Queen's Speech debate
House of Commons Debates
Thursday, 16 Nov. 2006
Orders of the Day
Health and Education
2:48 pm
David Tredinnick (Bosworth, Conservative)
It is perhaps no surprise that I will confine most of my remarks to integrated health care, but, if I may, I shall turn first to a local issue. Colleagues in all parts of the House have commented on the primary care trust crisis and the problems arising from reorganisation; indeed, my hon. Friend the Member for West Chelmsford (Mr. Burns) made some valuable points in that respect. The number of primary care trusts in Leicestershire is being reduced, which is affecting Hinckley, in my constituency. The proposed improvements to the new community hospital on the old Sunnyside hospital site were put on hold for re-evaluation. Why? In my view, it was because the hospital is on the fringe of the area. We see the same thing with policing. In cases where the organisation in question is large, it is the police stations—or hospitals—on the perimeter that tend to suffer first. More generally, the health service is having massive problems with procurement, which takes far too long, and there has been a very poor review of contracts, but I will leave that issue to my hon. Friends on the Front Bench, who will doubtless want to comment on it.
In turning to the importance of integrated health care in the health service, I want to point out to the Minister that since the 1987 Parliament, which is when I first entered the House, there has been a gradual and relentless movement toward improved integration of alternative and complementary medicine into the health service. During that Parliament, we introduced as a private Bill—I did not do so myself, but I sat on the Committee that considered it—the legislation regulating osteopaths, who were seen as being outside the health service. In the 1992 Parliament, chiropractors came forward with a Bill, which was passed successfully. As a result, osteopathy and chiropractic, which used to be seen as out on the wings of medicine in Britain, are increasingly part of its structure and fabric.
I pay tribute to the Government for looking very seriously at the regulation of acupuncture and herbal medicine—an issue on which Professor Pitillo, the late Lord Chan and others did a lot of sterling work. We will see better regulation of acupuncture and herbal remedies very soon, within the framework of law. That demonstrates the inevitable surge toward integration.
Those colleagues who recently saw on television the head of a patient in a Chinese hospital being removed for brain surgery using just acupuncture will surely need no further evidence. If one can take off the top of the skull and perform a complex operation using just acupuncture and no anaesthetic—
(Others' Comments)
I am grateful to the hon. Gentleman. You said that we should be brief, Madam Deputy Speaker, which is perhaps why I took out "the top". I did of course mean to say the top of the head. However, many hospitals are adopting that practice.
The Government claim to have a new modernisation agenda, which is supposed to offer all sorts of new commissioning possibilities. One obvious area for consideration is integrated health care. Such an approach would fit in with the Government's stated intention of increased patient choice and more innovation. This is surely a great opportunity for the Government to look carefully and seriously at existing therapies, of which there are 60,000 practitioners. There are a lot of conditions that doctors find very difficult to treat. For example, back pain: 91 per cent. of doctors surveyed said that musculo-skeletal problems were among the most difficult to treat. After that, 45 per cent. of doctors listed depression, 36 per cent. eczema and 32 per cent. chronic pain. All those problems can be treated by complementary therapists, of whom there are 60,000 in this country. They can alleviate the symptoms of chronic conditions and achieve improvements in patients' quality of life.
When she looks at integrated health care, the Minister should also bear it in mind that complementary medicines are very cheap. Compared with the cost of drugs and other services offered by the NHS, they offer very good value. The parliamentary integrated health care group met last night, and Committee Room 8 was full. One of the homeopathic doctors present said that his prescriptions often cost only 16p each. Osteopaths and chiropractors use only their hands, and acupuncturists use sterilised needles, with no big drugs bill attached. Healers just use their energy, so there are terrific cost savings to be made.
I am grateful to my hon. Friend for bringing that to the House's attention. Such treatments are available on the NHS in some parts of the country, and later in my speech I shall describe the success achieved by a practice in Nottingham that offers a free service to people largely from ethnic communities. However, cost is an issue, which is why we need a wider roll-out of such treatments—I hope that the House will forgive the jargon—in the NHS.
People want these services. In any high street chemist, one can find ranges of herbal medicines and food supplements, as well as homeopathic medicines with 6C or 30C potencies. People can use such preparations to treat themselves safely. There may be as many as 20 remedies for colds, and all sorts of treatments for stomach upsets. That keeps people out of GPs' surgeries, and improves patient throughput overall.
