Homeopathy: Veterinary Medicine
(5 years, 11 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
David Tredinnick (Bosworth) (Con)
This debate is very timely because of the recent changes that the Royal College of Veterinary Surgeons has made to its guidelines, which have angered the public and homeopathic vets alike and triggered two marches to the headquarters of the RCVS and a rally in Parliament Square, at which I had the honour of speaking. I am happy to see the Minister for Agriculture, Fisheries and Food, my hon. Friend the Member for Camborne and Redruth (George Eustice), in his place, not least because my family come from Redruth and were mining engineers—I am attempting to engender a little sympathy from him before I proceed.
The key issue is a new requirement in the guidelines that homeopathy should only be used in conjunction with conventional medicine. The second issue is the highly contentious assertions made by the Royal College of Veterinary Surgeons about a lack of evidence and safety and animal welfare, which are apparently related in this instance. The third issue is a lack of consultation.
The RCVS did not consult at all the people who know the subject—the Faculty of Homeopathy, the British Association of Homeopathic Veterinary Surgeons, the International Association for Veterinary Homeopathy, the European Committee for Homeopathy and the Homeopathy Research Institute. None of those organisations was consulted prior to the issuing of these guidelines. After the second march, the RCVS graciously agreed to meet a delegation, but sadly the delegation wrote to me afterwards saying:
“It became apparent that there was a total lack of understanding of the principles of homeopathy.”
It invited the RCVS to visit a practice, but I am not sure that that offer has been accepted.
I wrote to the RCVS, and it replied to my letter with, I regret to say, three glaring errors. First, it cited the 2010 report of the Science and Technology Committee, which it said
“concluded that the evidence base shows that homeopathy is not efficacious”.
It never did anything of the sort. I attended that Committee, and it was an evidence check. It only found that there was no evidence; it did not make any findings about effectiveness.
Secondly, the RCVS claims:
“we have not sought to remove choice as this remains”.
It does not. Choice has been removed, because before these guidelines came out, homeopaths could practise without using homeopathy and conventional medicine together.
Thirdly, the RCVS made claims about animal welfare issues. This is very important, and I asked a parliamentary question, to which my hon. Friend the Minister graciously replied:
“The Department does not have any evidence that shows that homeopathic vets are a risk to animal welfare by using homeopathy as an alternative treatment to conventional medicine options.”
Jim Shannon (Strangford) (DUP)
I sought the hon. Gentleman’s permission to intervene, and I thank him for letting me do so. Does he not agree that with the rise in antibiotic use in animals—it is very pertinent at this time—anything that can prevent the introduction of antibiotics can only be a good thing and must be given full consideration? Perhaps the Minister could tell us in his response what he is doing through his Department to reduce antibiotic use in animals.
David Tredinnick
The hon. Gentleman speaks with wisdom and experience. No doubt, he too has looked at the European position, which is completely the opposite of the one taken by the RCVS. There is a European directive on organic products, which states in article 24(2) of Commission regulation (EC) No. 889/2008, that
“Phytotherapeutic”—
that is, herbal—
“and homeopathic products, trace elements…shall be used in preference to chemically-synthesised allopathic veterinary treatment or antibiotics”.
That was because the European Union as a whole was so worried about the abuse of antibiotics, and I started speaking about the use of antibiotics in animals in the 1987 Parliament.
Let me give my hon. Friend the Minister the view of a farmer, who wrote to me, saying
“did you know that farmers often like using homeopathy for cows with mastitis because if they do so, they can sell the milk. If they use antibiotics, the milk must be thrown out.”
Safety is very important, and I hope the Minister will dispose of that point later as some homeopathic vets have simply stopped practising because they perceive themselves to be under a legal threat.
This is at a time when, according to the British Association of Homeopathic Veterinary Surgeons, there is an explosion of interest in homeopathy, largely I would suggest because of the antibiotics problem. It says that
“there is an explosion of interest in CAM”—
complementary and alternative medicine—
“including Homeopathy”, in the agricultural sector where the drive is to reduce and replace dependence on antibiotics in light of Antibiotic Resistance…concerns”.
