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That this House welcomes Professor Steele's review report and its endorsement that the principle of local commissioning introduced by the 2006 reforms provides a firm basis on which to develop NHS dentistry; agrees with the vision set out in the review of improving incentives to support dentists in delivering access and quality; acknowledges the Government's commitment to working with the dentistry profession and other stakeholders to ensure through careful piloting that it implements the recommendations in a way that delivers the best possible system for patients, dentists
and the NHS; acknowledges that children's oral health in England is already among the best in the world; welcomes the commitment of the NHS to deliver access for all who seek it by March 2011 at the latest, supported by some £2 billion in central funding for dentistry, and understands that access is now growing again; notes that in the last four quarters the number of people seeing an NHS dentist in the previous 24-month period has grown by 720,000; further notes that the dental workforce is growing, with 655 more dentists working in the NHS in 2007-08 and a further 528 in 2008-09; and recognises the support that the dental access programme of the Department of Health is providing to clinicians and managers to help them rapidly expand NHS dental services where necessary.
Business without Debate
Motion made, and Question put forthwith (Standing Order No. 41A(3)),
That at this day's sitting, Standing Order No. 41A (Deferred divisions) shall not apply to the Motion in the name of Huw Irranca-Davies relating to Common Fisheries Policy.-( Mark Tami.)
European Union Documents
Motion made, and Question put forthwith (Standing Order No. 119 (11),
That this House takes note of European Union Documents No. 15869/08. Commission Communication on the Proposal for a Council Regulation establishing a Community control system for ensuring compliance with the rules of the Common Fisheries Policy, and No. 15694/08, draft Council Regulation establishing a Community control system for ensuring compliance with the rules of the Common Fisheries Policy; and supports the Government's objective of ensuring that this proposal delivers stronger, proportionate, more effective control provisions which contribute to the long-term sustainability of fish stocks.-( Mark Tami.)
Delegated Legislation
Standards and Privileges
That Sir George Young be discharged from the Committee on Standards and Privileges and Mr David Curry be added .-(Mark Tami.)
Access to Parliament (United Kingdom Members of the European Parliament)
That the Resolutions of the House of 30 January 1989 relating to House of Commons Services and 6 December 1991 relating to Access (Former members and United Kingdom members of the European Parliament) shall cease to have effect insofar as they relate to United Kingdom members of the European Parliament.
Regional Select Committee (West Midlands)
That Dr Richard Taylor be a member of the West Midlands Regional Select Committee .-(Mark Tami.)
Regional Select Committee (Yorkshire and the Humber)
That Mary Creagh be discharged from the Yorkshire and the Humber Regional Select Committee and Mr Austin Mitchell be added.-( Mark Tami.)
Regional Select Committee (South West)
That Linda Gilroy be discharged from the South West Regional Select Committee and Roger Berry be added.-(Mark Tami.)
Complementary and Alternative Medicines
Motion made, and Question proposed, That this House do now adjourn. -(Mark Tami.)
7.15 pm
David Tredinnick (Bosworth) (Con): I am grateful for the opportunity to address the House on this important issue and I am glad to see the Minister in her place this evening. I wish to consider the House of Lords Science and Technology Committee's report on complementary medicine 10 years on. I shall cover three points: regulation, how we can widen the number of therapies available in the NHS, and the case for more research.
The Committee first met in 1999 and its report states in section 5.53:
"The Osteopathic and Chiropractic professions are now regulated by law. It is our opinion that acupuncture and herbal medicine are the two therapies"-
which at this stage would most benefit from regulation. I shall start by considering the position of osteopathy and then of herbal medicine.
The Osteopaths Act 1993, mentioned in the report, has been a huge success, but there is a postcode lottery at work. Only 16 per cent. of primary care trusts allow GPs to refer patients to osteopaths on the NHS and an additional 25 per cent. allow GPs to refer patients in exceptional cases. That is wrong, and I ask the Minister to address the problem. Where osteopathy is used in the NHS, its use increases year on year, suggesting patient and GP satisfaction, so the barrier is in the approach of the primary care trusts.
The Minister will be aware that the report from the Department of Health steering group on the regulation of acupuncture, herbal medicine and traditional Chinese medicine was published on 16 June. This followed the work done by Professor Pittilo and the late Lord Chan on herbal medicine and Chinese medicine respectively. The report recommended that in the interests of public health and patient safety all practitioners should be required to attain high standards of competence through the Health Professions Council as soon as practicable.
