June 17, 2011

Re: 2011.LS3.5 (Acupuncture Licensing)

Dear Mr. Palacio:

Re: 2011.LS3.5 (Acupuncture Licensing)

We are reaching out to you by writing this letter on behalf of five Traditional Chinese Medicine/ Acupuncture (TCM/A) organizations: the Chinese Medicine and Acupuncture Association of Canada (CMAAC), the Canadian Society of Chinese Medicine and Acupuncture (CSCMA),  the Ontario Association of Acupuncture and Traditional Chinese Medicine Association (OAATCM), the Traditional Chinese Medicine Physicians Association of Canada (TCMPAC), and the Ontario College of Traditional Chinese Medicine (OCTCM).   Together, we represent over 90% of the TCM practitioners in Ontario.

We, as Associations, have been in contact with the various Ministries of Health across Canada over many decades volunteering our time and efforts to promote TCM in Canada.  We had some contact with the City of Toronto in 2004 with a previous foray into exploring acupuncture licensing which was eventually dropped due to the progress towards a self-regulating TCM/A College in Ontario.  We are proactive and dedicated professionals.  Although each of our Associations have worked independently over the years in promoting TCM/A, provincially and nationally, we have now come together in a united front for this cause.

We strongly believe that the City of Toronto has been misinformed from the very outset regarding the background situation leading to 2011.LS3.5.  We are especially dismayed how this process has ended up hurting the integrity of our profession without any basis in fact. We are upset that Councillor Doug Ford requested this report for 2011.LS3.5 based on the input from certain groups with a long-time reputation among our TCM/A community as being against professional regulation.

In contrast, we are a group of professional organizations with a common objective of promoting high standards of TCM/A in Canada by governing our members with requirements of high standards and continuing education programs.  Additionally, we have been instrumental in the recognition of our practice across Canada as evinced by our role in the regulation of TCM/A in some provinces:

• Chinese medicine is fully regulated in British Columbia with a regulatory body approved by its Ministry of Health to govern the practitioners of TCM/A;
• Alberta and Quebec recognize acupuncture as an integral part of their health care system and require all practitioners in those provinces to be licensed;
• TCM/A practitioners in Ontario will soon be recognized as a self-regulated profession, the first profession to be regulated since 1991 under the Regulatory Health Profession Act, alongside twenty-three other regulated health professions; and
• In June 2010, Newfoundland and Labrador announced that acupuncture has passed a third reading for the Acupuncture Act in that province.

For almost three decades, our Associations have worked very hard in gaining the confidence and respect of the Canadian public, the Ministries of Health, health insurance companies, and even from international organizations.  Canadians are increasingly viewing TCM and acupuncture practitioners as an integral part of their health care.  We provide Canadians with reliable health care services in a context of safety, effectiveness, and integrity.

The remainder of this letter is divided into two sections:

1) Describing the situation around 2011.LS3.5 and the reasons for our unanimous opposition.

2) Background description of our TCM/A Associations.

 

SECTION 1- 2011.LS3.5- The City of Toronto Exploring Licensing TCM/A

On April 26, 2011, a consultative meeting was led by Policy and Planning Services for the City of Toronto with stakeholders from the TCM/A community regarding enforcement issues and possible licensing of TCM/A practices in the GTA. This was in direct response to a letter from Councillor Doug Ford (found as attachment). In the letter, he stated there had been complaints from a group of TCM practitioners that there were increasing cases of illegal businesses, specifically “rub and tug parlours”, operating under the guise of TCM/A offices.  At the meeting, they invited feed-back from the representatives of the TCM/A community, many of whom were from our Associations, on what actions could be taken to mitigate such illegal activities.

Some of the questions that were raised were:

• Are there documental reports of these activities happening in the GTA?
• Do the number of cases, if any, in the GTA warrant such widespread enforcement or licensing of TCM/A practitioners?

In short, there were no definite confirmed cases to document any problem. In fact, we still don’t know if there have even been any cases of these illegal practices in the GTA.  The message was clear at the meeting – if there were no reports to prove TCM is being targeted for illegal services, then why are we here?

Following the meeting, CMAAC came up with an action plan to issue a joint press release with the CSCMA. The press release made it clear that both organizations strongly oppose the suggested holistic licensing and enforcement. At the same time, newsletters were sent out to our members to keep them updated about this matter and to suggest that they inform the City of Toronto if they did not see any benefit to this licensing.

However, an article in the Toronto Sun on behalf of the City of Toronto Bureau, dated Wednesday, May 4 (after the first consultation process), presented otherwise.  It misled the public by saying that the majority of the TCM practitioners wanted to be licensed, that there were an increasing number of ‘rub and tug’ services operating under the guise of TCM, and that there was no College overseeing legitimate clinics.

This article publically insulted the integrity of TCM profession without any documented reports of these illegal services and either completely ignored or misrepresented the intentions of the majority of the TCM community.  Furthermore, the TCM/A profession in Ontario, under the Regulated Health Profession Act, are to be regulated by the College of Traditional Chinese Medicine Practitioner and Acupuncturist of Ontario (CTCMPAO) as soon as the College is implemented in the coming year. As a result of this article, the TCM/A community’s trust in the City of Toronto was damaged.

A follow-up consultation from the City of Toronto was scheduled for the evening of May 25, 2011. Despite the short notice that was given, the TCM/A community was determined to be fully prepared and to be heard.  We were able to voice our collective opposition and ask further questions.  The meeting revealed that the City still does not have any statistics that indicate that TCM/A is used to front any illegal services meaning that these publically aired “concerns” were brought aired through some sort of word-of-mouth.

Despite the fact that there were a grand total of zero TCM/A practices known to be operating as rub and tug parlours in the GTA, the City of Toronto still presented these regulatory options to the TCM community at that meeting:

1. Licensing Regime
   1. Implementation would take at least six months;
   2. Municipal licensing would not affect the professional registration from the province.
2. Registration Requirement
   1. Would require registration with the municipality but would not impose any operating standards.
3. Enhanced Enforcement
   1. Would be implemented immediately and would involve proactive enforcement as well as rely on the community for identification of illegal operators and would not impact Provincial registration

Our specific concerns about these licensing models from the City include:

• Licensing Regime (option 1) will take a long time to set up; over six months. Each practitioner will pay an initial cost of $250 follow by approximate $200 per year renewal fee.
• Registration requirement (option 2) again comes with a fee.  Also, why use the word ‘registration’ as it is bound to cause confusion amongst both the public and TCM/A practitioners as it would be confused with upcoming provincial registration requirements.
• Enhanced Enforcement (option 3) sounds similar to what Toronto Public Health was already doing.  They were inspecting premises of TCM/A clinics for a number of years and would presumably have notified the authorities if an office wasn’t actually performing TCM/A.

Our more general concerns with this process are:

• Why aren’t other health professionals practicing acupuncture asked to do this? Why is TCM/A being targeted?
• None of our TCM/A Associations has ever received a complaint from a practitioner or a member of the public about someone performing illegal services while pretending to be a TCM practitioner and the City does not have any numbers or reports to provide.  What is the extent of the issue?
• How will these forms of licensing or registration actually prevent illegal activities?
• What standards would the City use, if any, to determine who could have one of these licenses?  How would these municipal standards be developed?  Would each municipality have their own standards?
• Would the municipal standards be different than those of the provincial College?  It just does not make sense for individual municipalities to potentially have to develop and enforce their own different set of standards for TCM/A practitioners when it is going to be done in a uniform province-wide manner next year.
• Health care regulation is under provincial jurisdiction, not municipal jurisdiction and regulation is currently well underway in Ontario – registration should start in spring/summer 2012.
• A complaint regarding illegal or unprofessional services would fall directly under College jurisdiction for investigation and reprimand, if needed.
• It is difficult to see how these licensing schemes would benefit public safety. It may just provide a list of businesses but licensing is not the same as enforcement.

Section Two:  Background of the Associations

In what follows, a brief description of each organization is outlined for your review.  Our Associations have always required high standards of training and integrity from our members.  Each Association has a Code of Ethics and a Code of Practice that every member is bound to and each Association requires their members to be covered by medical malpractice and liability insurances.

The Chinese Medicine and Acupuncture Association of Canada (CMAAC) were federally incorporated in 1983 to unite practitioners of TCM/A in Canada.  There are eight CMAAC Chapter offices across Canada.  In 1987, the CMAAC became a member society of the World Federation of Acupuncture-Moxibustion Societies (WFAS).  WFAS is the only TCM and Acupuncture Society to be fully recognized by the World Health Organization.

In Canada, the CMAAC has fostered an alliance with the provincial and federal governments and assists the various Ministries of Health on many projects.  The CMAAC has submitted the application for regulation of Traditional Chinese Medicine and Acupuncture in Nova Scotia, British Columbia, Saskatchewan, Newfoundland and Labrador, and Ontario.  For more information, please refer to the CMAAC website at www.cmaac.ca

The Canadian Society of Chinese Medicine and Acupuncture (CSCMA), federally incorporated in 1994, is Canada’s largest TCM/A organization with 2,500 members, 80% of whom reside in Ontario. In 2008, the CSCMA became a member society of the World Federation of Acupuncture-Moxibustion Societies (WFAS). In 2003, the CSCMA became a member of the World Federation of Chinese Medicine Societies (WFCMS). The objectives of WFCMS are to promote the exchanging and cooperation among the Chinese Medicine societies world-wide as well as the cooperation between the field of Chinese Medicine and other medical fields. Other objectives include strengthening international academic exchanges, improving the professional level of Chinese Medicine personnel to inherit and develop Chinese Medicine.

For further information, please refer to the CSCMA website www.tcmcanada.org.

The Ontario Association of Acupuncture and Traditional Chinese Medicine (OAATCM) , established in 1973, have achieved an approved standard of training in both traditional medicine and western health sciences and are bound by the Code of Ethics and the Code of Practice for the Association.

For further information, please refer to the OAATCM website at www.oaatcm.com.

The Traditional Chinese Medicine Physicians Association of Canada (TCMPAC) is dedicated to uniting Traditional Chinese Medicine physicians, promoting ethical practice, and upholding a high level of professional standards. Their vision is to help shape the future of Chinese medicine in Ontario and Canada through involvement in the legislative process, providing professional development for TCM practitioners, and providing benefits for their members.

For further information, please refer to the TCMPAC website at www.tcmpac.org.

The Ontario College of Traditional Chinese Medicine is dedicated to training a new generation of practitioners in the 2,500 year old Art and Science of Traditional Chinese Medicine.  They strive to introduce students to the most advanced theoretical and practical Traditional Chines Medicine training available in North America.  They also make every effort to promote and advance public understanding and knowledge of Chinese Medicine in our communities. At OCTCM, they endeavour to guide students on a journey toward fulfilling both personal and professional dreams, as them become dedicated leaders and practitioners in the field of medicine. In 2007, the OCTCM became a member society of the World Federation of Acupuncture-Moxibustion Societies (WFAS).

For further information, please check the OCTCM website at www.octcm.com

 

CONCLUSION

To reiterate, our five Associations have come together to unite against the disparaging, unfounded public comments and licensing plan involving our TCM/A profession in Toronto.  We believe Councillor Doug Ford should apologize to the TCM/A community or, at least explain how this error came about.  We have tried to contact his office but we still await his reply.  We are strongly for the regulation of TCM/A but, being a health discipline, believe that this is best done through a provincial mechanism such as the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario.  We hope the Ministry of Health of Ontario will expedite TCM/A regulation to prevent further issues like this arising.

Thank you kindly for your time. We hope that the Licensing and Standards Committee will decide to discontinue the 2011.LS3.5 and leave TCM/A professionals to be governed by the College.  We hope we have clarified the true issues behind this idea of licensing as part of our mission to promote the practice and practitioners of TCM/A.  TCM/A will continue to be a safe and effective health care choice for Canadians for many years.

 

Yours truly,

Signature:	Signature:
Prof. Wei-Ling Qiu, President The Chinese Medicine and Acupuncture Association of Canada	Zhao Cheng, Ph.D., President The Canadian Societies of Chinese Medicine and Acupuncture
Signature:	Signature:
Dr. Tony Chuvalo, President The Ontario Association of Acupuncture and Traditional Chinese Medicine	Dr. Adam Chen, President The Traditional Chinese Medicine Physicians Association of Canada
Signature:	Contact Person: Jane Cheung, CMD, Dr. Ac. English Secretary The Chinese Medicine and Acupuncture Association of Canada
Dr. Ben Wu, President The Ontario College of Traditional Chinese Medicine	E-mail: jane.cheung@cmaac.ca

 

 

 

Minister of Municipal Affairs, Honourable Hector Goudreau

Premier of Ontario, Honourable Dalton McGuinty

Minister of Health and Long-Term Care (Ontario), Hon. Deb Mathews

Minister of Health Promotions, Honourable Margarett Best

Minister of Tourism and Culture, Honourable Michael Chan

Mayor Rob Ford (City of Toronto)

Councillor Doug Ford (City of Toronto)

 

 

Councillors from the City of Toronto

Rudi Czekella, Manager, Policy and Planning Services

Earl Provost, Director of Stakeholder & Councillor Relations

College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia (CTCMPABC)

College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO),

Ordre des acupuncteurs du Quebec

Ethne Munden,  CMAAC Chapter President, Newfoundland and Labrador

June 26, 2008

Ontario Establishes New College of Traditional Chinese Medicine

Ontario has appointed a 15-member transitional council to oversee the practices and services of traditional Chinese medicine practitioners and acupuncturists. The first public meeting of the council was held, today, June 26, 2008. Established under the Traditional Chinese Medicine Act, 2006, the College of Traditional Chinese Medicine will make traditional Chinese medicine and acupuncture services safer for Ontarians by ensuring that only regulated and qualified practitioners who are accountable to a regulatory body may deliver services.  The transitional council is the public’s voice in regulating the future development of traditional Chinese medicine in Ontario. Traditional Chinese medicine is a holistic system of health care that originated in China. Therapies include acupuncture, herbal therapy, tuina massage and therapeutic exercise. Ontario is the second province in Canada to regulate traditional Chinese medicine. 安大略任命了一個 15 名成員的過渡委員會，負責監督傳統中醫藥從業人員及針灸師的開業和服務。在傳統中醫藥法案下成立的傳統中醫藥大學將通過確保只有對法律機構負責的守法合格從業人員才能提供服務，使得傳統中醫藥和針灸服務對於安大略人民更加安全。過渡委員會是管理傳統中醫藥在安大略未來發展的公眾喉舌。在2008 年6 月26 日召開該委員會的首次公開會議。傳統中醫藥是發源於中國的一整套醫療保健體系。治療方法包括針灸、草藥、推拿和理療。安大略是加拿大第二個管理傳統中醫藥的省份。

