Since the publication of the Department of Health (DH) consultation document on statutory regulation (SR) on 3 August 2009 a number of practitioners of traditional western herbal medicine have been gripped by, what can be best described as, regulation hysteria. A pro-SR demonstration was held outside the Houses of Parliament, letters demanding SR have been fired off to MPs, and an article entitled ‘Herbal drug crackdown: Millions face having to buy remedies on black market as Europe tightens the rules’ recently appeared in the Daily Mail. The European Herbal and Traditional Medicine Practitioners Association (EHTPA) and its members are offering herbalists a stark choice: get behind SR or face oblivion from European legislation! But is herbal medicine really on brink? Below we attempt to separate fact from fiction (with a little help from the MHRA).
Fiction: Unless SR is implemented by 2011, section 12(1) of the Medicines Act 1968 will be superseded by the Traditional Herbal Medicinal Products Directive (THMPD) and European medicines legislation, effectively banning the practise of herbal medicine in the UK.
Fact: Section 12(1) of the Medicines Act 1968 remains available to herbalists in the UK beyond 2011, whether SR is implemented or not.
In an email (dated 6 November 2009), Richard Woodfield of the MHRA clearly stated that beyond 2011 ‘the s12(1) exemption [will remain] available where herbal practitioners are carrying out activity in accordance with the terms of that exemption.’
What exactly are the terms of the section 12(1) exemption? The exemption appears in statute in the following form:
’12. Exemptions in respect of herbal remedies
(1) The restrictions imposed by sections 7 and 8 [Licences and Certificates relating to Medicinal Products] of this Act do not apply to the sale, supply, manufacture or assembly of any herbal remedy in the course of a business where—
(a) the remedy is manufactured or assembled on premises of which the person carrying on the business is the occupier and which he is able to close so as to exclude the public, and
(b) the person carrying on the business sells or supplies the remedy for administration to a particular person after being requested by or on behalf of that person and in that person’s presence to use his own judgment as to the treatment required.’
In 2011, only section 12(2) of the Medicines Act 1968 will be replaced by the THMPD. Mr Woodfield picks up the story… ‘[H]istorically, OTC unlicensed herbal remedies supplied under the s12(2) exemption in the Medicines Act 1968 were regarded as non industrially produced – and hence not required to comply with European medicines legislation. However, with the advent of the European Directive on traditional herbal medicinal products [the THMPD] which provides a suitable regulatory home for OTC manufactured traditional herbal medicines, MHRA is switching its interpretation position to regard typical manufactured herbal medicines as being industrially produced. Whether a product is supplied for retail or for supply via practitioners does not affect whether it is viewed as industrially produced.’
Fiction: Unless SR is implemented by 2011, section 12(1) herbalists would not have access to unlicensed herbal medicines. Only registered/licensed herbal medicines or homemade remedies would be available to their patients.
Fact: Section 12(1) herbalists can continue to access unlicensed herbal medicines from their UK suppliers whether SR is implemented or not.
Richard Woodfield has confirmed the following to be accurate, ‘If a supplier is supplying ingredients for a herbal practitioner to prepare, e.g. blending into s12(1) remedies, this doesn’t require the supplier to have THR/MA [a registration or licence] for the product. [I]t is well known that many herbalists will buy in stocks e.g. of bulk tinctures and use them as [start-up] materials/ingredients to blend as individualised remedies. So in that situation, unless there are other factors, the MHRA wouldn’t need to challenge the supplier as to why they hadn’t got THRs etc.’
Mr Woodfield goes on to say, ‘In preparing their remedies to meet the needs of individual patient identified in consultation under s12(1) some practitioners will no doubt blend ingredients. Whether an item (e.g. a tincture) is itself a product or whether it is supplied as an ingredient for someone to use in making up a product is of course case specific. Overall, we expect the current position to be that some herbal practitioners rely mainly on s12(1) in their practice whereas others make more use of unlicensed herbal medicines manufactured by a 3rd party.’
Fiction: Unless SR is implemented by 2011, section 12(1) herbalists would be unable to access a wide range of ‘manufactured’ herbal medicines.
Fact: In 2011, ‘manufactured’ herbal medicines will come within the scope of the Traditional Herbal Medicinal Products Directive (THMPD) and will continue to be available to herbalists regardless whether SR is implemented or not.
Richard Woodfield states that, ‘These products [‘manufactured’ herbal medicines] would require either a marketing authorisation [MA] or traditional herbal registration [THR], unless it is possible to construct a UK scheme under the derogation in Article 5.1 of Directive 2001/83/EC [European medicines legislation].’
