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House of Lords

Wednesday, 24th June 1998.

The House met at half-past two of the clock: The CHAIRMAN OF COMMITTEES on the Woolsack.

Prayers--Read by the Lord Bishop of Leicester.

Homerton Hospital: Acupuncture Provision

Earl Baldwin of Bewdley asked Her Majesty's Government:

    On what criteria the Homerton Hospital recently closed the provision of acupuncture in its Rheumatology Department.

The Minister of State, Department of Health (Baroness Jay of Paddington): My Lords, this service has not been funded by the hospital's main purchaser--that is, the East London and the City Health Authority--since 1st April 1997. The hospital has however provided the service unfunded in 1997-98 but is unable to do so this year. Availability of complementary therapies within the health service always reflects decisions taken locally about the clinical and cost effectiveness of such services and the priority to be given to their provision in the light of other competing demands. Alternative methods of funding this service at Homerton Hospital are currently being investigated.

Earl Baldwin of Bewdley: My Lords, I thank the noble Baroness for that reply. I declare an interest as chairman of the British Acupuncture Accreditation Board. Is she aware that the cost of this service, which had been running successfully since January 1995, has been a mere £7,000 a year; and that an independent evaluation showed that over 80 per cent. of patients surveyed reported a reduction in pain; and several were also able to reduce their medication? Does she agree that any criteria which allow such an effective low-cost service to be closed need re-examination?

Baroness Jay of Paddington: My Lords, as I said in my opening reply, alternative methods of funding that service are being looked at by the Homerton Hospital, which may share some of the noble Earl's concerns about its effectiveness. The noble Earl was kind enough to tell me that he would raise the question of that independent evaluation. The Department of Health has no record of such an evaluation. I shall of course be happy to discuss it with the noble Earl if he wishes to pursue it later.

Earl Howe: My Lords, will the proposed national institute for clinical excellence have a role in determining what complementary therapies should be made available under the NHS and for what types of clinical condition? If so, how will it arrive at a balanced assessment of the cost-effectiveness of such treatments?

Baroness Jay of Paddington: My Lords, the national institute for clinical excellence will have a role in

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looking, in the first instance, at new therapies and the ways in which, for example, expensive new conventional drug therapies should be introduced into the NHS. Its capacity to look at existing complementary therapies has not been explicitly decided, but it will be something that will be available for consultation when the consultation paper on the detail of the national institute for clinical excellence is published shortly.

The Earl of Clanwilliam: My Lords, does the Minister accept the authority and integrity of the Research Council for Complementary Medicine, which confirmed the authenticity and efficiency of the practice at the hospital? In the light of the recommendation from that august body, is it not unusual that the hospital should have stopped it?

Baroness Jay of Paddington: My Lords, as I said in my original reply to the noble Earl, we are of course aware of the Research Council for Complementary Medicine. Some of its projects are funded directly through the Department of Health. However, this piece of research is not known to the Department of Health. I explained in my original Answer that the decision not to fund this local service was taken on the basis of local priorities.

The Countess of Mar: My Lords, in how many hospitals within the UK are alternative therapies such as acupuncture provided?

Baroness Jay of Paddington: My Lords, it is difficult to say how many hospitals provide it, but I am aware that 40 per cent. of GPs who work within the NHS refer patients for complementary therapies when they think that it is appropriate.

Earl Baldwin of Bewdley: My Lords, will the noble Baroness confirm that this case represents something of a pattern of reductions in complementary therapies around the place, doubtless because this way of cutting back is seen as a soft option by health authorities and hospitals?

Baroness Jay: My Lords, I cannot confirm that. I am afraid I do not think that the national figures on that are acquired in the form that the noble Earl suggests. The Government have suggested, especially through my right honourable friend the Secretary of State's speech to the conference on complementary and alternative medicine last month, that they see an important role for complementary medicine, although they expect that in the future it will be provided mostly by the independent sector.

Lord Mackie of Benshie: My Lords, do Her Majesty's Government have a view on the effectiveness of acupuncture?

Baroness Jay of Paddington: My Lords, the Government do not take a view on the effectiveness of clinical therapies, but the NHS health technology assessment programme is commissioning research into

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acupuncture, specifically for the management of back pain, because, on anecdotal evidence at least, that condition seems to be one in which many patients have experienced an improvement.

Smoking: White Paper

2.41 p.m.

Lord Janner of Braunstone asked Her Majesty's Government:

    When they will publish their paper on smoking reduction.

Baroness Jay of Paddington: My Lords, the White Paper will be published later this year. My noble friend will have noted, I hope with pleasure, the adoption last Monday, 22nd June, of the tobacco advertising directive by the European Union Council of Ministers. Now that the directive has been adopted, the White Paper will set out our plans for implementing it and other proposals to build a comprehensive policy to tackle smoking.

Lord Janner of Braunstone: My Lords, is the Minister shocked at the figures published in Hansard on Monday indicating the increase in regular smoking among children aged between 11 and 15? While welcoming the EU directive, surely we must now take urgent action. Can my noble friend say when the White Paper will be published? Meanwhile, as a gesture of goodwill, and recognising for once the excellence of action taken from the other side of the House, can my noble friend say how pleased she is at the decision by Mr. Archie Norman, chairman of the Conservative Party, to ban smoking at its headquarters? Can we not now ban smoking in at least part of the Library of this House?

Baroness Jay of Paddington: My Lords, the issue of young people starting smoking is indeed of great concern. The figures published by the Health Education Authority earlier this week were disturbing. One of the key priorities for action to be covered by the White Paper on tobacco control is to prevent the young from starting smoking. I join my noble friend in congratulating the honourable Member in another place, Mr. Archie Norman, on the decision he has taken about Conservative Central Office. The Labour Party headquarters at Millbank have been smoke free in that sense for a long time.

Baroness Trumpington: My Lords, first, when was the last time that health Ministers met with the tobacco industry to discuss the content and implementation of the forthcoming White Paper? Secondly, does the Minister agree that the noble Lord, Lord Janner, is the kind of Lord who stops people like me from visiting America with his bigoted idea of no freedom for anyone--although there seems to be freedom for some in another context?

Baroness Jay of Paddington: My Lords, I find the second part of the noble Baroness's question rather

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surprising. Is she suggesting that all forms of freedom are banned in the United States? That is something the founders of the constitution might find somewhat remarkable. If the noble Baroness refers to smoking on aeroplanes, I am entirely in support of those airlines which have made it easier for people who wish to travel in a smoke free environment to do so.

As regards consultation with the relevant tobacco industries, my honourable friend the Minister for Public Health, Ms Jowell, had a great deal of contact with the industry when the Green Paper on public health was being constructed. She intends to continue that as thinking on the White Paper is developed.

Lord Hardy of Wath: My Lords, does the Minister accept that there seems quite a head of steam calling for a ban on smoking in all places where food is consumed? Will my noble friend note that peanuts, pretzels, popcorn and pork scratchings are all regarded as foodstuffs? If the ban were comprehensive, virtually every public house in Britain would suffer marked commercial disadvantage.

Baroness Jay of Paddington: My Lords, my noble friend may have detected a head of steam in this direction but the Government are attracted by the considerable progress made over the past few years for a voluntary ban on smoking in public places. We have had discussion today in your Lordships' House about the decisions taken by the political parties, for example. Those are clearly voluntary. It is more likely that we shall develop policies on a voluntary basis as regards public places simply because experience shows that more draconian measures tried in other countries have been largely unsuccessful.

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