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David Tredinnick (Bosworth) (Con):
This is an exciting time to be in the House for Conservative Members, and we should look at the Queens Speech in
that context. We are ahead in the pollsby 10 per cent. Our new leader has a positive rating of 42 per cent. as against the Chancellors 38 per cent. It is clear that we will win the next general election. As the sun sets gently over the Labour Benches, it will not be long before, when we see Labour Members for marginal seats rising to speak, we shall raise our order papers and say goodbye. Some of us, such as my hon. Friend the Member for Ribble Valley (Mr. Evans), have seen it happen beforethe swings and roundabouts of politics.
Here we are considering yet another Queens Speech, and I have to say that it looks overloaded and tired to me, but in a spirit of generosity I shall start by thanking the absent Secretary of State for agreeing to meet me and a small delegationperhaps with the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton)to discuss the pressing problems associated with integrated health care. That issue could have been included in this Queens Speech, but it most certainly was not.
It is perhaps no surprise that I will confine most of my remarks to integrated health care, but, if I may, I shall turn first to a local issue. Colleagues in all parts of the House have commented on the primary care trust crisis and the problems arising from reorganisation; indeed, my hon. Friend the Member for West Chelmsford (Mr. Burns) made some valuable points in that respect. The number of primary care trusts in Leicestershire is being reduced, which is affecting Hinckley, in my constituency. The proposed improvements to the new community hospital on the old Sunnyside hospital site were put on hold for re-evaluation. Why? In my view, it was because the hospital is on the fringe of the area. We see the same thing with policing. In cases where the organisation in question is large, it is the police stationsor hospitalson the perimeter that tend to suffer first. More generally, the health service is having massive problems with procurement, which takes far too long, and there has been a very poor review of contracts, but I will leave that issue to my hon. Friends on the Front Bench, who will doubtless want to comment on it.
In turning to the importance of integrated health care in the health service, I want to point out to the Minister that since the 1987 Parliament, which is when I first entered the House, there has been a gradual and relentless movement toward improved integration of alternative and complementary medicine into the health service. During that Parliament, we introduced as a private BillI did not do so myself, but I sat on the Committee that considered itthe legislation regulating osteopaths, who were seen as being outside the health service. In the 1992 Parliament, chiropractors came forward with a Bill, which was passed successfully. As a result, osteopathy and chiropractic, which used to be seen as out on the wings of medicine in Britain, are increasingly part of its structure and fabric.
I pay tribute to the Government for looking very seriously at the regulation of acupuncture and herbal medicinean issue on which Professor Pitillo, the late Lord Chan and others did a lot of sterling work. We will see better regulation of acupuncture and herbal
remedies very soon, within the framework of law. That demonstrates the inevitable surge toward integration.
Those colleagues who recently saw on television the head of a patient in a Chinese hospital being removed for brain surgery using just acupuncture will surely need no further evidence. If one can take off the top of the skull and perform a complex operation using just acupuncture and no anaesthetic
David Tredinnick: I am grateful to the hon. Gentleman. You said that we should be brief, Madam Deputy Speaker, which is perhaps why I took out the top. I did of course mean to say the top of the head. However, many hospitals are adopting that practice.
The Government claim to have a new modernisation agenda, which is supposed to offer all sorts of new commissioning possibilities. One obvious area for consideration is integrated health care. Such an approach would fit in with the Governments stated intention of increased patient choice and more innovation. This is surely a great opportunity for the Government to look carefully and seriously at existing therapies, of which there are 60,000 practitioners. There are a lot of conditions that doctors find very difficult to treat. For example, back pain: 91 per cent. of doctors surveyed said that musculo-skeletal problems were among the most difficult to treat. After that, 45 per cent. of doctors listed depression, 36 per cent. eczema and 32 per cent. chronic pain. All those problems can be treated by complementary therapists, of whom there are 60,000 in this country. They can alleviate the symptoms of chronic conditions and achieve improvements in patients quality of life.
When she looks at integrated health care, the Minister should also bear it in mind that complementary medicines are very cheap. Compared with the cost of drugs and other services offered by the NHS, they offer very good value. The parliamentary integrated health care group met last night, and Committee Room 8 was full. One of the homeopathic doctors present said that his prescriptions often cost only 16p each. Osteopaths and chiropractors use only their hands, and acupuncturists use sterilised needles, with no big drugs bill attached. Healers just use their energy, so there are terrific cost savings to be made.