Patient demand for such treatments is increasing:75 per cent. of people support NHS access to complementary and alternative medicines, and6 million people use them. When I trawl the House on these matters by means of early-day motions, I find that perhaps one colleague in every three or four will say something like, "My daughter had a terrible problem with spots. We tried steroids and all sorts of strange things but nothing would fix it until we found a practitioner of Chinese medicine." People are always amazed at the results that can be achieved.
With homeopathy, for instance, a remedy might be so diluted—perhaps one part in 200—that it almost cannot be analysed. In theory, it should be weak, but in fact it gains power from being diluted. I have used homeopathy many times over the years, but I have never been trained in it. Even so, I once looked at the relevant research and prescribed—if I may use the term without insulting the hon. Member for Wyre Forest—a certain remedy for a child who had grommets inserted to deal with glue ear. The treatment was successful after one application, and the problem never recurred.
There is growing evidence that people want complementary services, and that those services are effective. I shall produce one or two relevant statistics, but not too many—unlike the Chancellor, who in his speeches uses so many figures that no one can understand him. That is one of the reasons why, at the next election, my right hon. Friend the Leader of the Opposition is going to trounce the Chancellor, if that is who he has to stand against. My right hon. Friend always speaks gently and persuasively, and manages to say so much with so few words.
There is no need to call me to order, Madam Deputy Speaker, as I shall not go down that track—although I suppose that it is in order, given that this is the Queen's Speech debate! I can say what I like about the Chancellor—in which case, let me say that I loathe his delivery. His is one of the most tiresome and repetitive styles ever witnessed in the House, and it compares unfavourably with that of the former Conservative Chancellor Lord Howe. His speeches were built around three or four main points, and we listened with care and interest.
There are great new opportunities to integrate complementary and alternative medicine through the so-called modernisation agenda of the NHS, especially in the context of patient choice and innovation. The situation is good in some parts but disastrous in others. Some practices are thriving and succeeding, with huge demand, but other older, well established alternative medical organisations, such as the Tunbridge Wells hospital, are under threat of closure. Indeed, a senior doctor from the Royal London Homeopathic hospital told me yesterday that he thought all homeopathic hospitals were under severe threat.
Why are complementary services and hospitals threatened with cuts? First, they are often the easiest to cut; they are soft services on the edge of the primary care trust vision. Secondly, when financial advisers are sent in they do not really understand the provision of complementary services; and thirdly, there is sometimes hostility from general practitioners.
What needs to be done? The Government need to do two things, which should perhaps have been included in the Queen's Speech. I shall be raising them when I visit the Minister, so she will be well briefed in advance. First, the Government need a proper CAM delivery framework, which does not exist at present. The development of such a framework was intimated in the 2003 White Paper, "Building on the Best: Choice, Responsiveness and Equity in the NHS"—I do not think that title was a joke. Secondly, there is a need for guidance from the centre, which is completely lacking. When I talk to people in the field in Leicestershire, they tell me that they receive nothing from the centre, which is amazing because Richmond house is like the Berlin bunker in some respects. Missives, orders and directives are sent out and counters are moved around on the board; regulation of even the tiniest surgery comes directly from Richmond house—Josef Stalin would have been happy with the way it is run. However, it is a great sadness that there is no central guidance for PCTs about how innovative service re-design could involve CAM, as suggested in the latest White Paper, "Our Health, Our Care, Our Say", published in February 2006. The Minister can see that there is work to be done.
I want to give some brief examples of what a good complementary and alternative medical practice can do. I have chosen the Impact integrated medicine partnership, a Nottingham-based social enterprise, which provides free acupuncture, chiropractic and homeopathy to patients with long-term conditions in a primary care setting. There is practice-based evidence of effectiveness in treating mental health conditions, musculo-skeletal disorders, back pain, chronic pain and gynaecological and menstrual disorders. As I have already noted, three of those—musculo-skeletal disorders, back pain and chronic pain—are conditions that doctors find difficult to treat and where they perceive a 91 per cent. effectiveness gap.