The only way for herbalists to bypass the THMPD (which Mr Woodfield says ‘represents a major advance… in terms of safety, quality standards, and systematic consumer information.’) and access unlicensed ‘manufactured’ herbal medicines commissioned from a 3rd party would be via the above mentioned derogation (which is a type of escape clause or exemption). To do so, herbalists would have to be recognised as ‘authorised health-care professionals’. This status, the DH has indicated, is most probably not attainable unless herbalists submit to SR. However, Mr Woodfield also reveals, ‘If there were to be a version of this arrangement for herbal practitioners [i.e. a UK scheme under Article 5.1 of Directive 2001/83/EC] this would require further specific consultation…’
A Note on Rights and Privileges
A number of herbalists believe that SR will preserve their ‘right to practise traditional western herbal medicine’. This is a misconception. SR is a government-granted ‘privilege’ to practise. Privileges are benefits that governments create and delegate; their terms can be altered or even revoked at any time. Rights are unalienable and cannot be taken away. By submitting to SR herbalists would not be asserting their rights, instead they would be taking a government conferred benefit.
The dangers of taking a benefit are illustrated in the DH consultation document. On page 11 of the ‘Impact Assessment’ report, under the heading ‘Risks’, is the following statement: ‘There is some evidence that some herbal medicines … are supplied for use on vulnerable patient groups, such as children and people who have serious illness.’ Does the DH really believe that herbalists should not be treating children and the seriously ill? Remember, it is alleged that the poor practice of herbalists is putting patients and the public at risk. DH bureaucrats view herbalists as a danger to the public. If herbalists submit to SR, then they are tacitly agreeing to these terms. Under such circumstances it would be perfectly reasonable and necessary for the government to ban herbalists from treating vulnerable patient groups.
To summarise, with or without SR
- Section 12(1) of the Medicines Act 1968 remains available to herbalists in the UK.
- Herbalists can continue to access unlicensed herbal medicines from their UK suppliers under the terms of section 12(1).
- ‘Manufactured’ herbal medicines will continue to be available to herbalists by way of the THMPD.
Any herbalists submitting to SR in the hope of making use of Article 5.1 of Directive 2001/83/EC – in order to access unlicensed ‘manufactured’ herbal medicines commissioned from a 3rd party – should bear in mind that this derogation does not currently exist in UK statute for herbalists and will require further consultation before being enacted, if at all.
The Herbarium 
34 comments
November 11, 2009 at 12:38 pm
philip evans
The above information, and most especially the statements direct from the person in charge of this whole process, is most helpful indeed. Thank you for your work on this.
November 11, 2009 at 5:03 pm
Anthony Rees
Never a truer statement made. Statutory registration of herbalists will only curtail their privileges they now have ‘unalienable right’ to.
Here in South Africa, a few Medical Herbalists decided it would be a groovy idea to get a statutory register going for their elitist grouping. At first it sounded quite advantageous, having a piece of paper on the wall from government to make the public believe that they were more ‘worthy’ and ‘professional’ than the rest.
At the end of the day, once they were under government’s control and the Department of Health’s rule, the screws were slowly turned and their scopes of practice were severely restricted and their benefits curtailed.
Others who were not Phytotherapists (Medical Herbalists) who decided to differentiate themselves from the ‘elitists’ put it on record throughout the process that they were not to be included in the statutory apparatus, as they never gave over their right to be controlled by the State.
At the end of the day, herbalists and phytotherapists are separated by law. Now we have only 30 phyotherapists on a government register and thousands of herbalists practising freely without constraint, seeing as many patients as before.
What difference has statutory recognition and registration had on phytotherapists? Arguably, none!
What effect has this had on people prescribing herbal medicines? Arguably none!
At the end of they day, threats of herbs being taken out of the hands of practitioners is nothing more than hot air. Please don’t get fooled by the carrot in front of you (fancy registration papers on the wall) and the big stick tapping you back (the threat of having your tools of the oldest trade on Earth taken away).
Those calling loudest for statutory recognition are usually power hungry individuals and organisations who merely want to control your market. They will simply place themselves at the front of your queue and further their political, financial interests to the fullest.
November 12, 2009 at 12:02 pm
Catriona Stewart MSc MNIMH
I need to respond to that last comment as it is slander, really. I am campaigning as vigorously as I can at the moment to support Statutory Regulation – I don’t think I’m ‘power hungry individual’. I do think I feel passionately about my profession and the care and support we offer to our patients and will do my utmost to protect those things.