The Government responded by launching a consultation that will seek views on whether a regulatory system should be established. What is the position of that consultation? I suspect that it has been pushed gently into the long grass. The regulation of traditional Chinese medicine, acupuncture and herbal medicine has been a long and arduous process on which many people have worked-I have met many of them-and we need to know whether the Government are still committed to the process. What is the likely timetable? If nothing happens, we will soon be in the ludicrous situation of the herbal medicinal products directive coming into force in 2011 without appropriately regulated practitioners.
Another issue that we need to address this evening is homeopathy. Section 5.50 of the report says that therapies should be able to seek statutory regulation, and homeopathy is the one therapy in group 1 in the report-the Minister will remember that there are different classifications-that is not statutorily regulated. I am informed by the Society of Homeopaths, which is the largest organisation representing non-medical homeopaths, that there is a move towards statutory regulation through the Health Professions Council. Will the Government look favourably on that application?
Homeopathy has had a long tradition in the health service; it was actually used by Aneurin Bevan-all those years ago-who helped to put it in the health service. However, homeopathy has been under attack, despite the new Royal London Homeopathic hospital. The hospital and those who support homeopathy have faced difficult times, not least the attacks by the so-called scientific establishment and a letter that purported to come from the NHS-it had the NHS logo on it-in May 2007 which was signed by many retired professors of medicine. That letter should never have been sent out under the NHS letterhead.
Attacks have also been made on the efficacy of homeopathy. A letter was sent to the World Health Organisation warning against the use of homeopathy, but it ignored the very clear randomised, double-blind trials that proved that it is effective in the particular area of childhood diarrhoea on which it was criticised. Will the Government therefore be robust in their support for homeopathy and consider what can be done so that it is used more effectively in the health service?
There are also serious problems in chiropractic, which one might call an assisted discipline to osteopathy. The General Chiropractic Council has been bombarded by complaints from bloggers-spurious complaints I would say-which it is obliged by law to investigate. I am very concerned that genuine complaints will not get through and that any practitioner against whom a genuine complaint had been lodged could continue to practise. Will the Minister look at this very unsatisfactory situation, which arose following an individual losing a court case against the British Chiropractic Association?
I would like the scope of complementary and alternative medicine to be widened. Way back in 2001, when I spoke on this subject, I quoted a Minister as saying in Committee that:
"Services that were considered outlandish several years ago are now almost considered to be part of conventional health care".-[ Official Report, Standing Committee G, 6 June 2000; c. 81.]
That was in 2001. Now we have a situation in which we can move on even further. The Government have done well with the guidelines from the National Institute for Health and Clinical Excellence that allow for osteopathy and chiropractic for lower back pain. That is definitely a step in the right direction. It has come about only because of the rigorous research carried out, resulting in acupuncture and, as I said, osteopathy and chiropractic being made available.
We now need to bring in other therapies and to ensure that they are made available. That can be done in different ways. The Complementary and Natural Healthcare Council has been set up to regulate some therapies, such as massage therapy, nutritional therapy, reflexology and aromatherapy. However, the numbers are less than expected. Can the Minister help in any way by publicising the benefits of this council to those who might join it?
The Science and Technology Committee reported in four sections. I shall not go through all the different categories, but all those listed-I have reviewed them all-have some validity.
Before turning to research, I want to focus on ethnic treatments, which are used by many people in this country. I am thinking of Chinese and Ayurvedic medicine. I want to look at how they are part of those cultures and at how those cultures look at the sky as part of their medical disciplines. Chinese medicine is closely aligned to feng shui, which is popular in this country and has a
sub-discipline called "right directions", and it relies on Chinese astronomy and astrology. I was on the last parliamentary delegation to Hong Kong before we gave it back to the Chinese, where I met Chris Patten's Chinese astronomer and astrologer-it was important to the Chinese that he should have one. Ayurvedic medicine also has a long tradition of looking at astronomical and astrological factors, and Lahiri is the official astrological system of the Indian Government.
In 2001 I raised in the House the influence of the moon, on the basis of the evidence then that at certain phases of the moon there are more accidents. Surgeons will not operate because blood clotting is not effective and the police have to put more people on the street.
