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West Midlands County Council Bill Lords (By Order)

Volume 979: debated on Tuesday 19 February 1980

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Order for consideration of Lords reason for disagreeing to a Commons amendment read.

Clause 25


[ The Lords have disagreed to the amendment made by the Commons in page 21, line 1, after '1957' insert "or a registered member of the British Acupuncture Association and Register Limited", for the following reason: Because it is desirable to give the House of Commons an opportunity to reconsider the Amendment.]

7.12 pm

I beg to move

That this House doth insist on its amendment to which the Lords have disagreed.

The House might have been forgiven for believing that it had seen the end of the West Midlands County Council Bill and for expressing surprise that it is the subject of further debate this evening. The matter at issue is clause 24 of the Bill. The West Midlands County Council proposed that persons who practise as acupuncturists should no longer carry on doing so unless they and their premises are registered with the district council. Failure to register would render acupuncturists liable to a fine of up to £200. Following registration they would then be subjected to district council byelaws which would aim to ensure standards of cleanliness of premises, equipment and persons employed.

Without having to petition, doctors and dentists, whether or not they practised acupuncture, were granted an amendment by the county council exempting them from having to register or be subject to the byelaws. The British Acupuncture Association petitioned against the clause and sought the same exemption as doctors and dentists who practised acupuncture. Because the association was still in negotiation with the county council for that exemption when the Bill first went to the other place, it reserved its position until the Bill came before the Commons Private Bill Committee, as it had every right to do.

My interest in this matter is that I am the sole surviving member of that Private Bill Committee that met prior to the election and received the petition of the Association. For two days we heard evidence from the Association and the promoters of the Bill—the county council. We cross-examined both parties at length, received Government reports and submissions and unanimously concluded in favour of removing the exemption clause for the Association.

When the Bill arrived at its consideration stage in the House last month, my hon. Friend the Member for Birmingham, Northfield (Mr. Cadbury) proposed to amend clause 24 by removing this exemption of the Association, but his amendment was not selected by Mr. Speaker for debate. Thus the Bill, retaining the exemption for the Association, went back to the other place for consideration of Commons amendments two weeks ago. There, even though there had been a Commons amendment to clause 24, Lord Derwent moved a motion to remove the exemption which we, in Committee, had granted to the Association. It is for that reason that we are having the debate tonight.

In my view, the motion from the other place has serious constitutional implications. The other place is asking this House to overturn a decision arrived at by a Private Bill Committee of this House. The other place has not had the benefit of the experience of our Committee in arriving at our decision. It should he remembered that we sat for two days cross-examining the petitioners and the promoters of the Bill and receiving evidence. The other place, after only 15 minutes, decided to reject our decision.

Do I interpret the hon. Member for Bournemouth, East (Mr. Atkinson) correctly? Is it a fact that the other place has interfered with a Committee of this House? Is it the principle of acupuncture or is it both?

As I hope to make plain during the course of my speech, it is a little of each.

The detailed examination in Committee, afforded by the Private Bill pro- cedure, is the way in which Parliament provides petitioners with a right to seek redress of grievance and protection. It is a procedure which is judicial in character. It is an ancient right that this House has proudly defended through the centuries. In seeking to amend the Bill the other place now challenges the strong tradition and to remove the principle of comity here in our Bill that where a Private Bill Committee of one House has reached a positive decision—as in this case—the other place will not seek to overturn it. This is a challenge that is not without precedent.

Lord Derwent, in the debate in the other place, said that the last occasion on which the other place agreed to disagree with an amendment approved by this House was in 1903. I need not remind the House of the events of a constitutional nature that followed in 1911. The Lord Chairman of Committees himself said in that debate in the other place, when referring to the decision that had just been made not to accept the amendment of this House that he had:
"very considerable misgivings about the proposal … and its possible effect on future private legislation."
Quite what lie meant by that I shall refer to later on.

I should like the House to understand the reason for clause 24. It is the first acupuncture clause to come before Parliament. I should also like the House to understand the reason for the petition of the British Acupuncture Association and the attitude that we adopted in Committee. Clause 24 was promoted to safeguard the public from infection, following an outbreak of viral hepatitis which was apparently caused by the use of a dirty hypodermic syringe needle by someone who had applied years before to join the association and who had been turned down by it. The clause requires all acupuncturists to register, irrespective of skills, qualifications and standards. It puts them in the same category as ear piercers and tattooists.

