Integrated Health Care

John Bercow Excerpts

Wednesday 2nd June 2010 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

I count myself lucky to have secured this debate on the day that we have debated health matters in the Queen’s Speech, and to discuss integrated health care for the first time in this Parliament. I am fortunate to be—[Interruption.]

[Mr Speaker]

Order. I apologise for interrupting the hon. Gentleman. This has been a stimulating and, for many, a rewarding day, but if Members who are leaving the Chamber could please do so quickly and quietly, the House will benefit from the words of the hon. Gentleman.

[David Tredinnick]

I am flattered to have the Secretary of State for Health on the Front Bench, the shadow Secretary of State for Health on the Opposition Front Bench and, to my left, a former Secretary of State for Health, my right hon. Friend the Member for Charnwood (Mr Dorrell). It is perhaps pertinent that it was him—then the Member for Loughborough—who, as an Under-Secretary, first made it possible for GPs to refer patients to practitioners who were regarded as complementary and alternative, if they took clinical responsibility. That was the Conservative policy that he instituted way back in 1990.

This debate fits so well with my right hon. Friend the Secretary of State’s determination that, in the words of Queen’s Speech,

“The voice of patients and the role of doctors will be strengthened”.—[Official Report, 25 May 2010; Vol. 510, c. 31.]

This evening I would like principally to address three related issues: the situation regarding homeopathy and homeopathic hospitals; the regulation of herbal medicine and acupuncture; and the consideration of other available models, particularly in Australia and the United States.

Let me start by welcoming my hon. Friend the Under-Secretary to her place. In a sense, this was an integrated health care general election, because the arch-opponent of anything to do with non-orthodox medicine, the former Member for Oxford West and Abingdon, was defeated and the gentleman who stood against me on an anti-alternative medicine ticket lost his deposit. That was because people are increasingly in favour of having alternatives in the health service. Indeed, 50% of the population have at some stage tried one form of integrated health care or another—acupuncture, herbal medicine or homeopathy—or a back treatment.

The Secretary of State’s proposal for an independent national health service board to allocate resources, provide commissioning guidance and allow GPs to commission services on behalf of patients is the ideal vehicle to give guidance. The first point that I would like to make to my hon. Friend the Under-Secretary is that the new board, when instituted, should offer guidance, through the primary care trusts, on what is available in the health service and stress why integrated health care is so important, for which I would suggest there are three principal reasons. First, people often turn to the alternatives when mainstream medicine has not succeeded. Secondly, conditions often fall into what is known as the effectiveness gap—that is, a category that conventional treatment is unable to help. Thirdly, people might not have benefited from conventional treatments or they might have experienced adverse effects owing to drug reactions.

Another important point, which fits the new coalition Government’s proposal for cost-effectiveness, is that the alternative disciplines—herbal medicine, aromatherapy, homeopathy, osteopathy, chiropractic—are very cost-effective. They are often cheaper than other treatments and, if used in conjunction with mainstream medicine, can be very effective in reducing the effects of heart disease, asthma, back pain and stress, for example. An integrated approach will offer my hon. Friend the Minister and my right hon. Friend the Secretary of State new weapons in the armoury of health care.

In the past few years, there has been a concerted attack on the homeopathic hospitals in this country, which go back to the formation of the health service, and on homeopathic treatments generally, on the ground that the science is weak and does not demonstrate that they are effective. This has manifested itself in bogus Department of Health circulars, in the fact that the British Medical Association’s conferences have tabled motions on the subject, and in the Science and Technology Committee’s recent highly controversial report claiming that homeopathy was a placebo.

The effect of that has been to reduce the number of referrals from primary care trusts in London, particularly to the Royal London Homeopathic hospital. The hon. Member for Hampstead and Kilburn (Glenda Jackson) took up that matter. In other parts of the country, pressure has been put on training. I encourage my hon. Friend the Minister to make a statement tonight that the Government are supportive of the homeopathic discipline, as they said they were before the general election.

The problem with the report that the Science and Technology Committee produced was that it did not take evidence from primary care trusts or from the Society of Homeopaths, and it ignored completely the evidence from abroad, which shows a greatly increased use of homeopathic treatments. For example, in France, homeopathy is taught in seven medical schools and practised by 25,000 doctors. In India, it is part of the health service. There are 180 colleges teaching homeopathy there, and more than 300,000 practitioners. Whatever the merits of the scientific research, the fact is that there are 500 doctors in Britain who choose to use homeopathic treatments as part of their work. Whatever the science says—whether it is proven or not—those people believe that homeopathy works, and that is important.

