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MERCHANT SHIPPING AND MARITIME SECURITY BILL
Ordered,
That, during the proceedings on the Merchant Shipping and Maritime Security Bill, Standing Committee A shall have leave to sit twice on the first day on which it shall meet.--[Mr. Coe.]
Ordered,
That Standing Order No. 14B (Proceedings under an Act or on European Community documents) shall not apply to the Motion in the name of Mr. Michael Jack relating to the salary of the Data Protection Registrar.--[Mr. Coe.]
Ordered,
That Sir Fergus Montgomery be discharged from the Liaison Committee and Mr. Bob Dunn be added to the Committee.--[Mr. Coe.]
19 Feb 1997 : Column 1019
NHS Prescriptions (Nutritional Supplements)
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Anthony Coombs.]
10 pm
Mr. David Tredinnick (Bosworth): In January this year, the British Society for Allergy, Environmental and Nutritional Medicine wrote to my right hon. Friend the Secretary of State for Health saying:
- "Your ministry is planning steps which may lead to the deaths of thousands of people in the UK, and to substantial avoidable suffering for many others."
I address the House as the long-standing treasurer of the all-party group on alternative and complementary medicine. As my hon. Friend the Minister will know, I have monitored and taken a great interest in such issues for the best part of a decade. The Department's proposal to blacklist more than 200 nutritional supplements, making it impossible for general practitioners to prescribe them on the national health service, would bring to more than 600 the total of supplements so blacklisted in the past three years.
That move would seriously damage the health of many ill people, and wastes an opportunity to reduce prescription costs and improve patient care. The proposal is the result of recommendations by the so-called Advisory Committee on Borderline Substances. In its submission, the committee stated that the products in question
My hon. Friend the Minister will be aware as he travels the country how many chemists and shops now stock all kinds of vitamin supplements. My constituency contains the headquarters of Holland and Barrett, which has a massive warehouse, with all kinds of vitamins and supplements readily available. But these have to be paid for, unless they are available on the NHS. By agreeing to the proposals, my hon. Friend runs the risk of removing the opportunity for less well-off people to be treated. I am certain that many in my constituency and my county of Leicestershire will suffer if the proposals are accepted.
I gave the Minister notice of more or less exactly what I intended to say, and I have briefed him on a number of points that I was seeking to raise. On behalf of the
BSAENM, I have also sent him a case study that amply demonstrates the problems that could be caused by the removal of those vitamins from the list. The case concerns Mrs. B. S., a 72-year-old retired nurse. I will not go through the whole case, but she suffered from water retention, arthritis and hypertension, and was treated using supplements.
Eventually, her doctors recommended that she came off that treatment--although it was helping her--and she was put on powerful drugs. Those drugs apparently made her much worse, and she turned to her nutritional medical adviser, who put her on a course of magnesium injections and magnesium amino acid chelate. At the moment, the supplements are provided on the NHS--and this is the point.
She responded well to treatment and, from being at death's door, she found that her weight and blood pressure dropped and she was altogether better. Without the magnesium and other supplements, I respectfully submit that this lady would probably pass away--the advice that I have been given is that she may have lived for about three months at most. This is the gravity of the situation we face, and that is why I have sought to give these important issues an airing.
There are certain specific points to which I want the Minister to respond. The first is the time that those in the field of nutritional medicine have been given to consider the proposals. According to the Department, the recommendations were published ahead of time to allow an opportunity to comment on them. But the release date of 25 November last year allowed only 45 days--including Christmas and new year--for responses to be prepared and submitted.
That may sound like a long time, but, as we are talking about 200 preparations, it works out at one hour per preparation for the submission of a proposal to retain a product on the prescription list. That is an inadequate period for consultation.
My second point is that the advisory committee has recommended that the products listed have not demonstrated a therapeutic value, or have more economic alternatives. This is a highly contentious statement, and the document does not specify which of those justifications has been applied to each item on the list. However, since it is the clear intention to blacklist most, if not all, of the readily available nutritional supplements, the suggestion that more economic alternatives are available is untenable.