In our approach in Committee to the association's petition it is fair to say that all four members of the Committee had no specific knowledge or experience of the practice of acupuncture. Indeed, I suspect that we shared the same human prejudices against a practice of which we knew little, which was of ancient and foreign origin and which, by its nature, was slightly discomforting—although we were assured by those with experience that that was not the case. We also shared a healthy suspicion of any attempt by a public body to impose unnecessary regulations and controls, with the accompanying bureaucracy of officials armed with powers of entry and inspection on those who practise reasonable and accepted activities. That applies particularly to qualified acupuncturists, osteopaths and chiropractors, to whose services a growing number of people are turning as an aid to healing.

It is interesting to note that in the debate on the National Health Service on 21 November 1979 in the other place Lord Cullen, replying on behalf of the Government said:
"I hope that in due course arrangements may be made by which qualified chiropractors, osteopaths and acupuncturists could if they so wished, make their skills available to National Health Service patients."—[Official Report, House of Lords, 21 November 1979; Vol. 403, c. 272.]
The British Acupuncture Association claims to be regarded as the pre-eminent acupuncture body in the country. It refers to a letter that the chairman of the Association received from the British Medical Association, which said:
"We would have no hesitation in stating that your Association is pre-eminent among the organisations with which we have come into contact."
The British Acupuncture Association demands of its members adherence to a code of ethics that is strictly applied under penalty of suspension or expulsion. Its training and qualifications and the methods of hygiene and sterilisation that its members apply, were cited in evidence to justify the exemption it sought.

The association argued that the clause which the county council sought to impose ignored their skills and standards and put them in the same category as tattooists, ear piercers and unqualified persons who practise acupuncture. It found that derogatory and offensive and believed that it would diminish the trust of its patients. It pointed out that it was the only body of acupuncturists to petition for exemption in the Bill. No evidence concerning the transmission of disease or malpractice was given against the association in the West Midlands. The instance of the outbreak of hepatitis which provoked clause 24 was fully considered by the Committee and it was made clear that no member of the association was involved.

The Committee also considered a report from the Department of Health and Social Security. In recommending us to accept the county council's exemption for doctors and dentists who practise acupuncture, the Secretary of State said that it would appear to be inappropriate to extend exemption to members of a body for which the requirement for membership did not include provision for statutory registration. Statutory registration does not in itself guarantee standards or prevent infections. It does not imply qualifications or confidence. That was made clear in 1977 in a letter to the British Acupuncture Association from the right hon. Member for Lewisham, East (Mr. Moyle) when he was Minister of State, Department of Health and Social Security. In that letter he said that the Health and Safety at Work etc. Act 1974 exists already to control those practitioners who are a menace to public health because of the constant lack of hygiene in their premises.

If the Department requires statutory registration of all who practise acupuncture, surely it should bring forward general legislation instead of attempting to take advantage of local authority Bills in this way. The association emphasised to us in Committee that it would welcome a national Act of Parliament providing for the registration of all qualified acupuncturists with proper standards, and that it would not welcome piecemeal legislation of this nature which would be bound to produce erratic results.

If my motion is not passed tonight it will be the first time that a positive decision by a Commons Committee has been subsequently rejected by the other place and a decision by a Private Bill Committee has been overturned by the Floor of this House. I believe that such a decision would reduce the confidence that the citizens of this country have in being able to exercise their right to petition this House for redress of grievance and protection. If it is seen that a successful petition to a Private Bill Committee of this House, requiring effort and money on the part of the petitioners, is overturned by the other place and that the House does not support its Committee's own decision, future petitioners will say to themselves "What is it worth? Why should I bother to spend the time and money to defend what I believe to be right in order to protect myself?"

Clearly, that was also the fear of the Chairman of the Lords Committee. I believe that if my motion is not passed, that will represent a further erosion of the rights of the individual to defend himself against large bodies, elected or otherwise, by appealing to Parliament. In effect, it will represent an undermining of the role of Parliament itself. It is not just a constitutional issue but a fundamental one for our parliamentary democracy. I hope that the House will give the motion serious consideration and support it tonight.

The hon. Member for Bournemouth, East (Mr. Atkinson) has a very good case against the constitutional impropriety that the other place is trying to force on the House tonight. It is unacceptable that by an amendment slipped in on the bureaucratic insistence of the Department of Health and Social Security—by grace and favour of Lord Derwent—the clearly decided will of the Committee which spent days in its deliberations on this matter should be subverted by a Lords amendment in this somewhat sneaky fashion. It is carried out in a way that has not been attempted or accepted by the other place since 1903, and this was the case of the hon. Gentleman.