Without Statutory Regulation we may or may not lose the ability to practise as we do now and our access to our medicines may be severely curtailed – including some that are not available to the general public, those
known as Schedule 3 herbs.
But notwithstanding the possibilities of those things (and given the history of all this to date, trusting the quotes of a politician of today to secure us in the future is a bit unwise):
Without Statutory Regulation, we cannot differentiate ourselves from people who do a 2 week correspondence course and then call themselves ‘herbalist’. We cannot hope to gain the level of professional credibility we need to increase and build upon our fledgeling dialogue with the mainstream medical institutions. We stand a real chance of losing many of our medicines. We will in fact be in danger of letting go of a substantial and vital part of our medical heritage
‘Power hungry’? I don’t think so.
November 12, 2009 at 12:19 pm
herbalistic
OK Catriona, we won’t think of you as ‘power hungry’. Maybe the ‘elitist’ tag is a better fit? Your comment is full of the fictional suppositions and presumptions the above article is attempting to dispel…
November 12, 2009 at 12:21 pm
herbalistic
Much is made of dispensing services going out of business if SR is not implemented. It is said that without the article 5.1 derogation these services would have no legal basis. It’s worth remembering that these services have no legal basis at present either [just look at the narrow terms of s12(1)], but they have never been driven out of business by the powers that be – common and commercial sense have so far prevailed. There is also no guarantee that any article 5.1 derogation for herbalists would sanction their continued existence either – the derogation does not exist in UK statute for herbalists & would require ‘further specific consultation’ before being enacted (or not). What would be the outcome of such a consultation process? Who knows, but there is a possibility the government would hand control of dispensing services to pharmacists…
November 12, 2009 at 9:22 pm
Catriona Stewart MSc MNIMH
I’m sorry that you feel the need to make offensive remarks about those with a different point of view and I’m also very disappointed. I really don’t by nature, respond well to the prospect of being ‘regulated’ in any way at all (porridge and dandelion apart); as a friend and colleague put it the other day, you won’t catch me chanting, ‘what do I want? – regulation, when do I want it? – now!’. It’s not where my heart is and I have many forebodings about it. The alternative that I can see is more imminently threatening however. Also, I cannot see why it should be viewed ‘elitist’ to want the skills I have gained over a prolonged period of training and clinical experience to be recognised and respected. People without that training but with inherited or self-taught knowledge will always be able to work with herbs, for themselves, for their families and perhaps a few people who come into their sphere. You cannot, until it becomes impossible to grow herbs at all, legislate that out of existence. But, and this in a way is the opposite of your view – I think that way is MORE elitist because it is only an option for a very small, select number of people, those with a bit of land, the time, the financial support…I want what I have learnt and the skills and knowledge I have gained to be available to as wide a number of people as possible, people who can only access my help if I belong to a recognised profession of people who have trained long and hard enough to stand up against all crap thrown at us by the vested interests.
Please don’t feel the need to throw insults at me; I suspect we’re really on the ‘same side’; we just have a different view on how to preserve what we love.
November 12, 2009 at 10:27 pm
herbalistic
You may think that SR is all about making herbalists stand out from the crowd, but the Pitillo Report & its consultation document make it very clear: SR is about safeguarding the public against the poor practice of herbalists. The fundamental question is, ‘Are you a danger to the public Catriona?’ SR has nothing to do with enhancing the status of herbalists as highlighted on p.43 of the WG on EPR report:
“In the past there has been a danger that the extension of professional regulation to new groups has been overly driven by the aspirations of emerging professional groups themselves, as a means to establish themselves as safe and effective players in the health care arena. This has at times led to the use of the terminology of “aspirant” groups. This term was introduced by the HPC for the purpose of indicating when applications for regulation were made to it by groups who were seeking recognition as “professions”. The term has since become associated with those groups seeking regulation through emphasising the risks inherent in their professions in order to secure their positions within health care, for reasons of status and market position as well as for reasons of public protection and patient safety. The Working Group agreed that continuing this approach to statutory regulation would not only have significant costs to the public purse and to the bureaucracy associated with spiralling legislation but would sustain an approach that did not have protection of the public as its primary concern: regulation is there primarily to serve the public, not the professions, and consideration of extension of regulation needs to start from the perspective of risk to the public and consider from that perspective which professional groups should be drawn into the system and how best to do so.”