Mr. Nigel Evans (Ribble Valley) (Con):
I agree with much of what my hon. Friend is saying about complementary medicines. I was treated with acupuncture for a problem that I had when I was younger, and I believe that it helped. However, does he agree that the problem is that most people have to pay for such
treatments, as they are not offered on the NHS? That can be quite expensive, especially for poorer families.
David Tredinnick: I am grateful to my hon. Friend for bringing that to the Houses attention. Such treatments are available on the NHS in some parts of the country, and later in my speech I shall describe the success achieved by a practice in Nottingham that offers a free service to people largely from ethnic communities. However, cost is an issue, which is why we need a wider roll-out of such treatmentsI hope that the House will forgive the jargonin the NHS.
People want these services. In any high street chemist, one can find ranges of herbal medicines and food supplements, as well as homeopathic medicines with 6C or 30C potencies. People can use such preparations to treat themselves safely. There may be as many as 20 remedies for colds, and all sorts of treatments for stomach upsets. That keeps people out of GPs surgeries, and improves patient throughput overall.
Patient demand for such treatments is increasing: 75 per cent. of people support NHS access to complementary and alternative medicines, and 6 million people use them. When I trawl the House on these matters by means of early-day motions, I find that perhaps one colleague in every three or four will say something like, My daughter had a terrible problem with spots. We tried steroids and all sorts of strange things but nothing would fix it until we found a practitioner of Chinese medicine. People are always amazed at the results that can be achieved.
With homeopathy, for instance, a remedy might be so dilutedperhaps one part in 200that it almost cannot be analysed. In theory, it should be weak, but in fact it gains power from being diluted. I have used homeopathy many times over the years, but I have never been trained in it. Even so, I once looked at the relevant research and prescribedif I may use the term without insulting the hon. Member for Wyre Foresta certain remedy for a child who had grommets inserted to deal with glue ear. The treatment was successful after one application, and the problem never recurred.
There is growing evidence that people want complementary services, and that those services are effective. I shall produce one or two relevant statistics, but not too manyunlike the Chancellor, who in his speeches uses so many figures that no one can understand him. That is one of the reasons why, at the next election, my right hon. Friend the Leader of the Opposition is going to trounce the Chancellor, if that is who he has to stand against. My right hon. Friend always speaks gently and persuasively, and manages to say so much with so few words.
There is no need to call me to order, Madam Deputy Speaker, as I shall not go down that trackalthough I suppose that it is in order, given that this is the Queens Speech debate! I can say what I like about the Chancellorin which case, let me say that I loathe his delivery. His is one of the most tiresome and repetitive styles ever witnessed in the House, and it compares unfavourably with that of the former Conservative Chancellor Lord Howe. His speeches were built around three or four main points, and we listened with care and interest.
There are great new opportunities to integrate complementary and alternative medicine through the so-called modernisation agenda of the NHS, especially in the context of patient choice and innovation. The situation is good in some parts but disastrous in others. Some practices are thriving and succeeding, with huge demand, but other older, well established alternative medical organisations, such as the Tunbridge Wells hospital, are under threat of closure. Indeed, a senior doctor from the Royal London Homeopathic hospital told me yesterday that he thought all homeopathic hospitals were under severe threat.
Why are complementary services and hospitals threatened with cuts? First, they are often the easiest to cut; they are soft services on the edge of the primary care trust vision. Secondly, when financial advisers are sent in they do not really understand the provision of complementary services; and thirdly, there is sometimes hostility from general practitioners.
What needs to be done? The Government need to do two things, which should perhaps have been included in the Queens Speech. I shall be raising them when I visit the Minister, so she will be well briefed in advance. First, the Government need a proper CAM delivery framework, which does not exist at present. The development of such a framework was intimated in the 2003 White Paper, Building on the Best: Choice, Responsiveness and Equity in the NHSI do not think that title was a joke. Secondly, there is a need for guidance from the centre, which is completely lacking. When I talk to people in the field in Leicestershire, they tell me that they receive nothing from the centre, which is amazing because Richmond house is like the Berlin bunker in some respects. Missives, orders and directives are sent out and counters are moved around on the board; regulation of even the tiniest surgery comes directly from Richmond houseJosef Stalin would have been happy with the way it is run. However, it is a great sadness that there is no central guidance for PCTs about how innovative service re-design could involve CAM, as suggested in the latest White Paper, Our Health, Our Care, Our Say, published in February 2006. The Minister can see that there is work to be done.