In the debate in the other place, Lord Aberdare expressed considerable misgivings about the underhand procedure. I shall quote what he said about this manoeuvre:
"The principle of comity between the two Houses in Private Bill procedure is of very great importance for the smooth working of the system. It is for this reason that our Companion to the Standing Orders, on page 176, reads: If there is any disagreement between the Houses on amendments to Private Bills, the same procedure of sending reasons for disagreement is followed as for Public Bills. In modern times the policy on Private Bill legislation is so co-ordinated between the two Houses that the need for this procedure seldom, if ever, arises. Another factor is the unwritten principle, scrupulously observed, that in a Private Bill neither House re-inserts a provision which has been struck out by the other House unless by agreement between the two Houses'."— [Official Report, House of Lords, 31 January 1980; Vol 404, c.1001.]

7.30 pm

I hesitated to interrupt the hon. Gentleman earlier. It is not normal to quote from the proceedings of the other House which have taken place during the current Session.

You have placed me in some difficulty, Mr. Deputy Speaker, because the case was so well put by Lord Aberdare, who is Chairman of Committee up there, that I am at a loss as to how I can make my argument unless I may quote him in extenso.

The hon. Member might use a free paraphrase. However, he has already done it.

I am delighted that you have considered it to be a free paraphrase, Mr. Deputy Speaker. I am very relieved about that. Lord Aberdare made other comments, but I do not have time to make a free paraphrase. However, I think I have made the point that this is an unacceptable and most unusual manoeuvre to override the will of a Committee of this House.

The House may wonder why I should seek to intervene in what is primarily a procedural matter between the two Houses. Thank God, I am not one of our procedural experts. However, I have a personal interest in the Bill in two respects. It is called the West Midlands County Council Bill [Lords] and I am fortunate enough to represent an interesting constituency in that part of the world. More importantly, I am probably one of the few hon. Members who regularly seek acupuncture treatment. If anyone wishes to stand up to say that he also suffers or enjoys such treatment, I hope he will do so. I am proud to make this claim, and I will tell you why.

For 20 years now, my wife and I have carefully—indeed, scrupulously—avoided the attentions of allopathic doctors. Occasionally one lands in a place where one has to seek allopathic treatment. It usually takes a long time to recover from such treatment. But my wife and I for those 20 years have sought homeopathic treatment because the sort of treatment that allopathic doctors, I find, are competent at is dealing with simple things such as syringing the ears or applying sticky plasters to the thumbs of little boys. For 20 years we have managed to avoid that excellence of attention from standard professionals in this country by seeking homeopathic treatment. I think you will see from my excellent physical and mental condition—mens sana in corpore sano—that the treatment usually pays off and provides a good return.

During a trip to China some years ago, my parliamentary colleagues and I saw deaf children being treated by acupuncture. They were apparently restored to hearing according to the figures that we were shown. We witnessed also an operation for the removal of an enormous cyst—the size of a small football—from the inside of a woman while she was fully conscious but anaesthetised by acupuncture. I began to think that I should look into the benefits of this form of treatment. Therefore, three years ago, when I took a few days' rest from the exhaustions and toil of the House, I went to a health clinic and there I sought and received acupuncture treatment, which I found highly beneficial. Since then I have sought such treatment for a variety of reasons. I shall not go into detail, because I would hate the House to know of my many afflictions. However, acupuncture or homeopathic treatment has worked the trick for each of those afflictions in a way that in my previous experience before allopathic treatment had failed to do.

These treatments were always given by members of the British Acupuncture Association. I am strengthened in my belief in the efficacy of acupuncture treatment by the appreciation of and support of acupuncture as an effectual means of medical treatment of a distinguished gentleman named Dr. Bannerman, of the World Health Organisation. He is a most distinguished medical authority, whose writings in such magazines as "World Health" make clear his acceptance of acupuncture. Perhaps, Mr. Deputy Speaker, I may quote his words instead of paraphrasing. It is a long article. If any of my colleagues wish to read it, I shall be happy to lend them the copy on condition that I get this valuable document back. I know the habits of some of my colleagues and I shall therefore vet their applications very carefully.

In the article, Dr. Bannerman says,
"The sheer weight of evidence demands that acupuncture must be taken seriously as a clinical procedure of considerable value."
He goes on in another passage to say:
"It has long been practised in the United States, but widespread interest in this and other aspects of Chinese traditional medicine awaited the reopening of significant communications between China and the United States."
Perhaps the one good thing of Nixon's Administration was that it restored that unhappy breach of relations.

Dr. Bannerman continues:
"Considerable controversy has surrounded acupuncture; on the one hand, extravagant claims have been made for its efficacy while, on the other, it has been criticised for its lack of scientific standing. It has now been introduced into several developing countries and since 1976, WHO has organised training courses in China. Quite a number of Western trained doctors practise it, and there is official interest and enthusiasm, particularly from the point of view of its potential usefulness as a tool in primary health care delivery. However, there is some resistance to its acceptance by physicians. So far, it has been used with considerable success for the treatment of"—
Dr. Bannerman then deals with a number of various afflictions that have been treated by acupuncture. He continues:
"With adequate logistic support, training and research facilities, acupuncture will be fully accepted in these terrorities in the foreseeable future."
I should hope that we in this country, when we have more open minds to the value of alternative medicine, will accept this practice against the resistance of the BMA, which hardly needs explaining. I hope that we in this country shall be able to benefit from alternative medicine.