November 13, 2009 at 11:46 am
Catriona Stewart
You’re right, this isn’t all about ‘status and marketing’ as descibed above, it IS about public safety – although ‘status and marketing’ certainly comes into it. I really do want people to stop talking to and about us as if we are uneducated, unethical charlatans and quacks at worse, misled weirdos at best, so that more people feel they can safely come to us for help. I also want to be able to be paid for my work, particularly as a single parent who needs to make a living. However, I also believe that people have a right to seek assurance that when they go to see someone calling themselves ‘herbalist’ they are placing their trust in safe hands. The point about the paragraph you have quoted above is that the former should not be allowed to overshadow the latter with which I am sure we would both agree.
I think you’ve misphrased your introduction which should perhaps read
“SR is about safeguarding the public against the practice of untrained and therefore misleadingly named ‘herbalists'”, rather than what you have put, which is:
“SR is about safeguarding the public against the poor practice of herbalists”.
If we are in danger of not being regulated because of peoples’ misinformed beliefs about our lack of credibility then perhaps we should educate them rather than walking off?
Anyway, on a positive note…if we are regulated or if we are not, as I wrote earlier – we will always have the herbs, as long as people are able to grow or find them – they cannot in themselves, or the knowledge of how to use them, be legislated out of existence, something we should all be able to take comfort from, whatever our points of view. After all the shouting has died down, you and I will still be herbalists, will we not and therefore colleagues, people with some kind of common cause?
November 13, 2009 at 12:12 pm
herbalistic
I agree with the sentiment expressed in your final paragraph, but I think you are mistaken on a number of other points. The underlying, unexamined assumption of your comment is that SR is a cure for a number of ills afflicting herbalists in the UK. How will SR stop people bad-mouthing herbalists? How does SR provide this magical public assurance? Where are these ‘untrained’ charlatan herbalists? There is no evidence to support your assertions. You are swallowing the EHTPA party line and engaging in wishful thinking. Much of what you write about has been examined and analysed elsewhere on this blog and I don’t feel the need to re-hash the issues here…
November 13, 2009 at 12:13 pm
Catriona Stewart
I’ve just had a look at the mission statement of this site, and it’s lovely. I can’t see anything in it with which I would disagree. But sadly and frustratingly, many, many people do not accept it is a ‘given’ that members of the NIMH or CPP or Master Herbalists or any other professional group we recognise anong ourselvelves are professional, effective and safe and that being a member of one of these automatically means we will do no harm etc. Most people outside our profession have ever heard of NIHM and it doesn’t mean anything to them when we tell them. The powerful vested interests, the sceptics, the negative, use that lack of ‘givenness’ to try to stop what we do becoming more readily and widely available. That, my friend, is why I believe we need this regulatory thing, however much it goes against the grain, which I assure you, it does. Anyway, I’d better stop this and go do some work. I wish us all the best, whatever turns out on this issue. Perhaps some day we will meet and we will have a chat over a cup of coffee (wine? herbal tea?)
November 16, 2009 at 8:13 am
philip evans
What I always seem to end up thinking, is to what an extent pro-SR herbalists are driven by a fear of something dire happening without SR, but which they are unable to qualify with specifics, they can only ever express vague or supposed threats: give me some actual proof of a dire consequence if there is no SR, and I will consider it. They usually seem to say that they don’t really want SR but have no choice: this is called disempowerment! They often say how regrettable it is that herbalists have become so divided over this, but to me there is nothing more divisive than their own proposal which would mean that many of their fellow herbalists would be outlawed. We have a long-standing and proven system in this country that works, there is no evidence of harm to the public under this system, and if SR is not now going ahead, then pro-SR herbalists need to stop being divisive and work with everyone else to ensure that the UK public’s access to herbal medicines continues.
Philip Evans
November 16, 2009 at 11:08 am
Catriona Stewart MSc MNIMH
Hi Philip
Why would regulation mean the ‘outlawing’ of ‘many’ herbalists? There is always, as far as I know, a ‘grandparenting’ clause for newly regulated professions. I was given to understand that all members of NIMH would automatically be included at the time of regulation. I can understand why that in itself wouldn’t be a solution, but there will be other criteria for inclusion such as other memberships or evidence of professional practice over time. Do you know for sure this isn’t the case?
For the record – there is no way I think that just because I have a degree or two it makes me more of a herbalist than any of those who have practised longer without such a piece of paper, that was never in my mind at all. Apart from anything else, I was taught by some wonderful inspiring teachers who have been herbalists long before there were such things.
Anyway, Philip, I only felt prompted to write at all because I wanted to have the points of view aired, I want to know what they are. Many people, many herbalists, don’t know what to think, I thought some open debate would be helpful.
