I was recently doing some routine housekeeping on my computer when I came across these two files from 13 and 12 years ago – and having copied them to the Herbarium team for interest, was asked to post them here, along with some explanatory notes.
During 2001 Michael McIntyre, Chair of the European Herbal Practitioner Association (EHPA), had fronted a series of regional meetings called the ‘EHPA Roadshow’ – to promote the notion of Statutory Self Regulation (SSR) to herbal practitioners, mostly members of the National Institute of Medical Herbalists (NIMH). There were subsequent complaints to the NIMH Council that its members felt they were simply being lectured – there was no balance of arguments and little opportunity for open discussion. With some reticence, NIMH Council organised a meeting in London in December 2001 to address this problem. I say ‘reticence’ advisedly – the event was notified to NIMH members with only a few days notice, the date and venue but no time was given, and thankfully the attempts by ‘Michael and his team’ to stage-manage the proceedings were successfully countered. Subsequently NIMH disowned the event, declaring that it was not an ‘official’ NIMH meeting: both the audio-tape and the Hon. Gen. Sec’s written minutes went missing, and it was never reported to the NIMH membership. Therefore you will have to rely on my own recall of the occasion. About sixty practitioners and students attended: speaking for SSR were Michael McIntyre, Andrew Chevallier and Alison Denham (NIMH president) – in opposition, Christopher Hedley, Susan Allshorn, Susan Tosoni and myself. This took up most of the morning, the afternoon being devoted to an open discussion from the floor.
I believe this was the only occasion that SSR (now simply SR) was ever properly debated, and it’s not surprising that the outcome embarrassed the EHPA (now EHTPA) as the majority of those attending held against regulation. Below is a transcript of my own submission to the meeting. What fascinated both myself and my peers was to see how little has changed in terms of argument or context in the ensuing years.
‘First and foremost, I’m here to represent the interests of Carol’s & my patients – and they do not want us to be registered!
We live and work in the middle of what are officially the three worst Health Authorities in the country and most of our patients, (we calculate about 70%), have been injured, betrayed or simply abandoned by state-controlled medicine. Part of their choice in coming to see us is for the very reason that we are not controlled by the state.
They don’t want us to be hobbled by bureaucracy, they don’t want us to become more expensive, they don’t want any more tampering with our materia medica or our freedom to make medicines for them, they don’t want our good work to be meddled with in any respect – they just want us to be left alone to get on with treating them in the fashion they have come to love and trust.
So this is a human rights issue, relating to freedom of choice, and it’s a good and just choice, because like all our colleagues we do a great deal of good, but never any harm.
However, this principle of freedom of choice extends beyond our relationship with our patients. Herbal Medicine is the indigenous traditional healing system of the British Isles – the Folk Medicine, the medicine of the people. The National Institute of Medical Herbalists is not that tradition, nor even is professional herbal medicine at large – we’re just a part of it.
Herbal medicine happens on many other levels between ourselves and basic home self-help. Good professionals have always nurtured, supported and taught to all these other levels – but now we’re seemingly set on a course that will destroy much of the rest.
Seven years ago we stood hand in hand with our patients and the public to protest against legislation that would have removed a huge raft of herbal remedies from public access – and between us we won the day – in fact, my information is that we broke the British public’s lobbying record in doing so.
Now it seems that part of the SSR package is to nominate a great many herbs for “practitioner use only” – once again denying the public a freedom of choice. They will most certainly campaign again, but this time I’m expected to stand in opposition to them. That, I’m afraid, I cannot do.
We also have to consider the freedom of choice of future generations. I don’t know how long the Empire of the Capitalist West can sustain itself, but it’s already shown itself to be vulnerable and one day, (if we have learnt anything from history), fall it certainly will. Quite what use are we going to be then – if we have developed our own grinding bureaucracy, have all but merged with the orthodox model and become dependent on the phytopharmaceutical industry?
Carol & I are truly blessed to have the resources to grow and make most of our own medicines, and through this we can give witness to the fact that you could all but cut our practice off from the outside world and our patients would hardly notice the difference. Herbal Medicine’s great and enduring strength is that it can function to a high degree of sophistication on spectacularly low technology. Of course, Carol & I are not the only custodians of this priceless knowledge and together we are all determined to protect it and keep it safe, come what may. Where your own personal choices regarding SSR are concerned, you’re going to have to decide which way to go – to remain part of this timeless tradition, or to try something dangerously different – surely it must be clear that you can’t do both.
I just used the term, “personal choice”, and advisedly. Many of you may not have realised that although the Institute has been a key player in the move towards SSR, when it comes to registration each and every one of you will be applying to be registered personally. So where we put our hands up at Institute AGMs and the like, we may have some small influence on the process – but ultimately each of us has our own very private decision to make – do I want to be a state-controlled herbalist or not? I believe that if the answer is not, then no harm will come to you, because our patients and the public will defend you – as indeed I believe your own professional body should, SSR or no SSR.