星島日報記者 –

安省中醫師及針灸師管理局過渡委員會昨天召開首次會議，在經過近一小時不記名投票後，張金達當選為主席，在15人的過渡委員會中有8名華裔。安省公 民及移民廳長陳國治指出，省政府委任過千人到各大小機構和委員會，全部任命都是透過省政府轄下的一個專責部門處理，省府亦有監管機制，可以罷免失職的人。張金達表示，過渡委員會的任期為兩年，首要工作是制訂專業水平和資格，訂「祖父法案」。省衛生廳在昨日上午正式頒發委任狀，他在前日(星期三)就已經辭去 所屬學會的會長職務。他不認為非專業成員人數較業界代表為多會影響運作，相信過渡委員會有很好的代表性，以及在各方面取得平衡。  安省公民及移民廳長陳國治說，省政府委任過千人到各大小機構和委員會，全部任命都是透過省政府轄下的一個專責部門處理，政府官員在篩選時要遵守嚴格和明確的守則，從透明度、代表性、多元化以至男女比例都有詳細規定。首要工作制訂「祖父法案」  註冊總監張關亮冰說，律師向管理局成員解釋清楚附例的規定。為了避免發生利益衝突，所有委員都必須作出聲明及澄清，遇上可能涉及利益衝突的事項，需要避席 和不參與投票表決。她說，管理局以公眾利益為前題，而團體則以會員利益為主。因此委員都必須辭去團體的公職，但可以保留會員的身分。至於教育機構就不可能 要求委員辭職，事實上各醫學會也有大學的代表。這些委員可以參與一般的教育討論，但不能夠涉及他們學校的課程或標準，亦不能夠向其他委員會成員介紹該校的 資料。  8名華裔委員之中，白曉東、程昭、張金達、董國慶、傅建平和吳秀梅都是執業中醫；代表市民的林陳少泉是註冊會計師，也是大多倫多公益金的義工；而曾任工程師學會副註冊總監的伍裕源則是政府委派。  過渡委員會在首日的會議經過近一小時的不記名投票選出包括正、副主席在內的5人執行委員會。主席張金達、副主席Lynn Bowering，執委伍裕源、傅建平和Joanne Pritchard-Sobhani。安省中醫師及針灸師管理局以規管專業資格，執業標準和操守，確保公眾安全為目標。

August 31, 2007

Registrar

• The McGuinty government is moving forward with the development of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario by appointing Emily Cheung as the Registrar to provide guidance and support to the Transitional Council of the College, Health and Long-Term Care Minister George Smitherman announced today.
• “I would like to congratulate Emily Cheung as the new Registrar for the college,” said Smitherman. “This is a big step forward towards making Ontario a leader in Traditional Chinese Medicine, and I am thrilled that Ms. Cheung will guide the new college towards achieving that goal.”
• “This is an important step for promoting the recognition of Traditional Chinese Medicine and Acupuncture in Ontario,” said Michael Chan, Ministry of Revenue.  “I have tremendous confidence that Ms Cheung’s appointment will lead to a new college that will enhance Ontario’s international reputation as an innovative leader in health care.” The Registrar plays an important role in administering the affairs of the college, including its financial operations and governance policies.
• “The Federation of Health Regulatory Colleges of Ontario welcomes the regulation of traditional Chinese medicine and the public protection that this extends to people in Ontario.  We offer our support to the College and its first Registrar, Emily Cheung,” said Mary Lou Gignac, President, Federation of Health Regulatory Colleges of Ontario.
• Ms. Cheung has been Registrar of the College of Dental Technologists of Ontario for the past 14 years, since its inception in 1993. Ms. Cheung has a Bachelor of Arts degree in Economics and Business Management from the University of Hong Kong.  “I want to thank the government for this wonderful opportunity to provide guidance and support to the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario,” said Ms. Cheung. “The College must regulate the practice of traditional Chinese medicine in the public interest.”
• “I support the government’s vision to make Ontario a world class centre for Traditional Chinese Medicine. Moving forward with the Transitional Registrar who has the experience to make this College successful is a very positive move. It shows the College of Traditional Chinese Medicine and Acupuncture will become a reality in Ontario,” said Professor Cedric Cheung, President of the Chinese Medicine and Acupuncture Association of Canada.
• The College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was established by the Traditional Chinese Medicine Act, 2006. This college sets and enforces the standards that regulate the practice of traditional Chinese medicine inOntario. The Act requires individuals who wish to practice TCM, practice a specialty of TCM, or call themselves TCM practitioners or acupuncturists to register and be accountable with the new regulatory college.
• Today’s initiative is part of the McGuinty government’s plan for innovation in public health care, building a system that delivers on three priorities – keeping Ontarians healthy, reducing wait times and providing better access to doctors and nurses.

麥堅迪政府宣佈委任傳統中醫學會會務主任 – 委任會務主任是發展管理院的一個重要步驟

• 多倫多August 31, 2007 -衛生及長期護理廳長喬治史密瑟曼今天宣佈，麥堅迪政府進一步發展安大略省傳統中醫師及針灸師管理院，委任張關亮冰為會務主任領導和支持管理院的過渡理事會。
• 「本人恭喜張關亮冰出任管理院的新會務主任。」史密瑟曼說：「這是使安省成為提倡傳統中醫的先驅者向前跨進一大步，而張女士將會領導新管理院邁向這個目標，我為此感到十分興奮。」會務主任在管理院會務的管理上，包括財務運作和管理方針各方面，扮演一個重要的角色。
• 安大略省衛生規管協會聯盟主席瑪利璐吉尼爾克表示 ：「安大略省衛生規管協會聯盟歡迎傳統中醫得到規管，及安省居民因而得到的公眾保障。我們支持管理院和它的首位會務主任張關亮冰。」 「這是在安省擴大傳統中醫和針灸影響的重要一步，」稅務廳廳長麥克陳指出。「我充分相信，張女士的任命將會為我們帶來一個全新的管理院，並將增強安省作為衛生建康領域一個創新領導者的國際聲譽。」
• 張女士是香港大學畢業的經濟及商業管理學士，自安大略省牙科技術學會在一九九三年創立以來一直任職會務主任，凡十四年。「本人感謝政府給予我這個機會領導和支持安大略省傳統中醫師及針灸師管理院。」張女士說：「管理院必需規管傳統中醫的執業以保障公眾利益。」
• 「本人支持政府的遠見，計劃使安省成為一個國際水準的傳統中醫藥中心。委任資深的過渡會務主任領導管理院運作成功是十分積極的行動。這表示傳統中醫及針灸管理院將在安省真正成立。」加拿大中醫藥針灸學會會長張金達教授說。
• 安 大略省傳統中醫師及針灸師管理院是根據傳統中醫法，二零零六成立的。該管理院訂立并實施標準以規管在安省執行的中醫業務。法例規定任何人想在安省執行中醫 業務、執行中醫的某專科業務或使用「傳統中醫師」或「針灸師」的職稱，必需向新的規管管理院註冊并向該管理院負責。今天的行動是麥堅迪政府的部份計劃革新 公眾醫療體制，建立一套系統實現三個重點：保障安省居民的健康、減省輪候時間與更容易得到醫生和護士的服務。
• From CMAAC:  McGuinty Government Announces Registrar of the College of Traditional Chinese Medicine: Appointment is a Major Step in the Development of the College.  As part of the legislative process the McGuinty Government on August 31, 2007 announced that they were moving forward with the development of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario by appointing Emily Cheung as the Registrar.  The Registrar plays a significant role in administering the affairs of the college, including the financial operations and governance policies.
• The College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was established by the Traditional Chinese Medicine Act, 2006.  The college sets and enforces the standards that require the practice of Traditional Chinese medicine in Ontario.  The Act requires individuals who wish to practice TCM or a specialty of TCM, such as Acupuncture, or call themselves TCM practitioners or Acupuncturists to register and be licensed with the new regulatory college.
• There has been a great deal of confusion and speculation within the Profession and in the Chinese Community.  Now that the TCM profession is being regulated and the new College is being founded, a transition time will occur prior to mandatory enforcement for licensing and those standards for licensing will be determined, only by the new Transitional College.  However, it should be noted that there is no other organization or association in Ontario that has the legal mandate to provide licensing in any form or to authorize examinations for licensing or for the granting of titles.
• As many of you know, there is a Provincial Election in October.  In the past many of our efforts towards legislation were set aside, bearing the outcome of elections and what priorities the new government had.  For clarification purposes we want our members to understand the reason this occurred in the past was that legislation never became law.  In 2006, The Traditional Chinese Medicine Act became law, which was unanimously voted upon by all members of Parliament.  Even though there is an election, despite any election outcome, the regulation of our profession will be a reality and the new Transitional Collegewill be formed.  If there was any doubt, the government’s decision to move forward by hiring the new Registrar is a clear indication of the intent of the Government to move forward in enacting the Traditional Chinese Medicine Act.  It is however, a long process that requires careful deliberation and to this end it is understandable because the choosing of a Registrar is integral to the successful implementation of new policy and directions.
• CMAAC is extremely pleased with this decision and encourages all of you to look forward to the day when we as Traditional Chinese Medicine practitioners and Acupuncturists will be licensed as regulated practitioners.  This is a major initiative in which we will be recognized as part of the government’s plan for an innovative health care system that provides equal opportunity to access safe and effective treatment from qualified professionals within the field of TCM.  For further information please do not hesitate to contact head office.

January 17, 2007

• The Minister of Health, Honourable George Smitherman invited Professor Cedric K.T.  Cheung, President of CMACC and a number of other Associations and Organizations to attend a celebration on January 17, 2007 acknowledging the conclusion of years of lobbying for the Regulation of  Traditional Chinese Medicine and Acupuncture.  December 20, 2006 was an historical event in Ontarioas Bill 50 received Royal Accent, making us the second Province in Canada to regulate Traditional Chinese Medicine and Acupuncture. The Honourable George Smitherman expressed his appreciation for the incredible commitment to the process that so many individuals and organizations have demonstrated over the years; despite the struggles and conflicts that emerged. Change is difficult, but the Minister and his staff have certainly shown their commitment to the process in a way that no other Government was able to do and most of all, they did so because it was in the best interest of the public. In retrospect it was great to share and reflect with Ministry staff and colleagues who have been involved in various capacities. The excitement in this historical moment was evident, seeing old faces and finally meeting new ones, all of whom played a critical role in lobbying for the regulation of our profession.  The next step now involves the establishment of the new Transitional College for which the Ministry is currently establishing selection criteria for appointments to the Transitional College.
• 安省衛生廳廳長George Smitherman 閣下邀請加拿大中醫藥針灸學會會長張金達教授，和其他組織團體參加了於2007年1月17日舉辦的慶祝會；慶祝會標誌了數十年爭取傳統中醫藥針灸立法管理的最終成功。  2006年12月20日，50號議案經過眾議院最高皇家的通過；使這一日成為了安大略省中醫藥針灸發展的歷程碑， 并使安省成為了加拿大第二個省份全面管制中醫針灸專業。安省衛生廳廳長George Smitherman 閣下向許多的中醫專業人員及團體組織為立法程序所付出的巨大責任和成就表示了衷心的感謝。儘管在立法過程中所出現的分歧和爭議， 改革是擁有代價的。 當今政府衛生廳和他的內閣成員展示了前所未有的責任感；最重要的是政府為公民著想而設立管制制度。 回顧奮斗歷程， 我們非常高興地看到政府工作人員和中醫藥界同行們在各個領域中共同協助。 在這歷史性永不忘記的時刻， 我們非常興與老同行相聚， 認識新同仁；一起， 我們為中醫藥專業付出了我們應有的使命和貢獻。 下一步， 就建立新的過渡性中醫管理院， 衛生廳正在設立有關任命管理局成員的條例章程。

November 23, 2006

• The Third Reading of Bill 50 on November 23, 2006 was a day that CMAAC will never forget. The Honourable George Smitherman (Deputy Premier, Minister of Health and Long-Term Care) acknowledged many of his colleagues in bringing this Bill forward as a result of good process and work of the Standing Committee on Social Policy on October 30th and October 31st 2006. What was unique to this process and quite rare was the unanimous support for Bill 50 to proceed to third reading by all parties. In his remarks, Hon. George Smitherman congratulated everyone expressing that he appreciated the efforts that have made by members on all sides to bring this bill forward.
• Despite the many challenges and the debates over the regulation of Traditional Chinese Medicine and Acupuncture, the process was a worthwhile one involving many different stakeholders that   has culminated in the passing of Bill 50 by all members of the Legislature…  The next step is that Bill 50 receives Royal Assent that then finalizes the Bill in Law.  Once this is completed the Transitional Council will be appointed by the Ministry.  So with excitement and somewhat awed by the passing of this Bill after so many years, what does this mean to us at this moment.  Once the Bill is law it does not mean that the world suddenly stops and we have to move into panic mode.  No, none of this happens. It is business as usual meaning that we don’t suddenly stop practicing.  Mr. Patten stated that the passing of Bill 50 will not have any immediate effect on anyone at the moment.  “It will only have an effect when the transitional council, which, by the way will carry and have the powers of a full council… but when the council has done its work, and everything is in place with regulations.  Until that happens, it is business as usual. Change is coming but as a matter of public record for those who had concerns that they would suddenly not be able to practice,” Mr. Patten confirmed that, “down the road when regulations are adopted about what the qualifications will be for people to be TCM practitioners what the grand-fathering provisions will be, then practitioners will have to deal with those changes”.
• It is in fact a time for Celebration, time to reflect that finally our profession has been recognized as a Regulated Profession.   Sit back and think about this for a moment the impact this will have on the public in their right to have access and choose the health care they deserve.  For the first time since 1991, just consider this as a historic moment because for the first time since 1991, a brand new regulated profession has emerged.  Traditional Chinese Medicine and Acupuncture is now one of the 24^th Regulated Professions in Ontario under the RHPA. Through a unanimous vote the Government of Ontario acknowledged that Traditional Chinese Medicine and Acupuncture are an important part of our health care system.  The Minister in his speech stated, “Regulation is the recognition that this is a profession that provides a contribution to keeping our Ontarian’s healthy. What I really want to herald here is that it is not every day in western environments that we move forward with the adoption of techniques that have been so deeply and profoundly influenced by different philosophies.”  Yes, indeed, his remarks reflect a remarkable evolutionary process that has and will continue to change the face of the health care system in Ontario.
• Through this process a number of amendments were made to Bill 50.  These were welcomed changes to improve the Bill.  We were absolutely confident the Ministry would make the necessary amendments to improve Bill 50 which is in the best interest of the public and our profession.
• The new name of the future regulatory College will be, “College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario”
• Two controlled acts have been added to the Bill. They are:
  1. The act of performing acupuncture is now a controlled act, authorized to only those qualified to “performing a procedure on tissue below the dermis and below the mucous membrane for the purposes of performing acupuncture”.
  2. The controlled act of “Communicating a TCM diagnosis identifying a body system disorder or the cause of a person’s symptoms using traditional Chinese medicine techniques”.