In the other place, Lord Winstanley made a cheap quip while discussing the Bill. He said—

Again, I shall paraphrase, Mr. Deputy Speaker. Lord Winstanley said that acupuncture might do very well for Chinamen but that it did not help other people very much. That is a load of unadulterated nonsense. All over the world, people have discovered the advantage of acupuncture. Why do ordinary doctors—and Lord Winstanley was an ordinary doctor before he moved down into the upper place—make such comments? Ordinary allopathic doctors have something to protect. Their practice is of intervention on a massive scale with the workings of the body either with scalpels or with drugs. That type of intervention frequently does more harm than good. All of us, if we examine our consciences, know from personal experience in our constituencies such cases of damage that have been caused by allopathic treatment. Such doctors have reason to be concerned about the efficacy of alternative medical practices, because those practices show up the limitations of allopathic practice.

My experience of the BAA is such that I am more than satisfied that members of the BAA pursue a course of practice with their own ethical code, which is highly satisfactory. I am delighted that the hon. Member for Bournemouth, East (Mr. Atkinson) made the constitutional element the main point of his speech. However, I deeply resent the implication that the work of those who practise in the British Acupuncture Association should require this statutory registration as if they were all chaps with dirty fingernails who use needles in a way that other needle practitioners, such as tattooists and ear piercers, do. That is a slander against the practitioners of the BAA.

I hope that we shall resist this manoeuvre by the House of Lords to get through an underhand piece of legislation. I hope that it will be resisted both for constitutional reasons and in order to defend the rights of members of the BAA to practise their properly trained skills.

I shall oppose the motion in the name of my hon. Friend the Member for Bournemouth, East (Mr. Atkinson). However, I congratulate the hon. Member for Warley, East (Mr. Faulds) on his excellent state of health. I am sure that that state of health is due to acupuncture. I am not against the practise of acupuncture; quite the contrary.

My hon. Friend the Member for Bournemouth, East explained why the amendment was made. I believe that the other House was right to disagree with it, and I urge this House to uphold that judgment.

There are two separate arguments. One is whether the British Acupuncture Association register should be exempted from the clause. That is an argument about public health. The second is a constitutional agrument about whether the other House can disagree with an amendment to a Private Bill that has been passed by a Committee of this House.

My hon. Friend believes that the other House should not disagree and should not return such a Bill to this House. It is perfectly true that in normal circumstances the other House would not disagree with such a Bill and return it to this House, but the circumstances were not normal.

The clause was debated in Committee but not on the Floor of the House. The motions referring to the clause were never called. I was here on one occasion when the Bill was debated. The part of the Bill dealing with processions was debated for such a length of time that the clause dealing with acupuncture was never reached. We have not previously had the opportunity to discuss the subject.

My hon. Friend is the only hon. Member in this new Parliament who had the opportunity to discuss whether the BAA register should be exempted from the clause. He is the sole surviving member of the Committee that considered the Bill.

I am sure that that is so.

To say that the other House has overreached itself is to ignore the fact that this House did not have an opportunity to express its collective view, one way or the other. By sending the Bill back to us, the other House has given us that opportunity. I believe that the other House has behaved properly and that the constitutional points raised by my hon. Friend are not valid.

The debate is about public health. It would therefore be helpful to trace the origins of the Bill and its progress. Reference has been made to the incident that gave rise to the Bill. In 1977 there was an outbreak of hepatitis, when 34 cases of hepatitis B were discovered in Birmingham. They were traced to an acupuncturist who was treating up to 80 patients a day without sterilising his needles.

Does the hon. Gentleman claim that the fellow who applied the acupuncture on that occasion was a member of the BAA?

I believe that the hon. Gentleman is right and that he was not a member of the BAA. I shall deal with that point later.

The fact that that acupuncturist was not sterilising his needles was a serious threat to public health. It is elementary that acupuncturists should sterilise their needles. It is horrifying that one of them did not.

That unpleasant incident prompted the West Midlands county council to include a clause in the Bill to make acupuncturists register with district councils and to make provision for regular inspection of premises. That provision would ensure that their premises had a high standard of hygiene. My hon. Friend made the point that that would not guarantee that they would sterilise their needles. However, if they knew that there would be a check to see that they were not operating out of unsatisfactory premises it would instil some degree of control over their practice.