Dr David Drew (Stroud) (Lab/Co-op)
Does the hon. Gentleman accept that this threatens biodynamic agriculture, which is a particularly interesting and growing part of the agricultural sector?
David Tredinnick
The hon. Gentleman makes his point well. The most successful methods for coping with this antibiotic problem are actually complementary and alternative medicines, of which homeopathy is proving one of the most successful modalities.
The placebo argument—that this is all in the imagination—is often used against homeopathy, but Buttercup and Daisy do not understand double blind placebo-controlled trials. Farmers do understand them, and when I sat on the Science and Technology Committee during the 2010 to 2015 Parliament, Roger Williams, the then Member for Brecon and Radnorshire from the Liberal Democrats, told me, “As a livestock farmer, I of course use carbo veg”—Carbo vegetabilis, which is known colloquially as the corpse reviver—“when I can’t do anything else with an animal that I think is going to die.” It is very often the medicine of last resort both for animals and, of course, for humans. Farmers will not waste money on something that does not work, as I am sure my hon. Friend the Minister agrees.
As I mentioned at Prime Minister’s questions two weeks ago, the World Health Organisation says that homeopathy is the second largest medical system in the world, with 300,000 doctors treating 200 million patients annually. I suggest to my hon. Friend that that is pretty powerful evidence—they would not otherwise be training and practising—and we should look at that. There are actually 700 vets in 36 countries who are members of the International Association for Veterinary Homeopathy. The German Ministry of Food and Agriculture backs homeopathy. In January 2018, it said that it
“supports the use of homeopathic remedies and the free choice of therapy for veterinarians.”
Why are we getting all these attacks? It actually has nothing to do with healthcare—it is to do with protecting vested interests, and a sense of defensiveness against the perceived threat to conventional practitioners, to drug companies supplying drugs and to currently held scientific beliefs. The scale of the vicious attacks that colleagues have had over the years by those opposed to homeopathy is testament to that. Given the hate mail that has been sent to MPs during past Parliaments, jamming their mail boxes, I believe those people could now face prosecution under new legislation. They ridicule and humiliate anybody who supports this very valuable branch of medicine. They use legal threats to clinical commissioning groups. I am kind of curious about this—I have a feeling that the Royal College of Veterinary Surgeons was itself threatened with legal action by this group. Once there is a writ and something is through the door, of course, the whole legal process starts; that is why I had a letter from a lawyer of theirs.
The antis also claim that there is no scientific evidence that homeopathy works, but of the 189 randomised control trials up to 2014, 41% were positive, finding that homeopathy was effective. The figures for conventional medicine are just about the same, at 44%. There is no difference. There is good statistical evidence that both homeopathy and conventional medicine work.
I also had the honour to serve on the Health Committee in the 2010 to 2015 Parliament; in fact, I chaired it for a while, when we got the long-term care and conditions report out. In 2014, I cross-examined the Secretary of State for Health about his views. He said:
“the system we have is that we allow GPs to decide whatever they think is in the clinical interests of their own patients.”
If my memory serves me well, the Parliamentary Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), who has subsequently signed a motion, was one of those under attack for supporting homeopathy. He said in answer to a question:
“Complementary and alternative medicine treatments can, in principle, feature in a range of services offered by local NHS organisations, including general practitioners.”—[Official Report, 14 November 2017; Vol. 631, c. 149.]
Mr Alistair Carmichael (Orkney and Shetland) (LD)
I should first declare an interest: my wife is a practising veterinary surgeon and a partner in a veterinary practice.
I gently suggest to the hon. Gentleman that he needs to be a little careful about conflating medicine for humans with medicine for animals. As a human, I am able to make these choices for myself; animals are not in a position to do that for themselves. That is why we have to approach the two disciplines differently.
David Tredinnick
The right hon. Gentleman makes his point. They are different: as far as animals are concerned, we cannot run trials; we can only take a view on how the medicine or treatment is working. I put it to the right hon. Gentleman that farmers are not so foolish as to spend a lot of money on something that does not work. They see it working over a long period of time.
I have an informal arrangement with the Minister to give him the full time of a quarter of an hour to respond. In the past, I have noticed that colleagues can run away with themselves, leaving only five minutes for the Minister, who says that they do not have enough time to speak. This Minister will have lots of time to speak.
