Welcome to the EHTPA
The EHTPA was founded in 1993 when it became clear that with the development of the European Union, the legislative framework under which herbal medicine was practised in the UK and Europe was likely to undergo radical change. The main professional herbal practitioner associations in the UK affiliated with Irish and Danish herbal associations to form the European Herbal & Traditional Medicine Practitioners Association (EHTPA).
The EHTPA is an umbrella body which represents professional associations of herbal/traditional medicine practitioners offering variously western herbal medicine, Chinese herbal medicine, Ayurveda and traditional Tibetan medicine. The EHTPA is dedicated to the development of herbal/traditional medicine, preserving and enhancing the legal basis of practice across EU Members States and promoting best practice throughout the traditions.
P R E S S R E L E A S E
Misleading Report may lead Government to deal devastating blow to UK Herbal Practitioners
[8 December 2015] The European Herbal and Traditional Medicine Practitioners Association (EHTPA) says public safety is put at risk if the Government accepts the recommendations made by the Walker Report which rejects statutory regulation of the UK's 3000 herbal practitioners and instead endorses voluntary accreditation by the Professional Standards Authority (PSA).
Although the Walker Report was made public in March this year, the Government has to decide whether to accept its recommendations by the end of 2015. The EHTPA is in no doubt that the Government should reject the recommendations of the Walker Report. The report was authored independently by Professor Walker without first sharing a draft, as formally agreed, with the Herbal Practitioner and Medicines Working Group convened by the Government specifically to work with Professor Walker, Chair of the Group. Moreover, the report failed to include the specially commissioned Safety Report by the Government's own Herbal Medicines Advisory Committee (HMAC).
EHTPA Chair and member of the Working Group, Michael McIntyre said: "It is a matter of real concern that the Department of Health will base this decision on a report written solely by the chair of the expert group when the findings of the report have been rejected by over half of the expert group itself. Despite a written undertaking that the expert group would see a draft of the report before it was published, this promise was broken.
"It is vital that the Government considers the full HMAC Safety Report which was commissioned by Professor Walker himself, as it clearly demonstrates the significant shortcomings of any scheme based on voluntary rather than statutory regulation. It is surprising that Professor Walker hasn't included this extensive report with his own recommendations in order that the Government can make an informed decision on the regulation of herbal practitioners."
The disputed Walker Report based its findings on a spurious evidence base involving evaluation of Cochrane Reviews two of which were not on herbal medicine at all. The Editor in Chief of the Cochrane Library (source of these reviews) has in fact questioned whether this is proper use of Cochrane reviews.
The EHTPA understands the Government's imminent announcement will accept voluntary regulation for the herbal sector which contradicts recommendations for statutory regulation made to the Department of Health by the prestigious House of Lords' Science and Technology Select Committee in 2000. The Government accepted this recommendation at that time. Voluntary regulation would also reverse an earlier decision by the Secretary of State for Health in 2011 to implement statutory regulation for herbal practitioners and is at odds with calls for statutory regulation made by two Department of Health Working Groups, in each case supported by an overwhelming public vote in favour of statutory regulation to ensure safe treatment by trained practitioners.
>McIntyre concludes: "The only way that the public can be assured of receiving safe treatment from well-trained, ethically practising herbal practitioners is via statutory regulation. Voluntary accreditation leaves the public open to poor practice from ill-trained practitioners who have opted out the voluntary scheme. Voluntary regulation also falls short of ensuring that herbs supplied by herbalists are sourced from companies with adequate quality assurance systems. At a time when antimicrobial resistance (AMR) is such a threat, this is a timely opportunity to develop herbal medicine practice that has the potential to play a vital role in ameliorating the menace of AMR. "
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Copy of the Herbal Medicines Advisory Committee’s (HMAC) safety report specially commissioned by the Professor Walker, Chair of the Herbal Practitioner and Medicines Working Group, to assess potential risk of failure to provide statutory regulation for UK herbal practitioners. HMAC advises government on the safety of herbal medicine supply. The HMAC report (see below)demonstrates the significant shortcomings of any scheme based on voluntary rather than statutory regulation. It is surprising that the report was not published at the time of the Walker Report and we publish it now in order that the Government can make an informed decision on the regulation of herbal practitioners and the public can see why statutory regulation is the only truly safe way forward.