The costs involved are absolutely minimal. The cost per year to the national health service of homeopathic medicines is £152,000, out of a budget of £11 billion. Over the three years from 2005 to 2008, the hospitals themselves cost the nation £12 million—£4 million a year. These are very small costs, and we really need to take that on board. We must also recognise that there are new approvals coming on stream. At Sao Paolo university in Brazil, homeopathic treatments have been found to be effective in treating depression, instead of Prozac, and the university of Texas has shown the positive effect of homeopathic treatments in killing cancer cells while maintaining good cells. There is a lot to look at there, and the message should be that doctors who wish to use these therapies should do so and should be free to refer. If we can get that simple message across, we will have performed a great service. I am of course speaking to my hon. Friend on the Front Bench.

The regulation of herbal medicine and acupuncture is a crucial area. The previous Government spent for ever debating the matter and calling various professors to look into it. They asked for more and more information, and the final recommendations, produced by Professor Pitillo and Lord Chan, were that these areas should be regulated by the Health Professions Council so that there could be an interface with European legislation next year. However, the recommendation of the outgoing Government was that these matters should be regulated by the Complementary and Natural Healthcare Council instead. I think that that would be a mistake; I believe that we should go for stricter regulation. All the other disciplines could join the 3,000 now registered on the CNHC register. That would be the way forward. Certainly, all the organisations in the field—including the Association of Traditional Chinese Medicine and the European herbal medicine and acupuncture societies—want statutory regulation.

Finally, I turn to deal with what is happening in the rest of the world. I have already referred to the fact that we should take note of the widespread and increasing use of homeopathy in France—I did not mention Germany —and India, while we should also look at what is happening in Australia, which has been a leader. In Australia, according to Government reports, 50% of the population are now using herbal or complementary medicines. There are a number of colleges where these disciplines can be studied and a Complementary Medicine Evaluation committee has been set up; the Australians also have a Therapeutic Goods Administration committee. Herbal medicines are considered by the TGA of Australia to be

“reasonably safe with less adverse reactions than conventional pharmaceutical treatment”—

this is the big hint that we should look seriously at these treatments—and Sydney university has established the herbal medicines research and education centre

“to promote high-quality scholarship and research excellence in herbal medicines through teaching, research and international linkages.”

In fairness to the former Secretary of State, the right hon. Member for Leigh (Andy Burnham), who has just left the Chamber, I should say that he introduced a number of surveys, through the National Institute for Health and Clinical Excellence, which was a welcome development. I think, however, that my hon. Friend the Minister could do more, and I hope that she will. The Australian institutions were given a lot of money. I am not suggesting that there is a lot of money around at the moment, but if Australia can provide $4 million to start up and get going its National Institute of Complementary Medicine, it is something that we should also consider doing.

The other country way ahead of us is the United States of America, which now has a National Centre for Complementary and Alternative Medicine, the federal Government’s lead agency for scientific research on complementary and alternative medicine. It is one of 27 institutes that make up the National Institute of Health in the US and it is statutorily regulated. The mission is to explore

“complementary and alternative healing practices in the context of rigorous science… train complementary and alternative medicine researchers and… disseminate authoritative information to the public and professionals.”

It conducts research using scientific methods and advanced technologies to study CAM. I believe that we should follow that model.

During my time in the House, I have had the honour to chair and be an officer of the parliamentary group for integrated and complementary healthcare and the old parliamentary group for alternative and complementary medicine. Over a period of more than 20 years, we have seen these disciplines come in from out of the cold to complement and augment the wonderful work of our national health service. With our very liberal approach to empowering doctors and to giving patients greater choices in what they want, we have a great opportunity to draw on the wonderful resources we now have vested in our homeopathic hospitals, which offer many other treatments besides homeopathy, and in our 20,000 to 30,000 practitioners out there in the field who can offer herbal medicine and acupuncture.

The Minister now has a great opportunity to grasp the nettle and complete the great work that was started when my right hon. Friend the Member for Charnwood—originally the Member for Loughborough—agreed that doctors taking clinical responsibility could refer to these practitioners. We need to move 20 years ahead, and complete this process with statutory regulation for herbalists and acupuncturists, proper referrals and an acceptance that our 500 homeopathic doctors can refer patients if they want to do so. If we do that, my hon. Friend the Minister will be well remembered in years to come.