Chris Davies (Brecon and Radnorshire) (Con)
My hon. Friend has clearly raised the fact that the Royal College of Veterinary Surgeons very much opposes homeopathy, but we have not mentioned the British Veterinary Association, which was equally opposed. My understanding is, however, that its mood may be mellowing towards homeopathy. Has my hon. Friend’s hard work paid off, I wonder?
David Tredinnick
One or two things have been “going off”, as they say nowadays, for the last few weeks, including questions and marches.
To sum up, in veterinary medicine there is room for all. Of course there is room for conventional medicine; we cannot produce a calf from a struggling cow unless we use conventional medicine. There is room for conventional and homeopathic medicine: on that much I agree with the Royal College of Veterinary Surgeons. But there is also room for stand-alone homeopathy, as there always has been—there is no need to change the playing field. Nearly two weeks ago, I asked the Prime Minister, during Prime Minister’s questions:
“Does she agree that homeopathic vets should be able to make their own minds up about whether to use homeopathy on its own or with other treatments, too?”
My right hon. Friend the Prime Minister replied:
“As regards all the issues he has addressed, it is right that those who are professionally able to make these judgments are left to make them.”—[Official Report, 25 April 2018; Vol. 639, c. 877.]
We should mark the Prime Minister’s words and agree that properly regulated homeopathic vets should be free to make up their own minds.
The Minister for Agriculture, Fisheries and Food (George Eustice)
I congratulate my hon. Friend the Member for Bosworth (David Tredinnick) on securing this important debate. With a name like Tredinnick he could only hail from Redruth, where it is a very common name. Anything that begins with the letters “tre” tends to be from Cornwall.
I recognise that my hon. Friend has been a very long-standing campaigner for alternative medicines in general and homeopathy in particular. I do not have any particular strong convictions one way or the other on this issue, but I recognise that the consensus among veterinary opinion is one of scepticism. Before addressing the specific issues he raised, I want to start by making a couple of more general points.
As a point of general principle, I do not agree that contrarian viewpoints in science should be deemed or labelled as some form of scientific heresy. Those who, like me, believe in an enlightened approach to evidence should always welcome and engage in debate, and should never tolerate the tactics of bullying, abuse or ridicule. I recognise that my hon. Friend has suffered a lot of this behaviour himself in this sometimes fraught debate. Let me say that I say that I find that unacceptable, irrespective of one’s views on the issue. Even those who believe strongly and passionately disagree with homeopathy and disagree with the evidence supporting it should recognise the value in discussing it so that it provides a reference point for their own version of the truth.
Traditionally in science it has been very important to observe, through scientific trials and scientific evidence, to try to discern patterns and then, having discerned and observed patterns, try to build a more precise body of evidence in the form of statistics. I think it is fair to say that in recent decades there has been a tendency in science to neglect those basic skills of observation and instead to just resort to narrow statistics and what can be measured. My hon. Friend, irrespective of different views we might have, raises a valid point about that tendency in modern science, which can mean that we sometimes miss things that are important.
The Royal College of Veterinary Surgeons has a role in maintaining a register of qualified vets. This is, effectively, a system of self-regulation underpinned by statute. It has a royal charter that dates back to 1844. The Veterinary Surgeons Act 1966 established a statutory role for it to recognise qualified vets. Under the 1966 Act, the RCVS has a role in maintaining a register. It also has a role in regulating the conduct of its professional members, supervising the registration of its members and suspending registration where it believes there has been a breach of its code. However, it is not the role of the RCVS to make decisions on veterinary medicines or indeed veterinary treatments. The Veterinary Medicines Directorate is a Government agency that makes evidence-based assessments of veterinary medicines.
Homeopathic products are not formally assessed for their efficacy, but they are assessed for their quality and safety. Their use is therefore lawful. I know that the RCVS statement in November 2017 caused quite a lot of controversy. As my hon. Friend pointed out, there have been protests and much disquiet among some of those vets who practise homeopathy. I should perhaps point out an interest here. In my constituency of Camborne and Redruth I have a fantastic charity called the Cinnamon Trust. It mobilises thousands of volunteers right across the country to visit the homes of the elderly who are no longer able to walk their own dogs and to walk those dogs for them. This fabulous charity means that the volunteers give social contact to those elderly people by taking their dog for a walk and they make sure that elderly people, often suffering from loneliness, can enjoy the companionship of pets with the help of volunteers.
