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10.33 pm
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I am grateful to the hon. Member for Bosworth (Mr. Tredinnick) for raising the regulation of acupuncture and its use in the NHS. I pay tribute to his unflagging enthusiasm for complementary and alternative therapies. He has raised them on a number of occasions and we have discussed them. Let me, however, sound a small note of caution at the outset. I would not like him to run away with the idea that complementary and alternative therapies are the answer to all our problems in the national health service, although they can clearly make a significant contribution.
A number of therapies which not very many years ago would have been dismissed as fringe activities are beginning to be taken seriously by orthodox medicine. Osteopathy and chiropractic have joined the established health professions by gaining statutory recognition. As the hon. Gentleman pointed out, herbal medicine and acupuncture are now making serious preparations to gain that ultimate recognition. Other therapies are beginning to strengthen their regulation—by bringing together a range of the diverse bodies involved to hold joint discussions—and that is much to be welcomed.
Acupuncture has already attracted interest in the NHS. A BMA report on acupuncture, published in June 2000, identified a growing interest in acupuncture among GPs, and called for improvements and strengthening of its regulation. Acupuncture was one of the therapies included in the complementary medicine information pack that was sent to primary care groups in July 2000. The pack outlines a range of complementary therapies; it describes what is involved and sets out how primary care groups—and now primary care trusts—can begin to commission such services. It does not pretend to act as formal guidance, but highlights where complementary and alternative therapies can be useful.
The fact that acupuncture can help in treating nausea, back pain, tooth pain, migraine and other forms of pain is well recognised. It was the subject of a complete review of the evidence base that was published last November.
There is a developing recognition of the evidence base for acupuncture. It is important to note, however, that the therapy cannot apply to the whole range of ailments. It is essential that we have a good, strong, well recognised evidence base for such therapies.The hon. Gentleman mentioned smoking cessation. A review of the evidence revealed that in 21 trials acupuncture was no better than placebos in securing long-term abstinence from smoking. In fact, it was less successful than nicotine replacement therapy. We must be aware of the contribution that can be made by acupuncture, while also being rigorous about the process. It is through such rigour that there will be acceptance, and people will feel confident and safe in making referrals. We need a balanced consideration of the issues.
Other sources have publicised the effective use of acupuncture. NHS Direct Online, in its new health encyclopaedia, includes advice on the use of acupuncture. It focuses mainly on types of pain relief, where it has been proven to be of most use.
As the hon. Gentleman said, the recent awards for good practice in integrated health care highlighted the work carried out in maternity provision at Derriford hospital. It has been suggested that the hospital might consider applying for beacon status, as a means of achieving wider dissemination and knowledge of the services provided in its maternity unit.
Acupuncture is already used by many, many NHS professionals. It would certainly be desirable if more of them could provide acupuncture. The hon. Gentleman mentioned the importance of doctor training and of ensuring that, through their curriculum and their education, doctors are made aware of the range of complementary therapies. The final draft of "Tomorrow's Doctors", currently being prepared by the professions, refers to the possibility of background instruction in complementary and alternative therapies for trainee doctors. That is an important step in ensuring that doctors are aware of the evidence base and the available therapies.
Even with more qualified NHS staff, however, there will be a need to expand the range of professional acupuncturists—those who practise that therapy exclusively—and there should be more scope for NHS providers to engage their services. That is why a new, professional, regulator of acupuncture could help the NHS by advising on the training and competencies needed by NHS staff to carry out those services. As the profession grows, equality of access to acupuncture on the NHS will ease considerably. Access is not universal and it will increase as the profession becomes more established and acquires more publicity and greater standing through regulation.
Acupuncture is generally considered relatively safe compared with other forms of treatment. However, in a few cases it has been known to have serious adverse effects, and its reliance on the insertion of needles clearly poses a risk to patients. Risk can be minimised by ensuring that acupuncture is administered to high standards of safety and competence by properly trained therapists. That requires effective regulation to define that competence and the necessary training standards, so that patients and the public can rely on the safety of the service.
