Complementary and Alternative Medicines

Part of the debate – in the House of Commons at 7:28 pm on 14 October 2009.

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Photo of Gillian Merron Gillian Merron Minister of State (Public Health), Department of Health 7:28, 14 October 2009

I congratulate 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.

The hon. Gentleman also referred to the roles that astrology and astronomy can play. I acknowledge that some forms of complementary and alternative medicines and thought consider that there is a link or relationship between astrology and their practice. An example is Indian ayurvedic medicine. I would say to him that, with this as with any other CAM, any proposals for research would be considered on their merits.

The hon. Gentleman also raised the matter of access to CAM therapies. I confirm that we are committed to providing the most appropriate and effective treatments for patients. Complementary and alternative medicine therapies that have been proven to be effective, cost-effective and safe will be made available to patients. As he will know, it is a matter for local NHS organisations to commission health care treatments for NHS patients, as they are best placed to make decisions in the interests of their local communities. Primary care trusts manage 80 per cent. of the national health service budgets, and they are responsible for making the decisions on what treatments to commission and fund. They often have specific policies on the commissioning and provision of CAM. Within these policies, GPs can give access to specific therapies, provided that they are in the patient's interest. If someone wishes to receive a specific CAM treatment on the NHS, they should discuss this with their GP. Clinical responsibility for an individual's health rests with their GP, who must be able justify to clinically any treatment referral.

I want to address the National Institute for Health and Clinical Excellence guidelines on complementary and alternative medicines. NICE has already agreed that where there is sufficient evidence to look at specific complementary therapies when developing clinical guidance for particular conditions, it will do so. The guidance focuses on a particular illness or condition rather than on the treatment or therapy. A good example are the recent guidelines produced by NICE on the management of non-specific lower back pain, of which I know the hon. Gentleman will be aware. These guidelines include consideration of treatments such as osteopathy, spinal manipulation and massage. NICE has already issued guidance on whether some complementary therapies do or do not add benefit in respect of specific conditions, including multiple sclerosis, antenatal care and palliative care.

The hon. Gentleman raised a number of important points about the regulation of CAM. Regulation, whether it is statutory or voluntary, is primarily, of course, about patient safety. It is our duty to protect the public from poor or potentially unsafe practices. I note the hon. Gentleman's point about osteopathy and chiropractic treatments, which are currently regulated by law. Any future review of regulation would most likely examine whether the current arrangements are the most cost-effective way to manage public safety. No decisions have yet been taken.

The Government have no current plans to extend statutory regulation to homeopathy. The hon. Gentleman raised concerns about a document recommending disinvestment from homeopathy, which was circulated using the NHS logo. I can confirm that our inquiries found no record of the Department having authorised the use of the NHS logo and that those who originated the document were asked not to circulate it any further. They were advised about the use of the logo in future and chief executives of trusts were also informed that the document does not represent Government policy.

Although we have committed to considering statutory regulation for herbal medicine and acupuncture, which carry significant risk because they involve skin piercing and/or the ingestion of potentially harmful substances, we have no current plans, as I have said, to include homeopathy. To clarify, that is because statutory regulations are a priority, I believe, for those conditions where there is a particular risk of harm if treatment is placed in the wrong hands. A consultation has been launched on whether practitioners of acupuncture, herbal medicine and traditional Chinese medicine should be regulated by statute. It closes on 2 November this year, and we will respond in due course.

Other schemes that the Department supports include the Medicines and Healthcare products Regulatory Agency's new traditional herbal medicines registration scheme, which will make it easier for consumers to identify regulated products. We will also continue to support the work of the Complementary and Natural Healthcare Council, and we have funded its start-up costs. The CNHC is a voluntary registration body that is open to massage, nutritional, aromatherapy and reflexology therapists. It will open to more therapies in due course. Registration means that the practitioner has met certain entry standards, including accredited qualification, and subscribes to a set of professional standards. The Department meets the CNHC regularly to discuss progress.

CAM, of course, covers a wide range of disciplines, and I believe that it is right to keep our options open and to continue to support research into new therapies and treatments. It is also right that we choose and fund those treatments that are effective, cost-effective and safe. That decision must be based on robust clinical standards, backed up by rigorous and evidence-based scientific assessment. I thank the hon. Gentleman for raising such an important issue this evening.