That charity engages a conventional vet who occasionally uses some homeopathic therapies. I am told by veterinary practitioners of homeopathy that they believe they see results for a number of particular conditions. Cushing’s disease in horses is mentioned—a condition that afflicts older horses and can lead to lameness—and I am also told that it can be effective when dealing with arthritis in older dogs and in managing some symptoms of certain cancers. Practitioners argue that for certain conditions that principally affect older animals, when conventional medicines have run their course and they have run out of options, homeopathy can help to manage a condition. I am told that homeopathy is at times quite useful when there may be side-effects from using more conventional veterinary medicines, or when there are allergies from their use.
A debate has always been had about the evidence and the quality of the evidence base, but as my hon. Friend pointed out, there are practitioners out there who believe that they see some results in some circumstances, and they can see they do not see those in all circumstances. Certainly, some of the vets that I have spoken to who practise homeopathy are very clear that this complements their approach to conventional medicine. When they believe that conventional veterinary treatments have run their course and can offer nothing further for a particular animal, or are not giving them the results they want, they will sometimes choose, as an alternative, to use complementary approaches and practices.
The RCVS statement, having sparked controversy, has been the subject of some discussion between the Department for Environment, Food and Rural Affairs and the RCVS, which has confirmed it is not at all its intention to ban the use of homeopathy. I understand that its concern is that in some instances, some vets, rather than using homeopathy as a complementary approach alongside conventional medicine, are perhaps refraining from using other, possibly more effective, conventional medicine in preference to homeopathy. In some cases, the RCVS believes that that may be affecting the welfare of the animal. It assures us that that is what it is attempting to address and that it has no intention to ban the use of homeopathy by its members. I hope that I have reassured my hon. Friend that that is the position that the RCVS has set out to us.
Since I have the luxury of time, I want to pick up on the point made by the hon. Member for Strangford (Jim Shannon) about antibiotic use. He is right: this is something that we are keen to reduce, and the O’Neill report set out some detailed approaches for doing that. It is also the case that adopting a different approach to livestock husbandry and using vaccines in a more effective way, rather than antibiotic treatments, is part of the key to getting down our use of antibiotics.
Mr Carmichael
I am grateful to the Minister for allowing an intervention. Has any advice that has been given to him on reducing antibiotic use recommended the use of homeopathic remedies?
George Eustice
No, I have not had any advice to that effect, but there are other approaches. For instance, one thing that we know can reduce the use of antibiotics in pigs is the gentle acidification of the water. We also know that turning animals out to grass in the spring can reduce the disease load and reduce the need to use antibiotics. Turning animals out to grass is quite difficult to measure, but we know that it is good for animals. On his specific point, no I have not had any such advice, but we are doing a great deal to reduce our use of antibiotics, since it is a very important issue.
In conclusion, we have had an interesting debate. I commend my hon. Friend for raising this issue.
David Tredinnick
I am nervous that my hon. Friend is about to sit down, in which case the debate will be over, so, as we have a little time, I want to take this opportunity to thank him for coming. That a Minister of State, not an Under-Secretary, is responding indicates the deep concern in DEFRA about this. Given the exchanges and public interaction, and his own conversations with the RCVS, surely we are all on the same side and what we need is for the RCVS to go away, take cognisance of what has transpired in the last couple of weeks and see if it cannot come up with something that might make everybody happy.
George Eustice
As I said, the RCVS has sought to be very clear that it is not banning the use of homeopathy by vets; it is not even its place to do that—were that to happen, it would be for the VMD—but my hon. Friend raises an important point. The RCVS might want, in its council and among its members, to clarify what it actually means, which I understand to be as follows: it is not banning the use of homeopathy, but vets who use it should use it to complement other approaches, possibly where those are not proving effective, and not refrain from using approaches that might be more effective in order to practise homeopathy in isolation. I think that was its point, but I am sure it would be happy to clarify the matter.
Question put and agreed to.