Copy of letter from more than half the members of the Herbal Practitioner and Medicines Working Group dissenting from the Walker report, explaining clearly why they think the Chairman got it wrong!
Personal letter from the Editor in Chief of the Cochrane Library questioning whether using Cochrane Reviews as a yardstick of statutory regulation is not a proper use of these reviews.
To illustrate how inapplicable Cochrane reviews are to determining statutory regulation of health professionals, here follows a review of the evidence base for current dental practises based on Cochrane reviews. The review concludes that "the overall quality of evidence can be regarded as low or non-existent for most of the dental procedures" but admits "it is not known… whether these reviews do, in fact, provide useful information for use in dentistry."
Report on the Regulation of Herbal Medicines & Practitioners 26 March 2015 Professor David R Walker
The European Herbal & Traditional Medicine Practitioners Association
Representing herbal & traditional medicine practitioners across Europe
Reaffirmation of Purpose
Publication of the Walker report on the future of herbal medicine practice in the UK in the dying days of the Coalition Government in March 2015 has resulted in continuing uncertainty within the profession about the benefits of statutory versus voluntary regulation and how best to secure the future of the profession.
The EHTPA has undertaken a review of its aims, work and structure and with the support of its constituent professional associations from across the herbal traditions remains dedicated to securing a secure legislative basis for herbal practice in the UK and more widely throughout the EU.
The EHTPA will continue to make the case for the statutory regulation of herbal practitioners in the interests of the millions of UK citizens regularly seeking herbal treatment.
In pursuit of this, the EHTPA has written to the UK government rejecting the main recommendations of the Walker report which was repudiated by the majority of the expert committee convened by the Department of Health to advise the Minister on the best way forward.
The EHTPA remains committed to ensuring that the benefits of herbal medicine are widely available through well trained, dedicated herbal practitioners and through its well-established Accreditation Board, the EHTPA continues to accredit UK training institutions providing high quality training in herbal medicine in its various traditions (Western, Chinese and Ayurvedic herbal medicine).
The EHTPA will continue to promote much needed research. Herbal medicine undoubtedly has the potential to play a major role in meeting the needs of patients with long-term chronic diseases, in combating the growing threat of antimicrobial resistance as well as in the general health maintenance of EU citizens.
The EHTPA continues to act as a platform for its constituent professional associations representing the Western, Ayurvedic, Chinese and Tibetan herbal sectors to promote the benefits of herbal medicine to a wider public.
Working with other interested partners including the British Herbal Medicine Association, the EHTPA continues work to ensure the provision of quality herbal medicines for use by UK practitioners for the benefit of their patients.
The EHTPA continues as an active member of EUROCAM, a forum of doctors, practitioners and patients. Based in Brussels, EUROCAM makes the case to the EU Commission, European Parliament and MEPs for the integration of CAM practice into the healthcare systems of the EU Member States and for the availability of a full range of herbal medicines for practitioner use throughout the EU. In this work, the EHTPA continues to represent the interests of its associated member professional associations from various EU Member States.
Government Report fails millions of herbal medicine patients and practitioners!
A report concerning the regulation of herbalists published in the dying days of the last parliament represents a total U-turn by the government and a betrayal of the millions of people who consult herbal practitioners.
- In 2014 the government convened yet another Expert Working Group to consider the statutory regulation of herbalists to ensure herbal practice meets the highest standards.
- There have already been three previous formal committees that recommended the statutory regulation of herbalists to provide a legal basis for practice and safeguards for the public.
- There have been two UK wide Dept of Health public consultations about this both of which recorded overwhelming public support for herbal statutory regulation.
- In 2011 the Secretary of State for Health announced that the statutory regulation of herbalists would go ahead.
- Now the government has done a complete U-turn publishing yet another report on herbal regulation that has recommended this should not happen.
- The majority of the Expert Group convened to advise the government on this matter has written to the Health Minister to say they do not agree with this U-turn but their views are being ignored. The Expert Group was not shown a draft of the Report before publication despite assurances that the Group would be fully consulted.