• Other healthcare practitioners will be able to use acupuncture as an adjunct within their scope of practice.   Eight Colleges have been authorized to use acupuncture as an adjunct.  They include:  Chiropody, Chiropractic, Naturopathy, physical therapist, nurses, massage therapists, occupational therapists and dentists.
• What is significant is that all of “The Colleges” must establish minimum standards and the Minister wants the Colleges to collaborate and co‑operate with one another and with HPRAC to develop those standards.  The Minister has assured all parties that a referral back to HPRAC will be made, asking for their advise on the matter of minimum standards.  Most of these professions were granted this authorization because they already have the controlled act of performing procedures below the dermis, and or have been performing acupuncture as adjunct within their scope of practice for quite some time.  Doctors & Surgeons remain exempt with regard to performing acupuncture. Note: Contrary to what you may have heard, this is not an option for the Colleges because this is written into the act. It is understood that the Ministry has the authority to enforce this provision with the other Colleges which will be in the best interest of public safety.
• “Grand-fathering” will be left to our Profession to establish, where the new Transitional Council will have the authority to develop grand-fathering provisions.  This is not new. In fact, many other new professions had grand-fathering provisions established by their professional body vs. by Legislation.  The advantages of this, quite clearly, is that the majority of the new college will be members of our profession, where we expect that they will understand this sensitive issue in which the provisions established would accommodate our profession in an ethical and safe way, paying particular attention to era appropriate training and language.
• This is a Historical Event that will change the face of the profession and the delivery of Health Care Services in Ontario that will focus on the prevention of disease and treatment of chronic conditions.  Yes, indeed the profession has been marginalized for many years because we have not been regulated. But, regulation will provide for the recognition of the profession in a manner never witnessed in Ontario with the right to use the Doctorate Title.  Every Ontarian will have the right to choose the type of health care they deserve, knowing that our profession has standards of education that protects the public from harm.
• Once regulation occurs, patients will have access to our services.  As a direct endorsement of new legislation the previous denial of coverage will no longer occur. Third party insurance companies, Workman’s Compensation, and Veteran’s Affairs will provide coverage enabling patients to seek our services.  This will decrease wait times and actually decrease the cost of health care by offering patients affordable holistic treatment that focuses on the prevention of disease.
• Regulation will increase our credibility in the health care field in which an integrated approach to health care will offer the patient’s the best treatment options available.
• In terms of educational programs, students will no longer be exploited by small private schools offering less than adequate programs and that said, legislation regarding standards of education and practice will signal extra-ordinary growth and development in this area where research literacy will provide further advancement in the field.
• Bill 50 provides for tiered registration which is in the best interest of the public because it will ensure that those individuals who practice Acupuncture & TCM do so, with the highest level of competencies within their scope of practice whether they are an Acupuncturist, TCM practitioner, TCM doctor or an adjunct practitioner.
• So, to this end we begin our journeys as one of the newest regulated professions, proud of our accomplishments, we now forge the future for the next generations to come.  Congratulations everyone.  Our dream is now a reality!
• 傳統中醫藥針灸專業50號議案的第三次審讀于2006年11月23日舉行了；這一天在加拿大中醫專業發展上具有深遠意義，對加拿大中醫藥針灸學會來講是個永記銘心的日子。 安大略省副省長，衛生廳廳長George Smitherman 閣下在審讀會上，向他的同僚們表示謝意， 感謝現任委員會10月30及31日就有關社會方針設立了良好的程序和工作結果，無疑地推動了50號議案的進展。 這次議案討論會與过去不同的，50號議案的第三次審讀獲得了當場朝野三黨代表的全體一致通過。
• Smitherman 閣下在他的講話中，恭賀和稱贊全體代表們攜手努力，團結一致地將50號議案推進到最高一步程序。盡管傳統中醫藥針灸專業就有關立法管理經歷了許多的挑戰和爭論，涉及了許多不同專業團體代表們，最終50號議案的眾議院通過，使立法程序具有了深遠意義和價值。 下一步驟將是50號議案將送到最高皇家批准，議案將最終成為法案。 當法案的成立， 過渡性管理院組成人員將被衛生廳任命。經過數十年的奮斗， 面對議案的通過，我們歡欣鼓舞；這一巨大的成就對我們來講具有什麼意義呢？ 專業法案的建立不會引起混亂，打擾人心，並且不會影響專業繼續施行和開展。 議員Patten 先生表示議案的通過目前不會有立即的影響。 他講到“過渡性專業管理院的成立， 將主管建立專業章程和操作程序。專業管理的改進必將來臨，但不會造成專業持業者忽然散失專業操作權利。 在今後的立法管理適應過程中，當中醫專業的合格標準和“祖父法”的設立時，專業持業者才將面對新的變動。”   對全體傳統中醫藥針灸專業的工作同行們來講， 這一時刻是終生難忘的。
• 回歸過去的奮斗歷史，我們衷心的慶祝中醫專業終于成為了立法管制的醫療專業體系的一部分； 並且立法的成功將帶給民眾更多的權利和途徑來選擇他們所應該獲得的醫療保健療法。 自從1991年來， 這是第一次新的管理醫療專業的出生；傳統中醫藥針灸專業如今成為安大略省24個法制管理的醫療專業專業的其中一個。審讀會上的全體代表的一致表決通過， 安省政府宣布了傳統中醫藥針灸專業成為醫療衛生專業體系的組成部分。 衛生廳廳長George Smitherman 閣下在他的講詞中，強調“立法管理是承認中醫專業在維持安省民眾的身心健康所作出的杰出貢獻。 在此我要特別指出在我們西方生活中，這是個非常重要的時刻，因為我們接受和采用這一早已深入我們生活中的古老醫療方式。” 衛生廳廳長 Smitherman 閣下的講話代表了安省衛生領域的巨大改進和發展，並將繼續提高和完善衛生醫療體系。
• 在第三次審讀會上， 50號議案增加了一些修正案。我們對安省衛生廳充滿了信心， 相信省政府所作出的必要改動將保證議案能夠為民眾的利益著想，并保護專業人員的合法權利。新的專業管理院的名字以定為“安省傳統中醫藥執業者及針灸師管理院”。兩個新的管制條例被填補到50號議案中﹕

1.        應用針灸療法條款成為一個管制法案條例，只有合格的專業人員能夠使用皮下和粘膜下針灸穿刺療法進行針灸療法。

2.        傳統中醫診斷法案條例，應用施行規範傳統中醫診斷手段，以確保疾病診斷和症狀原因。

• 其他衛生醫療專業工作人員將能夠在他們現有的醫療範圍內應用針灸作為他們的輔助醫療工具。 八個醫療管理專業被容許使用針灸輔助治療﹕足病治療師，整骨醫生，自然醫療， 物理治療師，護士，按摩治療師，職業病治療師，和牙醫專業。
• 最重要的管理條例是以上八個醫療管理專業必須建立最低程度的操作標準，並且衛生廳要求管制專業共同協作，與衛生醫療顧問委員會協調，建立規範的管理條例。 衛生廳廳長保證各大專業就有關設立操作標準，衛生醫療顧問委員會將幫助咨詢，提供合理性建議。 這些憲法管理專業被容許使用針灸療法是因為在他們的專業法案條例中已經設立了使用皮下療法，或早已應用針灸輔助療法。 西醫醫師和外科醫師免除針灸使用的法案管制條例。 但是，與社會輿論相反，以上專業不能夠免除管制，法案清楚地列出管制法規。 衛生廳具有權利強行管制其他醫療專業以保證公民的安全。
• “祖父法”將留給過渡性中醫專業管理院來建立具體的條例。 這不是新鮮事情。事實上， 許多其他新的醫療專業也具有共同的特點，并不由眾議院來決定；相反，他們自己專業設立具體的“祖父法”條例。 巨大的好處是大多數的中醫管理院組成人員都是我們專業的成員，他們能夠理解這個敏感的問題， 在符合醫德和保證公民安全的基礎上，他們可以設立合格條例，并注重在合理的培訓時間和條款書寫。毫無疑問， 50號議案的第三次審讀通過將提高中醫專業的知名度， 推進安省衛生醫療質量水平，并注重預防保健和慢性病的治療。 中醫專業多年來被忽略是因為專業還沒有被合理的立法管制。 如今，立法管制的成功將保證中醫專業擁有從未有過的社會聲譽和地位，併能夠擁有醫師頭銜。 安省的公民們將得知具有合格教育標準的中醫專業能夠確保醫療安全，併擁有自由權利來選擇他們所應得的醫療手段。 一旦立法施行， 病人將可以使用我們的醫療服務；而且新的立法條例將支持中醫針灸療法的保險。保險公司如工作安全保險，退伍軍人保險， 將保證他們的病人尋求中醫針灸療法。 提供合理的醫療體系，預防疾病醫療將降低等候看病的時間，和降低醫療費用。同時， 立法管理將提高中醫專業在醫療專業中的知名度和可信度，併與其他醫療專業相結合，提供最好的醫療服務手段。
• 就有關中醫教育培訓，學生們將不會被小數私人學校所利用， 不能夠達到合格的教育標準。 立法管理將設立合格的教育標準和操作程序；這表示中醫教育業將得到輝煌的發展，並將推動中醫研究領域的進展。 50號議案提出了一系列不同級別的登記標誌和區分；這將保障社會民眾的利益因為中醫專業人員將在他們的行醫範圍內具有最高水平的醫療和技術能力，不管他們是針灸師， 中醫執業師，中藥師，或中醫師。從今起， 作為最新的立法管理的醫療專業人員，我們開始了新的歷程。 我們為我們所創建的成就而自豪；展望中醫未來，未來中醫界將前途無量。 同行們，讓我們互相地恭喜我們的勝利；我們夢想成為現實了！

October 2006

Prof. Cheung, along with several other members of CMAAC presented in support of Bill 50 to the Standing Committee on Social Policy Hearings. Their support proved successful, with the final passing of Bill 50 regulating the profession of TCM and Acupuncture the following month.