I may be wrong in my choice here, it happens. I make mistakes, I’m human. So far, with the information available at this time, I think pro SR is the way to go. Do I stay frozen with inactivity through doubt? I may be wrong, but that doesn’t make me a bad person, it just makes me wrong. If I am wrong, then I still believe that herbal medicine will carry on being used and passed on throughout the UK. If I’m not wrong, well then ditto…hooray.
November 16, 2009 at 12:55 pm
herbalistic
Catriona, if SR were to be implemented and s12(1) restricted to herbalists on statutory register (this proposal already has the backing of the MHRA), then herbalists that do not consent to SR would be effectively ‘outlawed’. Herbalists in such a situation could either adopt a position of principled non-compliance or give up practising all together.
November 16, 2009 at 1:07 pm
Catriona Stewart MSc MNIMH
Ah, okay, I get it, thanks herbalistic. Yeah, I’ll need to go away and think about that.
November 16, 2009 at 5:45 pm
philip evans
And it would not just be herbalists not consenting to SR who would be outlawed, the list of people would include those not able to get on the register in the first place, who are nevertheless perfectly capable practitioners, and then those who fell off it for any reason (for example pregnancy, family issues, financial reasons, unreasonable or unaffordable CPD requirements, and ultimately their own retirement). Imagine being unable to treat your own family in your retirement because you were no longer on the statutory register; this for me is the main reason why the Steering Group’s proposals were so draconian as to be unacceptable.
November 17, 2009 at 10:45 am
Catriona Stewart MSc MNIMH
I don’t think GPs are allowed to treat people after they retire, should we? At least in terms of ‘general public’ and I keep saying, I don’t think there’s any way we can be prevented from using what we know in our immediate environment, ie ourselves, family etc, it just wouldn’t be ‘policeable’, I really don’t think that’s likely to be an issue. If it becomes an issue then we will need to do something about it. For a start, I don’t think it likely I’ll be able to retire until I’m 80 at this rate, so not a problem there…
I do accept the problems of affordability and circumstances like pregnancy, illness and so on, but there must be models already in place for other health professionals for these things. The fact is NIMH in its current incarnation is just too expensive for what it offers – that’s another story though, for another time.
CPD – we should carry out CPD, other professions engaged in public health or safety are required to, why not us? What those CPD requirements should be have to be sorted out, there’s no doubt about that, but that doesn’t mean we shouldn’t do it. We’re in a real chicken-and-egg situation here – many of us are struggling to make a living (who am I kidding, most of us are NOT making a living) as herbalists and huge membership fees, wadges of additional paperwork to fulfil the CPD requirements, not to mention that most CPD seminars are carried out well south of the border so are really out of most Scottish herbalists’ price range…none of these things help. But we should be able to fulfil these things if we see ourselves as professionals. If we don’t, then fine, but let’s not pretend then that we are entitled to be treated as such. I haven’t met a herbalist yet who isn’t constantly adding to their training, experience, sharing knowledge…CPD is just a way of recording all these things and the trick is to come up with a system of recording that is helpful, rather than onorous.
It seems like we all have fears and anxieties, whatever our view on SR…I suppose the only thing to do is to carry on thinking and asking and listening and doing what we believe, with the information available to us right now, is the right thing to do.
I would like to say thank you to this owners of this site, for such a good website and also, the opportunity to have this debate, which has offered much to think about. Thank you.
November 27, 2009 at 11:58 pm
Chantel McGrath
I have really enjoyed reading this little debate between you two. I was taught by some inspiring herbalists to! Currently conducting a massive all encompassing report on the regulation of herbal medicine and herbalists. It will be posted on the http://www.saveourherbs.co.uk website, but it is not pro SR or against it. I am a regulation and policy affairs consultant and a herbalist so the report is a balanced timeline of all the facts, many of things said in this website will be quoted in the report, because frankly some of your arguments against sr are fantastic. I aim to present it in a way that leaves a herbalist free to back a conculsion either way.
November 30, 2009 at 2:24 pm
Catriona Stewart MSc MNIMH
I’m really looking forward to seeing your report, Chantel, I’m sure many people will welcome it.
December 7, 2009 at 5:13 pm
Chantel McGrath
As you can see the groups for statutory regulation are very organised immersed in the political process and representing large numbers of practitioners. The groups against it are more dispersed and far less organised or influential in a political sense. The argument to me is not actually about statutory regulation. All these groups are using this as a tool to define their aims for herbal medicine. Should it be a distinct specialised practice with a variation of teaching disciplines or should it be integrated into wider healthcare by widening the scope of current practice to encompass more than evidence based research and symptom sorting? Should it continue to be the medicine of choice for middle to upper class women with degrees who read broadsheet newspapers (fact). Or should it be standardised and regulated more so it can become politically acceptable as a form of healthcare on the NHS (the people’s medicine of the UK, fact). “Herbal medicine is a living tradition that has adapted and remained relevant through all times” (declaration of intent- The herbarium). It is up to herbalists and the users of herbal medicine to try and shape the direction, because politics are involved (fact).