- Voluntary regulation is no substitute for statutory regulation; it cannot assure public choice and public safety as substandard practitioners cannot be struck off.
- The report suggests that herbal medicines can be recategorised as foods. If this happens many herbal medicines will no longer be legally available.
- The report fails to recognise robust existing processes and academic standards established by a number of responsible UK herbal voluntary registers.
- The report makes no provision to replace a off -site supply of herbal medicines to practitioners to take account of recent changes in EU medicines law. Without this route of supply, practitioners without dispensing facilities will be forced to give up practice and their patients will lose access to herbal treatment on which they rely. The report betrays earlier proposals that would have corrected this in the UK.
- The report claims that there is insufficient research to justify statutory regulation and published a 'randomly selected' number of research reviews never shown to the Expert Group. Exactly the same measure applied to dentistry recently demonstrated that "the overall quality of evidence can be regarded as low or nonexistent for most of the dental procedures assessed". The yardstick used in the report is clearly unfit for purpose. There are many thousands of scientific papers underpinning the therapeutic value of herbal medicines which is why WHO is calling on all national health systems to integrate traditional (herbal) medicine into medical practice.
Please ask your constituency candidates if they support the statutory regulation of the herbalists. Please consider only voting for candidates who support herbal statutory regulation!
Thank you for your help. For your interest, our full response to the report on herbal regulation and the report itself can be accessed here.
Response to the Recommendations of the Report on the Regulation of Herbal Medicines and Herbal Practitioners 27 March 2015
From the Chair European Herbal Practitioners Association (EHTPA)
A report from the Deputy Chief Medical Officer of Health about the future regulation of herbalists has just been published. Here is our response:
- In 2014 the government convened yet another Working Group to consider the statutory regulation of herbalists (SR)
- There have already been three previous committees that have recommended SR for herbalists
- There have also been two UK wide public consultations about this both of which recorded overwhelming public support for herbal SR
- In 2011 the Secretary of State for Health announced that SR for herbalists would go ahead
- Now the government has done a complete U-turn and despite the promise that the Expert Group convened to discuss next steps would be fully consulted has published a new report on herbal regulation written by the Deputy Chief Medical Officer of Health that has decided that SR will not now go ahead
- The majority of the Expert Group has written to the Health Minister to say they do not agree with this U-turn but their views are being ignored. The Expert Group was not shown a draft of the Report before publication
- Voluntary regulation is no substitute for SR and cannot assure public choice and public safety
- The Report suggests that medicinal herbs can be re-categorised as foods. If this happens many herbal medicines will no longer be legally available
- This report fails to recognise robust existing processes and academic standards established by a number of responsible UK herbal voluntary registers
Read the full text of our response here (pdf)
Government Report fails millions of herbal medicine patients and practitioners
[Friday, 27 March 2015, 09:00hrs] The European Herbal and Traditional Medicine Practitioners Association (EHTPA) and British Herbal Medicine Association (BHMA) says public safety is at risk following today's recommendation by the government to reject statutory regulation of the UK's 3000 herbal practitioners.
Despite previous agreement that statutory regulation could be the only way to safeguard the public from poorly trained and unethical herbal practitioners, the government now favours voluntary accreditation by the Professional Standards Authority (PSA).
The U-turn by the government comes 15 years after statutory regulation of herbal practitioners was first recommended to the Department of Health by the prestigious House of Lords' Science and Technology Select Committee in 2000.
The recommendation also reverses an earlier decision by the Secretary of State for Health in 2011 to implement statutory regulation for herbal practitioners and is at odds with calls for statutory regulation made by two previous Department of Health Working Groups, in each case supported by an overwhelming public vote in favour of statutory regulation to ensure safe treatment by trained practitioners.
Chair of the EHTPA and member of the Herbal Practitioner and Medicines Working Group, Michael McIntyre said: "Herbal medicine is internal medicine and like other types of internal medicine practised in the UK, requires statutory regulation for those who practise it.
"The only way that the public can be assured of receiving safe treatment from well trained, ethically practising herbal practitioners is via statutory regulation since voluntary accreditation leaves the public open to poor practice from ill-trained practitioners who have opted out of, or never signed up to the voluntary scheme in the first instance."