September 27, 2006

• First of all, we would like to express profound thanks to the Minister of Health, George Smitherman, and the government of Ontariofor seeing Bill 50, the Traditional Chinese Medicine Act, through its second reading on September 27, 2006. Bill 50 was first introduced into the Legislature on December 7, 2005 by Minister Smitherman.  It has been more than 23 years since Prof. Cedric K.T. Cheung, President of the Chinese Medicine and Acupuncture Association of Canada started lobbying, and in 1994, he applied to the Ontario government for regulation.  There is no doubt since the original application was made, that many other TCM and Acupuncture Organizations along with the regulated professions have participated in public hearings to finally move closer to the goal.
• From this point, a Committee will be established, composed of Members of Provincial Parliament, which will be open to the public and key stakeholders.  This Committee will function to gather input regarding the Bill and can potentially lead to minor amendments before the third reading.  Major amendments would lead to significant delays with further HPRAC review or possible shelving if the legislation is not passed before next year’s provincial election. We question why anybody who purports to have the best interests of TCM practitioners and acupuncturists in Ontario would be so opposed to this legislation at this point when there is still time for constructive input before the third reading.
• Should Bill 50 pass its third reading and achieve Royal Assent, a transitional Council would be established and eventually a College Council, as per the Regulated Health Professionals Act.  As all other regulated health professions already have their own Colleges in place which deal with any complaints regarding their own members.  This regulatory College for TCM will establish standards of Education and Practice for the Profession as well as a strict code of ethics.  There will be a tiered registration, including the use of the Doctorate title, reserved for those practitioners whose competencies and skills reflect the advanced training required. We cannot emphasize enough that even after it passes, Bill 50 does not become a comprehensive legislation.  There are mechanisms that allow the College to make further refinements in regulations regarding education, standards of practice, and prescribed and prohibited therapies.  Specifically, questions regarding “performing a TCM diagnosis”, “prescribing and dispensing of herbal substances”, “performing a procedure below the dermis”, and “point injections of herbal substances below the dermis” “Chinese Orthopedics, Traumatology and Tuina” can be included in the scope of practice of TCM.
• There has been a significant increase in the number of people who perform acupuncture since Professor Cheung’s first application for regulation.  Bill 50 limits the use of acupuncture to professions identified in the Regulated Health Professions Act.  Contrary to some reports, not every listed profession has acupuncture in its scope of practice.  Compare that to the current situation where there is absolutely no restriction on who can perform acupuncture in Ontario.  Surely, only allowing acupuncture to be performed by other regulated health professions, drugless practitioners, and as addiction treatment in a health facility is an improvement.  To deny the right to these regulated professions would be discriminatory and there is no doubt that such a Bill would be vigorously protested by them.
• As we proceed to the next phase in the development of this Bill, this issue will be addressed in a transparent way, because unlike B.C., the Health Professions Act cannot discriminate against regulated practitioners or prevent them from practising. This is because the intent of this legislation is that other regulated professions have shared scopes of practice.  Therefore, according to the World Health Organization and the World Federation of Acupuncture-Moxibustion Societies, regulated professionals such as Medical Doctors and physiotherapists could perform acupuncture as an adjunct, provided they become qualified with the requirement of a minimum of 220 hours of training.  This will enable them to treat some diseases.  It is logical that once our college is established, we will be in a good position to provide acupuncture training to members of the other colleges and thereby further enhance public safety.
• Regulation will improve our visibility and credibility in the public.  Tiered registration is necessary given the wide range of education and experience in the TCM and acupuncture community (this is distinct from the minimum WHO standard for regulated health professionals) and is in the best interest of the public as it will ensure that all practitioners will be able to perform at the highest level of competency within their scope of practice, whether they are an Acupuncturist, TCM practitioner, Herbalist, or Doctor of TCM.  This enhances our profile in the public and empowers general Ontarians to decide what level of treatment they wish to receive.  This also enhances the credibility of our profession in the health care field by opening the door to more opportunities in integrated health care, research, and even improved third party insurance, WSIB, and Veteran’s Affairs coverage for our services.
• “Grand-fathering” existing TCM and acupuncture practitioners is a given but the details can only be decided by the Transitional Council of the College after Bill 50 passes.  Certainly some time will be required to establish the educational programs and standards and then people will be given the opportunity to meet those standards or even upgrade their level of training. The amount of resistance from within the traditional Chinese Medicine community is disappointing.  If this is based on misunderstanding, hopefully we have adequately addressed some of the concerns that have already been raised.  If not, please bring forth your constructive comments to the public hearings.  Another possibility is that there is deliberate misinformation being spread by those with vested interest in maintaining the status quo of no standards and no accountability.  Right now, there is no justification for our profession to choose not to regulate TCM and acupuncture in the province of Ontario as there is no doubt that the passing of Bill 50 will change the face of the health care system.  It is time to move forward with our future as one of the regulated health professions.
• 首先， 我們感謝安省衛生聽George Smitherman廳長和省政府遵照計劃，于9月28日進行了傳統中藥藥針灸立法，50號議案的第二次審讀。50號議案是于2005年12月7曰由省衛生廳Smitherman廳長向眾議院提出的。 自從加拿大中醫藥針灸學會會長張金達教授作為中醫界的先驅者， 于1994年首次向安省政府申請專業的立法管理以來， 立法奮斗已經長達23年了。 毫無疑問，隨著最初的申請報告的呈交，其它中醫界同仁，及立法管制的醫療專業人員也陸續參與了許多的公開討論會，逐漸促進立法到目前的發展狀況。
• 下一步， 一個由省議員成員組成的管理委員會將會成立，並將面向社會團體組織和其他領域的重要成員代表。 這個委員會將聽取有關50號議案的改進意見，總結和提煉精華，并可能在第三次審讀之前進行一些議案修改。  但是，議案大的改動將極大地影響立法的進展，和再一次的醫療專業顧問委員會（HPRAC）的審閱；如立法不在下一年選舉前完成，專業立法有很大的可能被拖延。那些所謂聲稱支持傳統中藥藥針灸專業，為專業人員著想的少數人， 為什麼極大的反對議案。就目前來講， 我們還有時間在第三次審讀之前進行建設性議案修改。
• 只有50號 議案通過它的第三次審讀和眾議會的同意，就立法管制醫療專業法案的條例，一個過渡性的，并最終成為專業管理院將會成立。其他醫療專業都有他們自己的管理 院，處理有關他們專業人員的行醫規範和抱怨控訴。傳統中醫藥針灸管理院將會設立嚴格的醫療準則，道德規範，和高標準的教育培訓和行醫標準。立法條例將有不 同等級的專業登記； 包括頒發給那些具有專業能力和高超技術水平的專業人員“中醫醫師”的頭銜。
• 我們不斷地強調即使50號議案通過， 它還不能自動成為一個完整全面的立法條例。 法案的機構方式容許管理院就有關教育標準，行醫範圍，中藥配方和限制療法等方面作出進一步的改良。 具體來講，所涉及的有關施行中醫醫療診斷， 皮下針灸， 中藥開方配藥，和皮下中藥穴位醫療，骨傷，推拿，都可以包括在中醫醫療體系內。自從張金達會長第一次呈交立法管理的申請以來， 現有不斷增加人數進行針灸療法。 50號議案限制只有醫療管制的專業範圍內人員方能使用。與一些其他報道相反， 并不是所有列表的管制醫療專業在他們的行醫範圍里包括使用針灸。
• 目前就安大略省的現狀， 使用針灸療法沒有任何的限制。所以， 只容許管制醫療專業人員，不使用藥品的持業師使用，和采用為治療毒癮手段是一個很大的進步。拒絕其他醫療專業人員的使用權利是種族歧視； 并同時將導致我們的議案被他們強烈的反對。
• 當 我們繼續下一步立法程序，完善議案的條例， 這些問題會公開和明了的再次強調和討論。 與畢詩省的醫療專業法案的不同，我們不能歧視其他醫療立法管制的專業工作人員，或阻擋他們的專業使用。因為建立專業立法管理的宗旨是與其他醫療專業人員在 行醫範圍內共同努力，攜手合作。就世界衛生組織和世界針灸學會聯合會的標準，立法管制的醫療專業，如西醫醫師，物理療師，將可以使用針灸作為他們的輔助療 法，治療一些病症；只要他們受到至少220個小時的合格針灸培訓。這是非常符合邏輯的；只要我們管理院成立，我們將擁有很好的優勢，為其他管理院提供針灸培訓，以保障社會民眾的安全。
• 立法管理將極大提高中醫藥專業的可見度和可信度。 中醫藥專業界具有不同的教育程度的持業者，帶有不同水平的醫療操作能力；因此，分等級登記是非常必要的。世界衛生組織為管制醫療專業人員所設立的至少標準在此是非常明確的。 這將保證無論是針灸師，中醫持業者，中藥師，或中醫醫師，都能夠在他們不同行醫範圍內發揮他們最好的行醫治病能力。 等級登記將提高民眾對本專業的信任，并協助他們選擇他們所願意接受的治療手段和水平。 同時，它也將幫助中醫藥專業在醫療領域，綜合保健，研究學習方面打開大門； 并促進保險公司，如工作安全保險，退伍軍人保險，為中醫針灸療法提供保險。
• 傳統中醫藥針灸專業所存在的“祖父法”是獨特的特征；但是， 具體條例需要在50號議案通過后由過渡性管理院決定。  明顯地需要一些時間達到所規定的教育培訓和技術標準，并將給予持業者機會符合這一標準，甚至提高到更高的級別和水平。那些來自傳統中醫藥針灸界的一些阻力是非常令人失望的。 如果這是誤解，不了解立法程序， 我們希望在此我們恰當地解釋其中的一些擔心和問題。 可能有一些沒有合格的中醫教育和針灸培訓，沒有專業責任信譽的少數人抱有私心， 想要保持現狀，并有意傳播謠言。 現在沒有任何的理由要選擇放棄立法管理專業，因為毫無疑問50號議案的通過將改變提高醫療衛生健康體系。 時機已成熟；傳統中醫藥針灸專業加入管制醫療專業體系勢在必行，并將前途無量！

December 7, 2005

Ontario Government Introduction Legislation Bill

The McGuinty government is helping ensure that Ontarians have access to safe, quality services provided by the health professionals of their choice, with the introduction of legislation to regulate the profession of traditional Chinese medicine, Health and Long-Term Care Minister George Smitherman announced today. “We promised to protect Ontarians who choose alternative health care like traditional Chinese medicine, and we are fulfilling that promise,” said Smitherman. “If passed, this legislation will help give Ontarians confidence in the quality and safety of these treatments.” Traditional Chinese medicine is currently an unregulated profession inOntario; no restrictions exist on who may call themselves a practitioner or who may practice the profession. As a result, Ontarians have no reliable way of knowing which practitioners possess the appropriate competencies and training required for safe practice. If passed, the legislation will make traditional Chinese medicine the first new health profession to be regulated since 1991.Highlights of the proposed legislation includes:

§    The creation of a self-governing regulatory college. This college would have the authority to set standards of practice and entry to practice requirements for the profession

§    A defined scope of practice and restricted titles that only members of the profession may use, including the use of the “doctor” title by certain members of the profession

§    Restricting the performance of acupuncture to members of regulated health professions and to persons who perform acupuncture as part of an addiction treatment program within a health facility.

“The regulation of traditional Chinese medicine and acupuncture has finally become reality since our first application was submitted in 1994. This is, indeed, joyful news,” said Professor Cedric Cheung, President of the Chinese Medicine and Acupuncture Association of Canada (CMAAC), and Vice-President of the World Federation of Acupuncture-Moxibustion Societies. “The TCM community, including practitioners, patients and members of CMAAC, have been diligently pursuing regulation for 22 years. With the passage of the legislation being introduced today, the health and safety of Ontarians will be assured. “The proposed legislation builds on the consultation report released this past summer. It was prepared by MPPs Tony Wong, Richard Patten, Mike Colle and Peter Fonseca, who were appointed by the minister to travel the province to hear Ontarians views on traditional Chinese medicine. “I am pleased that our recommendations are being implemented and that the minister is moving forward to recognize a widely used form of complementary and alternative health care,” said Tony Wong, Chair of the MPP group. “Traditional Chinese medicine and acupuncture have been practiced for countless years, and we owe it to Ontarians to ensure that these services are delivered by practitioners with a high level of competence.” Traditional Chinese medicine is a holistic system of health care that originated in Chinaseveral thousand years ago. Therapies include acupuncture, herbal therapy, tuina massage, and therapeutic exercise. TCM views the body as a whole and addresses how illness manifests itself in a patient and assesses the whole patient, not just the specific disease.Ontario will be the second province in Canada to regulate traditional Chinese medicine after British Columbia. “The Ontariogovernment is to be commended for introducing legislation to regulate traditional Chinese medicine and acupuncture in this province under the Regulated Health Professions Act. This will provide fair and equitable access to valuable treatment for all Ontarians. Members of the Acupuncture Foundation of Canada Institute look forward to a collegial relationship with members of the futureCollege of TCM,” said Dr. Linda Rapson, MD, Executive President of the Acupuncture Foundation of Canada Institute.

麥堅迪政府監管傳統中醫藥 -有關立法可為安省居民對另類醫療服務建立信心

多倫多 － 安大略省衛生及長期護理廳廳長史密瑟曼（George Smitherman） 今日宣布，麥堅迪（McGuinty）政府立法監管傳統中醫藥（Traditional Chinese Medicine）行業，目的在確保安省居民可以透過自己選擇的醫療專業人員，而獲得既安全又優質的服務。 史 密瑟曼說：「我們曾經許諾，會保護選擇如傳統中醫藥的另類醫療服務的省民，我們正在著手實現這個諾言，法例一旦通過，將使安省居民對這類醫療服務的安全和 品質具備信心。」 目前，在安省內，傳統中醫藥是未受監管的行業；對甚麼人可以中醫師或中藥師自居，或甚麼人可以從事這類行業，並沒有現行的規限。因此，省民並沒有可靠的途 徑得知那一些從業員具備提供安全服務的適當能力和所需訓練。法例一旦通過，傳統中醫藥將是一九九一年以來第一個納入監管的新醫療專業。 有關法例如果通過，將包括以下要點：

‧ 成立一個自我管理的監管局。該局會擁有設定執業標准及規定入行要求的權力。 ‧ 業務範圍及只限業內人員專用職稱的界定，包括業內部份人員使用「醫師」職稱的規定。 ‧ 施針灸者必須是受監管醫療行業的從業員，或在醫療設施內施用針灸配合戒除癖隱療程的人員。

加拿大中醫藥針灸學會（Chinese Medicine and Acupuncture Association of Canada﹐簡稱 CMAAC）及世界針灸學會聯合會（World Federation of Acupuncture-Moxibustion Societies）會長張金達（Cedric Cheung） 教授說：「我們最初在一九九四年提出傳統中醫藥的立法監管要求，現在終於實現。這的確是令人高興的消息。這是傳統中醫藥界，包括執業者、病人和CMAAC會員，在過去二十二年內一直努力不懈地尋求有關立法的結果。現在，安省政府和衛生及長期護理廳廳長已提出傳統中醫藥立法，安省居民的健康和安全可有保障了。」提出的立法議案是以今年夏天發布的諮詢報告書為基礎。該報告書由省議員黃志華（Tony Wong）、Richard Patten、Mike Colle 和Peter Fonseca 等 人撰寫，他們由衛生廳委派，前往省內各地聆聽省民對傳統中醫藥的意見。 省議員傳統中醫藥諮詢小組主席黃志華說：「我很高興聽到我們所提出的建議落實在望，而廳長也在準備承認這種被廣泛使用的輔助性另類醫療保健服務。傳統中醫 藥及針灸的施用已有長久歷史，我們有義務向省民保證，提供這類醫療服務的專業人員是具備高素質的。」 傳統中醫藥是數千年前發源於中國的一套醫療保健整體體系，所包括的療法有針灸、草藥療法、推拿按摩和有治療作用的體操。傳統中醫藥將人體看作一個整體，所 要處理的，是疾病如何在病人身上出現的問題，以評估病人全身狀況為重，而不單只著重某種疾病的治療。安省將是繼卑詩省之後加拿大第二個立例監管傳統中醫藥 的省份。 加拿大針灸基金學院（Acupuncture Foundation of Canada Institute）執行院長 Dr. Linda Rapson，MD醫生說：「安省政府根據《受監管醫療專業法》（Regulated Health Professions Act） 提出立法監管省內的傳統中醫藥行業，是值得稱讚的。這一來，所有安省居民都可以在公平和平等的原則下，各適其適，獲得自己認為有用的治療。加拿大針灸基金學院成員希望能夠與待成立的傳統中醫藥監管局的成員建立同業關係。」 這項行動旨在配合麥堅迪政府所要建立的能夠反映病人和社會需要的醫療保健系統，以確保今後安省居民代代健康。

The McGuinty government today is introducing legislation to regulate the profession of traditional Chinese medicine.  Traditional Chinese medicine originated in China several thousand years ago. Its fundamental concepts are rooted in a philosophy that considers the person as a whole and nature to be interrelated.  Traditional Chinese medicine involves a number of treatment methods including acupuncture, Chinese herbology/dietary and exercise therapies. In Ontario, the practice of traditional Chinese medicine and performance of acupuncture are not regulated. Currently, few standards exist on who may practice traditional Chinese medicine or perform acupuncture. No statutory public protection mechanisms are in place relating to registration, complaints and discipline processes, and professional standards for the practice of traditional Chinese medicine.  By regulating traditional Chinese medicine, the government ensures that Ontarians who choose this alternative approach to health care will receive care from qualified individuals. This legislation is based on the premise that public safety and the best possible patient care are paramount.  The Health Professions Regulatory Advisory Council, and most recently the MPP group, led by Tony Wong, all recommended regulating traditional Chinese medicine, including acupuncture. The MPP group also recommended limiting the performance of acupuncture to qualified and regulated practitioners. Regulated practitioners include physiotherapists, massage therapists, chiropractors and others.  If passed, the legislation will create a self-governing college that will have the authority to enforce standards of practice and entry to practice requirements for the profession. It will also be responsible for implementing a complaints and discipline process.  The new College will have the authority to grant the use of the “doctor” title to certain members of the college who meet a standard. The minister will ask the Health Profession Regulatory Advisory Council for advice about what those standards should be.  If legislation is passed, Ontariowill be the second province to regulate traditional Chinese medicine and the fourth to regulate acupuncture. British Columbia is the only province to regulate both traditional Chinese medicine and acupuncture, while Alberta and Quebec regulate acupuncture only.

