I am grateful to my hon. Friend the Member for Birmingham, Yardley (Mr. Tierney) for having raised this subject of considerable public importance. Indeed, he has given me the opportunity to dispel what seems to be a lingering misconception.

I know that my hon. Friend will be the first to accept that registration of a profession or of those who practise it provides no guarantee that it will be practised properly. I know that the analogy is not exact, but even the registration of motor vehicles does not ensure that their owners will keep them clean. The licensing of drivers, after they have been tested, may keep off the roads people who do not know how to drive. However, it does not prevent someone who has passed the test from driving recklessly.

My hon. Friend referered to the serious outbreak of hepatitis in the city of Birmingham. I am deeply concerned, as is my Department, that there should have been such a grievous outbreak of the disease in that city. Between May and October this year 36 cases of hepatitis, which were attributed to the practice of acupuncture, were reported in Birmingham. It is both understandable and proper that my hon. Friend, who represents a constituency from which some at least of these cases were reported, should have expressed his concern in this debate.

My hon. Friend expressed his concern previously and promptly when he put down a Question for written answer in July. There was concern in my Department then, as there has been on other occasions before and since, when techniques involving the piercing of the skin have caused hepatitis. Yet, as was said in reply to my hon. Friend's Question and to one from the hon. Member for New Forest (Mr. McNair-Wilson), I do not believe that the introduction of legislation to seek to compel the registration of acupuncturists will by itself remove the risk. It is not only acupuncture, unhygienically practised, which can cause or spread hepatitis. So, too, can ear piercing or tattooing. I hope that this will be as widely noted as it deserves to be, not least among young people. After all, hepatitis can be a most grievous condition. Unfortunately, even in the best regulated institutions, there are rare instances of infection notwithstanding the best preventive endeavours of those in charge. That does not mean that we should ignore the threat of hepatitis from unhygienic acupuncture, ear piercing and tattooing. We have to consider how best the threat can be countered and reduced.

I believe that legal powers already exist to provide for the inspection of premises and, where necessary, the prosecution of those who practise their professions in a manner which is a threat to health. Section 3(2) of the Health and Safety at Work, etc. Act 1974 imposes on an employer the obligation to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that he and other persons (not being his employees) who may be affected thereby are not thereby exposed to risks to their health of safety. The same obligation is imposed by the same section of the Health and Safety at Work, etc. Act on the self-employed. Failure to comply with this legal requirement can lead to prosecution.

I am firmly of the opinion that if local and health authorities, which are themselves equally subject to the Act, Co-operate with the Health and Safety Executive, the Act can be invoked to curb the activities of anyone who by the careless practice of his profession, occupation or craft, threatens the health of people using his services. My advice is that the Health and Safety at Work, etc. Act can be as effectively used to enforce hygiene in ear piercing and tattooing as it can be to ensure the sterilisation of the needles used in acupuncture.

The Government are prepared to consider whether general empowering legislation is desirable to enable local authorities to control the hygiene of acupuncture, ear piercing and tattooing establishments. However—my hon. Friend will no doubt take careful note of this point—we believe that there are remedies in the law as it stands. Nevertheless, everything said by my hon. Friend will be carefully considered by my Department.

The Health and Safety at Work etc, Act is, of course, of wide application and the inspectorate of the Health and Safety Executive is nessarily limited. In consequence, some local authorities may consider that other powers are needed to control the premises of people whose skills, carelessly performed, may lead to outbreaks of hepatitis. If a local authority comes to this view, it can seek powers to enable it to license the premises about which it is concerned. It can then impose conditions upon the licensing of such premises.

I am informed that some local authorities already have powers to control tattoo parlours. The West Midlands County Council, no doubt because of the very serious—and, I hope, not to be repeated—outbreak of hepatitis in Birmingham to which I have already referred, is seeking powers to require district councils to register acupuncturists and their premises and to make byelaws for the purpose of securing the cleanliness of such premises and of the persons employed in them. The Bill seeking these powers has already been presented to Parliament. My strong advice is, therefore, that high standards of hygiene should be required of and enforced upon anyone who offers services for which he charges and which may threaten the health of his clients or customers.

I am deeply aware that there are many people, including hon. Members of this House, who believe that acupuncture, if properly practised, has much to offer in the treatment of the sick. I shall not, therefore, limit my reply to this debate to my hon. Friend's concern about the uncontrolled practice of acupuncture as a threat to public health.

There are those who wish to see acupuncturists become State registered. Indeed, this is sought by the British Acupuncture Association and possibly also by other organiastions of acupuncturists. They believe that registration would give recognition to acupuncture as a medical therapy in its own right and permit its practice within the National Health Service by other than the comparatively few doctors who are now its practitioners. They believe also that it would enable the public who seek acupuncture treatment to distinguish between those who are qualified to provide it and those who are not. In this respect, what the proponents of acupuncture want and what my hon. Friend wants tend to coincide.

There are, however, difficulties, in registering the members of any therapeutic profession. These have been explained on a number of occasions in the past. This happened, for example, when my hon. Friend, the Member for Wood Green (Mrs. Butler), introduced a Private Member's Bill for the registration of osteopaths and also when Lord Ferrier, in another place, sought the registration and recognition of chiropractors.

We have a tradition in this country of self-regulating professions. It is initially for the professions to determine what is involved in the exercise of their professions, what training and qualifications their members require and what are the ethics and standards of practice demanded of them.