Homeopathic Hospitals

Part of the debate – in the House of Commons at 2:00 am on 19th February 2008.

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Photo of Ivan Lewis Ivan Lewis Parliamentary Under-Secretary (Department of Health) (Care Services) 2:00 am, 19th February 2008

I congratulate David Tredinnick on securing this Adjournment debate and on his passionate advocacy of the case for complementary therapies over many years in this House. Whatever people's opinions and differences of view and perception, it is impressive when an hon. Member feels so passionately about an individual cause. Clearly, the hon. Gentleman feels that homeopathy makes a massive difference to the quality of people's lives both in his constituency and up and down the country. I pay genuine tribute to him for the work that he does in making the case.

I am also aware that there is a growing interest among patients in complementary therapies generally—for instance, as an adjunct to conventional medicine in palliative care, although I accept that it goes beyond that. Choice is absolutely fundamental to the delivery of a truly patient-centred national health service, and it gives providers the incentive to tailor services to the needs and preferences of patients. In turn, this leads to better outcomes and, over time we hope, a reduction in health inequalities. Primary care trusts are encouraged to provide access to complementary therapies where there is evidence to support the virtues of their use.

Of course, doctors are accountable for any treatment that they give their patients, and have to satisfy themselves of the safety and clinical and cost-effectiveness of the treatment, as well as the availability of suitably qualified practitioners. They have a range of options for treating different conditions, and they must advise on which treatment or combination of treatments will be most suitable for individual patients. Many GPs now give access to some form of complementary or alternative medicine, but if a doctor decides not to recommend a complementary therapy, it is likely that he or she will have a good reason.

We genuinely want people to have free choice about their health care, but we also want to make sure that the choice that they make is an informed one and gives assurance that treatments meet key standards of safety and quality. To achieve this, the Department and the NHS have been ensuring that as much quality information as possible is available and accessible to those who need it.

For example, the Department of Health commissioned the Prince's Foundation for Integrated Health to produce a patient guide on popular forms of CAM, which was published in 2005. It is encouraging to know that several thousand copies have been downloaded from the website and multiple copies have been ordered by intermediary organisations such as hospices.

NHS Direct Online and the national electronic library for health are also authoritative sources of advice on all health topics. NHS Direct already includes some material on complementary and alternative therapies and in future the national electronic library for health will also have a separate section dedicated to research on such therapies. In June last year NHS Choices was launched—a new online health information service, which also includes information on homeopathy.

Of course I hear the dissent from those who oppose the NHS commissioning complementary medicine. Most, if not all, of that opposition is focused on treatments for which, in some people's view, there is a lack of evidence of effectiveness. We know that there are strong views, which are sometimes articulated in the House. That is why the Government are investing in developing the evidence base for complementary therapies. We are supporting the research capacity for CAM through the £3.4 million CAM personal award scheme. The scheme was launched following publication of a House of Lords Select Committee report on CAM about eight years ago. As a result of two calls, we have successfully created a cohort of 18 CAM researchers at doctoral and post-doctoral level; as the hon. Gentleman will be aware, they are working on a broad range of research issues.

The National Co-ordinating Centre for Research Capacity Development is responsible for the personal award scheme. It also funds the CAM evidence online database, which is the result of collaboration between the Research Council for Complementary Medicine and the University of Westminster's school of integrated health. It involves a detailed review and critical appraisal of the published research on specific complementary therapies, focusing on their use for NHS priority issues, such as cancer, mental ill health, heart disease, stroke, and chronic conditions.

We are actively addressing the important issue of appropriate regulation of the treatments and their practitioners. At present only two CAM professions are subject to statutory regulation in our country: chiropractic and osteopathy. Our first priority is to decide whether to put in place statutory regulation for herbal medicine, traditional Chinese medicine and acupuncture, which carry significant risk because they involve skin piercing and/or the ingestion of potentially harmful substances. Proposals for regulation of herbal medicine, traditional Chinese medicine and acupuncture were made in a report by the House of Lords Select Committee on Science and Technology in 2000. The Department of Health consulted on proposals in March 2004 and published an analysis of the results in February 2005. As a result, a steering group was established in June 2006 to recommend whether and how those professions should be statutorily regulated. The group, chaired by Professor Mike Pittilo of Robert Gordon university, has completed its work, as the hon. Gentleman will know. Its report will be submitted to Ministers shortly, and a decision will then be taken about whether legislation should be brought before the House, and if so, how soon.

We expect unregulated CAM professions to develop their own unified systems of voluntary self-regulation, and to support that process we have commissioned and funded the Prince's Foundation for Integrated Health to develop voluntary self-regulation among a range of professions, including homoeopathy. The result of the work is a voluntary regulator called the complementary and natural healthcare council, which, as the hon. Gentleman will be aware, will be up and running from April.

In 2005, the Medicines and Healthcare products Regulatory Agency undertook a public consultation on proposals that would enable companies to market their products with indications. As the hon. Gentleman will know, indications are descriptions of diseases or conditions for which the product is intended to be used, but we are talking about minor, self-limiting conditions only—the types of conditions that people normally self-treat with over-the-counter products. Following widespread support for the proposals, the scheme was introduced in the United Kingdom in September 2006. Companies marketing homoeopathic medicinal products have the option of obtaining a full marketing authorisation for each product, provided they satisfy the requirements for demonstrating safety and efficacy set out in directive 2001/83/EC. However, at present no homoeopathic products are licensed with a marketing authorisation because of the difficulty of demonstrating efficacy under the rigorous conditions of controlled clinical trials.

The hon. Gentleman raised a number of issues to do with the future of specific services, and he referred to several hospitals. There is a constant tension in debate inside and outside the House about the balance between national command and control and devolution to local decision makers—the local people and organisations to whom we give the responsibility of making the best decisions for local communities.

The fascinating thing, as I have said in previous debates in the House, is that on the whole, politicians of all parties are united around the notion of maximum devolution and localism, until they find a decision that is made in their locality that they do not like very much. Then, the same politicians advocate national intervention and command and control from Westminster and Whitehall. That perpetual tension is evident in the House.

In this case we must maintain the principle that, based on patient choice, demand and a needs assessment of their local population, local commissioners are best placed to make commissioning decisions on behalf of their local populations. It is extremely important that we retain the integrity and credibility of that process if we are to move towards a world-class commissioning system in health care.