This site is intended for health professionals only

Why the Government is right to regulate herbalists

A Government suggestion to set up statutory regulation for herbal medicine practitioners has angered many readers, but I am slightly baffled by this reaction.

There is a public safety issue involved. Currently, anyone can set up as a herbal practitioner and sell powerful herbs. There is no requirement to be registered and as a result, the herbal industry is littered with underqualified and incompetent people, freely treating patients. Members of the public are often unaware of this fact.

An extreme example of the dangers this poses is the experience of Patricia Booth, who suffered cancer and kidney failure after taking pills containing a banned substance, aristolochia, and whose case was taken to the Old Bailey last year. Voluntary regulation was not robust enough to prevent this case.

Figures from the MHRA indicate six million people have used herbal medicine via a practitioner over a recent two year period. There is public demand for this therapy. Surely it is better to have a state regulated system where herbalists must have undergone recognised training that includes herb toxicity issues, drug-herb interactions, ethics and notifiable diseases?

Regulated herbalists would also adhere to criteria such as following a herbal ‘yellow card scheme' and holding valid insurance. Importantly, they would know when to offer treatment and when to refer patients to mainstream healthcare colleagues.

Competent herbalists are not concerned with the alleged status of belonging to a state regulated profession – what prestige is there to gain if the public think we are already regulated?

The Register of Chinese Herbal Medicine (RCHM) was established in 1987 to set and improve standards in the practice of Chinese herbal medicine. Our entry requirements have, for many years, mirrored those of broadly similar regulated healthcare professions. We represent a small proportion of Chinese medicine practitioners in the UK and this suggests that regulation will filter out a significant number of herbalists.

Our members treat around 200,000 people annually with patients coming to us for many reasons. Some seek herbs to complement prescription drugs, notably to ease nausea and other side-effects associated with chemotherapy (properly trained practitioners are aware of negative drug-herb interactions and will not treat in such incidences). There are also cases of GPs being able to reduce prescription dosages due to the positive impact of herbal medicines. Some patients find mainstream treatment has proved ineffective. Figures are not available to show the time and money this private treatment saves the NHS. However, too often we hear of instances where GPs and consultants strongly advise their patients against taking herbal prescriptions.

A frequent criticism of herbal medicine is the lack of evidence. The RCHM acknowledges that methodological weaknesses in research mean some trials and systematic reviews provide only preliminary evidence of the effectiveness of Chinese herbal medicine. However, there is now more emphasis on improving the rigour and transparency of clinical trials. As a consequence, an improvement in the quality of available evidence is anticipated.

To clarify one point: the use of animal and mineral products by herbalists is illegal in the UK. The RCHM also strongly condemns the illegal trade in endangered species and has a strict policy prohibiting the use of any endangered species by our members.

Our membership is fully aware of its position in the healthcare pantheon as complementary to mainstream practitioners, not an alternative to them. State regulation will not change this situation, but may give GPs and the public confidence in the safety and competence of their local herbalist.

It is planned that the statutory register of herbal medicine practitioners is established in April 2012. In the meantime, members of the public have a safeguard in the RCHM, and a small number of other self-regulating organisations.

Gary Minns is the president of the Register of Chinese Herbal Medicines.