December 8, 2009 at 1:28 pm
herboscy
Hello Chantel,
Generally I’m appreciative of what you’re trying to do here, and hope the following comments may be helpful:-
It’s true that the SR lobby ‘represents’ the majority of herbalists – but this is not the same thing as establishing if their wishes are actually being represented! By the same token, if you are to call NHS care ‘the people’s medicine’, it’s not as if the people concerned have a great deal of choice or say in the matter these days, is it? Next, my experience of current herbal practice is that it remains as ever broad-based, but the regulatory process seeks to limit it to EBM. And does you take on herbal medicine being focused on ‘middle to upper class women…’ relate to practitioners or patients? It doesn’t resonate at all with my experience, and certainly not where patients are concerned! There is a question implicit in your posting,- who decides how the living tradition of herbal medicine should adapt and remain relevant? The answer is – nobody. It’s a multifactorial, changing, organic process. Herbalists, like their patients, are not great conformists and tend to pick and choose according to their own lights, which is why the Herbarium is popular with pro- and anti- SR practitioners alike.
Lastly, whilst an objective assessment of the current state of play is of value, we all have to work out how best to proceed in the future. This is what we’re concentrated on, because with the triad of climate change, energy descent and bureaucratic decline, few of the truths currently held to be self-evident are likely to remain.
Stephen Church.
December 8, 2009 at 2:09 pm
Chantel McGrath
Yes representing does not mean representing the views, it means people have become members got on with their own practices and did not have the time or impetus to trawl through the europa, dh and mhra websites tracking the nuisances in direction in regulation and legislation of herbal medicines and herbalists. Therefore the working members of these professional organisations have taken the initative on their behalf (prehaps unchecked). By people’s medicine I am recongising that 80% of the world’s population rely on herbal medicine as their primary form of healthcare but in the UK it is more of a lifestyle choice that has grown in conjunction with lifestyle choices to eat organic food, recycle bags and support climate change environmental initatives. These stats are based on market research and population surveys from companies like mintel and Ipsos MORI. The herbarium is popular 13,000 odd hits kind of popular and I agree no one real group can decide the direction and the process will be organic. I feel happy to be a herbalist in such intresting times.
EBM is flawed the gold standard trial is based on quantative methods. A good quantative statistic is that families in the UK have on average 2.2 children, how do we define 0.2 of a child? However I feel the research field would be more intresting and wider if herbalists and other groups had an input into research methods and direction.
One the most intresting reports I have read is the house of commons-health commitee’s 2005 report on the ‘Influence of the pharmaceutical industry’ well worth a read to see the how the system, clinical trials etc works. Its a bit scary though, as one can see how powerless and entrenched we all are. The reason I like to look at the whole picture of an argument is herbalists to can become in entrenched in their opinions, I have never met more strongly opinionated people than herbalists, which is why they are my favourite people to have debates with!
I have been coming across other blogs like the quack o meter and UK sceptics and find the drive to discredit traditional medicine and CAM as a whole unrelenting and one wonders what drives them. I read an intresting interview with Maritin Walker the guy who wrote ‘Dirty Medicine’ on the http://www.saveourherbs.org website in which he states that alot of these sceptic blogs are actually indirectly sponsered by the PR arms of big pharmas.
December 11, 2009 at 9:56 am
Anthony Levy
I am confused by your article. You are clear (and I agree with this) that SR is not a good idea. But I understand from the comments (and elsewhere) that the European legislation (pushed by big pharma no doubt) for quality will give tinctures the status of medicines, so that you won’t have access to them unless you have SR status. If the European stuff is going through anyway (can this be stopped or neutralised, as happened in 1994?) then SR would seem to be vital.
December 11, 2009 at 10:53 am
herbalistic
It is not the case that EU legislation requires SR in order for herbalists to access their medicines, nor that tinctures are given the status of (orthodox) medicines. I think you are forgetting that s12(1) remains in force and under its terms herbalists can continue to access unlicensed herbal medicines from their UK suppliers. S12(1) does not require SR and has not been altered by EU legislation.
December 11, 2009 at 11:09 am
herbalistic
Apparently the Royal College of Physicians has dropped its support of SR for herbalists (http://www.telegraph.co.uk/health/healthnews/6720658/Doctors-abandoning-patients-over-herbal-medicine-claims-charity-boss.html).