Not only will voluntary regulation fail to ensure the public are consulting trained and ethical practitioners, it will also fall short of ensuring herbs supplied by herbalists are sourced from companies with adequate quality assurance systems, leading to cheaper supplies of inferior and suspect quality.
Dr Dick Middleton, Chairman of the BHMA commented: "The proposals will not prevent the continued availability of low quality or adulterated herbal supplies to herbal practitioners for use in their practice. Herbal practitioners will be unable to identify high quality herbal material and this will inevitably lead to a continued and unacceptable risk to patient safety."
Voluntary accreditation under the PSA is no substitute for statutory regulation: Voluntary accreditation of herbal practitioners already exists in the UK via a number of well-run professional associations with decades of experience of delivering training and monitoring fitness to practise of their members.
"The essential weakness of voluntary accreditation is that any practitioner disbarred by one of the voluntary registers can leave the register and legally continue to practise outside its jurisdiction," said McIntyre.
"Furthermore, training institutions that do not wish to submit themselves to independent accreditation can refuse to participate and operate outside the accreditation scheme.
"The PSA suffers exactly the same shortcomings that undermine other existing voluntary accrediting bodies since the PSA has no more ability than existing voluntary accreditors operating in the herbal sector to require herbal practitioners to belong to it or to require that all herbal training institutions adhere to agreed standards of training. More worryingly, accreditation via the PSA offers the public false security as it appears to have all the powers of a statutory regulating council but in reality in its role as a voluntary accreditor it has none."
McIntyre concluded, "A well trained herbalist is a safe herbalist. In the last two decades, practically every herbal misadventure has occurred at the hands of those practising outside the main UK voluntary registers without adequate training or unethically. Statutory regulation is the only way to ensure all practitioners work to the same high standards. With the growing interest in and use of herbal medicine, only statutory regulation can ensure that the sector as a whole works to agreed standards and can integrate herbal medicine into the healthcare systems of the 21st century."
In objection to the government's decision to recommend voluntary accreditation, an open letter to the Department of Health has subsequently been supported and signed by a over half* of the Herbal Practitioner and Medicines Working Group objecting to the government's ruling and calls on the government to reconsider its decision in the interests of public health.
The Matrix report, produced in 2012, but only publically released late
in 2014 , was commissioned on behalf of the European Pharmaceutical
Committee. The study investigates the availability of medicinal products
for human use in the EU and EEA, focussing on the authorisation procedures
for medicinal products including herbals see for instance page 23 and
Page 23 says...
"consulted industry stakeholders pointed out that the process of authorising products can take a long time (up to five years) and the approach to authorising such products can differ substantially between Member States. This makes it difficult for producers to bring such products to the market as medicinal products, potentially resulting in unavailability. Since the coming to force of Directive 2004/24/EC on Traditional Herbal Medicinal Products (THMPD), 572 products have been registered, with significant discrepancies across Member States (only seven Member States saw more than 20 products registered, and over 150 of all registrations were in Poland)."
This highlights how current EU legislation falls well short of the requirements for the development of herbal medicine. Read the full report here (pdf).
EHTPA mission and work
Click here to view the document (pdf).
Statutory regulation for herbal practitioners
Click here to view the document (pdf).
The Case for the Statutory Regulation of Herbal Practitioners
The following document has been presented by the EHTPA Chair to the Herbal Working Group in March 2014 in support of statutory regulation of UK herbal practitioners, based on maintaining public safety and public choice.
Click here to view the document (pdf)
The role of herbal medicine in combating antimicrobial resistance
PowerPoint presentation for meeting in the European Parliament Building on 1st April 2014 organised by EUROCAM
Click here to download (pptx)
In the press
Two recent stories from the Telegraph:
medicine could become available on the NHS
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the Minister for Magic Jeremy Hunt gone too far
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Scoping the Evidence
The EHTPA is dedicated to research into the effectiveness of herbal medicine. To this end it has published 'Scoping the Evidence for Herbal Medicines'. Click here to download the document (pdf).