When the Bill was first introduced in the other House late in 1978, an amendment was moved to exclude registered doctors and dentists, who were already subject to strict statutory controls by the General Medical Council and the General Dental Council. In March 1979, the Bill came before the Committee, and the BAA petitioned for an exemption similar to that granted to doctors and dentists. The association wished its members to be exempted from registering their premises and being subject to inspection by district councils.

7.45 pm

The then Secretary of State for Social Services, the right hon. Member for Norwich, North (Mr. Enna1s) made a report in which he said:
"The Secretary of State recommends that there is no need for district councils to be empowered to register medical and dental practitioners who are already subject to statutory registration, although it would appear to be inappropriate to extend exemption from the provisions of the clause to members of a body of which the requirements for membership do not include provision for statutory registration".

It was the clear recommendation of the previous Secretary of State that the BAA should not be exempted from registration.

Surprisingly, the Committee did not seek the Secretary of State's views through his representatives who were present in Committee. The Committee did not have to do so, although it would have been normal to consult the Secretary of State on a matter of public health.

Does my hon. Friend accept that we had the Department's submissions in writing and that they were perfectly clear? We took them into account in our decision. We did not need to call on the Department's representatives to outline further what we had in writing. We were not obliged to call on the Department's representatives.

I agree that there was no obligation, but it is rather strange that the Committee did not appear to take note of what the Secretary of State said on a matter of public health.

Secondly, the BAA is only one of a number of acupuncturist asssociations in the country. There is the Traditional Acupuncture Society, the International Register of Oriental Medicine and other smaller bodies. The Committee did not hear evidence from these associations and therefore had no opportunity of judging whether only one association should be singled out for special treatment. It is hardly logical or fair that one group should be exempted from registration while other groups that have advanced similar claims to high standards should receive no such exemption.

My hon. Friend suggests that other acupuncture bodies sought exemption. Why did they not petition the House for an exemption clause in the way that the British Acupuncture Association did? They did not. We had only one petition for exemption. That was from the BAA.

That is a valid point, and I cannot explain why, However, I insist that it is unfair and illogical to discriminate between groups. It is not logical that some groups should have to register and others not. If they were all exempted, the public would have no safeguard against the sort of outbreak of hepatitis that occurred in Birmingham in 1977. The whole object of the Bill would be defeated.

My third point concerns the balance of evidence heard by the Committee. I have read the minutes of the evidence. I have also listened in Committee in the other House to the proceedings on the South Yorkshire Bill, which was similar. The contrast is remarkable. The Committee on which my hon. Friend sat heard evidence that was almost entirely one-sided and favourable to the BAA. The evidence at the hearing of the South Yorkshire Bill gives an entirely different impression. Some of the witnesses called at the latter hearing were doctors who practised acupuncture. They were not necessarily biased against acupuncture. Almost all of the doctors, who were themselves acupuncturists, were emphatic that there should be no exemption from registration for any single group of acupuncturists. I do not feel that the Committee heard both sides of the argument.

None of the acupuncture associations has anything to fear or anything to lose from the requirement that members should be registered, provided that they are anxious that their members should practise the profession hygienically. The Bill in no way intends to discriminate against the practice of acupuncture. On the contrary, the new regulations are likely to inspire greater public confidence in the profession, and, therefore, will accelerate the full acceptance of acupuncture as an integral part of Western medical practice. That is an outcome that I, and I am sure all hon. Members, will welcome.

If the House accepts the motion, a dangerous precedent will have been created. It will have been conceded that it is proper that bodies over whose membership there is no statutory control may be exempted from the application of the law. However worthy such a body may be at the time at which the exemption is conferred upon it, there can be no guarantee that it will remain so, and that the privileges that it has won will not be abused in the future.

I should like to draw a simple parallel. If a Committee were considering a Bill for the control of environmental health in food stores, how would hon. Members feel if the Committee, having decided that Fortnum & Mason was a highly worthy and respectable establishment, proceeded to amend a clause in the Bill to exclude Fortnums, but to make Tesco, Sainsbury's and other stores comply? I am sure that the House would never agree to such an amendment.

Does the hon. Gentleman agree that there is more security for the public in accepting the ethical standards incumbent on members of the BAA than simply requiring a statutory registration of many possibly unqualified acupuncturists.

It is elementary, if there is some form of control over all acupuncturists, that the public should be given some safeguard. That is no reflection of the degree of excellence of one group of acupuncturists over another. They should be treated in the same manner.

Why should the House agree to confer exemption from the law on one group of acupuncturists, over which there is no statutory control and which can change its conditions of membership at will? Conferring such exemptions would be illogical.

