Motion made, and Question proposed, That the sitting be now adjourned.—(Mark Lancaster.)
I am extremely grateful to have the opportunity in this debate to raise the issue of herbal medicine with my hon. Friend the Minister. The issue has been on the agenda for many years, and I hope that by the end of the debate we can shed light on where we are going. I look forward to my hon. Friend’s remarks.
On Friday, I was at the Royal Society summer science exhibition. The Royal Society is our oldest and, some would say, most distinguished scientific society. Its fundamental purpose is to promote and support excellence in science and to encourage the development and use of science for the benefit of humanity. The Royal Society has played a part in some of the most fundamental, significant and life-changing discoveries in scientific history, and it continues to make outstanding contributions to science in many research areas. I will refer to what I saw at the exhibition and to what it has to say to us about herbal medicine generally.
If I may say in passing, Mr Speaker might like to visit the Royal Society because it has a wonderful gold mace that is the mirror image of the Mace that is carried into the Chamber. The mace was a present to the Royal Society from Charles II. Among the Royal Society’s former presidents are Sir Christopher Wren and Edmond Halley. The Royal Society has a wonderful line and body of knowledge, so I set great store by it. We must take note when the Royal Society seriously considers herbal medicine and related methods of delivery.
I was particularly struck by the Royal Society partnership grant project with Boroughbridge high school in Harrogate under the direction of Colin Inglis, the school’s biology tutor, and overseen by Professor Kerr, the consultant microbiologist at Harrogate and District NHS Foundation Trust. The project looked at several simple plants and herbs available in our gardens, from greengrocers and from garden centres to see what their impact could be on E. coli and other bugs—I will focus on E. coli. Working over not a very long period of time, the project found that E. coli growth is inhibited by the use of thyme, lavender and geranium set in essential oils. They said that they were able to identify the minimum inhibitory concentration of those oils derived from herbs and plants—the lowest concentration of essential oil that inhibits the growth of E. coli. When I discussed that with the directing staff, they said that the next step would be to determine the concentration that would kill E. coli—the minimum bactericidal concentration. That simple project in a school in Harrogate has huge ramifications, because it shows how easily-found common herbs and plants can be used in the furtherance of medicine.
In the evening at the Royal Society there was a panel discussion on “Nature’s Marvellous Medicine,” and those addressing the audience were not ill-informed: Professor Dianna Bowles, emeritus professor in the department of biology at York university; Professor Roderick Flower, professor of biochemical pharmacology at the William Harvey research institute; and Professor Monique Simmonds, director of the Kew innovation unit, where she studies the chemistry of plants and fungi—of course, Kew Gardens is currently classifying all British herbs. They are not ill-informed people, and they were speaking about what could be done with herbs and plants.
The chief medical officer, Dame Sally Davies, recently said that resistance to antibiotics risks health “catastrophe” that would rank with terrorism and climate change. She said that Britain’s health system could slip back by 200 years unless the “catastrophic threat” of antibiotic resistance was successfully tackled. The Select Committee on Science and Technology, of which I am a member, might address that in this Parliament. Dame Sally Davies said:
“This is a growing problem, and if we don’t get it right, we will find ourselves in a health system not dissimilar from the early 19th century.”
Although hospital infections from bugs such as MRSA are greatly reduced, they are being replaced by infections with other bacteria. Antibiotic use is rising, not least in agriculture, and resistance is steadily growing in fish and farm animals—I remember raising the matter in this House 20 years ago or more—and there are problems with farmers, particularly in the third world, feeding antibiotics to chickens. I said then that such use could have catastrophic consequences, and now we know that, in some parts of the world, cattle have been fed antibiotics as a prophylactic, so it is no wonder that the new chief medical officer is focusing on that.
It is perhaps also significant that Professor Christopher Thomas, the professor of molecular genetics at the university of Birmingham, added to Dame Sally’s remarks:
“We need new ways to kill resistant bacteria or reduce their carriage of resistance genes. Novel approaches that might have appeared unrealistic a few years ago need to be explored.”
I suggest that one of those areas that needs to be explored is better use of herbs and plants in medicine. In a sense, and this is not an original phrase, we need to go back to the future to find those solutions. If I have anything further to say about Dame Sally’s release, it is that it does not provide any solution other than to suggest that we need to go for more antibiotics. The problem is that some doctors are saying that no antibiotics will work in 20 years’ time. The Government have a catastrophe management team—that is not the official title—and I think that issue should be added to its list.
Today, we are not specifically debating common plants that are available as foods or in the garden. Such plants are covered by different regulations. What we are debating is the future of herbal medicine in this country. If I may, I will set out the stall on what has happened in recent years. We have to go back to the House of Lords Science and Technology Committee report of 2000 that considered herbal medicine and other medicines that are not currently used in mainstream health care. The written evidence from the Department of Health stated:
“There is scope for the larger professions to follow the osteopaths and chiropractors in gaining statutory self-regulation, and this would undoubtedly serve their professions well.”
I served in the Committee stages of the Osteopaths Act 1993 and the Chiropractors Act 1994, and the difference that statutory regulation has made to those professions in providing safe services for patients and giving assurance to doctors such as the Minister is extraordinary. They came in from the cold.
The Government then identified acupuncture and herbal medicine as specific therapies for which they wanted to achieve statutory regulation. I shall not dwell on acupuncture, as we must focus on herbal medicine. In her evidence to the Lords Science and Technology Committee inquiry, the then Under-Secretary of State for public health, the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) said:
“I think we would support their moves towards statutory regulation…We would strongly encourage them to continue the process towards proper self-regulation and statutory regulation as well…We do think that in the area of acupuncture and herbal medicine it is perhaps more important than in other areas.”
In its report, the Committee said:
“It is our opinion that acupuncture and herbal medicine are the two therapies which are at a stage where it would be of benefit to them and their patients if the practitioners strive for statutory regulation under the Health Act 1999,”
which is an enabling Act that, if I remember correctly, provides for different disciplines to come in via statutory instrument,
“and we recommend that they should do so.”