Short of a miracle – and that miracle will have to start happening here today – Carol & I will be leaving the Institute shortly – it would be hypocritical to remain part of an organisation that continues to act contrary to our own fundamental principles.
But of course we’re concerned for the fate of herbal medicine as a whole – and we’re convinced that what we have here is already a runaway train careering towards disaster. SSR is too expensive and herbal medicine is too humble and too diverse. We’re also ignoring the fact that herbalists are by nature people who choose freedom – we don’t like being organised. But if we turn aside from SSR at the eleventh hour, (or heaven forbid the thirteenth hour when our registration papers arrive and we don’t fill them in), then disaster it will be.
Meanwhile, right now, herbalists out there are suffering – they’re not doing well and their plight is in great part due to neglect of their real needs by their own professional body. We’re also pouring out graduates from the various universities to get the numbers up, but again, we’re doing precious little to help them gain a living either. Instead all we have is the fond hope that once we’re registered, doctors will find work for us. You must be joking!
I’d like to reiterate that the last four speakers [opposing SSR] have elected to speak more briefly than we were invited to so that this meeting can be something that we’ve never had since the term SSR was first heard – a consultation with you, the present and future membership of the Institute, to find out what you think about it all.
By all means ask questions, but don’t accept any politician’s answers. There is clearly great unrest, which I think arises from the sense that our political helm is not representing our interests to the state, but are instead representing the interests of the state to us. We want answers to questions, but if Michael and his team can’t provide them, perhaps it’s not too late for us to start providing answers ourselves.
So an even greater priority is for us to place a hand on the reins and express openly what we do and don’t want from SSR, what we are prepared to sacrifice, what must not be sacrificed at any cost, and what we hope to gain – which so far as I can make out, is too little to even consider. If you don’t take courage and grasp the nettle now, there may never be another opportunity.
Good luck to you all, and thank you for listening so patiently. Now it’s over to you.’
Despite the clear message of dissent voiced at this meeting, it was ruthlessly ignored, so a few months later in the spring of 2002, (and in the midst of a great deal of unpleasantness), Carol and I did indeed leave NIMH. However, to our surprise, the editor of ‘Herbal Thymes’ (NIMH’s own internal newsletter) accepted and published this article from us in the February edition: -
WHY YOU SHOULD SAY ‘NO’ TO SSR
Carol & I informed the Council of the Institute earlier this year that we would not be submitting to SSR and therefore must expect to leave the Institute shortly. We thought we were a voice in the wilderness when everybody else was in favour, or at least accepting of its inevitability. We’ve learnt a lot since then. We’ve found ourselves in surprisingly good company. If we’re used to being blanketed with motivational rhetoric from the Institute’s pro-SSR core then at least the present Council acknowledges the need for more information and a fair balance of opinion if we are all to be properly informed. In particular, we’ve found a culture of fear, based on the main political platform of SSR – that we must do or be done unto, and our only hope is to hide behind the skirts of the bullies. SSR is not inevitable. If there are enough people who really want it with their hearts, why should they not – but we can and must still insist on a safe haven for the tradition of herbal medicine. Clearly two heads cannot sit on the same shoulders. Here are some reasons why:-
What’s wrong with SSR?
Firstly, the ‘self regulation’ bit is just a smoke-screen – it’s ‘statutory’ that counts, and beware! Our understanding is that you will only be voting for a General Herbal Council to be set up – it will decide what it’s going to do later when we’ll have precious little influence. Herbalists will apparently not be in the majority on this Council, and the rest, the so-called ‘lay representation’ will be government appointees. So despite all the fine words, we’re looking at state registration & state control.
Why on earth should we choose to submit to state control at a time when the state concerned is so manifestly out of control? Why should we become part of a process that one senior NHS worker referred to as ‘another example of re-arranging the deck chairs on the Titanic?’ Why, instead of the dream of ‘free herbal medicine for all’ are we willing to accept punitive charges for the privilege of being registered? It’s our patients who will inevitably foot the bill.
Read any newspaper these days for increasing evidence that state registered medicine is not a guarantee of safe & ethical practice – whilst the Institute’s own matchless record will be sacrificed. Moving ever-closer to the orthodox model may amuse allopaths & academics but will not improve our effectiveness in practice. The promises of more doctor referrals or jobs within the NHS are ridiculous – such is their disappointment in this respect that Osteopaths are de-registering in droves – and allopaths feel even less kindly disposed towards herbal medicine!
The Principle of Freedom
As in most parts of the world herbal medicine is the indigenous traditional healing system of the British Isles – the folk medicine, the medicine of the people. Over the centuries we’ve proved particularly good at resisting attempts to persecute, hamper and legislate herbal medicine because ordinary people will fight for their innate right to reach out and pluck a plant for their nourishment and healing – and to seek sources of supply and the advice of experts if needs be.
Herbal medicine is practised at a continuum of levels from the humblest home self-help to the headiest heights of professional practice. Good practitioners have always nurtured and supported these different levels – and yet an inevitable consequence of state control is that much of the middle ground will be lost. Isn’t it telling that the only ‘perk’ of SSR on offer to date is that there will be more practitioner-only herbal remedies!