Its good to see orthodox medics reverting to type: In 1906, the NAMH (National Association of Medical Herbalists of Great Britain) made a formal petition for a Royal Charter. This was opposed by the GMC, the BMA and the Pharmaceutical Society. Undeterred, herbalists continued to agitate for official recognition and in 1923 a Bill for Registration of Medical Herbalists was presented to Parliament. The Bill proposed the formation of a General Medical Herbalist Council ‘to regulate registration and impose penalties for unauthorised use of the title of registered medical herbalist.’ The Bill was opposed by the medical establishment and never received a second reading.
[More details of the history can be found in Brown, P.S. (1985). The Vicissitudes of Herbalism in Late Nineteenth- and Early Twentieth-Century Britain. Medical History. 29: 71-92.].
December 14, 2009 at 10:25 am
Catriona Stewart MSc MNIMH
That’s very interesting and perhaps worth reviewing the opposition of some herbalists to SR – if the ‘medical establishment’ is sufficiently threatened by the prospect of herbalists receiving such formal recognition, then it suggests they have a similar perspective to those herbalists who are pro SR – in other words, if ‘orthodox medics’ don’t want it, perhaps we should…
It’s also interesting that herbalists have been lobbying for regulation since the beginning of the last century – so over a hundred years.
I’m not surprised people are so confused!
December 14, 2009 at 11:52 am
herbalistic
I’m not sure I follow your logic, but below is an extended quote from the book ‘Fringe Medicine’ for you to mull over:
In Britain, towards the second half of the nineteenth century, herbal medicine declined in influence, but not to the same extent as in the United States; ‘largely because of the existence, particularly in the north, of numbers of small herbal shops whose owners were also practitioners. Yet their existence presented a problem to the National Institute of Medical Herbalists, an organisation founded in 1864 to improve standards, in order to prove herbalism a reputable alternative to orthodoxy. Naturally, the NIMH did not favour the idea of herbalists as primarily shopkeepers, with an adjoining consulting room into which they could bring customers, as it were, by lifting the flap of the shop counter. The NIMH, too, wanted all members to have qualifications; it established a training school with the ultimate aim of confining membership to those who had passed through it, or at least taken some equivalent qualifying examination. Many of the old style herbalists, though, were not examination-minded; some were unlettered. Yet they could often claim, and with justice, that they were better and more experienced practitioners than most that the school would turn out. Inevitably, the attempt to impose qualifications split the movement. Some herbalists simply ignored the NIMH; others, with different ideas of what standards should be, formed the rival British Herbalists Union with standards of their own.’
‘This division was used by the authorities as an excuse to refuse to take herbalism seriously. At the time when the Health Act was in contemplation, causing concern to all unorthodox groups, an MP went to Aneurin Bevan to see if he would allay the herbalists’ fears. The reply was that their case could not even be considered until the two organisations had come together, restoring the movement’s unity, and enabling it to ‘put its house in order’ in respect of training and qualifying standards. What Bevan (or his advisers) did not appreciate was that the disunity was caused by the attempt to put the herbalist house in order; all attempts, in fact, to enforce training and qualifying standards inevitably brought divisions of this kind… The price of higher standards was disunity: the price of unity was lower standards. The authorities might reasonably have indicated which they preferred, but to demand both was to demonstrate their inability to understand the nature of the problem.’
[Inglis, B. (1964). Fringe Medicine. Faber & Faber. p.68-69.]
December 14, 2009 at 12:58 pm
Catriona Stewart MSc MNIMH
So aiming for higher standards/regulation = disunity?
December 14, 2009 at 1:05 pm
Catriona Stewart MSc MNIMH
btw – I do understand the other point that’s being made, about lack of NIHM training doesn’t necessarily mean poor practice, I’ve already made that point myself. However, for the majority of people, some kind of ‘quality control assurance’ is needed.
I also feel strongly that we should constantly, as a profession, be pushing for raised standards. I’ve put in writing before and am happy to do so again – i don’t think new graduates from 1st degree courses at uni should be allowed to go straight into practise, I think they should do some on the job time first and then something like a vocational MSc, as other professions working with peoples’ health or safety are required to do.