Regulation was recommended because those herbal professionals met the agreed criteria for statutory regulation that the Lords had come up with. There was a risk to the public through poor practice, and they had a voluntary regulation system and a credible evidence base. Regulation would ensure that appropriate training was established, resulting in competent practitioners with an understanding of the evidence base for their therapy along with an appreciation of the limitations of the treatments that they could provide. Safe practitioners would understand when to refer. Effective regulation would therefore seek to safeguard the public from incompetent practitioners and identify practitioners suitably qualified to use a range of potent herbal remedies not appropriate for over-the-counter sale. There are some powerful remedies.
The next stage in the saga is the European Union’s intervention. However, I want to make one point at the outset before we consider European directives. The proposal for statutory legislation pre-dates all the arguments about European directives, such as the traditional herbal medicinal products directive and others. The policy had broad cross-party support, and the distinguished Lords Committee, which included members such as Lord Walton of Detchant and Lord Baldwin, had proposed it. Distinguished men came up with that proposal. We were going down that route anyway.
Then the European Union became involved, with directives. We must address the directives, but we are not dealing only with them; we are dealing with a policy that was already in train. The objective of proper regulation had been there before the European Union directive 2001/83/EC, amended by directive 2004/24/EC, which said:
“A Member State may, in accordance with legislation in force and to fulfil special needs, exclude from the provisions of this Directive medicinal products supplied in response to a bona fide unsolicited order, formulated in accordance with the specifications of an authorised health-care professional”—
a key phrase—
“and for use by an individual patient under his direct personal responsibility”.
That meant that herbal practitioners would have to be classed as authorised health care practitioners in order to be able to continue using their herbal products.
In January 2002, the Department of Health, along with the Prince’s Foundation for Integrated Health and the European Herbal and Traditional Medicine Practitioners Association established the herbal medicine regulatory working group—HMRWG. The group and subsequent groups were chaired by Professor Mike Pitillo, a well-respected man whom I knew and who devoted many years of his life to the issue. His efforts were and are still appreciated by all who knew him; sadly, Mike died in February 2010. God bless him; he put so much into the issue on behalf of the community. The working group’s remit was to make recommendations on the regulation of herbal medicine practitioners and the reform of section 12(1) of the Medicines Act 1968. In 2003, the group published its report, “Recommendations on the Regulation of Herbal Practitioners in the UK”.
In effect, the group’s work on the issue of possible reforms to the regime of unlicensed herbal medicines supplied under section 12 represented the first stage in the exploration process envisaged by the Government. It needed to be seen as distinct from but complementary to the wider European negotiations on the then proposed directive on traditional herbal medicinal products, which related to industrially produced traditional herbal remedies sold over the counter directly to the public.
Working in parallel to the group was the acupuncture regulatory working group, which I need not discuss. The HMRWG concluded that the two professions should be regulated together, thereby addressing the high practitioner costs of running two separate registers. The Department of Health ran a consultation on regulation of the two professions, published in 2004 as “Regulation of Herbal Medicine and Acupuncture: Proposals for Statutory Regulation”. The results of the consultation were published in February 2005 as “Statutory Regulation of Herbal Medicine and Acupuncture: Report on the Consultation”.
The Medicines and Healthcare products Regulatory Agency ran a simultaneous consultation on section 12(1) reform—MLX 299, “Proposals for the Reform of the Regulation of Unlicensed Herbal Remedies in the United Kingdom Made Up to Meet the Needs of Individual Patients”—and published its results in January 2005. In 2005, if colleagues recall, we had a general election. There were delays at the Department, unsurprisingly, and pending developments in health care regulation as part of the Foster review stalled further work for nearly a year.
However, in early 2006, the Government set up the steering group on the regulation of acupuncture, herbal medicine and traditional Chinese medicine in order to consider how to proceed with the regulation of those professions. That involved yet another consultation process. On 12 June 2008, the steering group’s report was presented to the then Minister, the right hon. Member for Exeter (Mr Bradshaw). On 16 June, the steering group, chaired by the late Professor Pitillo, held a press conference at the King’s Fund to report on the document.
All the reports and consultations found massively in favour of herbal medicines generally and statutory regulation in particular. After that tortuous process, they arrived at that conclusion.
I am enjoying my hon. Friend’s speech immensely. No one else in the House knows as much about herbal medicine as he does. He speaks for the nation. In its survey, the MHRA found that as many as 3 million people had consulted a practitioner of Chinese herbal medicine, and as many as 25 million had bought herbal medicines over the counter during the previous two years of its survey.
I am grateful to my hon. Friend, who is ever supportive. He has tabled questions and acted for his constituents on this issue, as he always does. He is right. Three quarters of the population of the United Kingdom have used traditional Chinese medicine, herbal medicine, phytotherapy or one of the other disciplines sometimes classed as complementary. There is a huge swell of people out there who want such medicines. Going back to Dame Sally’s remarks, people are now frightened of using antibiotics; they are worried about overuse and that, when they really want them, they might not be effective. We have a crisis not only of effectiveness but of confidence. People who tend to go down the herbal medicine route have a lot of confidence, however, because they are dealing with nature and natural products that have been used over the years. Properly administered, those products do not have side effects and they are not prone to becoming ineffective.
I congratulate the hon. Gentleman, who is knowledgeable on the subject. Would it be helpful if he outlined what he feels might happen if the Government do not do what they said that they would do and what we all want to see happen on regulation?
I am grateful to the hon. Lady, with whom I discussed the debate earlier, and I will be coming on to the options available to the Minister. In fairness to him, I know that he has been focused on the matter, with his colleague in the Lords, the noble Earl Howe, a distinguished Minister. However, before I look at the solutions and some of the obstructions and problems—why we are not getting a solution—I will first go through where the Government are now.
On 16 February 2011, the then Secretary of State, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), made a written statement on the regulation of herbal medicine. Subject to parliamentary procedures, he aimed to have legislation in place by 2012—importantly, when the European law kicked in—and he stated:
“When the European Directive 2004/24/EC takes full effect in April 2011 it will no longer be legal for herbal practitioners in the UK to source unlicensed manufactured herbal medicines for their patients. This Government wish to ensure that the public can continue to have access to these products.
In order to achieve this, while at the same time complying with EU law, some form of statutory regulation will be necessary and I have therefore decided to ask the Health Professions Council”—
the strong regulatory body—
“to establish a statutory register for practitioners supplying unlicensed herbal medicines.”—[Official Report, 16 February 2011; Vol. 523, c. 84WS.]