麥堅迪政府監管傳統中醫藥二○○五年十二月七日

麥堅迪（McGuinty）政府今日提出立法監管傳統中醫藥（Traditional Chinese Medicine）行業。 傳統中醫藥於幾千年前發源於中國。它的基本概念植根於一套把人看作一個整體而跟大自然息息相關的哲學。 傳統中醫藥包括針灸、中草藥療法∕食療及體操治療等多種治療方法。在安省內，以傳統中醫藥行醫和針灸的施用都未受監管。目前，還沒有甚麼標準規定甚麼人可以用中醫藥行醫或施用針灸。有關註冊、投訴及紀律約束程序、中醫藥行執業標準等方面，也沒有符合法規的保護公眾的機制。 省府立法監管中醫藥行業，可確保選擇這種另類醫療的省民所獲得的服務由合格專業人員所提供。這項立法是以「公眾安全至上」及「讓病人獲得最好醫療服務」為前提的。 醫療專業監管顧問委員會（Health Professions Regulatory Advisory Council）及最近成立由省議員黃志華（Tony Wong） 所領導的省議員小組（MPP group），都建議立法監管包括針灸在內的傳統中醫藥行業。省議員小組也建議，針灸的施用必須只限於合格的受監管的醫療從業員。受監管的醫療從業員包括物理治療師、按摩治療師、整脊師及其他治療師。有關法例一旦通過，則根據規定，會成立一個自我管理的監管局，該監管局有權力實行執業標準，並加強入行從業資格。該監管局也將負責確立投訴和紀律約束程序。 即將新成立的傳統中醫藥監管局有權力准許符合起碼高標准的監管局成員使用「醫師」的職稱。衛生廳長將向醫療專業監管顧問委員會尋求制訂有關標準的建議。 如果議會通過了有關法例，安大略省將是加拿大第二個立法監管傳統中醫藥行業的省份，同時為第四個立法監管針灸行業的省份。目前，卑詩省是我國唯一已經立法監管傳統中醫藥和針灸行業的省份，而阿爾伯達和魁北克兩省，則只有針灸行業受到監管。

在新聞發布會上，張金達教授非常謙遜地感謝安省政府及黃志華等議員為設立議案50所作出的努力。  歷經千難萬苦， 我們當中的許多人都覺得無法保持冷靜；張金達教授始終既然如往，帶領我們繼續奮斗。有關議案的要點如下﹕‧ 成立一個自我管理的監管局。該局會擁有設定執業標准及規定入行要求的權力。 ‧ 業務範圍及只限業內人員專用職稱的界定，包括業內部份人員使用「醫師」職稱的規定。 ‧ 施針灸者必須是受監管醫療行業的從業員，或在醫療設施內施用針灸配合戒除癖隱療程的人員  對所有為傳統中醫藥針灸合法的管理，不倦奮斗的工作人員，和爭取自由選擇醫療權力的病人來講，將迎接一個終生而忘的一日。法律程序從建立議案開始；議案在國會上首次宣讀；接下來，一個過渡性的管理委員會將成立，並設立教育和行醫的標準。  衛生廳廳長對有關“祖父法”的問題表示了重點的強調；像其它新的專業， 有很大的可能性使持業者成為祖父法。 傳統中醫藥針灸議案提供途徑，使它被獨立地包括在“受管制的醫療專業法”下（Regulated Health Professions Act).  議案本身不包括具體的條例，如祖父法和行業標準。議案所提到的新將成立的管理委員會將具有責任，在過渡期間和將來發展中，設立具體的，全面的專業標準。 歸納到“受管制的醫療專業法（RHPA）” 之下的專業管理是非常重要的，因為法案是僅具體為某一專業設立的，僅僅在安大略省， 如西醫醫師， 整骨醫師， 心理醫師，物理醫師，等等。 目前， 自然療法是在“無藥持業專業”法案之下監管，所以這是原因他們要求免除。 自然療法還在要求將它的專業歸納到“受管制的醫療專業法”下；但是，到如今還沒有成功。所以，作為持業者是非常必要地了解和懂得法律程序的立法管理，提供 合理的宣傳手段以達到專業立法合法化。法案鼓勵“不同種類的醫療專業工作人員可分享行醫的範圍”；這意思為目前在不同的管制法案中還沒有具體的條款來監管 針灸。 我們必須意識到不能拿畢詩省立法與安省相比的。 不同的管制法案管理傳統中醫藥針灸將會造成混亂，導致中醫不能歸納到“受管制的醫療專業法（RHPA）”之下，像其它醫療專業一樣；自然療法還在申請要求歸納到“受管制的醫療專業法（RHPA）”。 如上詳細的解釋是為了幫助我們的會員們懂得其他以被監管的醫療專業人員在他們的設立的行醫範圍內，根據立法條例，可使用針灸為輔助療法。 傳統中醫藥針灸立法管理如走向不同的方向，將導致質劣的立法成效和更多年的延遲。這沒有權力給予持業者使用“針灸師”，“中醫治療師”和“中醫醫師”的職 業頭銜。如立法走到正軌，在監管法案範圍內，可以為公眾劃分明顯的界限，分辨輔助使用針灸和傳統中醫藥針灸專家的巨大區別。同時，對于公民來講， 這將提供顯著和方便的途徑﹕在平等的條件下，病人可以擁有他們的權力選擇我們的醫療服務，並獲得醫療保險公司所提供的醫療費用保險。在此，我代表所有的會 員們，同行們，向張金達教授致以崇高的敬禮。張金達教授，我們敬慕您的全心奉獻和不倦努力，我們感激您不畏艱難，具有高瞻遠囑的目標。您是我們大家的鼓舞 核心和精神支柱；您將繼續帶領我們全面發展安省統中醫藥針灸行業。

2006 April

• On April 13, 2006 CMAAC’s President, Professor Cedric Cheung, Dr. Joanne Pritchard-Sobhani, Director of IATCM, and Dr. Linda Rapson, President of The Acupuncture Foundation of Canada held a  press conference at Queens Park, Legislative Building at 1:00p.m.  The purpose of the press conference was to address concerns that had been identified regarding Bill 50.  Bill 50 was introduced to the legislature on December 7, 2006 by the Minister of Health, Hon. George Smitherman.  The Bill is an Act to regulate Traditional Chinese Medicine and Acupuncture.  Although the Act refers to Traditional Chinese Medicine, regulation under this Act clearly indicates that Acupuncture is part of Traditional Chinese Medicine.  The press conference focused on the fact the Bill, is a mechanism for the regulation of Traditional Chinese Medicine.  Its language is broad in nature and does not specify for example “grandfathering”.  This is because such specifics will be established by a Transitional Council, appointed by the Ministry and will have such power as to develop appropriate guidelines for standards of education and practice.  As such the Transitional Council will also have the power to deal with scope of practice issues.  But in interpreting the Bill one has to be careful not to think that statements regarding referral are mandatory referrals in which we would somehow be accountable and dependent on physician referrals. This is not what this term means.  It is however, a requirement of every other regulated profession, that when the nature of a patient’s treatment is beyond your scope of practice, the patient should be referred.  This is standard protocol and to interpret this otherwise has been extremely misleading to the profession.
• CMAAC as well as a number of organizations present, endorse the view that other regulated professions, who practice adjunct acupuncture in their scope of practice, does not pose a risk of harm to the public or to our profession.  In fact, once Traditional Chinese Medicine is regulated, as regulated professionals, the playing field will be equal and TCM practitioners will no longer be marginalized.  This means that the public will have greater access to TCM practitioners that are qualified and 3rd party insurance coverage will enable the public to make an informed choice regarding treatment from TCM practitioners. Once regulation occurs, other regulated professionals will feel more comfortable making referrals to TCM practitioners because they will be confident that individual is competent and is capable of performing acupuncture in a safe and effective manner.  This has not been the case because without regulation, acupuncture can be performed by anyone. In a very real sense, the expected outcome of regulation will be that we will be able to anticipate an increase in referrals and patients seeking treatment options, regardless of whether other regulated professionals perform adjunct acupuncture.
• Bill 50 is not about regulating those who are already regulated. This Bill is only to regulate Traditional Chinese Medicine and Acupuncture. CMAAC’s priority is to support Bill 50 because this is an Act to regulate Traditional Chinese Medicine, our profession, which is designed to protect the public. The press conference was designed to deal with facts rather than react to propaganda and recognize this step as part of a process.  The next step is a Transitional Council, and as such necessary amendments may be added or deleted and other issues like “grandfathering” will be appropriately addressed.  We understand that regulation can be confusing and encourage you to contact us if you have any questions.  As well we also wanted to convey that we are excited about regulation and recognize that Bill 50 is our first step towards this.  The press conference was well attended and a number of organizations and other Associations were present to support Bill 50!
• 2006 年4月13日1時下午， 加拿大中醫藥針灸學會會長張金達教授, 中醫針灸學院院長 Joanne Pritchard-Sobhani 醫師， 加拿大針灸基金會會長Linda Rapson 醫師， 共同一起在省政府議會大樓會議廳，舉辦了記者招待會。記者招待會是就50號議案所引起的社會關注和專業同行的憂慮所舉行的。 50號議案是于2005年12月7日由衛生部部長George Smitherman 閣下和他的內閣成員所提議立法的。 議案是專業立法管理傳統中醫藥針灸行業。 儘管議案引用“傳統中醫學”，立法條例明顯地強調針灸是傳統中醫學的一部分。 記者招待會重點集中在議案是立法管制的機構運轉。 議案條例和大綱是綜合和概覽專業的精華，還沒有具體條例的細節，如“祖傳法”。 原因是具體詳細的條例法規將衛生部聘任的過渡性立法管理院來建立。 管理院將擁有權力來設立具體合理的專業教育培訓條例和持業規範；同時，管理院委員們將擁有職權去管制行醫的道德和範圍有關的問題。 但是，在解釋議案的內容時，大家必須謹慎地理解有關咨詢推薦條款。 條款並不是強制性的推薦制度；這將成為專業人員的責任並需西醫推薦，這絕對不是這一條款的意思。  在 任何其它立法醫學專業中，都有這一條要求﹕如病人的病案複雜，超過現有的醫療範圍和知識，醫療工作人員一定要推薦病人咨詢其它醫療專家的意見。這是標準的 醫療規範，和正確的理解；否則將極大地誤解，使專業立法走向歧途。加拿大中醫藥針灸學會以及其它各個組織團體積極推動其它立法專業的醫療人員使用針灸作為 他們的輔助治療手段，並保證社會民眾的安全，和中醫民眾的聲譽。 事實上，一旦傳統中醫藥針灸專業立法成功，作為立法醫療專業人員將與其它醫師平起平座， 地位相等。 社會民眾將有很多的機會獲得合格傳統中醫藥針灸療法；同時，第三者的醫療保險公司對專業療法的擔保將極大地保障民眾有更多的權力來選擇合格和信任的中醫醫 師。立法后，因為中醫專業人員所展現的專業能力和勝任安全中醫針灸療法，其它專業的醫療人員將更加理解和信賴中醫療法，並將推薦病人。目前， 我們還沒有贏得這一信任；只要立法程序還沒有建立，任何人都可以使用針灸療法，導致危害于民眾。 總體來講，儘管其它醫療專業使用針灸為輔助療法，專業立法的成功將贏得更多的專業人員推薦病人和更多病人尋求中醫替代療法。
• 50號議案不是關於那些已經專業立法的醫療專業。 這一議案是針對傳統中醫藥針灸專業所設立的。 加拿大中醫藥針灸學會堅決支持50號議案，因為這一立法將合理地管制中醫專業，使我們達到我們專業的崇高目的—保證民眾的安全。記者招待會是面對事實，認真地處理和解釋問題，讓大家理解立法的現有程序步驟；對少數不正確的政治宣傳保持冷靜，不與理睬。 下一步的程序將是建立過渡性中醫管理院，提供各種合理的議案增補改進或簡除條例，和討論有關問題和關注，如“祖傳法”。

July 29, 2005

• TORONTO –Ontario has moved closer to regulating traditional Chinese medicine (TCM) and acupuncture with the release of a public consultation report, Health and Long-Term Care Minister George Smitherman announced today.  Ontario will become the second province in Canada to regulate traditional Chinese medicine including acupuncture, herbs and tai chi as medical therapy.“ We owe it to the people of Ontario to ensure they are protected,” Health Minister George Smitherman said Friday in making the announcement.  “But at the same time, we have to realize traditional forms of medicine have helped a great number of people for a very long time.” The consultation report was written by Parliamentary Assistant to the Minister of Research and Innovation, Tony Wong, Minister of Citizenship and Immigration Mike Colle, Parliamentary Assistant to the Minister of Health Promotion, Peter Fonseca and Parliamentary Assistant to the Minister of Training, Colleges and Universities, Richard Patten. “We have promised to regulate traditional Chinese medicine and acupuncture, and hope to introduce legislation by the end of the year,” Smitherman said. “The work done by Tony Wong and his colleagues is going to be invaluable in helping us decide how best to proceed.”  The report contains 10 recommendations on the regulation of TCM and acupuncture including:

1.     Creating a regulatory college for TCM

2.     Establishing different classes of TCM practitioners, based on level of education, acquired competencies and experience

3.     Limiting the performance of acupuncture to qualified, regulated practitioners, and;

4.     Designating as herbalists a class of TCM practitioners who use Chinese herbal medicines within the context of traditional Chinese medicine.