I am arguing for more research. I have been criticised for raising the subject, but the criticism is generally based on a misunderstanding. It is based on the idea that I am talking about the stuff that we see in the newspapers about star sign astrology, but I am not. I am talking about a long-standing discipline-an art and a science-that has been with us since ancient Egyptian, Roman, Babylonian and Assyrian times. It is part of the Chinese, Muslim and Hindu cultures. Criticism is deeply offensive to those cultures, and I have a Muslim college in my constituency.
The opposition is based on what I call the SIP formula-superstition, ignorance and prejudice. It tends to be based on superstition, with scientists reacting emotionally, which is always a great irony. They are also ignorant, because they never study the subject and just say that it is all to do with what appears in the newspapers, which it is not, and they are deeply prejudiced, and racially prejudiced too, which is troubling.
Over the past few years I have looked at the issue in detail, as well as at the impact of astronomy and astrology on western herbalism, as taught by Culpeper, whose book "Culpeper's Complete Herbal" has been in print longer than any other book in this country besides the Bible. There are now people who teach, such as Jane Ridder-Patrick, who published "A Handbook of Medical Astrology". They look at aspects of the subject and how it affects people's health. Whatever one believes personally, the issue is one that we should look into and consider. We must get away from this awful, mediaeval superstition.
Finally, I want to appeal to the Minister to fund a little more research. Research into complementary medicine is usually done with individuals, but I am seeking perhaps £5 million and for the research to be placed with the King's Fund, or perhaps another body, for use in universities. It takes about £125,000 to fund a trial. At the moment we just do not know how effective some complementary medicines are in surgeries where different therapies are used. The Government have helped and some useful steps have been taken, but if we are really going to understand the best way of using such therapies, which are increasingly popular, we need more research. I appeal to the genial nature and the good judgment of the Minister to help in this way.
7.28 pm
The Minister of State, Department of Health (Gillian Merron):
I congratulate the hon. Member for Bosworth (David Tredinnick) on securing this debate on the important matter of complementary and alternative medicine, which was the subject of an important report by the House of
Lords Science and Technology Committee, which the Government welcomed at the time and responded to in 2001.
I hope that the hon. Gentleman, whom I listened to carefully, will find it reassuring that the Government's position on complementary and alternative medicines, which I shall refer to as CAM, is the same as our position on mainstream medicines. First, decisions about care are best made by clinicians on the ground. Doctors and health professionals are best equipped to make the right choices for their patients, and local NHS services are best placed to decide which treatments will benefit their communities best. Secondly, the decision to embark on any course of treatment has to be made on the basis of robust clinical evidence. That means clinical trials, peer-reviewed papers, and guidance from the National Institute for Health and Clinical Excellence. Thirdly, the way in which the Department funds new research is through the National Institute for Health Research. The NIHR provides substantial funding for a wide variety of studies that meet strict scientific criteria and that reflect the needs of the national health service. Finally, we should always be open to new methods and ideas. That means using the NHS's world-leading innovation and research facilities to ensure that health professionals get the latest and best clinical information, and that patients get the best, safest care available.
I want to address the main points that the hon. Gentleman has raised. On the question of research, as he has pointed out, the Lords Select Committee report made recommendations on strengthening the evidence base and investing more to encourage new research. The Department of Health is one of the largest mainstream UK funders of research into CAM. It is investing record sums in health research in general, with the NIHR spending nearly £1 billion in 2010-11. Our research strategy, Best Research for Best Health, is being delivered by the NIHR and has resulted in significant new funding opportunities for health research. A number of awards have been made in the past year or so in support of studies directly concerned with demonstrating whether specific CAM therapies work and whether they represent good value. That builds on the 100-plus projects that were funded in the past 12 years and recorded in the national research register.
Current projects funded by the NIHR include a £1.3 million study into the effectiveness and cost of acupuncture, a £500,000 clinical trial into acupressure for the control and management of chemotherapy-related nausea and a clinical trial looking at the use of self-hypnosis by pregnant women to reduce pain and anxiety during labour. In each case, these awards have been made following rigorous peer review and in open competition.
The Government also run a £3.4 million award scheme, which has supported 18 researchers, including those engaged in post-doctoral studies. They have completed a number of reports on topics ranging from acupuncture to Chinese medicine. In addition, the Department has funded research on the role of CAM in the care of cancer patients, and on the use of complementary medicine in primary care. It is safe to say that, if CAM researchers continue to come up with high quality proposals, there is no reason why they should not continue to attract NIHR support.
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