formal educational and research-linked institutions, and that it continues to validate itself without recourse to the huge financial resources that are available to mainstream medicine and generated by pharmaceutical companies.
References:
1.House of Lords Select Committee on Science and Technology, 2000. Complementary and Alternative Medicine. The Stationery Office.
2.Department of Health, 2001. Government Response To The House Of Lords Select Committee On Science And Technology’s Report On Complementary And Alternative Medicine. The Stationery Office.
3.Herbal Medicine Regulatory Working Group (Department of Health/ Foundation for Integrated Health/ European Herbal Practitioners Association). 2003. Recommendations on the regulation of herbal practitioners in the UK. Foundation for Integrated Health.
4.Secretary of State for Health. 2007. Trust, Assurance and Safety: the Regulation of Health Professionals in the 21st Century. The Stationery Office.
5.Department of Health. 2009. Extending Professional and Occupational regulation: Report of the Working Group on Extending Professional Regulation. DH Website.
6.Department of Health. 2008. A joint consultation on the Report to Ministers from the DH Steering Group on the Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and Other Traditional Medicine Systems Practised in the UK. Robert Gordon University.
PRESS RLEASE FROM THE EUROPEAN HERBAL AND TRADITIONAL MEDICINE PRACTITIONERS ASSOCIATION: 17TH JANUARY 2010
Herbal Practice on the Brink
It’s just 100 days before UK herbal practice goes into meltdown and patients lose access to a broad range of herbal remedies available for over forty years. This is a real threat because the Government has singularly failed to honour an undertaking given ten years ago to extend statutory regulation to herbal practitioners. Statutory regulation of this sector has had unequivocal backing from the House of Lords’ Science and Technology Committee as well as two Department of Health Committees. Now scores of herbal suppliers and practitioners will be put out of business because EU legislation at the end of April will deny herbalists and their patients access to herbal products from third party suppliers. On the other hand, statutory regulation for herbalists will allow them to be considered “authorised health professionals” under the main EU medicines Directive and thus be able to continue to access the full range of herbal medicines from next May onwards.
Statutory regulation needs to be robust and delivered through an experienced regulator such as the Health Professions Council. Terms bandied about like “light touch regulation” disguise the fact that any other solution (e.g. regulation via the Complementary and Natural Healthcare Council) will fail to provide necessary public protection. The DH Committee that looked at regulation of the herbal sector rejected all other plans for regulation of herbalists other than via the Health Professions Council and the HPC has written to the Secretary of State for Health saying it is ready to undertake this initiative as soon as the Government gives the go-ahead.
Michael McIntyre, Chair of the European Herbal and Traditional Medicine Practitioners Association said “Ministers should act without further delay to regulate herbal medicine practitioners via the Health Professions Council. They should ignore calls from self- interested factions of the scientific community that seek to block this vital legislation as this is clearly not in patients’ interests.”
Sunday, 16 January 2011