The MPPs began their consultations in March and heard from representatives from TCM organizations, practitioners of TCM and acupuncture, regulated health professionals, health regulatory colleges and members of the public. They listened to almost 100 presentations and received more than 200 written submissions. “We heard many different viewpoints but the general consensus is that public safety is paramount and we must put in place a system to protect the public,” Wong said. “Traditional Chinese medicine and acupuncture have been practiced for countless years and benefited many, and people want to make sure there is a high level of competence guaranteed in the practitioner they are seeing.”  This initiative is part of the McGuinty government’s plan to build a health care system that delivers on three priorities – keeping Ontarians healthy, reducing wait times and providing better access to doctors and nurses.

 In total, approximately 100 people were in attendance at the news briefing which was held at the Mon Sheon Home for the Aged inToronto, Ontario.  The audience consisted of people from the TCM/A and Chinese communities, and members of the Western and Chinese media. Tony Wong, Chair of the MPP Consultation group and Parliamentary Assistant to the Minister of Research and Innovation began the news release with a brief introduction followed by the findings of his report.  Dr. Mary Wu, President of the Toronto School of Traditional Chinese Medicine and Acupuncture, also gave a short speech.   This was followed by a question and answer period with the Ministry of Health.  As a whole, all people where pleased with the press release and were very optimistic about the regulation of TCM and acupuncture.

There were cheers at the CMAAC Head Office as regulation in Ontario was formally announced. After 22 years of intensive lobbying and public education, with many of our efforts seeming to bear fruit only to be put on the government’s back shelf as they pursued other issues, it was almost hard to believe that regulation was finally here. Regulation in Ontario was at once so inevitable and yet seemed so hard to reach. Well, now we can say, “We did it!” We are one step closer to seeing regulation in all of Canada.

List of Recommendations – The MPP Group recommends:

Regulating TCM and Acupuncture in Ontario

1. That the profession of traditional Chinese medicine (TCM), and acupuncture practiced within the TCM context be regulated under the Regulated Health Professions Act, 1991 under a new profession specific Act and that a new regulatory college for TCM be created.

2. That a future standards of practice regulation for treatment modalities used by TCM practitioners be developed by a future regulatory college for TCM and be approved by the government of Ontario. Current Education and Training for TCM Practitioners

3. That, given TCM practitioners have a diverse range of education and experience in TCM, different classes of practitioners be developed by a future regulatory college for TCM based on the practitioner’s level of education, acquired competencies, and experience.

4. That the classes of TCM practitioners include TCM practitioners with general TCM education, acquired competencies, experience, and who focus on one or more TCM treatment modalities; and a Doctor of TCM with advanced TCM education, acquired competencies, experience, and who practice the full range of TCM treatment modalities.

5. That a future regulatory college for TCM consider, among other things, the experience of British Columbia and other jurisdictions that have recently regulated TCM when determining regulatory issues such as, classes of registration, education and the acceptance of individuals currently practising in Ontario (grandparenting).

6. That a future regulatory college for TCM develop and implement an appropriate, fair and transparent grandparenting process for the different classes of registration to facilitate the registration of qualified individuals currently practising TCM in Ontario. The Performance of Acupuncture

7. That the performance of acupuncture be limited to qualified, regulated practitioners; that non-regulated practitioners should not be permitted to perform acupuncture.

8. That there be a class of TCM practitioners in a future regulatory college designated as acupuncturists practising acupuncture within the TCM context.

9. That regulated health professionals who use acupuncture as an adjunct therapy in the course of their professional practice be authorized to perform it only if they possess the required education and competencies as set by their respective college or board to safely practice acupuncture, and that it is practiced only within the scope of practice and standards of practice of their respective profession.

Chinese Herbal Remedies

10. That there be a class of TCM practitioners in a future regulatory college designated as herbalists who use Chinese herbal remedies within the TCM context.

2005年7月29日對安省中醫藥針灸專業的醫療保健和持業人員來講，是一個非凡的日子。 在安省衛生廳舉辦的新聞發布會 上， 衛生及長期護理廳廳長George Smitherman 閣下宣布了省政府即將著手辦理立法管制中醫藥針灸專業， 並公開發布了中醫藥針灸醫療的咨詢報告書。 安省將成為加拿大第二個省份完整地立法管理傳統中醫藥醫療，包括針灸， 草藥和太極療法。在講 話中，廳長Smithman閣下談到﹕“我們責任是保護安省民眾的醫療安全；同時，我們意識到傳統中醫療法早已在很久之前開始幫助許多的公民，提供了有效的醫療成效。”“我們履行諾言，將進行管制傳統中醫藥針灸行業，並希望今年年底能夠提出一個法案。，” Smithman 閣下講到﹕“咨詢小組所呈交的咨詢報告書為我們決定如何最好地實現管理工作提供了寶貴的意見。” 咨詢報告書包括有關管理中醫專業的十項建議，其中包括如下﹕

1。 建立傳統中醫藥針灸管理學院

2。 設立傳統中醫藥針灸專業不同的等級，根據不同的教學程度，專業能力   和實際經驗。

3。 限于合格的管制醫療專業人員使用針灸

4。 指定中草藥醫師為傳統中醫藥針灸專業的一個分支， 並僅應用于傳統中醫藥醫療的範圍內。

省議員傳統中醫藥針灸醫療咨詢小組是由主席Tony  Wong 省議員， 及三位小組成員， Mike  Colle 省議員， Peter  Fonseca 省議員，Richard  Patten 省議員組成的。 議員小組自2005年3月起， 開始了他們的調查咨詢， 聽取了近百名人士的意見， 並收到了兩百多份有關傳統中醫藥針灸的意見書。  參與咨詢的人士包括受管制的醫療保健人員， 傳統中醫藥組織及非傳統中醫藥組織的代表，醫療服務管制學院，持業醫師，學生及其他普通大眾。“我們聽取了各種不同的觀點， 但是大家共同一致的意見是民眾的醫療安全是最為重要的；我們必須建立一個完整系統來保護社會公民，”Tony Wong 談到，“傳統中醫藥針灸以沿用了數千年， 並為民眾的健康帶來了極大的利益；並且民眾希望能夠確保專業人員符合高標準和具備專業能力。”進行立法管理傳統中醫藥針灸是安大略省McGuinty 所領導的政府工作規劃之一，以便建立完整的健康衛生體系，而達到三項目的﹕保障安省民眾的健康， 減少等候看病的時間，為醫生和護士提供更好的途徑。

總共上百人出席了這次安省政府在多倫多市政府舉辦的新聞發布會； 積聚了傳統中醫藥針灸界的持業者，社會團體的代表，及西方及中文界報社的記者們。省議員傳統中醫藥針灸醫療咨詢小組主席Tony  Wong 省議員簡短地介紹了咨詢報告的結論。  多倫多中醫藥針灸學院校長Mary Wu 也在之後發布了簡短的講話。最後是新聞答辯，衛生廳官員解答了聽眾的多種問題。 在新聞發布會上，全體出席人員都為省政府的決定所歡欣鼓舞，為中醫針灸立法充滿信心。 加拿大中醫藥針灸學會為這歷史性的轉折點而自豪，我們歷經千難萬苦，終于等到了今天。學會會員們，立法進在眼前，中醫發展前途無量！

March 2005

• On March 16, 2005, Prof. Cedric K.T. Cheung attended the Consultation Group on Traditional Chinese Medicine and Acupuncture at the Hilton Hotel in London, Ontario.  The purpose of the meeting was for the government to obtain input from members of the community and key stakeholders regarding how best to regulate Traditional Chinese Medicine and Acupuncture in Ontario.  Also of importance to the government is to the safety and protection of patients using these services. The government was interested in hearing about the profession’s experiences with and/or practice of TCM and acupuncture in relation to:  1) the practice of TCM, and the use of acupuncture by TCM practitioners, regulated health practitioners of TCM and others in Ontario; 2) the education and training that TCM and acupuncture practitioners in Ontario have acquired to support their practice; and 3) the practice of prescribing, compounding, dispensing or selling of Chinese herbal remedies. More specifically, the topics addressed were divided into three categories:

Acupuncture

1. How do you use acupuncture in your practice?
2. What is your opinion on allowing only TCM practitioners and regulated health professionals that currently have the controlled act of performing a procedure on tissue under the dermis (skin) (i.e. Physicians, nurses, dentists) to use acupuncture?
3. What is your opinion on allowing regulated health professionals that currently do not have the controlled act of performing a procedure on tissue under the dermis (skin) but who currently perform acupuncture under the legislative exemption, (e.g. chiropractors, physiotherapists, midwives, massage therapists) to use acupuncture?
4. What is your opinion on allowing unregulated health professionals who currently perform acupuncture under the legislative exemption to use acupuncture?

Education and Practice

1.        If you are a TCM practitioner, what is your education and training?  How does that training assist you in your practice?

2.        If you perform acupuncture, what is your education and training in acupuncture? How does that training assist you in your practice?

3.        If you provide education in TCM or acupuncture, what is your school’s curriculum?

4.       In your view, what are the factors that make for the ideal training and education in TCM and acupuncture?

Chinese Herbal Remedies

1.        How would you be affected if the prescription of Chinese herbal remedies is limited to regulated TCM practitioners only?

2.        What are some of the adverse effects when taking Chinese herbal remedies?

3.        What has been your experience with Chinese herbal remedies?

4.       Have you changed your practice or has your care been affected by the federal Natural Health Product Regulations?

• The meeting, the first in a series of four to be held across Ontario — meetings also included Markham on March 17, Mississauga on March 21, and Ottawa on March 24– was chaired by Hon. Tony  C. Wong, MPP.  Hon. Wong was appointed by George Smitherman, Minister of Health and Long-Term Care, to oversee the consultations.   MPPs Mike Colle (Elginton-Lawrence), Peter Fonseca (Mississauga East) and Richard Patten (Ottawa Centre) rounded out the four-member panel.   Following the conclusion of the meetings, the MPPs will report back to the minister.
• The CMAAC Head Office would like to thank the following members who presented at the consultations held across Ontario:  Dr. William Brown, Ahmid El Turk, Dr. Xue Lan Zhang, Dr. Joanne Pritchard-Sobhani, Dr. Gwo Wu Shyu, Dr. Guo Qing Dong, Dr. Bing Jiang Wu, Dr. Kwong Kee Liu, Dr. Zhao Qi Guo, Dr. Li Pang, and Dr. Gasan Askerow.  Overall, the meetings went quite well, and the CMAAC was well-represented.  We are proud of our members and thank them for their time and contributions!
• 張金達教授參加了在安省倫敦市舉辦的傳統中醫藥針灸的座談會。座談會的宗旨為安省政府能夠從社會團體和各中醫組織的代表聽取有關如何管理中醫專業。  同時，讓政府意識到安全使用中醫針灸療法和保障病人安全的重要性。安省政府重點集中在中醫行醫的有關問題﹕1。 中醫和針灸的應用，針對于中醫藥針灸的持業者和其它醫療專業立法管制的工作人員。 2。 傳統中醫藥針灸專業人員所應用的教育培訓。 3。 中草藥處方的應用，中醫的合成，配藥和出售中草藥配劑.
• 進一步，這三個問題被分類地劃分為詳細的問答形式。

中醫針灸

1. 你是如何在中醫行醫中使用針灸療法的？
2. 對于只容許傳統中醫藥針灸和其它醫療專業立法管制，擁有執行穿刺皮膚的法案的工作人員，如醫生，護士，和牙醫，使用針灸療法，你的意見如何？
3. 針對目前立法管制，卻不擁有執行穿刺皮膚的法案，但得到憲法容許的醫療工作人員，如整骨師，物理療師，接產婦，按摩師，使用針灸療法，你的意見如何？
4. 針對立法沒有管制，但得到憲法容許的醫療工作人員，使用針灸，你的意見如何？

教育培訓

1.      如果你是傳統中醫藥針灸持業者，你的教育程度和培訓是什麼？培訓在你的行醫中起到如何的作用？

2.      如果你應用針灸療法，你的教育程度和培訓是什麼？培訓在你的行醫中起到如何的作用？

3.      如果你學校提供中醫學習，中醫的課程是如何設計和管理的？

4.      請告訴我們，對于中醫藥針灸的教育和培訓，重點的因素是什麼？

中草藥的處方

1.        如果中草藥的開方只限于立法管理的傳統中醫藥針灸的持業者，你將會受到影響嗎？

2.        當服用中草藥配方，有什麼副作用？

3.        你有什麼中草藥處方的經驗？

4.       聯邦政府自然健康產品的立法管理將如何影響到你的行醫？

• 座談會是計劃性的四個連續會議的第一個會議。 其它座次會在安省Markham  3月21日, Mississuaga  3月24日, Ottawa  3月24日 分別舉行。 座談會由衛生廳廳長George Smitherman聘任的Tony Wong 議員主辦的。 其它三位議員們Mike  Colle (Elginto-Lawrence), Peter Fonseca (Mississauga East), Richard, Patten (Ottawa Center) 組成了四人議員小組。議員們將會議的談論結果總結報告到衛生廳廳長。
• 傳統中醫藥針灸學會總部在此感謝所有參加安省傳統中醫藥針灸咨詢座談會的代表﹕ Dr. William Brown, Ahmid El Turk, Dr. Xue Lan Zhang, Dr. Joanne Pritchard-Sobhani, Dr. Gwo Wu Shyu, Dr. Guo Qing Dong, Dr. Bing Jiang Wu, Dr. Kwong Kee Liu, Dr. Zhao Qi Guo, Dr. Li Pang, Dr. Gasan Askerow.  總體來講，咨詢座談會舉行的非常成功， 學會代表積極踴躍，發表主見。 我們為我們的會員而自豪，並再一次感謝你們對專業的無私貢獻。