I shall not do a Chancellor; I shall use only a few statistics, but I must cite two or three to show the effect on primary care. On completion of treatment at Impact, 87 per cent. of patients reported that they either stopped or reduced their medication on completion of treatment, which represents a saving of both doctors' time and NHS medicine bills. Three quarters of patients reported that they visited their GP less often and some patients no longer required secondary care. The Nottingham case is particularly interesting because 48 per cent. of the patients—nearly half—are from black and minority ethnic communities, in an area where they comprise about 30 per cent. of the population overall. Furthermore, 40 per cent. of the patients are men, which is very unusual because usually one gets a much higher proportion of women, which tends to indicate that there is a very high acceptance of the way this practice is treating patients. Furthermore, a third of the patients consider themselves to have a disability. So that service in Nottingham provides a free service to the ethnic minorities—to those who are most disadvantaged—and it is also treating others. That is a very interesting role model for the Minister to consider; I can provide her with the details if she wishes.
I shall discuss two other issues. One is the general problem facing the homeopathic hospital community, and I should like to give a couple of illustrations of cost comparisons. There are in the United Kingdom five homeopathic hospitals. They are Royal London, which has just been refurbished, Glasgow, which is brand new—I went to the opening two years ago—Bristol, Tunbridge Wells and Liverpool. All are threatened. Tunbridge Wells came within three weeks of closure in September but it is still going. Those hospitals have a total budget of £6 million per annum. The total NHS budget is £742 billion per year. So the homeopathic hospitals' budget is just under 1 per cent. of the total. I will say straight away to the Minister that I think they are incredibly good value for that small sum of money.
Surveys have been done to see whether the treatments are effective. The Bristol homeopathic hospital did an outcomes study, not just of a percentage of its patients, but of the lot. It surveyed 6,544 consecutive follow-up patients, and the outcomes scores were as follows. They had all taken homeopathic medicine, and they were asked whether it worked. Seventy-one per cent.—three quarters—said that they had improved, half said that they were better or much better, and homeopathy was associated with positive health changes to a substantial proportion of a large number of patients with a wide range of chronic diseases. In other words, cutting out the jargon, the hospital was treating lots of different people for lots of different things—lots of serious problems.
In the press recently there has been much rubbishing of homeopathy generally. There have been some front pages in the newspapers claiming that it does not work. But I have looked into this carefully. Up to the end of 2005 there have been 119 randomised, peer-reviewed clinical trials—randomised, controlled trials of homeopathy, using placebo or active comparators. Of those, half showed that homeopathy had a positive outcome, only 3 per cent. were negative and just under 50 per cent.—48 per cent.—were inconclusive. So that shows a very positive outcome indeed.
Finally, I want to highlight some cost comparisons. I am indebted to the Royal London homeopathic hospital for this information. I want to focus on two medical problems: irritable bowel syndrome and intractable nerve back pain. With irritable bowel syndrome, using conventional therapy—referral to gastroenterologist/endoscopy/colonoscopy/radiology —would cost approximately £5,000 to £15,000 per patient. If a patient is treated at the out-patient department of the Royal London homeopathic hospital—that is one new treatment plus two to three follow-ups and investigations—the total cost is approximately £500 to £1,000 a patient. So that is a fraction of the other figure, with the same outcome. That itself, I say to the Minister, needs investigating,
I have already said that intractable low back pain is the most difficult problem for doctors to treat; 91 per cent. of those doctors surveyed said that it was the most difficult issue for them. For conventional therapy—that is, referral to orthopaedic/ rheumatology/pain relief/ongoing drugs costs including MRI and CAT scans—the total cost is between £5,000 and £10,000 per patient. However, at Royal London homeopathic, for one new out-patient appointment plus two to three follow-ups, investigations and treatments, the total cost is £500 to £1,500 per patient. We are talking about phenomenal reductions in costs. If only the Government were able to see a way of linking in those therapists, or boosting the hospitals that we already have—perhaps I should not be saying this. Perhaps we should save this information for the incoming Conservative Government. Why am I tipping this Government off when they will be out of office soon? [ Interruption. ] My colleagues are not pleased with me for tipping off the Minister.
The Minister has a great opportunity. In a spirit of comradeship—is that not the Labour party terminology?—I say to her, please look at this area. We will come and talk to her. What I am talking about works. Give it a chance. It will save the Government a lot of money, and it will make a lot of people happy and save their lives.
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