The key issue is not to do with the profession, or the state, or even the general public, but our patients. Freedom of choice! A substantial proportion of our patients have been injured, betrayed or abandoned by state-controlled medicine (or for other reasons are simply mistrustful of it) and a powerful motive for seeking our help is that we are not state-controlled. Ultimately everything we have solemnly sworn to is for the benefit of our patients – are we to abandon or betray them ourselves?
What’s the alternative?
One of the curiosities is that traditional herbal medicine, real herbal medicine is in amazing good shape at the moment. With the growing availability of organics, the proliferation of small fresh-herb manufacturers and more in-house medicine making, we have herbal remedies of a quality unimaginable even a few years ago. We have been able to access global ideas and resources with ease and have been enriched by the experience. Our contact with other traditional healing systems and their (often oppressed) practitioners continues to grow, and we link these inextricably with the concepts of ethnobotany, ecology & conservation, for which we take increasing responsibility. Holism has progressed from theoretical re-invention to a well-practised and highly effective model in which intuitive techniques, the concepts of energetics and an insistence on the indivisibility of body/mind/spirit have become routine to our work. We are no longer frightened of magic. A folk tradition is not an antique artifact, it’s a living thing that adapts to and is sustained by the times it finds itself in. We and our patients have something to be proud of and we will not relinquish it gladly.
SSR was never inevitable – one of the prerequisites is that a “substantial majority” of us must be in favour (in Civil Service terms this usually means over 70%). That would be hard to achieve within the Institute, let alone amongst the other herbalist bodies. The question now is, having considered the full implications, will we turn aside from it in unity, or are we facing another of herbal medicine’s famous schisms? Either way, we have nothing to fear – as always, our patients and the public will protect themselves by protecting us if needs be.
A final thought: of late the world has been dominated not by western democracy but by western capitalism – and now the world economy is teetering on the brink of quite a precipice. In the face of such uncertainty gaining a top-heavy official structure, moving towards the allopathic model and increasing our dependency on the phytopharmaceutical industry sounds like entirely the wrong direction. Being the last drop of oil on a machine belching blue smoke is not a place in history to be savoured. Instead we must re-affirm herbal medicine’s unique value as a cheap and effective medical therapy that can function to a high degree of sophistication on remarkably low technology and with very little call on external structures or resources. Was there ever a greater need for the custodians of this extraordinary knowledge to keep its flame burning bright?
That is our determination, as we hope it may be yours.
Stephen & Carol Church
Looking back, some of the language has changed (professional bodies rather than professional associations, for instance), and there are a few technical differences between SSR and the current proposals for SR: but the main tenet of the principled objections could have been written yesterday. In point of fact, the current ‘big push’ to achieve state sanction dates back a further 10 years to 1991, and the arguments were just the same then.
All that the latest round of lobbying has achieved is an undertaking from the Department of Health that a new working group will be set up (a working party is the start of a process, not the end-game!) Meanwhile, copying the ‘herbalists exemption’ piecemeal from the 1968 Medicines Act to the new Human Medicines Regulations 2012 doesn’t give a signal that change is imminent. Do you see a pattern developing here? Any committee work, any new public consultations, will doubtless carry through past the next general election, when the whole thing will start from the bottom again, if anybody still has the stamina for it. Whatever fate befalls the EHTPA, NIMH will surely carry on – its own history of petitioning for official recognition is now in its 150th year.
If the context and the arguments have changed so little, the micro-environment of herbal medicine has changed quite a lot. The failed experiment of the BSc courses has come and largely gone again. Those manufacturers who opted to invest in pharmaceutical-style processes have not profited from it, or at least not from the practitioner market. For the PAs, their members probably account for less hours of herbal practice in the UK than at any other time in post-industrial history: the recession is blamed, rather than acknowledging the huge mistakes made, or the neglect of the real needs of their members for an entire generation. But the worst thing of all is the current political gambit of the pro-SR lobby, declaring that herbal medicine is inherently dangerous (on the grounds that only highly trained BSc graduates, subject to rigorous state control, can be trusted to handle this hazardous medium). This affects all of us, and it may take decades to restore public confidence.
To end on a positive note, there are not huge numbers around of the custodians of traditional herbal practice to which I referred 12 years ago, but they are able, busy and resilient, and there is plenty of fresh blood joining in. Then there is another unanticipated change – to which the Herbarium has contributed but is only a small part – the sudden expansion of the ‘middle ground’, (what PA members would no doubt dismiss scornfully as ‘lay practitioners’). This is a wonderfully colourful and expansive environment, proliferating through a huge network of personal blogs and websites. Whilst PAs and their executives still bleat on about standards, conformity and control, the middle ground, I am quite convinced, will provide the motive force for traditional herbal medicine’s future, and it is there, I would respectfully suggest, that anybody who loves it as I do should turn their attention.