By comparison with some of the other therapies, acupuncture already has in place many of the features that provide effective regulation on a voluntary basis. Most of
those who practise acupuncture full time are regulated by the British Acupuncture Council—an organisation of some 2,200 members that was formed in 1995 by bringing together the membership of five disparate professional groups. The council was favourably mentioned in a House of Lords Select Committee report, not least because the council had formed an independent accreditation board for educational standards and was well on the way to setting up proper regulation.In this country, two different groups use acupuncture in different ways. One group consists mostly of professional acupuncturists, who are fully trained in the holistic Chinese approach. The hon. Gentleman has mentioned the relationship between traditional Chinese herbal medicine and acupuncture. The other group consists of established conventional health professionals, who are already regulated on a statutory basis in connection with their majority employment. Whether they are nurses, physiotherapists or general practitioners, they use acupuncture in their more conventional practice. They may have had more limited training and may make more limited use of acupuncture than the professional acupuncturists who operate full time.
It is very important that those two groups come together and collaborate. They have already carried out joint research, illustrated by articles published in the British Medical Journal in September last year, so the groups are considering such issues together. It is important that, when we begin to develop the regulation, damaging splits should not occur between the different forms of practice. Those groups have many issues in common, and they can come together to help to make the regulation effective, safe and of comfort to patients; and to ensure that the whole acupuncture profession can function properly in the future.
Safety is clearly a key issue for the Government. That is why we want to try to appoint a single, authentic source of professional expertise to protect patients' interests. I am extremely pleased that members of the British Acupuncture Council have supported the case for strong self-regulation. At its recent annual general meeting, the ballot was overwhelmingly in favour of taking forward such steps.
We want to ensure that we create the body with professional expertise, so that it can speak with authority on behalf of acupuncture as practised in the United Kingdom, and so that it can encourage competent practice. We also want to try to ensure that we embrace the whole range of approaches to acupuncture in taking that forward. We can build on the approach that has been taken in relation to herbal medicine by ensuring that we set up proper working groups to consider the issues, that those groups meet regularly and make recommendations, and that the Department of Health is involved.
The way in which herbal medicine has been taken forward—we are involving lay people—provides an important model to ensure that we have the widest possible agreement on such issues. A working group has been appointed to consider herbal medicine, and it is a little in advance of the one considering acupuncture at the moment, but I hope that both bodies can learn from their joint experience as they progress.
The working group on herbal medicine will make recommendations which will form the basis for a subsequent order under section 60 of the Health Act 1999. Clearly, there will be a great deal of work to do before we reach that point, but it is important that this be a joint enterprise with the Government, so that we can embrace the recommendations from the consultation exercise properly in the necessary legislation to give the professions a proper statutory footing.
It is important that the bodies play a major role in deciding how to make progress. This is not a matter for the Government to dictate; it is for the people involved in the service in the professions—the people who treat patients—to make their recommendations. I understand that there will be a meeting on 31 January when all the parties will get together. The Department of Health will be fully represented at that meeting, and we will begin to see dramatic progress.
I can tell the hon. Gentleman that we already support a great deal of research in this area. There are two major research projects, and about £350,000 is being spent on research, but clearly more work remains to be done. I understand that the hon. Gentleman was involved in preparations for the regulation of osteopathy and chiropractic medicine, and I am sure that his contributions will continue to be extremely helpful in developing the statutory regulation of herbal medicines and acupuncture. I urge him to maintain his involvement and to ensure that he continues to contribute to that process as it develops. Indeed, I urge other hon. Members who are members of the all-party group who have an interest in such issues to ensure that they take part in the consultation that takes place.
The hon. Gentleman asks about the Government's contribution to the cost of regulation. Clearly, regulation costs money. As professions become increasingly successful, the unit costs can be spread more widely and thus perhaps become more manageable. We will make a contribution in the form of the section 60 order, the preparations, and the consultation process. If there is a good, strong case for us to contribute to the profession's infrastructure, we shall certainly consider that in so far as we can.
The motion having been made after Ten o'clock, and the debate having continued for half an hour, Mr. Speaker adjourned the House without Question put, pursuant to the Standing Order.
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