2000 – 2003

2000 March

• CMAAC sent out 121 copies of their submission for the regulation of the profession of TCM and Acupuncture under the Regulated Health Professions Act of 1991 to the HPRAC and many other participants.  加拿大中醫藥針灸學會向衛生專業咨詢委員會和許多其他參加組織，發了121份复印件的1991年衛生專業立法管制下的傳統中醫藥針灸立法申請書

2000 May

• After reading the various proposals for regulation made by different interest groups, we submitted a response to the submissions for the regulation of TCM and Acupuncture under the Regulated Health Professions Act 1991 經過仔細研究各個中醫和社會團體的立法建議申請，我們呈交了傳統中醫藥針灸一九九一年衛生專業憲法管制的答疑書。

2000 September 20

• Prof. Cheung spoke at the HPRAC Discussion forum to clarify various points before the final referral on the Regulation of TCM and Acupuncture in Ontario was made at the end of the year.在年底做出最後傳統中醫藥針灸立法的推薦前期，張金達會長在安省衛生醫療咨詢委員會主持的討論會上重申解釋了幾個重要觀點。

2001 April

• On April 24, 2001, Ontario Minister of Health, Honorable Tony Clement, announced the government’s intent to work with TCM professionals to realize the Regulation of the profession. “…The government understands Traditional Chinese Medicine and Acupuncture to many in Ontario.  It wants to work with practitioners on the creation of a self-financing, regulatory college that would establish professional standards for these traditional practices, and will act quickly once the Health Professions Regulatory Advisory Council issues its report “
• The Government of British Columbia announced on April 13^th the establishment of the College of TCM Practitioners and Acupuncturists of British Columbia.
• 在四月二十四日，安省衛生廳廳長， Tony Clement 閣下，在省議會上提出將對傳統中醫藥針灸專業立法管理。他闡述說:“政府非常理解傳統中醫藥針灸對安省公民的重要性和價值。 我們將與該專業人士合作建立一個自我管理的管理院， 為該專業的執業人員建立專業標準。一旦衛生專業立法顧問委員會完成推薦報告， 我們將很快采取行動”。
• 畀詩政府在四月十三日公布畀詩省傳統中醫針灸專業管理院的法規。

2001 September

• On September 6th, we received a summary report from the HPRAC.  The report summarized suggestions made by council to the Minister of Health and Long-Term Care, the Hon. Tony Clement.  The council acknowledged that it supports the regulation of TCM and Acupuncture.  Key issues that arose from this report centered on educational or academic standards for practitioners, the differentiation of biomedical acupuncture and TCM based acupuncture, grand parenting, and the use of title “Doctor”.
• 九月六日，接到安省衛生專業醫療咨詢委員會的推薦報告。衛生廳長， Tony Clement 閣下直接審閱這份報告。委員會在報告中表示支持傳統中醫藥針灸的立法管理。這份報告所產生的討論焦點為中醫教育培訓衡量標準，使用針灸的標準和法案不同，選用祖父法的可能性， 中醫醫師頭銜的使用。

2001 November

• On November 9th, the Ministry of Health and Long-Term Care invited a representative sample of stakeholders who have been following HPRAC’s processes to provide feedback regarding the HPRAC report and recommendations surrounding the issue of TCM and Acupuncture.  Issues discussed at this meeting included: (1)Title: Criteria required for adoption of the title Doctor of TCM (2)Grand parenting options (3)Entry Requirements and core competencies (4)Acupuncture (5)Continuing competence
• 11月9日， 就安省衛生專業資格顧問委員會對傳統中醫藥針灸立法的推薦報告， 衛生廳邀請各個團體組織代表召開座談會， 稱述各自對報告的建議與觀點。座談會主要討論內容包括﹕
• 傳統中醫醫師頭銜的衡量標準,
• 選用祖父法的可能性
• 從事中醫的條件和行醫資格
• 使用針灸的標準和法案規定
• 繼續提高行醫標準的措施

2002 June

• Professor Cedric Cheung was invited to attend a Town Hall Consultation on Health Care in London, Ontario, at London City Hall Council Chambers. 張金達會長應聯邦衛生部的邀請， 出席了安生倫敦市舉行的衛生體系改革的咨詢座談會

2002 August

• Professor Cedric Cheung was invited by Minister of Health Tony Clement to attend a meeting at Queens Park on August 29.  Topics discussed included the possibility of a new college and related legislation issues in Ontario.  During this half hour meeting, the Minister of Health stressed that the entire cabinet supports regulation, but must await proper timing before it can follow through with the process.  八月二十九日，張金達會長出席了衛生廳廳長在省政府主持的座談會。 會議討論題目包括建立新的管理院，和完善安省中醫立法條例。在這個短暫的會議上， 衛生廳廳長表示內閣全體人員積極支持立法工作，但是，必須等待者良好時機。所以，立法施行方案和具體時間尚未決定。

2002 December

• Submitted a formal letter to the honorable Carol Skelton, M.P. of the Canadian Alliance outlining the CMAAC’s stance on labeling, regulatory, and approval powers for complimentary and alternative medicines. 向眾議院議員，Carol Skelton閣下，正式呈交了一份書面信件，表明加拿大中醫藥針灸學會對令類及輔助醫學的不可忽略的強大功效，中草藥的標簽正軌化，和立法管理的旗幟鮮明的立場和態度。

2003 January

• TCM/Advisory Council of Ontario created by Tony Clement, former Minister of Health, to provide advice to the Minister regarding TCM regulation. 安省衛生廳廳長Tony Clement 閣下著手成立了傳統中醫藥針灸顧問委員會。 經過八年的咨詢和公眾聽證會， 這個顧問委員會能夠為衛生廳提供建議。

1997 July 3

1997-1999

• Attended meeting to deliver comments to the Ad Hoc Committee on Complementary Medicine, College of Physicians and Surgeons of Ontario regarding Bill 126, and to assist with the establishment of policies to govern physicians wishing to utilize complementary therapies
• 出席了安省內外科醫學有關126 法案的會議， 以帶給輔助醫療特別委員會有關評論， 並且幫助建立有關政策以管理那些有意應用輔助治療方法的西藥醫師。 

1997 October 8-10

• Attended and presented a paper at British Columbia public hearings to assist in determining whether it is in the public’s best interest to regulate TCM in its entirety.
• 出席畀詩省公開聽證會以幫助決定對中醫藥整體立法管制是否順應民眾最大的利益， 並發表講演。

1998 April 22

• Presentation submitted to the Standing Committee on Health regarding “Regulation of Herbal products” Toronto, Ontario. Professor Cheung stressed to the Standing Committee that the Government’s recent ban of herbs is unjust, and that it is the unqualified use of herbs that requires scrutiny and not the herbs themselves.
• Professor Cheung also stressed that the Regulation of the profession of TCM is of vital importance. It is not only in the best interests of the Canadian public and the profession, but also in the best interests of the government in terms of savings to health care costs. In 1979, the WHO indicated at an interregional seminar that Acupuncture alone could effectively treat forty-three diseases. However, according to Chinese medical classics, Nei Jing, Nan Jing, and Biao You Fu, current research and study, this is significantly augmented to a wider range of treatable diseases when acupuncture, moxibustion, and Chinese Herbs are used in combination. Many diseases can be treated by TCM. Since acupuncture treatment requires no costly equipment, there is anenormous potential for the reduction of health care costs.
• Prof. Cheung urged in conclusion that the safe use of Chinese Herbs should be judged fairly. They must be understood in their proper context as an integral part of TCM, but also seen in light of the benefits they can offer if used in cooperation with Western Medicine.
• 在安省多倫多市， 向衛生常務委員會發表並呈交 “草藥制品的立法管制”一文。 張金達會長向該常委會強調指出， 政府近來對草藥制品的禁令是不公正的， 應該進行的是對那些不合規定的草藥的使用進行審查， 而不是草藥本身。張金達會長同時強調指出，對傳統中醫的立法管制是相當迫切和重要的。 這不僅有益廣大民眾和中醫專業本身， 還有利于節省政府的醫療開支。 早在1979年， 世界衛生組織（WHO）就在一個跨地區的會議上提出， 針灸本身可以治療43種疾病。 然而， 根據中國古代經典醫學論著，如內經和標幽賦， 以及當代的科學研究， 如果針灸結合艾灸術和中草藥，將能夠治療更廣範圍的疾病。 有很多疾病可以被中醫藥治愈。 因此， 它具有極大的潛力大大地削減醫療費用。 張金達會長最後在總結中呼吁， 對中草藥的安全性的評估應該基于公平和事實。 它們必須被看作傳統中醫藥的一部份， 但是， 同時應該看到它們與西方醫學結合使用產生的良好效果.

1998 October 30

• Submitted a comprehensive legislative package to New Brunswick’s Minister of Health with the cooperation of the Association de Medicine Traditional Chinois du Nouveau Brunswick
• The Maritime Association of Registered Acupuncturists (MARA) merged with CMAAC to create a united front in Nova Scotia.
• 向New Brunswick 省衛生聽呈交了一份傳統中醫藥針灸法制管理的全面報告。
• 在Nova Scotia 省，東北沿海注冊針灸師協會與加拿大中醫藥針灸學會結成聯盟。

1998 November 21

• Established the Professional College of TCM and Acupuncture Ontario through the cooperation of CMAAC, Professional Acupuncturists Association of Ontario (PAA), Supporters of Holistic Medicine and Acupuncture (SHMA), Toronto Traditional Medicines Advisory Committee (TTMAC) of the World Wildlife Fund (WWF), the Toronto Chapter of Chinese Canadian National Council (CCNC), and other interested parties 正式成立了安大略省傳統中醫藥針灸管理院。管理院由加拿大中醫藥針灸學會，安省專業針灸醫師公會，支持整體中醫藥針灸社團，多倫多傳統中醫顧問委員會，世界野生動物保護基金會，多倫多平權會組成。

1999 June 11

• After studying the draft “Request on Regulation of Chinese Medicine and Acupuncture” provided by CMAAC Head Office, the New Brunswick Ministry of Health insists that legal counsel review the application before the Ministry will take further action. New Brunswick 省衛生廳經過閱讀加拿大中醫藥針灸學會呈交的管制中醫藥針灸專業的申請報告，決定在做出任何決定之前，進行法律咨詢調查。

1999 June 22

• Our westernmost province announced the establishment of the College of TCM Practitioners and Acupuncturists of British Columbia to replace the former College of Acupuncture. Now all aspects of TCM will be regulated together.西部畀詩省建立了畀詩省傳統中醫針灸專業人員管理院，以代替以前的針灸管理院。從此，傳統中醫各個系統結合在一起，將整體中醫管理。

1999 November

• Made a joint submission with the Professional Acupuncturists Association of Ontario (PAAO) and the Supporters of Holistic Medicine and Acupuncture (SHMA) in application for Regulation of the Profession of Traditional Chinese Medicine and Acupuncture under the Regulated Health Professions Act, 1991
• This 500-page report was submitted to HPRAC in accordance with their set criteria.
• 加拿大中醫藥針灸學會接受安省衛生咨詢顧問委員會的來信。 在信中寫道﹕“衛生廳最近重新考慮傳統中醫藥針灸立法管理的要求；衛生咨詢顧問委員會將就此提供調查意見和推薦報告。 我們意識你學會自1994年開始立法管理中醫專業，並為我們呈交各種有關資料。 在此， 我們要求你填寫要求專業立法，歸納到1991年立法管理衛生健康保健專業的法案的申請表。”
• 與安省專業針灸醫師公會，及支持整體中醫藥針灸社團聯合， 向安省衛生專業醫療咨詢委員會呈交了申請書，關於一九九一年衛生專業憲法對傳統中醫藥針灸的管理。長達500頁的立法申請書符合安省衛生專業醫療咨詢委員會所要求的格式和標準。

 1999 December 14

• With the passing of Bill 46, “An Act to amend the Medical Act,” the House of Commons removed the legal impediment for the practice of Acupuncture in Newfoundland and Labrador for those other than regulated health care professionals.  Newfoundland andLabrador 省通過46號憲法，“衛生醫療補充法”，去掉對非立法衛生專業人員使用針灸的限制。

1996

1996 January

• Joint Submission of 1014 pages “Answers to the core questions of Acupuncture” presented to the Health Professions Regulatory Advisory Council, by The Chinese Medicine and Acupuncture Association of Canada (CMAAC), the Supporters of Holistic Medicine and Acupuncture (SHMA), and the Professional Acupuncturists Association of Ontario (PAAO).加拿大中醫藥針灸學會（CMAAC），支持整體醫療社團（SHMA）和安省專業針灸醫師公會（PAA0）向安省衛生廳專業醫療咨詢委員會呈交一份一千零十四頁的聯合報告 “對針灸核心問題的解答”

1996 April 18

• Provided comments to the British Columbia Health Professions Council in support of the Regulation of Traditional Chinese Medicine致畀詩省衛生廳有關支持中醫藥立法管制的評論

1996 June 20-21

• Participated and gave presentation in the Public Hearing on Acupuncture Toronto, Ontario.  Professor Cheung spoke to HPRAC on the following topics: Acupuncture is a modality not a profession; Education in TCM and Acupuncture; Acupuncture cannot be separated from TCM; and regulations under the RHPA.
• Prof. Cheung made the following conclusions to HPRAC:
• This review of acupuncture has clearly demonstrated the complexity of this issue that extends beyond the scope of acupuncture itself into the realm of general health care delivery systems.
• Acupuncture cannot be separated from the body of knowledge of TCM. The entire profession of TCM should be recognized and regulated in order to enable the establishment of regulations pertaining to other professions.
• It is not our intention to limit the practice of acupuncture to one profession, but each practitioner must meet the minimum acceptable standards. We are concerned that those who use acupuncture only as an adjunct may have a significantly narrower knowledge base in comparison to practitioners of TCM and Acupuncture
• The public deserves access to the most highly qualified practitioners in a field, and the failure to regulate Doctors of TCM will deprive the public of the best care.
• The failure to regulate the profession of TCM will perpetuate the myth that acupuncture is best delivered by a regulated health professional whose membership in the regulated health profession per se does not guarantee adequate training in acupuncture.
• The following recommendations were made to HPRAC:
  1. A new controlled and defining acupuncture according to TCM theory, practice and delegating of acupuncture practice to those who are qualified to practice.
  2. Regulation of the profession of TCM with appropriate titles and the establishment of a College of TCM and Acupuncture. An acceptable alternative would be a College of TCM based Acupuncture.
  3. Establishment of appropriate standards of education and practice guidelines based on the body of knowledge of TCM for all practitioners of acupuncture, including the existing regulated health professions.