I believe that the House would be failing in its duty to protect the public health if it upheld this unfortunate amendment. I therefore urge the House to vote against it.

I am pleased that the hon. Gentleman spoke before me, and not after me. His interpretation of the law changed my mind. I can see his point of view that there was no arrogance in the dismissal of the claim, but that it was simply being referred back to the House. We must all agree that that is a common practice which we rarely can ignore. I have changed my mind in that direction.

It is not a common practice at this stage of a Private Member's Bill. It has been unheard of since 1903. That is borne out by the declaration of Lord Aberdare.

I agree with that. I said that it is common practice in the House for measures to be returned from the Lords to this Chamber for further consideration. In any case, whether it is a Private Member's Bill or a Government Bill, the procedure that has been accepted by successive Governments over the years can hardly be wrong.

The hon. Member for Birmingham, Northfield (Mr. Cadbury) put forward a reasonable argument about acupuncturists. Some who wish to practise acupuncture are hardly qualified in terms of honour and healing ethics. I know about acupuncture in Hong Kong. I have had sessions with the Chinese who practise acupuncture there. Those people are highly reputable, and I have read about many cures that they have effected. In that respect I am happy to support the hon. Member for Bournemouth, East (Mr. Atkinson) in bringing the matter to the attention of the House so that it can be properly discussed. At the same time I ask him, not only with respect, but with a sense of fraternity, to pursue the matter. If the regulations on hygiene, cleanliness and so on are adhered to, I believe—from the people to whom I have spoken in Hong Kong—that it can make a valuable contribution to the health of the nation. I do not find it necessary to denigrate the orthodox medical profession. One does not have to denigrate the one to extol the other. One has only to consider the thousands of people who are cured in hospitals to realise the vast contribution of the orthodox medical profession to society.

I recommend that the hon. Member for Bournemouth, East should re-examine the matter. My first impression was different. I intended to go into the Lobby with him. I now ask him to reconsider the matter and to bring the matter before the House again, on the principle of the value of acupuncture to society.

8 pm

I simply wish to enter a short caveat, possibly because I was in China with the hon. Member for Burnley (Mr. Jones) who spoke so vividly about acupuncture. My object in doing so is that I am considering not simply acupuncturists, but osteopaths also. There should be a recognised standard of the BAA, and if other bodies wish to register they can do so. But to seek to legislate to give local councils powers to search and examine is a constricting attitude. It takes away the freedom of the individual to choose the acupuncturist or the osteopath that he wishes to treat him.

I am intervening because of the strong feeling of some very distinguished osteopaths in my constituency. I should like the Minister's assurance that there will not be a closed shop for the medical profession. I hope that we will be able to give freedom to osteopaths and acupuncturists, and give the individual the freedom to choose the acupuncturist that he would like to treat him. I should have thought that it could have been done by allowing a proper register of acu- puncturists and osteopaths. Some difficulty is caused when people walk in and make inquiries, and this could be very harmful to the practice of this branch of medicine. I would like an assurance from the Minister that he will give the freedom to acupuncturists and osteopaths to practise in freedom without restriction.

Perhaps it would be helpful if I said at the beginning that the Government have nothing against acupuncture or osteopathy. I shall write to my hon. Friend the Member for Harwich (Mr. Ridsdale) on the question that he raised about osteopaths. I hope to be able to give him the assurances which he sought.

I noted what the hon. Member for Warley, East (Mr. Faulds) said about acupuncture. I was impressed by his experiences. However, he has slightly more flesh to pierce than I have, and that fact might deter me a little from seeking the cure that obviously worked so well for him.

There have been two objections to what my hon. Friend the Member for Birmingham, Northfield (Mr. Cadbury) seeks to do. At this stage I must say that my Department supports my hon. Friend in seeking to resist this amendment. The two objections have been first on constitutional ground, and secondly, on the merits of the case. On the constitutional ground I should end the conspiracy theory about the House of Lords by making it clear that my right hon. Friend the Secretary of State for Social Services and the right hon. Member for Salford, West (Mr. Orme) wrote a letter to the House of Lords asking whether the House of Commons might have an opportunity to reconsider this matter. The House of Lords acceded to that request. Therefore, I do not believe that any allegation can be made in this case that the House of Lords is seeking to frustrate the will of the House of Commons.

That does not lessen the impropriety of what has happened. The House of Lords has adopted a procedure which has not been followed for years since the reform of the other place. The Minister is making use of that improper manoeuvre to get the will of the Committee changed when that Committee deliberated on this matter for many days.