Antimicrobial resistance and herbal medicine
A paper presented to the House of Commons Select Committee on Science and Technology by the EHTPA - November 2013 Click here to view the document (pdf)
Oral evidence on herbal medicine and antimicrobial resistance
given by EHTPA to House of Commons Select Committee on 26th February 2014. Click here (opens in a new window)
Report to Council about the Working Group meeting on Thursday 31st January 2014.
Click here to view the document (pdf)
Commissioner Borg highlights the economic benefits of CAM treatments in the EU. Address June 2013.
Click here to read the full text (pdf).
New National Professional Herbalists Register (RNEP) – Italy
The Federazione Erboristi Italiani - FEI is delighted to announce the launch of its new pan-Italian Register, the National Professional Herbalists Register (RNEP).
Membership of this Register is open to all graduates of University courses currently training herbalists in Italy.The Register will also be open to non-FEI members, as long as they possess a University qualification in herbal medicine providing the necessary prerequisites.
The Register will provide a public a reference point listing qualified herbalists throughout Italy and will be easily accessible to all Italian citizens via the FEI website. The Register will be published listing the names and addresses of qualified herbalists on a regional basis making it possible for anyone living in Italy to contact a local herbalist. This Register will make it easier for healthcare practitioners throughout Italy and beyond (including those operating in the CAM sector) to consult qualified herbalists throughout Italy for professional advice concerning the use of medicinal plants for their patients.
For further information please contact the Federazione Erboristi Italiani - FEI, 00153 Roma - Piazza G.G. Belli, 2, tel. 065866345 – 305 - fax 065812750, e-mail: email@example.com - firstname.lastname@example.org, website www.feierboristi.org.
Signing up to train as a herbal/traditional medicine practitioner? Consider this (February 2011)....
The Government is about to give its decision on whether herbalists should be statutorily regulated. We expect to hear about this shortly.
Should the decision to statutorily regulate our sector be made, it is possible that the regulator (e.g. the Health Care Professions Council) will accept the members of some professional associations that have acceptable standards of training and accreditation for direct and immediate transfer over to the new statutory register when it opens.
The Department of Health Steering Group under its independent chair, Professor Mike Pittilo, published a snapshot of many courses on offer and their standing according to certain accreditation criteria in 2008. These are published on pages 169-171 together with a listing of courses and their processes according to the information received at the time of the Report’s publication (see pages 161- 167 of the Report). Click here to access DH Steering Group Report final proof.pdf (1MB). Those using the 1968 Medicines Act Section 12(1) herbal exemption in their practice (i.e. one-to-one prescription) who belong to professional associations that do not qualify for such direct transfer will still have the opportunity to apply to join the register during the grand-parenting period but it is likely that applications will be considered on an individual basis.
It is impossible for us to give specific guidance about particular training at this time but it would seem sensible to check and see if there is any independent accreditation of the course you plan to take; for example, as you will see some courses listed in the Report have both university and our own EHTPA independent accreditation. As you will also see, there are other accreditation boards listed aside from our own. Whichever they are, a properly constituted accreditation process should include clear training outcomes that deliver on a published curriculum. For example the EHTPA Common Core Curriculum is published on pages 124 onwards. This is the kind of thing you should look for to underpin any accreditation process and satisfy yourself as to the standard of the training you are thinking of applying for. The accreditation board should be properly constituted , set up at arm’s length from the training institution and ideally should include lay membership.
Lastly, you will see from the Common Core Curriculum that it is generally agreed that students should learn an appropriate amount of western medicine knowledge and skills as well as some pharmacology. As herbalists practise internal medicine and see patients without referral from GPs, it is incumbent on practitioners to know enough western medicine to be able to recognise the limits of their competence and know when to refer patients to doctors etc...
Herbal and traditional medicine practitioners get statutory regulation
On 16th February the Secretary of State for Heath, Andrew Lansley announced in a written statement to the UK Parliament that all UK practitioners prescribing herbal medicines are to be statutorily regulated via the Health Professions Council. The Health Secretary went on to explain that 'this would ensure that practitioners would meet specified registration standards' giving practitioners and consumers continuing access to unlicensed manufactured herbal medicines to meet individual patient needs after the introduction of new EU legislation after April 30th this year. Click here to read Andrew Lansley's statement.