Overview of Hearings:

• CMAAC believes that the public hearings were quite successful. HPRAC has a clear understanding of the wide variation in education among regulated and unregulated health care practitioners using acupuncture as a modality or as primary care. It became quite clear that there is also a significant amount of variation in the level of TCM knowledge these practitioners have; therefore, the extent of their use of acupuncture only or in combination with all other components of TCM is affected.
• CMAAC strongly feels that many of the health care professions believe that they are entitled to continue to practice Acupuncture as part of their scope of practice. However, the predominant opinion among TCM practitioners, regardless of race, was that all practitioners using Acupuncture must have sufficient education and training in TCM in order to practice Acupuncture in any form. Many TCM practitioners voiced their concern over the lack of recognition of their TCM profession and the need for the implementation of regulations.
• In general, the consensus among TCM practitioners was that acupuncture must be TCM based and practitioners cannot perform this modality as an adjunct without a minimum of 220 hours of instruction. It was also agreed that titles are an important issue as currently unregulated professionals require a title to lend credibility to the profession and to enable the consumer to differentiate between the varying types of acupuncture that are available, such as anatomical/adjunct acupuncture, and TCM treatment in combination with Acupuncture.
• Upon the completion of the public hearings, the Ontario Association of Acupuncture & Traditional Chinese Medicine (OAATCM) withdrew from the Ontario Coalition for the Regulation of Acupuncture (OCRA) and formed an alliance with CMAAC, due to a difference in opinion regarding the Regulation of TCM with Acupuncture. The OAATCM supports the use of Acupuncture treatments when Traditional Chinese Medicine theory is used as the guiding philosophy.
• 出席了安省多倫多的針灸問卷公開聽證會， 並發表講演。 張金達會長就以下四個方面發表了論述﹕
• 針灸是一種醫療方法，不是一種專業
• 傳統中醫和針灸教育體系
• 針灸不能與傳統中醫分離
• 將中醫立法列入立法管制衛生專業法案中
• 張金達會長向衛生廳專業醫療咨詢委員會做了如下的總結﹕
• 該次講演清楚地闡明，針灸立法的複雜性，已遠遠地超過針灸本身的範圍。 針灸立法是屬于為安省廣大民眾提供有效，安全醫療服務的衛生保健系統的一部分。
• 針灸不能脫離傳統中醫體系。只有整體傳統中醫藥針灸立法，才能保障建立中醫體系內的各個專業。
• 我們並不限制其它專業人員應用針灸療法，但是，他們必須具有基本的培訓水平和標準。 我們堅持認為應用針灸療法作為輔助療法的其它專業人員，不能與傳統中醫針灸醫師所具有的中醫知識相提並論。
• 廣大民眾具有自己的權利去獲得最好的針灸治療。對傳統中醫醫師水平不予認可，只有妨礙民眾獲得最好的醫療服務機會。
• 如不管制傳統中醫體系，就會造成一種誤解，民眾誤認只有立法的醫療專業才能有資格提供針灸醫療服務。實際上，其它專業應用針灸療法並不全部具有合格的中醫針灸知識和培訓。
• 最終，張金達會長向衛生專業醫療咨詢委員會提出如下建議﹕
• 建立基于傳統中醫哲理和醫療法的新針灸法案。 中醫針灸醫師可以指導其它醫療專業做針灸。
• 管制傳統中醫專業，並給予合理的職稱， 成立傳統中醫藥針灸學院，或成立以傳統中醫為基礎的針灸學院。
• 成立一個專業資格審查委員會，以傳統中醫為基礎來管理中醫針灸醫師和其它已立法的專業醫療人員。

聽證會的會後總結﹕

• 加拿大中醫藥針灸學會認為公眾聽證會的結果是相當成功的。它使衛生專業醫療咨詢委員會委員們對于傳統中醫針灸醫師有了一個清晰的認識。衛生專業醫療咨詢委員會了解到，從事中醫針灸醫師受過不同程度， 不同水平的教育，具有不同水平的臨床經驗。 在已立法和尚未立法的情況下， 他們將針灸作為直接或輔助的醫療手段。另外，在這些從事中醫針灸人員中，對傳統中醫知識的了解和掌握存在著很大的差別。所以， 不論是直接地應用針灸療法， 還是將針灸配合其它醫療方式，醫師對與傳統中醫的認識程度會影響到針灸的運用與效果。總體上， 傳統中醫從醫人員一致認為， 針灸必須以中醫理論為基礎， 醫師必須經過至少220小時的中醫指導才可施行針灸治療。 專業人員普遍認為職稱是很重要的問題， 因為目前尚未立法的專業人員需要通過職稱來傳播他們的聲譽。 這樣， 才能促使求醫者區分市場上提供的不同種類的針灸治療， 例如， 解剖學的輔助針灸， 或傳統中醫配合針灸等。聽證會結束後， 由于對中醫藥針灸立法持有不同的觀點， 安省傳統針灸中醫學會立即退出了安省針灸立法同盟，與我學會結盟。 安省傳統針灸中醫學會支持在傳統中醫的理論指導下進行針灸治療的哲理。

1996 July 31

• Submitted Supplementary Report containing new issues rose at the public hearings on Acupuncture referral.呈交含有在針灸卷公開聽證會上提出的新問題的輔助報告

1983 – 1995

1983

• Submitted “A History of the Chinese Medicine and Acupuncture Association of Canada” to the Federal Ministry of Health 向聯邦衛生廳提交 “加拿大中醫藥針灸學會的創立史”

1986 Oct.

• President Cheung approached Dr. W.E. Spoerel for assistance with Dr. Linda Rapson of the AFC to initiate a joint effort in compiling submissions to the Ministry of Health for the regulation of TCM and Acupuncture.  However, this initiative was completely ignored by Dr. Linda Rapson and the AFC.張金達會長與Dr. W.E. Spoerel 接洽，以尋求與針灸基金會合作共同為衛生廳提供有關中醫藥及針灸立法管理的建議。但是，這最初合作意向被以Dr. Linda Rapson 為代表的針灸基金會完全不理睬。

1986 Dec.

• Drafted “A Submission to the Government of Ontario on Chinese Medicine and Acupuncture” 草擬 “致安省政府有關中醫藥及針灸的建議書

1988 Jan.

• Drafted and presented “Report of Minister’s Advisory Committee on Acupuncture” 草擬並發表 “衛生廳顧問委員會的針灸報告”

1990 March

• Submitted “A Brief to be presented to the Standing Committee of the House of Commons on Health and Welfare, Social Affairs, Senior and the Status of Women”呈交 “致眾議院常委會之健康福利，社會事務，老年和婦女地位報告摘要”

1990 Nov.

• Delivered Presentation to the Standing Committee on Social Development for the Purpose of Establishing Criteria for the Regulation of the Profession of Chinese Medicine and Acupuncture向社會開發常委會發表講演，宗旨為建立中醫藥針灸專業立法管制標準

1991 April 15

• Introduced “Proposal for the Regulation of the Profession of Chinese Medicine and acupuncture” to Hon. Evelyn Gigantes, Minister of Health致衛生廳長Evelyn Gigantes “立法管制中醫藥及針灸建議書”

1992 May 20

• Presentation at the Senate Sub-Committee Hearings on Veterans Affairs, Senate of Canada向加拿大參議院隊伍軍人事務聽證小組委員會發表講演

1992 June 1

• Submitted “The Chinese Medicine and Acupuncture Association of Canada 1992 Lobbying Campaign Letters of Support” to Hon. Francis Lankin, Minister of Health致衛生廳長Francis Lankin “加拿大中醫藥針灸學會一九九二年游說運動支持信

1992 Oct.

• Submissions made to the Health Professions Council of British Columbia呈遞畀詩省健康專業局建議書

1992 Dec. 3

• Drafted “Fundamentals in the Need for Regulation of Traditional Chinese Medicine and Acupuncture” for Hon. Francis Lankin, Minister of Health致衛生廳長Francis Lankin “立法管制中醫藥針灸的根本需要”

1993 Jan. 21

• Report compiled on “The Regulated Health Professional Act and the Exemption from the Controlled Acts” submitted to Hon. Francis Lankin, Minister of Health致安省衛長Francis Lankin“衛生專業管制法及豁免受管制行為”的報告

1993 June 15

• Submitted “Blueprint for the Regulation of Chinese Medicine and Acupuncture in the Province of Ontario and the Designation of Appropriate Professional Titles for Practitioners” to the Health professions Regulatory Advisory Council致安省衛生廳專業醫療咨詢委員會（HPARC）“中醫藥及針灸管制藍本及醫師專業職稱命定”

1993 June 28

• Drafted “Proposed Exemptions to the Controlled Acts of the Regulated Health Professions Act” for Professional Relations Branch致衛生廳專業關係組織衛生業協調官員Vahe Kehyayan “豁免衛衛生專業管治法的管制行為”

1993 Sept. 30

• Compiled “Review of Criteria to be used for the Designation of Unregulated Professions under the Regulated Health Professions Act, 1991”衛生專業管制顧問局主席Christie Jefferson “一九九一年衛生專業管制法中指定非受管制專業準則的檢評”

1993 Nov. 27

• Report regarding “The Use of Professional Titles of C.M.D. (Doctor of Chinese Medicine) and Dr. Ac. (Doctor of Acupuncture)” submitted to Hon. Ruth Grier, Minister of Health致衛生廳長Ruth Grier “中醫師及針灸醫師專業頭銜的使用”

1994 Jan. 23

• “Comments in Regard to the Proposed Regulation of Acupuncture in British Columbia” submitted to Hon. Paul Ramsey, Minister of Health.  Also attended and presented paper at public hearings to express the CMAAC’s position.致衛生健康及老年事務廳長Paul Ramsey “畀詩省管制針灸意見書的有關評論”；同時，出席公證會，再次稱述加拿大中醫藥針灸學會的觀點

1994 March

• Submitted 10,000 signature petition to the Ontario Ministry of Health demanding regulation of Traditional Chinese Medicine and Acupuncture向安省衛生廳呈交萬人簽名請願書，呼應對中醫藥及針灸實行立法管理

1994 July

• Received request from Ruth Grier, Minister of Health, Ontario, for HPRAC to review the CMAAC application for regulation of the profession of Traditional Chinese Medicine and Acupuncture收到衛生廳長Ruth Grier 致衛生專業医疗咨询委员会（HPRAC），要求接受加拿大中医药针灸学会提出的对中医药针灸进行立法管理的申请。

1994 Nov.

• Submitted a 5 pound “Application for Regulation of Traditional Chinese Medicine and acupuncture” to the Health Professions Regulatory Advisory Council呈递卫生专业医疗咨询委员会重达五镑的 “对中医药针灸进行立法管制的申请报告”

1995 June

• Drafted and Submitted “Comments Regarding the Scope of Practice Statement and Controlled Acts for the Profession of Naturopathy” to the Health Professions Regulatory Advisory Council 草拟并呈交卫生专业医疗咨询委员会 “有关自然疗法专业的持业范围和控制行为的评论”

1995 September

• On June 30, 1994, the Minister of Health requested that the Health Professions Regulatory Advisory Council (HPRAC) review whether Traditional Chinese Medicine and Acupuncture should be regulated under the Regulated Health Professions Act, 1991 (RHPA).
• On March 15, 1995, the Minister also extended a referral to HPRAC to investigate and make recommendations on the regulation of acupuncture.  The Ontario Coalition of the Regulation of Acupuncture (OCRA) requested this latter referral.  OCRA is a collective of groups interested in the regulation of Acupuncture alone, and not the regulation of Traditional Chinese Medicine and Acupuncture.  OCRA comprises the Acupuncture Foundation of Canada, the Board of Directors of Drugless Therapy – Naturopathy, The Canadian Academy of Chinese Traditional Health Sciences, The Ontario Association of Acupuncture and Traditional Chinese Medicine, The Ontario Chiropractic Association Committee on Acupuncture, and the Ontario Naturopathic Association.  As well, a third referral on the scope of practice and controlled acts for Naturopaths, which includes Acupuncture, has been ongoing for more than a year.  This means that the current application of regulation of Traditional Chinese Medicine and Acupuncture will be delayed until recommendations on acupuncture are completed.  Accordingly, HPRAC developed a series of Core Questions that address acupuncture.
• 1994年6月30日，卫生厅要求卫生专业医疗咨询委员会重新调查是否应该将中医药及针灸设定在1991年的立法管制卫生专业法案中(RHPA)。1995年3月，应安省针灸立法同盟(OCRA)的请求，卫生厅委托安省卫生厅专业医疗咨询委员会对针灸专业的立法进行调查和提出推荐。 OCRA 是一个由几个有意不结合传统中医而只对针灸进行单独立法的组织组成的。OCRA的成员包括如下：(1)The Acupuncture Foundation of Canada(2)The Board of Directors of Drugless Therapy – Naturopathy(3)The Canadian Academy of Chinese Traditional Health Sciences(4)The Ontario Association of Acupuncture and Traditional Chinese Medicine(5)The Ontario Chiropractic Association Committee on Acupuncture(6)The Ontario Naturopathic Association. 同時，第三個有關自然療法，包括針灸的執業範圍和行為控制的委托，已經進行了一年多。這意味著當前對中醫藥和針灸立法管制的申請將被擱置延期，直到對針灸的推薦報告完成為止。 為此，安省衛生廳專業醫療咨詢委員會提出了一系列的有關針灸的核心問題