To ask Her Majesty’s Government what progress is being made in the use of immunotherapy in the treatment of allergies.

My Lords, immunotherapy is a suitable treatment for a specific, small group of patients with specific types of allergy. Due to the risk of life-threatening side effects, the Government’s guidance is that immunotherapy should be offered only in specialist centres. However, the Government are committed to increasing the provision of specialist allergy services and have asked NHS North West to develop a model for these services, which can then be extended to the rest of the UK.

My Lords, I am somewhat disappointed by that reply because, as the Science and Technology Committee report on allergies recently pointed out, this country is way behind other countries, especially those in Europe, that regard immunotherapy as one of the most effective treatments for many forms of allergy, particularly hay fever, which seriously impairs the quality of life and often leads to more serious conditions such as asthma. If one looks at the figures, the availability of immunotherapy in this country is way behind. We have something like 5,000 treatments a year; France and Germany have more than 300,000 treatments a year. Will the Government reconsider their position and regard this as a matter of real urgency?

My Lords, it is certainly true that the work of the Science and Technology Committee in this area provided the Government with a boost, and we welcomed its findings. Indeed, its work, and that of the noble Lord, has pushed this issue up the agenda of the health service, which is why we are working hard to do several things, including to increase the number of specialists and clinicians who deal with this and to create a model that can be rolled out across the NHS to deal not only with immunotherapy but with the generality of allergic therapies.

My Lords, will the Minister say whether the other recommendations in that report—I declare an interest, having been chairman of that sub-committee of the Select Committee on Science and Technology—such as the recommendation that NICE should produce guidelines on the management of allergy in primary care and should urgently look at immunotherapy, are being acted on with a degree of urgency?

My Lords, there is already a range of NICE guidance on allergies, and NICE is working very closely with department officials and leading experts in this field to draft detailed and focused clinical guidelines on effective diagnosis, the assessment of food allergies in adults, the management of anaphylaxis in children and adults, drug allergies, seasonal allergic rhinitis—hay fever, to the rest of us—in adults and children, and various technological appraisals in immunotherapy. We expect that, in its topical selection, it will consider a whole range of these in July 2009. It will decide which topics should be prioritised and will make recommendations to Ministers.

My Lords, the noble Lord, Lord Taverne, will be sorry to hear this, but is the noble Baroness aware of the beneficial use of homeopathy for the treatment of allergic sensitivity, treating like with like, without any risk of severe reaction?

My Lords, the noble Lord will be pleased to know that a consultation on the regulation, statutory or otherwise, of practitioners will be launched shortly, although other noble Lords may not be quite so pleased to know that. Once that consultation and the responses have been analysed, a decision will be taken as to whether to move towards statutory guidance on those professions.

My Lords, the United Kingdom has one of the highest prevalences of allergies in the world, which creates a huge cost for the health service and for the economy generally in work days lost. I do not think that we can expect the Minister to give a full answer to the questions on allergies and immunotherapy during Question Time. Will she undertake to ask her department to place in the Library a progress report on those recommendations made by the committee chaired by the noble Baroness, Lady Finlay, almost a year ago, so that those of us who are interested can have a full account of what is going on?

My Lords, that is absolutely right. This weekend, I read the committee’s report, which has 37 recommendations. The noble Baroness’s request is perfectly reasonable and I will undertake to make sure that that happens. The report was, in fact, published two years ago and not one year.

My Lords, is the Minister aware that the time commitments for patients during immunotherapy courses are potentially huge? Each session, I understand, can last for up to two hours. The possible time commitments for specialist NHS staff are also considerable. Has an assessment been carried out as to the cost implications of rolling out this treatment further?

My Lords, the noble Earl points to a very important matter. Clinical skills are at the heart of effective care. Certainly, the desensitisation treatment is very time-consuming. My understanding, which I will confirm with the noble Earl, is that the NHS North West strategic model will roll out over the next few years. It will assess exactly those sorts of issues, so that the rest of the NHS can learn from that and take the necessary action to recognise that this is, for a small number of people, a very time-consuming therapy.

My Lords, does the noble Baroness accept that one of the most devastating forms of allergy is the kind of acute anaphylactic shock that may occur in individuals who are sensitive to nuts and that, recently, there has been some progress in desensitisation against, for example, peanuts? Nevertheless, it is crucial that this desensitisation process should be carried out only in a specialised unit where the risks of such a process are fully appreciated and can be handled.

My Lords, the noble Lord is correct. Two recent studies from Addenbrooke’s Hospital in Cambridge and Duke University in the United States suggest the possibility of removing peanut allergy in children by very slow and careful exposure. However, we have asked the Food Standards Agency and the Committee on Toxicity to advise the department about how to proceed with this. We will continue to monitor it, but the noble Lord is right that this has to be done with extreme care.

My Lords, I live with an allergy problem every day of the year and I was a member of the Select Committee. Are more allergy specialist consultants being trained, rather than just the very few who have been trained so far?

My Lords, we are increasing the number of allergy specialists. Five new such specialists have come through in the past year, and more are in the pipeline.