The move to regulation has been under discussion for over a decade in the UK since the prestigious House of Lords' Select Committee on Science and Technology called for UK herbalists to be statutory regulated in its seminal report on Complementary Medicine in 2000. The following year, the Government agreed that this should go ahead and launched two committees under independent chairs, one to look at the regulation of herbalists and the other acupuncturists. The process was most generously supported by the Prince of Wales and his Foundation for Integrated medicine. The two committees published their reports in 2003 and the following year the Department of Health (DH) undertook a public consultation on the statutory regulation of herbal practitioners. The results of this consultation were published in 2005 and showed a 98% opinion in favour of statutory regulation (Department of Health 2005. The Statutory Regulation of Herbal Medicine and Acupuncture. Report on the Consultation. Stationery Office, London.) That same year the DH published a timetable for such statutory regulation. In the event, a General Election and a public outcry in the wake of murders by the rogue doctor Harold Shipman brought considerable delay. The newly elected Labour administration put the herbal regulation on hold whilst it commissioned an overview of the regulation of all healthcare workers from doctors to hospital porters. This process took many months to complete and in the meantime the Government decided that there should be another DH Committee under the chairmanship of Professor Michael Pittilo to advise Government how best to regulate herbal medicine, traditional Chinese medicine and acupuncture.
The Pittilo report, outlining specific measures to bring about this regulation, was published in 2008 and in 2009 the Government commissioned a second public consultation on this subject. Such consultations usually attract no more than about 40-60 responses; this one elicited an extraordinary public response with over six and half thousand replies. A decade after the House of Lords called for the statutory regulation of herbalists, the Government finally decided that statutory regulation of herbalists should go ahead and, once all the devolved administrations (Scotland, Wales and Northern Ireland) had agreed to this, the announcement was made by Andrew Lansley on February 16th. Once again the public expressed its clear view that herbalists should be statutorily regulated. The results of the 2009 public consultation published concurrently with the Minister of Health's announcement showed there was a massive majority (85% of the responses) in favour of statutory regulation. Click on link shown on footnote.
Herbal medicine faces regulation
From The Press and Journal, published: 21/02/2011
North-east academic's efforts pay off as health secretary announces register of practitioners by Lindsay Watling
SUCCESS: Dr Carol Blow, widow of Professor Mike Pittilo, says herbal medicine regulation is a victory for patient safety. Raymond Besant
An Aberdeen academic's long-standing campaign for a law to regulate the herbal medicine Industry reached a major milestone this week - exactly a year to the day since he died.
Former principal and vice-chancellor of Robert Gordon University, Mike Pittilo, who died of cancer last February aged 55, was a staunch advocate of the need to regulate herbalists.
Professor Pittilo was heavily involved with the Prince of Wales Foundation for Integrated Health (FIH) and in 2003 chaired a Department of Health steering group which published a report recommending the urgent implementation of a system of regulation.
Last year he was made an MBE for this work, but the sector remained unregulated until Wednesday - the first anniversary of his death - when Health Secretary Andrew Lansley announced in parliament that the findings were accepted.
Mr Lansley told MPs that practitioners in all four UK nations should be statutorily regulated by the Health Professionals Council and said a register would be set up to ensure practitioners met specified standards.
He added: "I'm pleased to say this decision resolves a long-standing issue, to the benefit of practitioners and the public who use herbal medicines."
Prof Pittilo's widow Dr Carol Blow called the news a "real victory for patient safety". She said: "The most important thing was Mike's concern about patient safety. Herbal medicines are sometimes seen as being natural and safe, but they can be toxic and they do kill people.
"After all these years of debating it, it's really reassuring to know that there's going to be some formal regulation because at the moment, anybody can set themselves up as a practitioner and supply potentially toxic substances. Mike would be so satisfied the recommendations have been accepted."
That the announcement had coincided exactly with the anniversary of Prof Pittilo's death was "incredibly symbolic", she added.
RGU acting principal Professor John Harper said the news was "another illustration of Mike's continued influence" and said it "marked the successful culmination of a major exercise".