In a few moments I shall submit that this case warrants the procedure in that the House of Lords had come to one decision in dealing with the South Yorkshire Bill, and had refused to grant the exception, and at the same time the House of Commons had come to a totally different decision in respect of the West Midlands Bill. This gives no guidance at all for future petitioners. Therefore, it seemed right that this House should have the opportunity to consider the case on its merits and see whether we could rationalise the position and come to a coherent decision which would guide future petitioners.

I hope that my hon. Friend the Member for Bournemouth, East (Mr. Atkinson) and those who have supported him will seek to win their case on merit, rather than try to get it through without proper debate and perhaps without a vote in this House.

I turn to the merits of the case and express the concern that the Government would feel if the Bill went through as it stands. I digress a little to give the history of the matter. The Bill was introduced in the House of Lords and it completed its Commons Committee stage before the dissolution. It was the subject of a carry-over motion to enable it to continue in the new Parliament.

Following an outbreak of hepatitis in Birmingham in mid-1977, caused by the use of unsterilised needles by a single acupuncturist, the West Midlands county council included in the Bill a clause whose effect was that no one should practise acupuncture unless he and his premises were registered by the appropriate district council. The clause empowered district councils to make byelaws for the purpose of securing the cleanliness of the premises, equipment and persons.

My Department, which was then in different hands, offered no objection to this initiative by the West Midlands county council in seeking powers to regulate acupuncturists and their premises. This initiative was designed to protect the public from the risk of unhygienic acupuncture.

In a report to the Lords Committee on the Bill, the Secretary of State recommended exclusion of registered medical and dental practitioners, some of whom practise acupuncture, from application of the relevant clause. This was because doctors and dentists are already subject to statutory regulation, whereas most acupuncturists are not medically qualified or subject to statutory regulation, and may have no formal training of any kind. The recommendation was accepted by the Lords Committee.

The British Acupuncture Association and Register Limited petitioned the House of Commons saying that, if registered medical practitioners and dentists were to be excluded from the operation of the clause, its own members should equally be exempted on the ground of their alleged reputation, international recognition and qualifications. In his report to the House of Commons which took account of the petition, the former Secretary of State said:
"The Secretary of State recommends that there is no need for district councils to be empowered to register medical and dental practitioners who are already subject to statutory registration, although it would appear to be inappropriate to extend exemption from the provisions of the clause to members of a body of which the requirements for membership do not include provision for statutory registration".

As has been said in the debate, the BAAR is merely one of several non-medical and non-statutory acupuncture bodies.

The Opposed Private Bill Committee of the House of Commons heard the evidence of the petitioners and the representations of their counsel on 13 and 14 March last year. Officials of my Department were present throughout the proceedings but were not invited, as Standing Orders would have permitted, to explain why in the Secretary of State's view the petition should not be granted. After deliberation, the Committee announced that the petition had been allowed.

However, Committees are required by Standing Orders to notice ministerial recommendations in their reports to the House, and, if they do not accept them, to state their reasons. In this case the report states that the recommendation of the Secretary of State was adopted, but, in view of what I have said, I submit that that is not the case. I regard it as a matter of principle that exemptions from the law should not be granted in privately-promoted legislation, as much as in any other, to organisations or members of organisations which have not themselves been statutorily created and for the membership and conduct of which there is no statutory control. I think that this view must commend itself to any hon. Member who has considered the implications of not adopting that principle.

We are not here to consider the merits of the BAAR or even whether those who are members of it are likely always to practise their profession hygienically and so present no risk to their patients or the public at large. We are here to consider whether—as both Houses have determined—it is desirable that acupuncturists practising in the West Midlands should be required to be registered, have their premises registered and be subject to bye-laws ensuring that their premises are clean.

It would be desirable that some acupuncturists who are not otherwise statutorily registered or subject to statutory controls should be exempted from this registration and that others should not. If we accept the principle as I have enunciated it, we cannot stand by the amendment of the House of Commons which provided that the members of the BAAR should be exempted from the provisions of the clause.

Many of us believe that there can be a healthy compromise. Could not the Minister give his hon. Friend the Member for Bournemouth, East (Mr. Atkinson) an undertaking that if he is prepared to withdraw his amendment the DHSS will take over the measure and see it safely to the statute book under the conditions that the Minister himself has prescribed?

I am not sure that I can give that assurance in quite those terms. I think that my hon. Friend sought exemption for acupuncturists, but I have made it clear that we are not minded at this stage to exempt them when doctors and dental practitioners, who are statutorily registered, have to conform to stringent requirements. We have nothing against acupuncturists, but I cannot say that we will exempt them from statutory controls at a time when other medical practitioners have to submit to them.