I want to give some brief examples of what a good complementary and alternative medical practice can do. I have chosen the Impact integrated medicine partnership, a Nottingham-based social enterprise, which provides free acupuncture, chiropractic and homeopathy to patients with long-term conditions in a primary care setting. There is practice-based evidence of effectiveness in treating mental health conditions, musculo-skeletal disorders, back pain, chronic pain and gynaecological and menstrual disorders. As I have already noted, three of thosemusculo-skeletal disorders, back pain and chronic painare conditions that doctors find difficult to treat and where they perceive a 91 per cent. effectiveness gap.
I shall not do a Chancellor; I shall use only a few statistics, but I must cite two or three to show the effect
on primary care. On completion of treatment at Impact, 87 per cent. of patients reported that they either stopped or reduced their medication on completion of treatment, which represents a saving of both doctors time and NHS medicine bills. Three quarters of patients reported that they visited their GP less often and some patients no longer required secondary care. The Nottingham case is particularly interesting because 48 per cent. of the patientsnearly halfare from black and minority ethnic communities, in an area where they comprise about 30 per cent. of the population overall. Furthermore, 40 per cent. of the patients are men, which is very unusual because usually one gets a much higher proportion of women, which tends to indicate that there is a very high acceptance of the way this practice is treating patients. Furthermore, a third of the patients consider themselves to have a disability. So that service in Nottingham provides a free service to the ethnic minoritiesto those who are most disadvantagedand it is also treating others. That is a very interesting role model for the Minister to consider; I can provide her with the details if she wishes.
I shall discuss two other issues. One is the general problem facing the homeopathic hospital community, and I should like to give a couple of illustrations of cost comparisons. There are in the United Kingdom five homeopathic hospitals. They are Royal London, which has just been refurbished, Glasgow, which is brand newI went to the opening two years agoBristol, Tunbridge Wells and Liverpool. All are threatened. Tunbridge Wells came within three weeks of closure in September but it is still going. Those hospitals have a total budget of £6 million per annum. The total NHS budget is £742 billion per year. So the homeopathic hospitals budget is just under 1 per cent. of the total. I will say straight away to the Minister that I think they are incredibly good value for that small sum of money.
Surveys have been done to see whether the treatments are effective. The Bristol homeopathic hospital did an outcomes study, not just of a percentage of its patients, but of the lot. It surveyed 6,544 consecutive follow-up patients, and the outcomes scores were as follows. They had all taken homeopathic medicine, and they were asked whether it worked. Seventy-one per cent.three quarterssaid that they had improved, half said that they were better or much better, and homeopathy was associated with positive health changes to a substantial proportion of a large number of patients with a wide range of chronic diseases. In other words, cutting out the jargon, the hospital was treating lots of different people for lots of different thingslots of serious problems.
In the press recently there has been much rubbishing of homeopathy generally. There have been some front pages in the newspapers claiming that it does not work. But I have looked into this carefully. Up to the end of 2005 there have been 119 randomised, peer-reviewed clinical trialsrandomised, controlled trials of homeopathy, using placebo or active comparators. Of those, half showed that homeopathy had a positive outcome, only 3 per cent. were negative and just under 50 per cent.48 per cent.were inconclusive. So that shows a very positive outcome indeed.
Finally, I want to highlight some cost comparisons. I am indebted to the Royal London homeopathic hospital for this information. I want to focus on two medical problems: irritable bowel syndrome and intractable nerve back pain. With irritable bowel syndrome, using conventional therapyreferral to gastroenterologist/endoscopy/colonoscopy/radiology would cost approximately £5,000 to £15,000 per patient. If a patient is treated at the out-patient department of the Royal London homeopathic hospitalthat is one new treatment plus two to three follow-ups and investigationsthe total cost is approximately £500 to £1,000 a patient. So that is a fraction of the other figure, with the same outcome. That itself, I say to the Minister, needs investigating,
I have already said that intractable low back pain is the most difficult problem for doctors to treat; 91 per cent. of those doctors surveyed said that it was the most difficult issue for them. For conventional therapythat is, referral to orthopaedic/ rheumatology/pain relief/ongoing drugs costs including MRI and CAT scansthe total cost is between £5,000 and £10,000 per patient. However, at Royal London homeopathic, for one new out-patient appointment plus two to three follow-ups, investigations and treatments, the total cost is £500 to £1,500 per patient. We are talking about phenomenal reductions in costs. If only the Government were able to see a way of linking in those therapists, or boosting the hospitals that we already haveperhaps I should not be saying this. Perhaps we should save this information for the incoming Conservative Government. Why am I tipping this Government off when they will be out of office soon? [ Interruption. ] My colleagues are not pleased with me for tipping off the Minister.