In preparing its response, the society surveyed many of its members. Ninety-six per cent. considered that nutritional supplementation was essential to their method of practice. It is those practitioners who will suffer, and at a time when more and more people are turning to alternative and complementary medicines because they do not feel that the medicine available--good and proven though it is--on the national health service through conventional preparations and doctors is adequate.
People are voting with their feet. I referred to the enormous number of shops that now sell the preparations. They include high street chemists, which would not have considered selling them five or 10 years ago. My hon. Friend is in danger of undermining the use of these important supplements for those people who are unable to pay and must get them on the national health service.
Thirdly, the national health service executive says that other products will meet patients' clinical needs equally well. I have already referred to the lady who suffered from water retention and hypertension, who was put on magnesium. In that case, the magnesium was crucial, but it is one of the products listed in annex 2, along with 13 other magnesium or calcium and magnesium products. Not to coin an original phrase perhaps, but there is no alternative to that product--it is essential in the treatment of certain problems. There is no licensed multi-vitamin and mineral product with adequate potency for the treatment of those nutritional deficiencies.
The qualifications of the committees are another contentious issue--we come across this throughout the alternative and complementary medicine spectrum. The Advisory Committee on Borderline Substances has made the judgments, but it lacks the expertise to deal adequately with the issues. The practitioners with knowledge and experience of nutrition are simply not on that committee. Experts in the field need to be appointed to it. It is not good enough that committee members have some related experience. I suggest that the management of the committee should be modified to include medical practitioners with knowledge and experience of nutritional medicine.
My next and perhaps final point is that the Department contends that the selected list scheme has the aim of ensuring that all the real clinical needs of NHS patients can be met as economically as possible. That is such a contentious area. The national food survey in 1994 and the survey on the diets of British schoolchildren in 1986 stressed the need for certain minerals which are not necessarily readily available to the population in their diet, such as iron, zinc and magnesium. The survey of schoolchildren found that 95 per cent. of subjects had insufficient intakes of various minerals. Sometimes, it is necessary for those to be prescribed.
Doctors need that right, and it is good value, because, if people do not get them, they will become ill, and then they will become a burden on hospitals. It is a false economy to suggest that removing vitamins, which strengthen the immune system and the patients, and keep them out of expensive hospital care, is in the interests of the economy of the health service.
Another report, "Effective Nutritional Medicine", found that between 75 per cent. and 90 per cent. of cancers are attributable to environmental factors and can often be corrected--perhaps not cured--by nutritional medicines.
My final point concerns vitamin B6 and peripheral neuropathy. The issue is contentious, as my hon. Friend knows, because of the proposed removal of high doses of vitamin B6 from the list on the grounds that they are toxic. The society I mentioned submits that there is no evidence that toxicity begins at 50 mg a day for humans. Human evidence supports toxicity at 500 mg a day and upwards. There are various reports, as my hon. Friend knows, many of which date back a long time. The evidence is insufficient for the ban that is being canvassed. I encourage him to pause and reconsider this crucial issue.
I was looking at the Parliamentary Office of Science and Technology technical report in the Library on treating problem behaviour in children. Bad diet is one of the
problems that causes such behavioural difficulties. Vitamins can often right that. There is an educational angle to the matter. If children have the right supplements to their diet, their behaviour improves, they become less disruptive, and they live better lives.
On the threat to 200 vitamin supplements, my hon. Friend the Minister should suspend consideration of proposals for blacklisting nutritional supplements. Many hundreds have been blacklisted already. Important supplements such as magnesium are threatened now. I ask him please to think again.
"have more economic alternatives"
and
"have not demonstrated a therapeutic value".
I hope to demonstrate to the House tonight and to persuade my hon. Friend that those contentions are completely wrong. Members of the BSAENM are doctors, and they say that many patients will suffer greatly if those vitamins and nutritional supplements are removed from the list. One estimate puts the potential savings to the NHS from improved nutrition for hospital patients alone at £266 million a year. GPs who are members of the BSAENM report similar savings in their practices. I suggest to my hon. Friend that the removal of these products is a false economy, benefiting neither the patient, the Department of Health nor taxpayers.
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