December 14, 2009 at 4:46 pm
herboscy
Doctors spend many years working under supervision after getting their degree in medicine – and yet there are wonderfully competent GPs and grossly incompetent GPs. All that the NHS can try to do is ensure that they are safe – although clearly they’re not doing a very good job of it. Meanwhile, Herbal Medicine keeps shooting itself in the foot by being elitist about ‘standards’. We currently have a qualification hierarch of MScs, BScs, Diplomas and Certificates (plus some of NIMH’s most revered members having nothing at all!) Would you like to say which group you think evidences the greatest level of competency? Meanwhile, I can stand two recent graduates with the same degree together and say one is truly gifted, the other hasn’t got a chance. Fortunately, unlike doctors, we don’t have to worry too much about safety – it just isn’t an issue, evidencing that it’s very hard to injure a human with medicinal herbs in the preparations and at the dosages we (so far!) are accustomed to.
Stephen
December 14, 2009 at 9:32 pm
Catriona Stewart MSc MNIMH
I agree with most of what you have said, you are really stating the obvious, hope you don’t mind me saying so…the point is, one system has some kind of ‘come back’ within it, the other hasn’t.
I find your comment ‘herbal medicine keeps shooting itself in the foot by being elitist about standards’ seriously weird – ‘elitist about standards’???????? Are you serious about suggesting it doesn’t matter to what level of competency we work as we can’t do any harm? Frankly if you are serious in what you appear to be saying then the ‘quackbusters’ and the sceptics, the vested interests, the anti-herbal medicine lobby may all rest their case – you are writing it for them.
As far as I can make out from all the recent postings, the main reason we are continuously denied recognition and professional status is because we are lacking in cohesion as a group and can’t get our act together. This issue has been rumbling for over 100 years (and then some, really) and it took a law, some 3 – or was it 4 – hundred years ago, to allow us to keep practising in England at least, to give us protection…we need legal protection now and the people who are being ‘divisive’ could clearly be argued to be those who are dragging their heels and arguing against. I really began to have serious doubts as to whether I had made the wrong choice over all this but I am absolutely certain now I have not – the only real concern I have now is that yet again, we have allowed something I can’t reasonably describe here to win over common sense and commitment to serve.
December 15, 2009 at 10:05 am
herbalistic
We are saying that SR does not guarantee ‘competency’: there is no evidence to support the contention that SR raises standards or makes ‘poor practise’ disappear. If you have the evidence, then I’d like to see it. In the 2 documents under the heading ‘Herbal Communities’, we propose an alternative model by which herbalists can organise themselves without government (it includes details about ‘come back’). Try reading a few of the other documents on this site to see the bigger picture – this thread is going over ground covered elsewhere on this site.
December 16, 2009 at 4:22 pm
Catriona Stewart MSc MNIMH
It was clear to me what you are saying and I thought I just as clearly agreed – SR indeed does not equal competency. But with SR there should be at least a route to recourse, without it there is little or none.
My issue with the statements made above was in relation to the issue of safety, with which, ‘unlike doctors’, according to Steve, we apparently don’t have to concern our selves…That we, as a profession, have a superb record in terms of safety, is testament in itself to the seriousness with which issues of safety have been treated in training and in practise.
I’ve read the documents under ‘Herbal Communities’, thanks.
December 16, 2009 at 8:36 pm
herboscy
Of course there has to be a route to recourse. That’s why we all carry professional indemnity.
December 16, 2009 at 9:33 pm
herbalistic
How about this for SR recourse (http://ipnosis.postle.net/pages/HPCPerspective0709.htm):
Protecting the Public the HPC way
Statistics from recent HPC Annual reports
2008: £3.76m spent. 108 allegations made by the public (25% of all allegations), but HPC only get round to considering 63 in the year, leaving 42% of allegations made by public unconsidered. This is building up a massive backlog. Only 18 (29%) of the allegations from the public that are considered are taken any further.
The rest of the money is spent processing allegations from Employers, the HPC itself through the Article 22(6) rule, others within the profession and a small amount from the police.
Out of £3.76m, only 18 allegations from public are found to have a case to answer.
2007: £2.9m spent, out of 78 allegations made by the public HPC only got round to considering 34. Of these only 12 were found to have a case to answer. 56% of the total allegations made by the public were not considered. Most of the allegations made by the public have not been heard within the year they were made. What protection is that?
Massive amount of money for not very much. Huge bureaucracy with an ever growing backlog of complaints. Year on year there are 30% more allegations made than cases considered. The waiting time is bound to rocket, or the costs will escalate even more. The vast majority of these allegations are made by employers, the HPC itself or from within the profession.
COMMENTS CLOSED: We’ve covered a lot of ground but we’re not going to solve all of herbal medicine’s problems here. We’ve decided to close this thread to further comments. Thanks to all who have contributed. Feel free to pick up the cudgels elsewhere on this blog…