Another Committee in another place recently considered a petition of the same association against a similar clause in the South Yorkshire Bill. It heard the argu- ments of the petitioners at length and the counter arguments of the promoters. Unlike the Committee of which my hon. Friend the Member for Bournemouth, East was a member—a singularly accident-prone Committee—it heard the representatives of my right hon. Friend express his views on why the petition should not be allowed.

Would my hon. Friend care to enlarge on that description of my Committee?

Yes, indeed. Nothing offensive was meant. It seems that none of them survived the last election, apart from my hon. Friend. That Committee disallowed the petition. So we now have two Committees that have reached contrary conclusions on the same issue. Whatever may be our pride, I urge hon. Members to accept that the decision of the Committee of the other place on this point of principle was correct and that the decision taken by the Committee of the last House of Commons was wrong.

The other place took an unusual step, as I readily concede, by seeking to discuss with this House the exceptional implications of this amendment. But, as was said in another place, such a step has a precedent, although one has to go back to 1903 for it. I am sure that what was done in another place was right. There can be no doubt that we require the opportunity that we have tonight to consider what is an important issue of principle. Now that we have the opportunity, I hope that we shall use it to reverse the amendment of the last House of Commons. If this is done, promoters of other Bills containing parallel clauses will know what is the will of Parliament and will not be under any obligation imposed by the unfortunate precedent created by this amendment to emulate. I ask my hon. Friend, in the light of the debate, to consider withdrawing his proposition.

8.15 pm

I have listened to the debate with care. I wished particularly to hear the explanation by the Minister.

One had grave misgivings on two points. The first is the constitutional point. There is no validity in denigrating the identities of the members of the Committee simply because three of them either lost their seats at the last election or did not stand again. What seems to me important is that the Committee was set up by the House of Commons to investigate an issue. It investigated at great length. I have read the minutes of evidence taken before the Opposed Private Bill Committee, as has the Minister. I believe that the Committee satisfied itself that the British Acupuncture Association was a proper and reputable association.

One is obviously apprehensive about doing something that has not been done since 1903. I believe it is wrong to accept advice from the other place. I read the debate in the other place as well. Like the hon. and afflicted Member for Warley, East (Mr. Faulds), I have little sympathy with the statement by my noble Friend Lord Winstanley and his lighthearted remark that acupuncture was something that the Chinese did and that it did not work anywhere else.

The real issue of this debate is whether the British Acupuncture Association takes sufficient care for it to be above the inspection of a local authority. Perhaps, at this moment, one may even consider whether a local authority is sufficiently expert to look at an acupuncturist and come to a realistic decision. Looking at the evidence given, it seems clear that acupuncturists from this country take great care. No one is allowed to practise acupuncture without supervision unless he has been doing it for two years. This is a proper provision. I accept it.

I am a little less happy about the accommodation that is given acupuncturists from other countries. I have listened with care to what the Minister says. I shall give way if he cares to intervene.

I had intended to intervene on the constitutional point. Is the hon. Gentleman aware that the Liberal spokesman in the House of Lords supported the course of action on which we are embarked this evening?

I think that the Minister read his brief beautifully. I wish he had listened to me. That is what I said. [HON. MEMBERS: "Cheap".] It is cheap to insult the political party of a man simply because a Minister is sufficiently deaf not to hear what has been said. [HON. MEMBERS: "Oh".] That is exactly what happened.

I was interested to hear the report of the hon. Member for Warley, East about acupuncture and deafness. I also went to China on a parliamentary delegation. It is important to state, before a great deal of hope is given to deaf children, that research shows that, while there was a temporary relief of deafness in children, what usually occurred was that, as a result of a subsequent cold or influenza, or worse, the deafness returned and, in some cases, was worse than before. I mention this simply because I have a number of deaf constituents who were fascinated by the findings of the home to which I went and made inquiries.

I do not wish to question the bedtime reading of the hon. Gentleman. That was not the report that we had on our visit to China. Perhaps next time we can go together.

I believe that the issue is bound up, not with the competence or otherwise of acupuncture, but with the care of the British Acupuncture Association. That is what the House must concentrate upon when voting.

I intervene briefly to pick up the remarks of the hon. Member for Isle of Ely (Mr. Freud). My hearing of the Minister's speech—he read it well and I agree with it—was not that anything dangerous or anything more dangerous, is likely to be done by acupuncturists than by other people in the medical professions that they should be relieved of the responsibility on people in other medical professions to being supervised and inspected. Nothing that he said is an aspersion on British acupuncturists.

There is no insult in referring to one hon. Member as afflicted and others as accident prone. The idea that two years supervised practice in any profession is sufficient could presumably be extended to doctors, dentists and the rest. I do not think that the hon. Member's speech takes us much further on the issue.

Question, That this House doth insist on its amendment to which the Lords have disagreed, put and negatived.