| Previous Section | Index | Home Page |
3 Jun 2009 : Column 131WH—continued
On implementation, NICE has developed detailed guidance on costings and commissioning, which is available on its website. Obviously, it includes advice on the full range of treatments set out. However, guidelines are just that. Decisions on what treatments GPs suggest for patients remain with GPs. They need to take into account the safety of a treatment, its effectiveness and the availability of suitably qualified practitioners, but they are obviously best placed to know the individual circumstances of the patient. Likewise, the commissioning of local services must remain at the discretion of local PCTs, based on their understanding of the needs of their local community.
Maintaining autonomy for local practitioners to make local decisions is paramount for running an effective NHS, even though it means some variations in services. The hon. Gentleman used the term “postcode lottery”. The Government believe—I hope he agrees with us—that the closer to the community and the patients we go, the better the decisions. It would be entirely inappropriate for a Minister to promote one treatment over others, however effective it is. Ultimately, decisions about the most appropriate treatment for a patient must be made by them and their GP.
A number of developments should help to ensure that the full range of NICE-approved treatments, including complementary treatments, gets a fair hearing with clinicians, commissioners and patients. First, last year’s Next Stage Review clearly set out a future for the NHS in which primary care services are increasingly influenced by the patient’s individual needs. The review clearly states that GPs and PCTs should have an innovative and entrepreneurial approach to developing new services for patients. We are beginning to see a culture change throughout the NHS that should encourage GPs and commissioners to be more creative, ambitious and flexible about the treatments they offer. That shift presents new opportunities for complementary and alternative therapies.
David Tredinnick: Will the Minister assure me that he will write, on the basis of this new development, a general instruction about the availability of the new service, so that there is no confusion?
Phil Hope: As I said earlier, such decisions are ultimately a matter for the GP and local commissioners, who look at the NICE guidelines. I want to assure the hon. Gentleman that we are doing what we can to draw attention to the new guideline, which was published only last week. That will make a big difference. Generally encouraging the NHS to be more entrepreneurial and responsive, and to offer a full range of treatments, will have a direct impact of the kind that we would both like.
Personal health budgets, which we are piloting at this stage, could be a powerful mechanism to broaden the range of available options. We are not being prescriptive about the areas for personal health budgets that should be piloted, but through some 40 pilots, we want to investigate the use of personal health budgets to provide services for people with long-term conditions, which could include people with chronic back pain. The provisional pilots are still developing their proposals and we will know more about their scope in due course.
However, in time, personal health budgets could indeed be another mechanism to support the wider use of complementary medicine in back pain relief, if, of course, the patient wants to go down that route.
The hon. Gentleman mentioned research. The Department of Health commissions research to underpin policy and practice in health and health care through the National Institute for Health Research and the Department’s policy research programme. Our research programme includes £3.4 million for a complementary and alternative medicine personal award scheme. That forms part of our research capacity development programme. The scheme supports 18 CAM researchers at the doctoral and post-doctoral level. They are developing a programme of research and nurturing the methodological skills of the more junior researchers in their teams. Their presence in the programme has allowed factors specific to CAM practice to be incorporated into approved research methodologies. That is an important step forward.
We are also funding complementary and alternative medicine evidence online, which is a collaboration between the Research Council for Complementary Medicine and the university of Westminster school of integrated health. That involves a detailed review and critical appraisal of the published research on specific complementary therapies, focusing on their use in NHS priority areas. The Department has also put money into research on the role of CAM in cancer patient care, and on the use of complementary medicine in primary care.
Finally, regulation is crucial when it comes to giving alternative techniques the credibility and respect that they need in the eyes of GPs and the general public. At present, there is no statutory regulation system in the UK governing the practice of complementary and alternative medicine, with the exception, as the hon. Gentleman said, of chiropractic therapy and osteopathy. As he said, he played an important role when, during
his long service in the House, he sat on the Committees that brought the measures into being.
We will, however, soon be launching a public consultation on whether and how we should regulate practitioners of acupuncture, herbal medicine and traditional Chinese medicine. That comes from the recommendations of one of the working groups that were established in 2006 to implement proposals in the “Trust, Assurance and Safety” White Paper, so there is more work under way. Once the consultation is completed and when we have assessed the response, Ministers will make a decision on the way forward.
People with chronic back pain expect the NHS to do its utmost to help them to manage their condition. The new NICE guidelines will bring new clarity and choice to patients, in line with the Next Stage Review vision and the work we are doing to improve pain management in general. I expect clinicians and commissioners to pay equal attention to the full range of options that the new NICE guidelines advocate. The Government are playing their part to ensure that all scientifically proven treatments are considered on their merits, including complementary techniques.
The bottom line is quite simple: we want all patients to have access to the best possible treatments for them. I believe that the NICE guidelines are another important step towards achieving that for people suffering with the misfortune of chronic back pain. A debate such as this is another good opportunity to raise public awareness of the changes that are being made and of the enthusiasm of the hon. Gentleman and others for our work, and to ensure that patients, GPs and commissioners take the issue seriously and take it forward in the interests of the wider community.
4.59 pm
| Index | Home Page |