Health and Care Services

David Tredinnick Excerpts

Wednesday 3rd July 2013 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

I wish to run through some of the points in our report for the benefit of the House and to suggest that there is one area of supply to the health service that is not being considered enough. At the moment we have two legs on the stool, rather than three.

Before I do that, I would like to congratulate my right hon. Friend the Member for Charnwood (Mr Dorrell)—I used to know him as the Member for Loughborough, which might cause some confusion—on his speech. He is ever modest to say that the Committee came up with the term “Nicholson challenge”. I firmly remember that it was he who came up with it. It is absolutely to his credit that, as a former Treasury Minister, he has focused absolutely on the costs; and here we are today, addressing estimates and how we deal with the ever-increasing demand for health services.

Although they have come up already, there are a couple of points that we must bear in mind. They include the devastating impact of the potential 6p on income tax if we do not get this right and the difficulties—although some of my hon. Friends might dispute this—of achieving a 4% efficiency gain.

We have seen the impossibility of solving the problem through public sector pay restraint alone, and tinkering with tariffs is another issue. How do we cope with that? Tinkering with the tariffs will not solve the problem; we have to go for a full integration of services. That issue was well illustrated by the ghastliness of the Mid Staffs experience, the Winterbourne experience and the Morecambe Bay experience—those unbelievable failures in the health service. Apart from the financial requirements, that points us in the direction of the importance of delivering improved services through integration.

We really must focus on structures and the delivery of care. The primary response of the NHS to the Nicholson challenge should be, as the Committee said, to prioritise fundamental service redesign. That will lead to better quality care for more NHS patients. Paragraph 82 of the Committee’s report states that it is

“inconceivable that this performance can be delivered—together with quality improvement that is…required—if planning proceeds within traditional silos.”

We have to break down the old system and start afresh.

Of course, the Health and Social Care Act 2012 is the foundation of this new approach. It is a Bill that had a somewhat tortuous passage through the House, with some reconfiguration, but it has delivered enormous opportunities. Yesterday, when the Health Secretary came to the Health Select Committee, I was struck when he explained to us the savings that the 2012 Act has already achieved. Although the reconfiguration is hugely costly in itself, running to over £1 billion, the fact is that the savings are already in place. My right hon. Friend the Member for Charnwood highlighted the importance of bearing down on costs, and this is already being realised through the reconstruction that the Health and Social Care Act 2012 has provided.

The Conservative party is ever the party of choice, and we made it quite clear—in deference to my Liberal colleagues I should say that the coalition made it clear—that we want patient choice. That is essential. Through the Health and Social Care Act 2012, the health and wellbeing boards and personal budgets—they are somewhat overlooked but have proved to be incredibly successful—we have the structure to provide for patient choice.

What we have not really addressed or seen yet is what the patients will choose to ask for. There is a supply-side issue here in the range of services, treatments and therapies that are—or are not—currently available through the health service. If we are further to reduce costs, and broaden choice, we are going to have to put what I would describe as the third leg on the stool. We have the integration of health and social care, but what is also important is the integration of the range of therapies available in this country that are not necessarily statutorily regulated and available within the health service as we speak.

You may recall, Madam Deputy Speaker, that many years ago I had the honour of serving on the Committees considering the osteopathy and chiropractic Bills, which subsequently became Acts. That legislation which brought statutory regulation to osteopathy and chiropractic, brought them more fully into the mainstream health service. The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter)is, I am reliably informed, tasked with dealing with the next great challenge, which is herbal medicine. He may not be overwhelmingly delighted to know that there is a one and a half hour Adjournment debate next Tuesday in Westminster Hall, where we will discuss this issue in some detail.

When we talk about 13-year spans in this place, it usually refers to 13 years of Conservative government. It has also been 13 years, however, since the House of Lords Science and Technology Committee report on complementary medicine, which recommended the statutory regulation of herbal practitioners. We must address this issue, as we will next Tuesday in some detail, but let me set out the stall by pointing out that three quarters of the population are using herbal medicine, homeopathy or other types of alternative medicine.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

The hon. Gentleman mentions 13 years, but it is only three years since the House of Commons Science and Technology Committee delivered a damning report, saying that there was no evidence base for homeopathy at all. Does the hon. Gentleman think that we should address that before we try to use precious NHS resources in this way?

--- Later in debate ---

[David Tredinnick]

There are two separate issues here: herbal medicine and homeopathic medicine. The Science and Technology report was very controversial. I now have the honour to serve on the Science and Technology Committee, and we have been looking at these issues. Let me tell the hon. Gentleman that in France, 70% of the population and all pregnant women use homeopathy. Some doctors are trained in both types of medicine, and they tend to prescribe fewer allopathic drugs for their patients, which works out much cheaper. There is a lot of research to be done on that. Homeopathy is, of course, widely used across the world, including in the United States and in India. I think this country has a lot of catching up to do. That is why, as I said to the Secretary of State yesterday, I have stuck with this issue over the years.

I would also say to the hon. Member for Birmingham, Selly Oak (Steve McCabe) that there is a huge injustice here. Just as we had racial prejudice in the past, we seem to have a similar kind of prejudice here based on the worst possible “turf war” considerations. I think I had better leave it there, Madam Deputy Speaker, as I might be indulging your patience.

The former Secretary of State for Health said in 2011 that he thought statutory regulation was the way forward. I have to say to my hon. Friend the Under-Secretary that he should consider going down the route of the Health and Care Professions Council; I think there is some talk about the Professional Standards Authority. As the Minister reflects on the challenge he faces, he should remember that many people in this country are affected by this, and that we are looking to him to come up with a workable solution.

I leave him with one thought on this subject. By chance, I spoke in a recent meeting to Lord Wilson of Tillyorn, the last but one Governor of Hong Kong. He brought statutory regulation of herbal medicines into Hong Kong. He said that he did so not just because it was better to have a properly regulated discipline that would help to avoid the misuse of prescribing, but also because of the turf war between the medical establishment and the herbal community. I think that there is a real danger—I shall expand on it next week—of the Minister being pressurised by people who are doing so only because of vested interests, which I think is very sad.

I applaud the direction in which my right hon. Friend the Member for Charnwood has taken our Select Committee in focusing on the need to bear down on costs in the health service and to shine a bright light on this phenomenally difficult challenge of increasing demand and how we pay for it. I have suggested that while it is brilliant to have the integration of health and social care, if we are to satisfy the demands of people—through the different boards under the Health and Social Care Act 2012 and through personal budgets—we are going to have to look more seriously at the other therapies that are available but are not regulated or brought into the health service. The Minister really must try to grasp the importance of herbal medicine because practitioners cannot get the supplies they need to be able to practise as they should. I wish him well in his endeavours.