The Minister has a great opportunity. In a spirit of comradeshipis that not the Labour party terminology?I say to her, please look at this area. We will come and talk to her. What I am talking about works. Give it a chance. It will save the Government a lot of money, and it will make a lot of people happy and save their lives.
Dr. Richard Taylor (Wyre Forest) (Ind): It is a pleasure to follow the hon. Member for Bosworth (David Tredinnick) and I can reassure him that in the cancer units that I know, acupuncture, aromatherapy and reflexology are routinely used. However, I have to take issue with him about irritable bowel syndrome. The manoeuvres that he mentionedcolonoscopy and sigmoidoscopyare not part of the treatment. They are necessary in the diagnostic work-up, before one can begin to treat irritable bowel syndrome, because it is a diagnosis of exclusion.
I welcome the comments from the hon. Member for Bristol, North-West (Dr. Naysmith), who is an expert on the draft Mental Health Bill, having served through many sittings of the Committee. I shall study his comments and talk to him before deciding my reaction. I welcome the contribution of the hon. Member for Warrington, North (Helen Jones) and particularly her tribute to the good qualities of our young people, which I echo. I also welcome the fact that the
Government have included in the programme educational reform that will continue to raise standards in schools. The educational reform taking place on my patch is proving extraordinarily difficult and there are tremendous problems to overcome.
Before I talk about the modernisation of health care, I must join the argument about job losses and staff reductions. Like my eminent predecessor, A. P. Herbert, I sometimes see myself as a referee between the warring factions on either side. What we need in the case of job losses, or staff reductionswhatever we call themis the truth. The Conservative Front-Bench health spokesman, the hon. Member for South Cambridgeshire (Mr. Lansley), began to try to unravel the patterns. We have to separate compulsory redundancies, voluntary redundancies, retirements when people are not replaced, promotions when people are not replaced, the vacancy freeze, and natural turnover. My acute trust has a natural turnover of approximately 10 per cent., which is 450 jobs. If those are not replaced, that means 450 fewer people doing the work. We need a list of the 300,000 new posts, which the Government cite and which I do not dispute, broken down into clinical staff and administrative staffwe need the detailand they should then be matched with all the categories that are being reduced because of the various sorts of staff reduction.
I want to talk about two aspects of the modernisation of health care in particular: the National Institute for Health and Clinical Excellence and hospital reconfigurations. NICE has been much maligned recently, particularly because it appears to be stopping extraordinarily useful drugs getting to patients, and appears to be impeding innovation. It is partly responsible for the UKs slow uptake of new drugs, which is not half a bad thing when one considers the speed with which Vioxx was taken up, and the problems that that caused.
I strongly support NICE, but several criticisms of it can be made. Does it do everything right? Does it get the selection of expert advisers right? The technology appraisal committees are all generalist in nature, so they must depend on expert advisers; the system must be absolutely right. Is the NICE process as fast as it should be? Is the method of selecting the therapies that it examines appropriate? Somehow we must allow it to approve more drugs for use, which means lowering the cost-benefit ratio so that drugs to combat diseases such as Alzheimers become affordable.
There is a great deal of discussion about drugs for wet age-related macular degeneration. I believe that they will cost about £6,000 a course, per patient. The chief executive of my primary care trust tells me that this will cause such a crisis in the NHS that it could well lead to a major rethink of the role of NICE and the way in which it works.
Mr. Stewart Jackson (Peterborough) (Con): What would the hon. Gentleman say to taxpaying constituents of mine who suffer from Alzheimers or breast cancer and are told that they cannot receive the appropriate drugs, while the Government make a value judgment that convicted drug dealers and drug abusers in prisons can have drugs because of the Human Rights Act 1998? Does he think that a strange set of priorities for any Government to pursue?
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