Herbal Medicines

Baroness Northover Excerpts

Wednesday 24th April 2013 Grand Committee

[Baroness Northover]

My Lords, I thank the noble Lord, Lord Pearson, for securing this debate. I thoroughly enjoyed his speech, and as the last debate of the day, he made sure that we are all wide awake.

I recognise that the Government’s progress in establishing a statutory register for practitioners supplying unlicensed herbal medicines is of interest both to Members of this House, as has been demonstrated today, as well as to consumers and practitioners who use these products. I am glad that the noble Lord was assisted by a herbal remedy.

The issue of whether herbalists and traditional Chinese medicine practitioners should be statutorily regulated has been debated, as the noble Lord, Lord Hunt, will be well aware, since at least the House of Lords Science and Technology Committee report in 2000. The Government appreciate that there is, understandably, strong support from many herbal practitioners for the statutory regulation of this group, and the noble Lord, Lord Hunt, has made the case as well. In addition, many consumers of herbal medicines wish to access unlicensed manufactured herbal medicines. As noble Lords will be aware, on 16 February 2011, the Government announced that they intended to take forward the regulation of herbal medicine practitioners and traditional Chinese medicine practitioners specifically with regard to the use of unlicensed herbal medicines within their practice.

At the time that the decision to take forward the regulation of this group was made, the Government’s intention was to allow herbal practitioners to once again lawfully source unlicensed manufactured herbal medicines. That is something which practitioners have not been able to do since April 2011, when a European directive made it illegal for herbal practitioners in the UK to source unlicensed manufactured herbal medicines for their patients.

Where the noble Lord, Lord Pearson, criticised the EU, others may well feel that the EU can offer a level of protection, depending on one’s point of view. Perhaps I can address here the issue of subsidiarity. The noble Lord suggested that this meant that it was not applying to herbal medicines. The principle of subsidiarity does indeed apply. The directive makes provision to facilitate the free movement of herbal medicines while ensuring a high level of safe public health. It was thought that the directive strikes the right balance of rules to facilitate free movement to the EU level, while maintaining flexibility through domestic implementing regulations.

Since the announcement in February 2011, the Department of Health has been working with officials in the devolved Administrations and the Health and Care Professions Council to look at establishing a statutory register for herbal practitioners supplying unlicensed herbal medicines, along with a strengthened system for regulating medicinal products, to enable consumers to have safe access to unlicensed manufactured herbal medicines.

This process continues to be complex and lengthy and, with regret, I must say that we are not in a position to consult on proposed legislation. My noble friend Lord Colwyn asked about what “going out to consult” meant. As announced in the Written Ministerial Statement in February 2011, any proposed statutory legislation has to go out to an open and public consultation. I hope that that clarifies the issue and reassures him. However, I am sure the noble Lord, Lord Pearson, will appreciate that it would be irresponsible for the Government to undertake to alter the status of a group of workers without first ensuring that the policy and final decision offers an appropriate form of regulation and ensures the proposals adequately address the risks posed to consumers of unlicensed herbal medicines.

My noble friend Lord Colwyn flags the serious dangers associated with all medicines. Nothing is risk-free, whether it is conventional or complementary medicine, or doing nothing at all. That is why it is important that there is careful regulation and consideration of all these areas.

We recognise the need to balance the economic wish of practitioners to continue to supply unlicensed herbal medicines and the wish of some consumers to have continued access to them against any risks identified. We understand that there is a strong desire in the field to bring the matter to a conclusion both for practitioners and the public. However, it is clear that there is a potential risk to public health where practitioners supply unlicensed herbal medicines which may be potent. For example, the Medicines and Healthcare Products Regulatory Agency has recently become aware that an unlicensed herbal product containing aconite, a prescription-only medicine in the UK which can cause serious and potentially fatal adverse reactions if consumed, is being marketed and prescribed by traditional Chinese medicine practitioners for the treatment of migraine. It is therefore crucial that the nature of the regulation in the sector is carefully thought through.

[Lord Pearson of Rannoch]

My Lords, does not the noble Baroness agree that in this case, which was flagged up in the Daily Mail the other day, statutory registration of the people who supply the product would be helpful?

[Baroness Northover]

Various noble Lords have made that point.

My noble friend Lord Colwyn asked whether the Government have in fact dropped the commitment to regulate. The Government recognise that there is a body of evidence about the public health risks associated with herbal medicines. It is important that the department does not proceed with the statutory regulation of any group, including herbal practitioners, unless we are sure that this will provide the necessary safeguards for patients. In other words, it is being looked at very carefully—whether the balance of regulation helps or hinders. Noble Lords have heard various views expressed.

