National Institute for Clinical Excellence

Part of the debate – in Westminster Hall at 10:00 am on 5 March 2002.

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Photo of David Tredinnick David Tredinnick Chair, Statutory Instruments (Joint Committee), Chair, Statutory Instruments (Select Committee), Chair, Statutory Instruments (Select Committee), Chair, Statutory Instruments (Joint Committee) 10:00, 5 March 2002

My hon. Friend has done tremendous work on multiple sclerosis with the Multiple Sclerosis Society. She speaks with eloquence and has great knowledge of the subject. She is right to look at other aspects. We are in a new health paradigm. People are going to doctors, such as the hon. Member for Oxford, West and Abingdon, saying, "Doctor, I want to try homeopathy." It is no good doctors saying that, although they do not know anything about that treatment, it will probably not do any harm. Patients now demand that doctors know about different therapies. My hon. Friend's point about the transfer of responsibility for such practices from voluntary organisations to the Government again illustrates the need for the Government to take the whole range of services very seriously. We are talking about service providers coming into the health service.

The Government need to focus on the fact that a vast number of doctors do not have much idea of how to refer patients to other practitioners such as those that my hon. Friend the Member for North-East Hertfordshire mentioned when he spoke about mental health. They must take on board the fact that many treatments are multi-treatments. Most of the people working in complementary, integrated medicine, which I understand best, are multi-discipline practitioners. Homeopaths are often experts in Bach flower remedies, which work at a mental level. They tend to help people with depression or those who have difficulties in managing their lives. For example, oak or olive may be taken to give strength to someone who is run down. The high levels of the bush and American flower essences are all valuable tools. However, far too few, if any, medical colleges offer courses for doctors so that they can understand how to interface with this world.

Many years ago, I did a masters degree in business administration, which some think makes people a master of absolutely nothing and an understander of little. I can see hon. Members smiling at that description. Hopefully, I gained some understanding from such studies. Having spent a few weeks studying a range of subjects, I did not necessarily become a great expert. However, that does not matter. What people need to know is where to look when they need help. I shall never be an expert on economics. I do not speak in the House about economics, but I know when to contact an economist.

Doctors need to be able to say, "We cannot fix this skin problem. We have tried steroids, but the patient has not responded." That certainly happens at the George Eliot hospital, a massive national health service hospital in Warwickshire. It has brought in a homeopath, who specialises in skin conditions. He is not getting the easy patients, but those whom no one else can treat. There are worries about steroid creams, but homeopathy and traditional Chinese medicine, in particular, deal effectively with skin conditions. I could give the Minister chapter and verse about such matters.

We need to consider a new health paradigm in this country. That is the strategic thrust of my argument. We must take patient experience into consideration much more. That is something NICE could do: it could collate patient experience and anecdotal evidence. We are told that anecdotal evidence is not enough, but if one collates enough anecdotal evidence, it is pretty powerful. If 25 people came into the Minister's advice surgery in the run-up to the next general election and told her that they were unhappy about the ring road around Salford, I bet that she would not say that that was just anecdotal evidence, and that a double-blind, consumer-driven trial was needed. When people come to see me about the Earl Shilton bypass in Hinckley, I do not say that their comments are not representative because they are not statistically sound. Instead, I say that I am going to listen like blazes, and ask them to sit down and tell me about the problem because my job is to represent them.

We must not get fogged by the terminology. We have intuition, which derives from the right side of the brain. The left side of the brain deals with thinking clearly. We have lost much of our right-side intuition, which can be observed in animals sensing fear. A very effective way of preventing deer from eating roses, if anyone ever has that problem, is to put lion dung in the beds. Deer, who have not seen lions in England for 1,000 years, know if they smell a lion that they have to get away. That is intuitive and instinctive. We have lost that and we need to return to it.

My hon. Friend the Member for Chesham and Amersham, who has carried out so much work on multiple sclerosis, referred to beta interferon, as did my hon. Friend Angela Watkinson. NICE's decision on beta interferon is very controversial. What is just as controversial is the failure to investigate the effectiveness of acupuncture in relieving the condition. That is not some crazy moon therapy of which no one has heard. The therapy has been around for 3,000 years and is practised in 60,000 hospitals in a country that comprises a fifth of the world's population. We are not considering it, and we must.

We have referred to costs, which are crucial to the national health service. We have already been told that new Labour has blown it on its existing budget, and is returning to tax and spend. That is now Labour's policy. It cannot fix the health service. It has tried to, but will have to spend more of people's money. The Minister would not have to spend quite so much if she considered other treatments. Acupuncture treatment is incredibly cheap. All one needs is a set of 14 to 20 needles per patient. They are terribly cheap; one uses them once and then throws them away. The expense lies in training the practitioners, although even that is cheaper. NICE should consider that.

The cost-effectiveness of medicines and the outcomes for patients, to which my hon. Friend the Member for Upminster referred, represents another straw in the wind. The Government must consider the cost. I am minded to table questions to the Chancellor of the Exchequer asking whether he has investigated the cost comparisons of the different medicines. Perhaps the Public Accounts Committee should consider that. I may ask my right hon. Friend David Davis, who chairs that Committee, to consider it. The costs are completely different, and out of line. We ignore that and we should consider it: it is terribly important.

Last week, we launched the parliamentary group on integrated and complementary health care, which replaces the one on complementary and alternative medicine that was set up in the 1970s by my hon. Friend Mr. Cash with the former hon. Member for Erewash, Peter Rost, in order to create awareness. People are now very aware. A vast amount of the population is using such therapies and the Government are lagging. They need to wake up because we are undergoing a seismic change in health care in Britain as primary care trusts take over from the old health authorities. Many of the novel therapies offered under the old system have been done away with as the new system tries to bed in. More information provided through NICE and a greater number of inquiries would go a long way towards alleviating such problems.

It is rare that one gets a chance to say more than one hoped to in a debate. I hope that I have not monopolised the available time too much. I am grateful for the indulgence that my hon. Friends and hon. Members have shown in listening to me for so long.