Progress, however, has been slow.
Before I get to the solutions, as prompted by the hon. Member for Vauxhall (Kate Hoey), let me emphasise that, although a Health Minister is responding to the debate, we should not be under any illusion that only the Department of Health is affected. If we do not got things right, we will see a large number of small businesses folding, because the whole supply chain of herbal medicine will collapse. That is extremely unsatisfactory.
Furthermore—I will not stray into this territory for long, Mr Bone, in case you are thinking of calling me to order—when the Science and Technology Committee went to Harwell to look at the European Space Agency, at its work on satellites and at what we are doing with the global positioning system in Europe, we looked at the Catapult centre, which is an organisation backed with hard cash by the Government to drive science forward. That is fine, and I asked them whether it was picking winners, but while I was listening in the state-of-the-art space centre, I was thinking, “But what about the small businesses we already have?” What will we do about the people who are providing a service to the community in health care? What will we do with them if their livelihoods are under threat?
My hon. Friend’s excellent speech has come to the nub of what could be a huge crisis. If statutory regulation fails to go ahead, a wide range of herbal medicines supplied by practitioners to their patients will be lost. The directive has already stopped practitioners prescribing herbal medicines made by manufacturers and herbal suppliers for prescriptions to individual patients. Potentially, thousands of small and medium-sized herbal enterprises could go out of business.
My hon. Friend illustrates the point. The European directive on traditional herbal medicinal products now prevents third-party manufactured herbal medicines being prescribed to patients by practitioners, as well as individualised herbal medicines prescribed by practitioners and manufactured by a third party. One of the communities in the herbal medicine diaspora most affected is that of traditional Chinese medical practitioners. The directive has already had a negative impact on the availability of Chinese herbal medicine in the UK and Europe. The problem lies in the fact that the directive stipulated that, to prove traditional usage, there must be a 30-year history of usage, of which 15 years must be in the European Union. That can be difficult, because many Chinese medicines have been used for thousands of years in China—Chinese medicine goes back 3,000 years at least—but not in the European Union or the UK.
The directive was also conceived before we had the vast opening up of trade with China. Probably, no one envisaged what was going to happen. I will touch on that, because I was speaking to the Foreign Secretary about it last week. We now have a situation in which, once stocks of some Chinese medicines run out, it will not be possible to buy many of the formulations currently available.
Is this another example of the European Union interfering in all sorts of areas about which our own country should be able to make up its mind? Is this not another opportunity to say that we need to get some powers back from the European Union or leave it altogether?
The hon. Lady is right. We all saw the headlines in the Sunday papers, and the coalition Government are intending to do just that. I hope that we can get some powers back. One of the solutions that I will propose—I know that you have an impartial role as Chair, Mr Bone, but I have heard mention of the European Union pass your lips in the past—may not even involve the European Union.
To finish with the Chinese problem, we are dealing with an international issue. We are trying to develop trade with China and have just opened a lot of trade missions there—the Department for Business, Innovation and Skills and the Foreign Secretary are backing such attempts—and we see it as a great area, but the Chinese are not happy about the idea that they have western medicine in their country, but we do not make full use of Chinese medicine over here. I have spoken to people about that. The idea that we will have a sweeping of the shelves of Chinese medicine will not play well in the international domain. We have had some controversial issues—the Government’s approach to the Dalai Lama was not overwhelmingly well received by some people in China, although many in this country support what has happened over there. If the Foreign Secretary has not yet been in touch with the Minister, he might well do so, because our international position with China is affected.
Recently, somehow, we have got to an impasse. I have had some helpful conversations, but there have been all sorts of suspicious signals and it is no secret that some practitioners have found it hard to get to the Department; some of the herbal medicine governing bodies have complained that they have not had easy access. Things do not feel quite normal, because the flow of information has not been what we might have expected. I have been told that the problem that stalled the process occurred in Poland.
In short, the European Court of Justice ruled that Poland was importing and selling unapproved drugs. It ruled against the Poles. Apparently, that has brought everything to a grinding halt in the UK. I sent the Minister a copy of the opinion that I received from the European Herbal and Traditional Medicine Practitioners Association, which was provided by David Reissner, a partner with Charles Russell lawyers and an acknowledged expert in pharmacy and health registration. There is no better person to give an opinion. In his letter he says:
“In my view the Poland case was primarily about whether financial considerations could be used as a justification for permitting the use of medicines that do not have a market authorisation. My conclusion is that the statutory regulation of herbal practitioners is still compatible with the ability by such practitioners to be authorised health-care professionals”—
that is a key phrase—
“who can order specials for individual patient use, relying on the exemption in Article 5.1 of EC Directive 2001/83.”
“I also confirm that it is my opinion that statutory regulation is the only way to ensure that herbal practitioners are considered to be authorised health-care professionals within the meaning of Article 5.1 of the Directive.”
To ensure that I understand, is my hon. Friend saying that Poland has effectively been caught out misusing the special needs provision in article 5.1, whereas the Department of Health proposed a perfectly legitimate scheme under the same article but has been put into a state of paralysis by the European Commission’s judgment?
That is pretty much right. The fact is that the Poles were trying to get round the system, were caught out and European law was applied effectively, but we are not in the same situation. I am sure the Minister has looked at the matter carefully, so will he please tell us his view? As far as I can see, there is absolutely no justification for using Poland and that view is widely held in the Community.
The key reason why the issue has got stuck has nothing to do with health care but is to do with the turf war and vested interests. I suspect that there are people in the medical establishment who do not want statutory regulation because they think it would interfere with the status of their own profession. When I talked to the Department for Business, Innovation and Skills about this, there seemed to be some confusion because it thinks that we might be going down a route of more regulation unnecessarily, but, sine qua non, there will be no herbal sector if we do not do something about it. Not doing something is not an option. We cannot just leave the matter as it is. I am pretty sure that vested interests in the medical establishment are trying to block this.
