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New Clause 7

Alternative and complementary therapies

'.--(1) A person is an alternative or complementary therapist if he is providing or offering for gain or reward services purporting or claiming to alleviate, cure, suppress or improve any condition which is customarily addressed by services of a type provided by health authorities, special health authorities, National Health Service trusts, primary care trusts or by local authorities in the exercise of their social services functions, and who is not required to be registered under section 11 or section 42.

(2) The Commission shall maintain a register of alternative or complementary therapists.
(3) The Secretary of State shall provide by regulations the method by which--
(a) applications for registration shall be made; and
(b) applications for registration shall be determined.
(4) The Secretary of State may by regulations make such provision as he deems necessary to protect the public in respect of--
(a) the description of the services provided by the alternative or complementary therapist;
(b) the claims that may be made in respect of those services;
(c) the techniques which may or (as the case may be) may not be employed in delivery of such services; and
(d) any other matters relating to such services as the Secretary of State may specify.'.--[Mrs. Spelman.]

Brought up, and read the First time.

Mrs. Spelman: I beg to move, That the clause be read a Second time.

One of the most intriguing things about this wide-ranging Bill is the opportunities that it provides for mini-debates on quite different subjects. We shall see the advantages of that this evening as Members have the chance to discuss their particular interests, as in the previous debate on adoption and in this one on alternative and complementary therapies.

In Committee, we tabled an amendment on alternative and complementary therapies. The Under-Secretary resisted it. First, she said, complementary and alternative medicine is, by definition, evolving and cannot be clearly defined. Secondly, she said that it was neither practical nor justifiable to regulate an ill-defined sector. Having read and considered Hansard, I have moved the new clause because I believe that those arguments are not sufficiently robust.

In Committee, the Minister said:

Within the huge bracket of alternative and complementary medicine, some therapies have been around for a very long time. Acupuncture has existed for at least 2,000 years, but, at the other end of the spectrum, new therapies such as reflexology were probably unheard of by most people as recently as 10 years ago.

Therapies quickly become established. Alternative medicine is growing rapidly. The medical care research unit at Sheffield university estimates that 40 per cent. of general practitioners provide access to some sort of complementary medicine. Already, there is a close interleaving between traditional and complementary medicine. Acupuncture, which I have already said is one of the oldest complementary therapies, is provided by 73 per cent. of primary care groups. Osteopathy, which is

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also well established, is provided by 43 per cent., homeopathy by 38 per cent. and chiropractic--which I have had good reason to use--by 23 per cent.

Those therapies are well established and widely used. Members of the public will often consider alternative and complementary therapies when they feel that they have made no progress down the conventional medical route and are prepared to pay their own money to solve the problem or salve the pain that they are experiencing. We all have good anecdotal evidence from friends and relations of success with complementary and alternative medicines.

11.15 pm

The Bill offers an opportunity to help to provide a regulatory framework for complementary medicine, some branches of which are long established. There has been no over-arching regulatory framework because different techniques are used and different training courses apply. For example, chiropractors go through undergraduate training to gain a BSc honours degree, but I understand that, in the eyes of those who practise acupuncture, a 24-hour training course will suffice for a certificate of basic competence.

However, the diversity of qualifications should not deter us from drawing alternative and complementary therapies into the Bill. Social care is to be regulated and a distinction made between social care workers and social care assistants who have different qualifications. Therefore, within the logic and principle of the Bill, it is possible to regulate care workers with different qualifications and the different titles resulting from them. I see no logical objection to trying to regulate alternative and complementary medicine.

The availability of alternative and complementary therapies is increasing and people are becoming better informed about fresh approaches to established medical conditions. They avidly read the features pages of the broadsheet newspapers and, if conventional medicine has found no solution, often present their GPs with new findings on long-standing problems. A large number of new practitioners have set up in response to increasing demand. Therefore, it seems logical to provide through legislation adequate protection for the public and regulation that recognises the importance and status of the complementary therapies.

In Committee, my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) pointed out the need to protect the public from the possibility of misleading diagnoses by people who are not properly qualified or who might provide the wrong treatment. He gave an example that drew attention to the potential for serious abuse, given that a lot of therapies are provided one to one. Intimate touching may be part of a therapy and that could put the individual receiving treatment in a risky situation. His constituency example is probably not an isolated case and it should cause us, as legislators, to think about whether to take it as a warning and whether to provide protection for both parties.