[Lord Taverne]

Will my noble friend answer one question? Is registration supported by the Chief Medical Officer?

[Baroness Northover]

I am afraid that I cannot answer that very simple question. I may be inspired to do so shortly, but in the mean time I should say that this is a more complex area than that. Although I will be happy to come back to my noble friend, I think that there are a number of wider issues to look at.

[Lord Hunt of Kings Heath]

Perhaps I may also intervene briefly. I am most grateful to the noble Baroness for her answers, but can she be absolutely clear? Mr Lansley, when he was Secretary of State, announced an intention to implement a register by 2012. Does that mean that the Government are not going forward with it? I am not clear about this. The noble Baroness has said that she is not in a position to consult and has suggested that the Government are taking a new look at the relative risks. Can she help the Committee to understand whether in fact these rumours that the proposal has been dropped are correct?

--- Later in debate ---

[Baroness Northover]

I think that what I should do is continue with what I was going to inform noble Lords about. It may be that that will satisfy them in this regard. They are seeking an answer right now which I do not think I can give.

I should point out that while the Government are working through the issues relevant to this policy, this does not affect the availability of over-the-counter licensed herbal medicines. Significantly, there are now more than 240 products registered under the Traditional Herbal Medicines Registration Scheme. In addition, practitioners can continue lawfully to prepare herbal formulations on their own premises for use with their own patients. I also want to make it clear that the previous announcement made by the Government and any steps taken to regulate herbal practitioners should not be seen as an endorsement of the efficacy of herbal medicines either way. The Government do not have a view on the efficacy of herbal medicines that do not have a full marketing authorisation; in other words, a product licence. However, the Government do recognise that members of the public may wish to purchase complementary or alternative treatments, including herbal medicines. The Department of Health would always advise someone considering the use of complementary or alternative medicines to find a practitioner who is a member of an organisation that has set robust standards of qualification, an ethical code of practice, and a requirement for appropriate public indemnity insurance.

As I stated earlier, I regret that the Government are still not in a position to go out to public consultation on this matter, but we want to make sure that any proposals are proportionate and fit for purpose.

[Lord Pearson of Rannoch]

My Lords, in that case, perhaps the noble Baroness, before she finishes her remarks, would be good enough to answer the point made by me, the noble Lord, Lord Hunt, and other noble Lords. Will the Minister concerned and his officials meet interested Peers and Mr McIntyre? If not, why not?

[Baroness Northover]

Funnily enough, I was just going to get on to the point about a meeting. The noble Lord will be well aware that I am filling in for my noble friend Lord Howe. I am very sorry that it is me rather than my noble friend, with whom I am sure the noble Lord would rather have disputed this. However, my noble friend might very well be detained by the noble Lord, Lord Hunt, in the Chamber and so therefore he is potentially otherwise engaged. My noble friend Lord Howe is, as the noble Lord will know, most forthcoming in terms of engagement and meetings. I will pass on the request for meetings. I am informed that my noble friend has not refused to meet noble Lords—knowing my noble friend, I absolutely believe that—and the department will be in touch shortly. I hope that that reassures the noble Lord, Lord Pearson.

The noble Lord suggested that other speakers in this debate should be included. I was very struck by that, so I look forward to hearing reports of such a meeting, which clearly must include my noble friend Lord Taverne.

[Lord Colwyn]

My Lords, my recollection was, in February 2011, that it had been settled. We shook hands and congratulated each other on the fact that strategy regulation had been promised by the Government.

[Baroness Northover]

As I say, my noble friend Lord Howe is happy to meet people and no doubt this will be discussed further. Maybe I had better hurry up and conclude because I think I am about to go beyond time. Unless I hurry up, nobody will have a chance to say anything else.

[Lord Pearson of Rannoch]

My Lords, we have 20 minutes on the clock.

--- Later in debate ---

[Baroness Northover]

No, we are all time-limited, as I know as a Whip. I am time-limited to 12 minutes. The fact that the debate can go up to an hour is neither here nor there.

I fully appreciate that this delay is causing concern among both practitioners of herbal medicines and consumers. However, I assure noble Lords that once the Government have worked through the difficult issues they face on this policy, an announcement will be made on their proposed way forward. I assure noble Lords that the Government are carefully considering this very important issue and that we anticipate being able to make a more substantive announcement shortly.

Committee adjourned at 7.02 pm.