I said in the House recently that I had had a chance meeting with Lord Wilson of Tillyorn who was the last but one Governor of Hong Kong and introduced statutory regulation of herbal medicine there. I asked him what the objectives had been and whether he had problems with the medical establishment, and he said that he did. There are two issues: health care and vested interests. That is worrying because those vested interests may be very powerful. Returning to what Dame Sally, the chief medical officer, said and what I learned at the Royal Society last Friday, I ask those vested interests to back off because antibiotics are not working. We need to find something else and herbal medicine is one way forward. It has been suggested that there would be a legal challenge, presumably by people who are generally hostile to herbal medicine and increasingly misguided and misinformed. The Royal Society is the premier scientific body in this country, and the game is changing.
I have seen evidence in Europe that when doctors combine the two, the allopathic drugs bill can be reduced because herbs tend to be less expensive. That may worry manufacturers, and it has long been said that they are actively campaigning against this. They would be wise to accept that working with natural medicine is good for sales of conventional medicine.
You are ever courteous, Mr Bone, and I will not detain the Chamber much longer. I am acutely aware of not taking up other people’s time.
The Minister has three options. The Health Practitioners Council was the original idea. The Professional Standards Authority for Health and Social Care oversees the regulatory work of other organisations but is not as robust. A special licensing system for practitioner-prescribed products is a possibility, provided they are not traded between member states, and that may be a way out of the problem. We must find a solution, or there will be a disaster in the long term. I have used Chinese herbs and herbal medicine for many years, and I find them extremely safe and effective. I want people in this country to be able to use herbs. The key objective for the Minister is to ensure that the maximum number of products is available safely through regulated practitioners.
I congratulate the hon. Member for Bosworth (David Tredinnick) on bringing this matter to the Chamber for consideration. Many of us have herbal shops in our constituencies. We are aware of their good work, and that has been backed up in interventions today.
I have been contacted about the issue by a small local health food shop in the main town of my constituency, Newtownards, and by numerous patrons of that little shop who benefit from it. That is the point I want to make. The issue is clear: if EU interference continues, it will put businesses out of operation and people out of jobs, and it will result in more people searching the internet for remedies that may not be safe. That will not bring about any benefits. The EU lingers like a shadow over almost everything. Regulation is needed, but it is also necessary for common sense to prevail, and the balance may be difficult to achieve.
My hon. Friend has touched on the crucial point of the debate. Balance is needed to try to avoid people accessing unauthorised, unprofessional and perhaps harmful products, but to enable them to access products made by professional herbalists that they believe and evidence shows improves their condition. We must ensure that we get the balance right between the pursuit and prosecution of those who engage in bad practice and the promotion of those who engage in good practice.
My hon. Friend has gone to the crux of the debate in those few words. It is about getting a balance between allowing people to continue to use their herbal medicines and ensuring that they do not indulge in anything outside that.
I beg your indulgence, Mr Bone, because I would like to take this opportunity to highlight the save our supplements campaign, which has been well publicised. We should all be aware of the goals of that campaign and the ramifications for today’s topic of regulation. The issue that is causing concern in health shops is maximum permitted levels. It has been suggested to me that interference by Brussels—the shadow of Europe is almost like the grim reaper who hangs over everything that we do in the House—will set low doses for dietary supplements, so removing choice from consumers and adversely impacting on high streets.
It would not be a Westminster Hall debate without a contribution from the hon. Gentleman, and I am enjoying it hugely. I am all for bashing Brussels and agree that there is no need for the EU to interfere with the issue, but the EU has given this country a way to address the matter through the establishment of a statutory register, which the present Government undertook to do by the end of 2012. Surely, there is complicity in the Department of Health, and we need the Department to explain why it has not fulfilled that undertaking.
I thank the hon. Gentleman for his valuable intervention, which gets to the crux of the matter and makes a point that I will come to later. We have an opportunity to address the issue, and I hope that the Minister can put the record straight when he responds.
Some high street health food shops are struggling to compete with internet retailers, which often offer a cheaper price, even though, more often than not, the product is inferior. Again, that uncertainty must be addressed. We have been made aware of the facts through previous speeches and interventions on the subject. For example, in a statement on the regulation of herbal medicine and traditional Chinese medicine, the Secretary of State said that he aimed
“to have the legislation in place in 2012.”—[Official Report, 16 February 2011; Vol. 523, c. 77WS.]
We are very aware of that and are wondering why it has not been done. Will the Minister indicate what is going to happen?
I have not been in Westminster long—I am one of the new intake from 2010—but I realised early on that things do not happen in a flash. However, “subject to parliamentary procedure”, should, in my opinion, not involve such a delay. I share the concern of my constituents and of Members present that the issue has been hijacked by EU regulations. In conjunction with the hon. Member for Bosworth, I reiterate that that was never the intention. Let us get the legislation working in Westminster and ensure that it delivers for our constituents.
The idea of the legislation is to ensure that people are licensed to sell and offer advice and that the trade is as safe as can be. On the issue that my hon. Friend the Member for East Londonderry (Mr Campbell) referred to, the girls in my office, who are always trying to get me, as an MP, to slow down and take better care of myself—that is what they tell me anyway—told me that they went to the local health food shop and were amazed at the wealth of knowledge that the lady who helped them had. She clearly was tremendously knowledgeable, and someone could spend the afternoon discussing what the best herbal medicine for them is. It turned out that that lady had a degree in herbal medicine and was able to suggest many different things.
There is a very real fear that should the legislation not go through and should our health food shops continue to suffer from our inaction, or from the Government’s inaction, such closures will mean that more people will order online with no face-to-face interaction or advice. They will not be told that they should not take certain supplements if they are on other medications, or that two supplements may counteract each other. The problem will not only mean fewer jobs on high streets, but potentially more pressure on our GPs in surgeries, as they try to figure out symptoms that may have been caused merely by people taking the wrong combination of supplements. In other words, the expertise and knowledge of people in herbal medicine shops is critical.
Not many of us question the benefits of supplements, especially in the busy lives that we lead, which often mean that we cannot eat as healthily as we would otherwise like. However, who here knew that taking the blood thinner warfarin with a multivitamin containing vitamin K would put people’s health in jeopardy? The lady in the health food shop did, and she was able to advise people who came to her about it. What happens when there is no local shop? Will GP calls be taken up with queries from, for example, people suffering from nausea, dizziness and so on, who find out, after extensive and expensive tests, that when they read in their magazine that vitamin E encourages glossy, thick hair, they had not realised that the aforementioned symptoms could be caused by too much vitamin E. That did not appeal to me, but if I had thought that vitamin E would have given me glossy black hair, or even roots, I would have bought it by the gallon. However, unfortunately, that was not the case. When people are buying supplements in health food shops, they ask what they are taking and are given advice. I hope that the point I am trying to make can be seen; it is very clear.