In Committee, the Minister gave her reasons for resisting our amendment on alternative and complementary therapies, saying that the original clause 39 would provide adequate scope to cover the issue. The clause referred to services similar to those provided conventionally through health authorities and NHS trusts and also covered the

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example that I gave earlier: 40 per cent. of GPs refer patients to complementary medicine. There are many members of the general public who, without going to a GP, seek treatment from complementary and alternative therapies. In reflecting on the reasons for rejecting our amendment, I am not satisfied that there is adequate protection.

I am sure that my hon. Friend the Member for Bosworth (Mr. Tredinnick) will seek to catch your eye, Mr. Deputy Speaker, because he has an interest in this area. On 6 April, in Westminster Hall, my hon. Friend made some interesting observations about aspects of complementary medicine that are already regulated; homeopathic doctors, since 1950, and osteopathy, since 1993, were examples. Already, some alternative and complementary therapies have a degree of regulation and protection. It is not unreasonable to look for an extension to cover some of the others.

The therapies are new and evolving; reflexology, for example, has been around for about 10 years and is now well understood by the public. I cannot see the argument that it is too new to be the subject of some protective legislation, similar to other alternative therapies.

Mr. Swayne: My hon. Friend makes a powerful case that the Bill provides the opportunity for such regulation, but not all of us are persuaded that, because the opportunity to regulate exists, it should be taken up. There are those of us on the Opposition Benches who are not entirely disposed to regulation for its own sake. If my hon. Friend could outline some of the regulations that she thinks might be made under the new clause, it would give us a greater sense of confidence in what she is spelling out.

Mrs. Spelman: I understand exactly where my hon. Friend is coming from. Ours is not a party that seeks to legislate unnecessarily; in fact, it is committed to trying to remove as much unnecessary legislation as possible. However, I referred earlier to a genuine constituency case, in which there has been a claim of serious abuse in a situation where an alternative therapy was being provided. A therapist was providing one-on-one treatment to someone who, in good faith, placed their trust in the practitioner as they would with a medical practitioner. Undoubtedly, members of the public would expect that trust not to be abused. However, it is claimed that it was. We must take that seriously, as it is likely that other examples exist. I can see the potential risk that that represents.

Mr. Burns: Does my hon. Friend agree that, as well as giving protection and peace of mind to the patient, the measure will give protection to the practitioner?

Mrs. Spelman: My hon. Friend makes exactly the point that I tried to make earlier; the new clause cuts both ways. It provides protection for the person seeking help through the therapy, but it also provides important protection--a title, in due course--for the practitioner, and sets out the necessary qualifications to assume the title. That helps to raise the status of that profession, and is entirely consistent with legislation introduced for the professions allied to medicine.

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There are some difficulties in getting what was envisaged in the Health Act 1999 to work, and there are a lot of difficulties in devising the right structure for a diverse group of professions allied to medicine. None the less, the practitioners of those professions recognise the advantage that the measure gives to them; the protection of a title and a clear definition of their therapy and skills.

I do not think that the new clause falls into the category of onerous and unnecessary regulation. On the contrary, there is a need to protect patients who place themselves in a position of potential risk, trusting the professional in whose hands they have placed themselves not to abuse that trust. As I have said, we have examples of such abuse. I feel comfortable about promoting a new clause that would benefit both patients and practitioners of the new therapies.

We intend to remain entirely within the guiding principles of the Bill, which are extensive. The Bill proposes the establishment of a commission to regulate diverse types of care. It seeks to remedy some of the abuses that have occurred, in regard to which there is a consensus that additional protection should be provided. I am thinking particularly of children's homes. It also creates an opportunity for complementary and alternative medicines--some of which have been around for a long time--to be included in the legislation. I believe that failure to include them would constitute yet another inconsistency of the type that we have tried so hard to address from the outset of our debates on the Bill. The most notable inconsistency is the Government's willingness to regulate public and private care homes uniformly, along with their rejection of the application of the same principle to private and public hospitals.

I fear that, unless the new clause is accepted, practitioners in professions allied to medicine--and those seeking therapy from them--will be protected in terms of title and the definition of the qualifications necessary for practice, but complementary and alternative therapists will be out in the cold. Here is a legislative opportunity to put that right. It is not superfluous, and it is supported by the Institute for Complementary Medicine, which was pleased to observe an attempt to fill what it sees as a gap in the law. I therefore feel confident in asking the Minister to look at the matter again, and to reconsider her reasons for objecting to our original amendment. I hope that, following that reconsideration, she will have a change of heart.

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