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Following is a question by Dr the Hon Lo Wing-lok and a reply by the Secretary for Health and Welfare, Dr E K Yeoh, in the Legislative Council today (February 6):

Question :

Regarding the regulation of alternative treatment modalities, will the Government inform this Council:

(a) whether it has defined and classified alternative treatment modalities;

(b) whether it has conducted surveys on the popularity of alternative treatment modalities at present, and collected statistics on the number of persons who were injured, fell ill or died as a result of receiving alternative treatment over the past five years, and the details of such cases; and

(c) of the other mechanisms, apart from the strict regulation on the utilisation of alternative treatment modalities imposed on registered medical practitioners under the Professional Code and Conduct made by the Medical Council of Hong Kong, for regulating the utilisation of alternative treatment modalities by other persons and the legal basis for such mechanisms; if there are no such mechanisms, of the reasons for that?

Answer :

Madam President,

(a) There is no internationally agreed definition of the term "alternative treatment modalities". This term, or other terms such as "complementary and alternative medicine", may be used to refer to a diverse group of health-related therapies which are not considered to be a part of conventional or mainstream medical care. It may be even extended to therapies which are not health related. One distinct category are traditional systems of healthcare, many of which are long-established and have their own theoretical basis. Chinese medicine is one such discipline which is recognised by the World Health Organisation as based on systematical knowledge, a comprehensive methodology and real clinical experience and in our context is recognised as a parallel discipline and regulated by the Chinese Medicine Ordinance.

Another category covers the more organised alternative therapies which have an individual diagnostic and treatment approach, such as chiropractic, osteopathy and homeopathy. Formal training programmes are usually available for practitioners of these therapies.

In addition to the above, there has evolved over the years in different parts of the world a variety of therapies or techniques, some of which do not purport to embrace diagnostic skills but may claim to improve the users' general state of health or complement conventional medicine, such as aromatherapy and reflexology. These therapies or techniques are heterogeneous in terms of scope of practice, mode of intervention and vary in their appeal to potential users in different cultures at different time points.

(b) As far as the organised alternative therapies are concerned, there are about 50 chiropractors and a few osteopathy practitioners in Hong Kong. Moreover, registered medical practitioners can carry out alternative treatment modalities subject to the conditions stipulated in the Professional Code and Conduct issued by the Medical Council. Because of the diverse nature, no survey has been conducted to ascertain the number of patients seeking treatment from practitioners of the other varieties of alternative treatment modalities.

We have on record one case where the patient has received alternative therapy in addition to conventional medicine. It has been the subject of the Coroner's Court inquest where the verdict is death from natural causes to which neglect contributed. Based on the information on a limited survey conducted in the public hospital system, there were no other deaths or serious injuries arising from alternative therapies in the last five years. There were a few isolated adverse events, all of which did not require hospitalisation.

(c) There are many factors to be considered in deciding whether practitioners of alternative treatment modalities should be regulated. The factors include whether the alternative treatment practice covers a discrete area of activity displaying some homogeneity, whether the practice involves applying a defined body of knowledge and practice based on evidence of efficacy, the prevalence of such practice and the risk incurred when a patient receives such treatment modalities. Other relevant factors are whether the practitioners have in place an established professional body and that training and education of the discipline is well defined. We need to strike a balance between the benefits of regulation and the costs of regulation to be imposed on the consumers.

Among the second category of therapies mentioned in part (a) above, chiropractic practice is regulated under the Chiropractors Registration Ordinance (Cap. 428) in Hong Kong. While practitioners of other alternative treatment modalities may not be regulated under specific legislation, they are subject to controls under various ordinances, as follows -

(i) The Undesirable Medical Advertisements Ordinance (Cap. 231) prohibits advertisement of treatment modalities for certain diseases. The purpose of this ordinance is to prevent the public from being misled by advertisements of treatment modalities resulting in delay in seeking proper medical attention for diseases that carry serious consequences.

(ii) The Public Health and Municipal Services Ordinance (Cap. 132) requires that manufacturers and sellers of food or drug ensure that their products are fit for human consumption.

(iii) The Consumer Goods Safety Ordinance (Cap. 456) stipulates that a person shall not supply , manufacture, import into Hong Kong consumer goods unless the goods comply with the general safety requirement for consumer goods or the approved standard for the particular consumer goods.

(iv) As for pharmaceutical products, they are registered under the Pharmacy and Poisons Ordinance (Cap. 138).

Moreover, under common law all practitioners have a duty of care towards their patients, i.e. they are required to exercise the care and skill reasonably expected of the competent practitioner practicing in their field.

We are also devising a system to regulate health claims. The system will cover orally consumed products initially and, in the long run, would be extended to cover both products and services.

Based on surveillance intelligence in the public sector in addition to any possible legal recourse, we will issue health advice to the public if any treatment is found to pose imminent risk to consumers. Members of the public who wish to receive alternative treatment have the personal responsibility to exercise due care by ascertaining the risks involved before receiving treatment.

End/Wednesday, February 6, 2002

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