It is my belief that regulation by those who are knowledgeable is essential, and that should not be diluted by trying to ensure that the latest round of EU tick-box regulations are checked. The issue merits Government attention and a full debate process, and we are glad to have this opportunity in Westminster Hall. I again congratulate the hon. Member for Bosworth on securing this critical debate. I will support him in continuing to bring the issue to the Government’s attention to see action in terms of health and safety, as well as job security. I apologise, Mr Bone—I have guests in the Gallery that I have to take round the Chamber in a very short time, but like the character says in the film, “I’ll be back.”
It is a pleasure to follow the hon. Member for Strangford (Jim Shannon). I congratulate the hon. Member for Bosworth (David Tredinnick) on securing the debate, which is very timely, given that the House is about to rise for the summer recess, and we are seemingly still no nearer to getting what was promised some time ago—indeed, by the previous Government as well. It has been a long saga, as the hon. Gentleman outlined. I shall speak only briefly, because I want to give the Minister a long time to explain why we are in this position.
I start by reiterating my view that when people voted to join the common market back in 1975, they never would have dreamt that the EU would interfere in this kind of thing. However, it is absolutely crucial that if we are going to prevent the very well-established and effective herbal medicine products from disappearing, literally, from our shops and stop the consequent blow that that would mean for the retail sector, we need to get this regulation as quickly as possible.
I dislike regulation and want to see less of it. I believe that most people have common sense; they know what is good for them and want to do what they think is right. They do not need bureaucrats from the Department of Health telling them all the time what they should and should not be taking. We hear that all the time in so-called public health adverts, when most of what is said is either common sense or complete nonsense. I am a great believer in using not only herbal medicine, but natural products from our countryside. There are so many common-sense things that most of us grew up with—not necessarily only people brought up in the countryside but them in particular. If someone got stung by a nettle, they went immediately and looked for a docken leaf. We did all sorts of things naturally, and now, very few people seem to feel that that is what we should look to. I am afraid that vested interests are the reason for a lot of that. The pharmaceutical industry does not want to see it happening and would love to get rid of all health food shops.
Does the hon. Lady agree that as well as the vested interests that she alludes to, at times, in the medical establishment, there is almost a form of elitism that denigrates herbal medicine, suggesting that it only has a placebo effect and is not practically of benefit to people, even though many testify that it is?
The hon. Gentleman puts it very well. That is what happens, not only in the pharmaceutical industry, but with doctors, who have a very narrow view of what health is, in my opinion. That makes it all the more important that we ensure that alternative medicines are available. It is great that we have an heir to the throne who believes that some of this is really important. I wish that the Department would listen to His Royal Highness Prince Charles, because some of what he says on the matter is absolutely right.
The other issue that I want to raise is about the Health and Care Professions Council, which I think the Minister has overall responsibility for. It is based in my constituency and does a brilliant job. However, recently, it seems as though the Department’s general view on what it does and how it works has changed. We have been trying to get sports therapists registered for a very long time. Everyone agrees that that should happen. The HCPC, which is meant to be the body that gives advice, has gone and said, “This must be registered. We must do this.” Sport England wants it to happen, as does anybody involved in sport; yet somewhere in the Department, there is a block. I actually do not think that it is Ministers; I think that it is officials. Officials do not care who is in government; they do what they want to do; and they will continue to pull a line. It seems as though the Minister or the new Secretary of State could be dangerously close to heeding advice from officials to drop the whole thing. I worry very much about that.
When I was working on my speech for today, I looked at the lists of those who are regulated by the Professional Standards Authority for Health and Social Care and the Health and Care Professions Council and I could not for the life of me work out why some were on one list and some on the other. There is another debate to be had on that issue.
I hope that the Minister will give us some clarification on that.
Many campaign groups, including Consumers for Health Choice, are very clear that they want the Secretary of State and the other Ministers to ignore the siren call from officials and fulfil their promises. This is very simple. When the register was announced back in February 2011, it was warmly welcomed by virtually everyone. Consumers were pleased that the register allowed an exception for herbal practitioners from the traditional herbal medicinal products directive—an EU law that became fully applicable in April 2011 and would have meant the banning of all unregistered herbal medicinal products. People will remember the campaign that was held across the country. All MPs got many letters of protest from constituents and from herbal shops and health shops. At the time, the position was that virtually all herbal medicinal products would have been banned. A register would have allowed practitioners to access unlicensed products, thus preserving choice in relation to safe and effective products for thousands of consumers. We all want people to be safe, but that has to be within the broad band of common sense and experience, not because a particular official decides that they do not like a product.
The industry was very pleased. Obviously, the practitioners were delighted that they could still use products that they had used for many years and would not see their consumers drift away, disappointed by a restriction stopping them buying things. All the manufacturers and retailers were pleased for the same reason. It was a win-win situation, so where is the register? The reality is that, because campaigners were reassured by the Government’s words—perhaps people should have been more cynical about the promises of a Government of any sort; that is why there is such a disconnect between the public and politicians—we relaxed the pressure to introduce the register. Of course, the Government got distracted by the huge and messy Health and Social Care Bill and we lost the then Secretary of State. That is where we are now.
I am very concerned and I want to hear the Minister give us an assurance today that this proposal has not been dropped, that the officials are not getting their way and that the register will be introduced as quickly as possible, so that everyone can exercise choice about what they use—choice about their health and how they treat their body—in a way that is not dominated by directives from the European Union.
Natures abhors a vacuum, Mr Bone; it looks as though it falls to me to fill it, albeit briefly. I apologise that I cannot stay for the end of the debate, but I have been encouraged to speak by the excellent contributions that we have had so far, led nobly by my hon. Friend the Member for Bosworth (David Tredinnick), who has an unparalleled reputation for knowledge in this area. I am sure that we all commend him for that.
There is no reason at all why the European Union should interfere in this issue. Why should not the United Kingdom be able to decide for itself whether it wants to regulate herbal medicines? This is another area in which the European Union is unnecessarily interfering in our daily lives and, of course, affecting millions of people. We have already heard that more than 3 million people access Chinese herbal medicine in any two-year period and that 25 million of our citizens buy herbal products over the counter in any two years, so this is a matter of huge interest.
The problem is quite technical, but I think that we could easily overcome it, as indeed the Government said that they would. The European Union has given this country a way around the European Union regulations, and the Government took up the challenge. In February 2011, two months before European directive 2004/24/EC took effect, the then Secretary of State for Health said:
“This Government wish to ensure that the public can continue to have access”
to unlicensed manufactured herbal medicines. That was the clear will of Her Majesty’s Government. The Secretary of State continued:
“In order to achieve this, while at the same time complying with EU law, some form of statutory regulation will be necessary and I have therefore decided to ask the Health Professions Council to establish a statutory register for practitioners supplying unlicensed herbal medicines.”—[Official Report, 16 February 2011; Vol. 523, c. 84WS.]
As the hon. Member for Vauxhall (Kate Hoey) said, millions of people throughout the country—practitioners and users—took great comfort from those words and the clarity of direction laid out by Her Majesty’s Government.
Sadly, although the Government promised that the register would be introduced by the end of 2012, we are now well into 2013 and there is no sign of it. Presumably, the Secretary of State made his clear statement on the advice of officials in his Department. If it is the officials who are now telling the Government that they cannot have the statutory register, we need to hear from the Minister today that that is the case and the reasons for that about-turn, because millions of people in this country, including many of our constituents, took great comfort from those words in 2011.
As my hon. Friend the Member for Bosworth said, it appears that the Department has been thrown into a state of paralysis by the judgment on Poland. Poland was clearly caught out trying to break the rules and, under EU regulations, the Commission took Poland to the Luxembourg Court, which duly found against Poland. The Polish case is not a parallel to the United Kingdom situation. It may be a judgment on the same part of the EU legislation, but Poland was trying to abuse article 5.1; the United Kingdom Government said that they wanted to comply with article 5.1, by coming up with the statutory register. If Her Majesty’s Government believe that that judgment on Poland is the cause of their paralysis, the Minister needs to say so today and explain why that judgment is holding up the United Kingdom setting up a statutory register.
An EU directive has come in; that was in April 2011. The Government said that they would have a statutory register by the end of 2012, to ameliorate the worst effects of the directive, yet more than two years on, the herbal medicine industry, which Her Majesty’s Government said that they wanted to protect, remains exposed to that EU directive. That is simply an unacceptable situation. There will be, in all our constituencies, small and medium-sized herbal practitioners that are finding their livelihoods affected by an EU directive that the Government promised they would ameliorate—two years on, they have failed to do so. The Minister needs to explain to the House today why we are in this sorry state and what he will do to sort it out as quickly as possible.
It is a pleasure to see you in the Chair, Mr Bone. I congratulate the hon. Member for Bosworth (David Tredinnick) on securing the debate. As someone who, over the past few days, has been suffering with quite bad hayfever, I would quite like a remedy, herbal or otherwise, for my suffering. I am pleased that we have had a chance in today’s debate to discuss some very important issues in relation to the regulation of herbal medicine. I know from the hon. Gentleman’s previous contributions in the House that he takes a very keen interest in and is a committed supporter of various forms of alternative medicine, including homeopathy and herbal medicine. He continues to raise these issues passionately in the House, most recently in the estimates day debate last week. I also congratulate the hon. Members for Strangford (Jim Shannon) and for Kettering (Mr Hollobone) and my hon. Friend the Member for Vauxhall (Kate Hoey) on echoing the many issues and problems. There are issues with the provision of non-manufactured herbal medicine due to the absence of regulation of herbal regulation practitioners. There have admittedly been delays in making progress on the regulations, which all relevant parties agree with, and all sides agree that the unexplained delays are frankly unacceptable. I will return to that later in my contribution.
As we know, the MHRA is responsible for medicines. It explains the licensing of manufactured herbal medicines as follows:
“The new European Traditional Herbal Medicinal Products Directive…came into effect on 30 April 2011. The Directive establishes a regulatory approval process for herbal medicines in the European Union...It requires each EU Member State to set up a traditional herbal registration scheme for manufactured traditional herbal medicines that are suitable for use without medical supervision. Companies are no longer able to sell manufactured unlicensed herbal medicines unless they have an appropriate product licence”.
The supply of non-manufactured medicines is permitted, but there remains a long-standing concern with the non-regulation of herbal medicine practitioners. Currently, anyone can set up as a practitioner. The guidance states:
“Regulation 3 of The Human Medicines Regulations 2012 (formally Section 12(1) of the Medicines Act 1968) is commonly referred to as the ‘herbalist exemption’ and permits unlicensed remedies to be made up and supplied by a practitioner to meet the needs of an individual patient following a one-to-one consultation. The existence of this regime is greatly valued by herbal practitioners and by many members of the public. However, there are widely acknowledged weaknesses in the public health protection given by the regime. Regulation 3 remedies are not subject to a regime of specific safety or quality requirements. There are no restrictions in terms of those who operate under the regime. Anyone—irrespective of qualifications or experience—can practise herbal medicine and, after making a diagnosis and forming a judgment about the treatment required, can make up and supply an unlicensed herbal medicine.”
As we heard in the debate, there was a great deal of discussion about regulation under the previous Government. They supported moves towards statutory regulation of herbal medicine practitioners, which was the subject of consultation in 2004. The consultation report stated:
“The majority of the responses indicated strong support for the introduction of statutory regulation, in order to ensure patient and public protection and enhance the status of the herbal medicine and acupuncture professions.”—
That point is important in its own right. In 2008, a report to Ministers from the Department of Health steering group on the statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK concluded:
“The Steering Group is strongly of the view that the decision to statutorily regulate professions practising herbal medicine and acupuncture is in the public interest.”
It also urged that there be no Government delay in introducing regulation, saying:
“The Steering Group is of the view that there is an urgent need to proceed without delay with the statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems. The Department of Health has been working with practitioners from these sectors, in some cases for over a decade, and a timeframe has been published that has not been adhered to.”
On 3 August 2009, the four Health Departments of the UK published a consultation paper on statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK. A clear majority of responses—85%—were in favour of statutory regulation, but, as we have heard, there has been little progress, despite the then Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley), pledging on 16 February 2011 to regulate herbal medicine practitioners, as the hon. Member for Bosworth pointed out. The Health and Care Professions Council was asked to establish a statutory register for practitioners supplying unlicensed herbal medicines, but there has been no further progress. When does the Minister expect that he will establish a statutory register for practitioners supplying unlicensed herbal medicines? The National Institute of Medical Herbalists is rightly critical of the lack of progress:
“In February 2011, the Secretary of State for Health announced that UK herbalists were to be statutorily regulated. He pledged that, subject to the usual procedures, the Department of Health (DH) would have this ready by 2012. Statutory Regulation (SR) is urgently needed to protect the public from untrained herbalists and also to allow trained herbalists to continue to practice within the constraints of EU Directives. Regulation will be via the Health and Care Professions Council (HCPC) which regulates dentists, dieticians and physiotherapists. Two years later the DH has failed to publish the draft legislation and there is no sign of progress. The fear is that with many other priorities the DH will let the issue drop. Failure to implement SR for herbal medicine practitioners is disastrous…In short, statutory regulation is clearly in the public interest!”
A recent MHRA survey showed that about a quarter of the population use over-the-counter herbal medicines. If that continues, as I suspect it will, surely the Government have a responsibility to ensure that arrangements are in place to make certain that such medicines are safe, as far as they can be, and that those who prescribe and dispense such medicines are appropriately qualified and regulated. It is therefore important that we get a clear view from the Government today on whether they will continue with the statutory registration proposals. It is also important that they give us some confidence that it will be done within a reasonable time frame, so that we can give that confidence back to the industry and those who use herbal medicines.
I commend the hon. Member for Bosworth for his persistence in this matter and for securing the debate today. I look forward to the Minister’s assurances that the Government still take regulation seriously—I hope— and are looking for practical ways to ensure that it can proceed swiftly.
It is a pleasure to serve under your chairmanship, Mr Bone, for, I believe, the first time. I am sure that you were salivating, listening to the issues raised in the debate—
Indeed, Mr Bone, as you say, you have no views on anything when you are impartially chairing the debate, but I am sure you pay keen interest to the topics raised, in your position as Chair and otherwise.
I pay tribute to my hon. Friend the Member for Bosworth (David Tredinnick) for securing the debate, which I am sure is of interest to the consumers and practitioners who use herbal medicines, as well as to the many Members who attended the debate today. None of us disagree with the principles articulated here—we can all sign up to them—but good government is about working through the practicalities of proposals to ensure that they become good laws, as I will discuss later.
There have been many good and worthy contributions to the debate. The hon. Member for Strangford (Jim Shannon) showed his strong support for herbal practitioners in his constituency, and he was right to say that things in Government do not happen in a flash but have to be properly thought through. I want to reassure him that some of the products he mentioned—he talked about the benefits of vitamin E, for example—are freely available from herbal practitioners, and indeed from pharmacists and other places.
There were other strong contributions from my hon. Friend the Member for Kettering (Mr Hollobone), who is no longer in his seat, and the hon. Member for Vauxhall (Kate Hoey). The hon. Lady made her case eloquently, and I would be happy to meet with her at a later date to discuss sports therapists further, but I would not wish to intrude on Mr Bone’s patience by talking about the issue today and I hope she will forgive me for that.
I pay particular tribute to my hon. Friend the Member for Bosworth for his principled and long-standing support for herbal practitioners and his interest in alternative therapies, homeopathy and many other such issues. Today he has demonstrated his extensive knowledge of the topic under debate, and of alternative therapies in general. I am sure I am right in saying that he is the most informed Member of Parliament on many of these issues, and it is a great tribute to him that he has secured the debate today. I am sure that herbal practitioners and alternative therapists would wish to pay tribute to his great work and his advocacy on their behalf, and on behalf of his constituents.
My hon. Friend is right to highlight the chief medical officer’s challenge about the future of antibiotics, but we can make a clear distinction between those remarks and the subject of today’s debate. I am sure that the chief medical officer would not wish her remarks to be associated with a call for a greater use of herbal medicine—that was clearly not outlined in her paper. Although it is important that we always consider ways—via traditional medical routes or otherwise—of improving people’s health and providing the right therapies, the paper clearly laid out the long-standing challenges as being about antibiotic resistance, and it would be wrong, therefore, to allow the two issues to be confused.
By way of background, it is worth highlighting that although we support patient choice some herbal products have caused harm to consumers. There are a number of reasons why that might happen: the herb may be intrinsically toxic; the product may be accidentally or purposefully contaminated by harmful materials or heavy metals; people may choose herbal products for serious conditions when medicines with a solid evidence base would be more appropriate; and, if herbal products are taken together with conventional medicines, the interactions may be unpredictable. It is right, therefore, that we support the responsible use of medicines and have a licensing system.
Directive 2004/24/EC on traditional herbal medicinal products was introduced to harmonise the European Union internal market and remove barriers to free movement. The directive deals with products manufactured on an industrial scale, and makes all operators in the market comply with the same set of rules, facilitates free movement and ensures increased product safety, which, I am sure we agree, has a positive impact on patient safety and public health.
The question of whether herbalists and traditional Chinese medical practitioners should be statutorily regulated has been debated since the House of Lords Science and Technology Committee first reported on the matter in 2000. The hon. Member for Vauxhall and my hon. Friend the Member for Bosworth outlined in their remarks that there is a lot of background and history. The previous Government grappled with the issues, and the current Government are also considering how to address and fulfil the commitments made by the previous Health Secretary, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley). Hon. Members will be aware that on 16 February 2011 the Government announced their intention to take forward the regulation of herbal medicine practitioners and traditional Chinese medicine practitioners, specifically with regard to the use of third-party products in their practice.
Herbal products broadly fall into three categories. The first are the 310 herbal medicines that already have a marketing authorisation or a traditional herbal registration—in other words, a product licence. Those 310 medications are currently available for use and are effectively licensed. They are safe and widely used, and have undergone all relevant testing and checks. The second category, which is the one we are addressing today, covers products manufactured by a third party. Such products have been illegal since April 2011, following the implementation of the EU directive. The third category is products made up by a practitioner on their own premises following an individual consultation. Although such products are not affected by the directive, some of the herbal ingredients may be restricted by the Human Medicines Regulations 2012.
The previous Health Secretary’s concerns about the second category—products manufactured by a third party—prompted the decision to take forward statutory regulation of such products. The Government’s intention was to allow regulated herbal practitioners lawfully to source third-party manufactured herbal medicines, with appropriate safeguards in place to minimise the risks associated with the products, but since April 2011 the European directive has made it illegal for herbal practitioners in the UK to source such products for their patients.
Following the EU judgment in the case of the Commission v. Poland, which my hon. Friend the Member for Kettering mentioned, we have reassessed the risks. That case actually concerned unlicensed conventional medicines being used because they were cheaper, and although there is a clear distinction between those products and herbal remedies we had to look at what else the judgment said. It looked at the specials regime and, critically, it emphasised how strictly the regime must be applied. The judgment has a knock-on effect for what we propose for the use of herbal medicines manufactured by third parties without a licence, and it therefore needs careful consideration because there is a very high risk that we would be found to be in infraction of the European directive. We therefore need to consider further herbal products manufactured by a third party, and I will return to that point later.
The Government would, of course, like to find a way through the issue that supports responsible businesses and ensures public safety. Since the announcement in February 2011, the Department of Health has been working with officials in the devolved Administrations and with the Health and Care Professions Council to establish a statutory register for herbal practitioners. Alongside that, we have been considering a strengthened system for regulating medicinal products, to enable consumers to have access to a greater range of third-party manufactured herbal medicines. The process continues to be complex and lengthy, and it has been further complicated by the judgment in the European Union v. Poland case.
We acknowledge that there is strong support from some groups of herbal practitioners for the statutory regulation of the sector, but not all practitioners are in favour. I am sure, therefore, that hon. Members will appreciate that it would be irresponsible for the Government to undertake to alter the status of a group of workers without first ensuring that the policy and final decision offered an appropriate form of regulation and ensured that the proposals adequately addressed the risks posed to consumers of third-party manufactured herbal medicines.
As I stated earlier, complex issues are involved. We are discussing how to ensure that our proposals are fit for purpose and proportionate, and that they properly protect the public. I want to assure the hon. Member for Vauxhall that the matter has not been dropped. We absolutely support the principles outlined by my right hon. Friend the Member for South Cambridgeshire in his written ministerial statement to the House, and I fully appreciate that the delay is causing anxiety and concern to practitioners of herbal medicine and to consumers.
To ensure that we take forward the matter effectively, we want to bring together experts and interested parties from all sides of the debate to form a working group that will gather evidence and consider all the viable options in more detail, particularly because of the Polish case. I am aware of the concerns of my hon. Friend the Member for Bosworth about making timely progress, and I would therefore very much welcome his direct involvement in the working group to ensure that the interests of practitioners are properly looked after. We can meet when the House returns to work out how to take forward the proposal.
I hope that my commitment to setting up a working group will reassure my hon. Friend and all hon. Members that the Government are carefully considering this important issue. We recognise and agree with the principles, but the practicalities are such that we must have legislation that is fit for purpose—that does not trigger infraction proceedings from the European Union, but protects the public. That is vital in all health care matters, whether in relation to traditional medicines or to herbal medicines and alternative therapies. For that reason, we want to set up a working group and to work with my hon. Friend, and herbalists and others, to ensure that the legislation is fit for purpose. I look forward to discussing that with him in due course.
Before my hon. Friend sits down—I think that he was about to do so—may I thank him for his remarks? I am sure that knowing there is some progress is welcome, but I remind him that there have been many working groups in different guises over a long period, and the image that springs to mind is of the long grass. I am grateful to him for suggesting that I might be part of the process, but I want to be reassured that we are in the short grass. Lastly, is there general agreement with the devolved Administrations or is that a sticking point?
I reassure my hon. Friend that I am not aware of any points of disagreement with the devolved Administrations, but I will write to him and provide reassurance if there are any issues of which I am unaware. My understanding is that there is a unified position across all of the different health Departments.
On the devolved Administrations, I speak with some knowledge of the Northern Ireland Assembly, where my colleague Edwin Poots is the Minister of the Department of Health, Social Services and Public Safety. We and the Minister in the Northern Ireland Assembly are keen to have a focus of attention and a continuity of thought among all the regions of the United Kingdom to ensure that we can support the Under-Secretary of State for Health. The quicker he and the Government move that on, the gladder the regions—especially Northern Ireland—will be to jump in behind and support them.
The hon. Gentleman is absolutely right to highlight the strong working relationships, particularly with his colleague in Northern Ireland. We are grateful for that continuing strong working relationship on both this and other issues, and I look forward to working with him.
I reassure my hon. Friend the Member for Bosworth, who was concerned about the short and the long grass, that the intention behind his involvement in the working party is to keep it firm to its task. I am sure that he will want, as part of his involvement, to ensure that that happens. When we meet to discuss this further after the House returns in September, we can ensure that the proposals are proportionate and fit for purpose, and that they protect the public, including through giving people an informed choice about the use of herbal products.
We need to sit down together. I very much want to involve my hon. Friend the Member for Bosworth, and the hon. Lady would be very welcome to join that discussion when the House returns. The idea is to get a working party up and running in the early autumn to ensure that we progress matters. We obviously need to discuss issues raised today about statutory regulation and third-party manufactured products, and to look at such products in detail to see which might be classified as more akin to food additives or vitamin and mineral supplements and which as more akin to medications, because there is a spectrum. We need to work through such issues to make sure that we get to the right place.
It is important that any legislation not only passes the test of principle—we are all signed up to it—but is practical and fit for purpose. Particularly in light of the judgment in the case of the EU Commission v. Poland, we have other issues to consider that make the matter a little more complex. I reassure my hon. Friend the Member for Bosworth and the hon. Member for Vauxhall that we are committed to making timely progress, and when we meet on our return in September, we can progress things. I am sure that my hon. Friend’s involvement will keep the Government keen to their task.