St John's Wort (Hansard, 17 February 2000)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, we have no plans to draw attention to this particular treatment for depression. However, like other complementary medicines, St John's Wort can be provided on the NHS, provided that clinicians consider it a safe, effective and cost-effective means of meeting patient health needs and its provision is in line with locally agreed health priorities.

§ Earl Baldwin of Bewdley
My Lords, I am grateful to the noble Lord for that reply. Is he aware of the research which has shown St John's Wort to be as effective as standard anti-depressants, without the side-effects—some quite serious—that go with drugs such as Prozac and Amitriptyline? Should not the Government be doing a bit more to promote herbal medicines with this in mind, particularly in areas of further research and a more appropriate licensing system?

§ Lord Hunt of Kings Heath
My Lords, I am certainly aware that many people feel that St John's Wort is beneficial. However, I have to say that the Medicines Control Agency, which approves product licences, has informed me that there have been no successful licence applications for such products in the UK. The Committee on Safety of Medicines has considered a number of applications for product licences, but the data provided have failed to satisfy current regulatory requirements for efficacy.
I take on board the noble Earl's concern regarding research generally. Of course, the NHS has a substantial research programme and applications for research can be considered in line with the normal application processes.

§ Baroness Rendell of Babergh
My Lords, is my noble friend the Minister aware that it is said that a side-effect of taking St John's Wort is that exposure to sunlight may result in serious damage to the skin?

§ Lord Hunt of Kings Heath
My Lords, I am certainly aware that some concerns have been expressed about the impact of St John's Wort. There have been recent 1336 reports of possible interactions between St John's Wort and other medicines. I can tell my noble friend that the Committee on Safety of Medicines is in fact meeting next week and will be considering the evidence very carefully. It will then advise me on this question.

§ Lord Clement-Jones
My Lords, whatever the outcome of the committee's investigation into St John's Wort, is it not the case that current arrangements for the registration of herbal medicines are extremely unsatisfactory, both for the consumer and for the producer? Indeed, they can be treated as food, as pharmaceutical products or as border-line cases. I know that the Minister has been sympathetic on a number of occasions to the idea of a third category to go alongside homoeopathic medicines and pharmaceutical products, but can he say something about the Government's intentions in this respect?

§ Lord Hunt of Kings Heath
My Lords, the noble Lord is quite right. There are unsatisfactory aspects in the current regime. First, when seeking a licence for herbal medicines, many companies have difficulty in meeting conventional requirements as regards product efficacy. Secondly, there are no specific safeguards on quality and safety for unlicensed herbal remedies. We have had extensive discussions with those most concerned and are committed to finding a better regulatory mechanism within the current medicines framework.
As regards the noble Lord's suggested third category, I can tell him that there are many points within the proposals that have been put forward which we have been glad to support. However, we do not see the case for a completely new regulatory category outside medicines.

§ Baroness Strange
My Lords, is the Minister aware that St John's Wort (hypericum)—of which there are over 350 varieties—is a plant subject to the sun, as are rosemary, rue, angelica, lovage, calendula and about 40 or so others? Is the noble Lord also aware that the sun is a very strong anti-depressant? That is why we all feel so much better on a lovely sunny day like today.

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness continues to educate me in the glories of flowers. I am very happy to agree with her.

§ Viscount Falkland
My Lords, does the Minister agree with me that, on listening to these exchanges, one might be led to believe that one needs to distinguish between clinical depression—we have all known people who suffer from that grave malady—and what Sir Winston Churchill used to call "black dog", from which all of us suffer from time to time? Indeed, should not young people today, especially those looking for a quick fix of one kind or another for feeling down on one day, be warned against quickly reacting to this by taking any remedy, whether it be St John's Wort, drinks or anything of that kind?

§ Lord Hunt of Kings Heath
Yes, my Lords. The noble Viscount is right. We should always be cautious about the quick jump into whatever remedy is available. However, one has to be aware that at least 6 per cent of the population at any one time suffer from depression and that one-half of women and one-quarter of men will suffer from the condition before they reach the age of 70. It is a worrying problem and it is essential that the NHS has the local services available to support people who are suffering from depression.
Sometimes anti-depressant medication will be the right answer, but other times more psychological therapies will be the best prospect for a cure. In developing a mental health strategy, the tackling of depression and its prevention are most important.

Baroness Young
My Lords, although I recognise that a great many people use complementary medicines—and the number is, I believe, increasing—is there not a very serious case here for bringing them into line with the tests that would be applied to pharmaceutical products and others that are used in the National Health Service, both as a safeguard for those who are using them and for people who might just buy something off the shelf which could have undesirable side-effects?

§ Lord Hunt of Kings Heath
My Lords, as I said earlier, it is certainly important that we have a more effective regulatory system for herbal products. We believe that they should be within the current medicines framework. However, in the discussions that have been taking place between the Government and those who represent herbal interests, it has been recognised that we must have a regime in which the safety of the public is paramount. Indeed, I very much agree with that.
As far as concerns the use of complementary medicine in the NHS generally, the noble Baroness is right. We have seen increases over the past few years in this respect. My understanding is that at least half of all primary care groups provide some form of complementary medicine. Clearly, although we need to recognise the absolute requirement of safety, we should also recognise that many people in the NHS also feel that complementary medicine has something to offer.

§ The Countess of Mar
My Lords, can the Minister say—

A noble Lord
My Lords—

§ The Lord Privy Seal (Baroness Jay of Paddington)
My Lords, I believe that several noble Lords wish to intervene at this point, but we have now spent eight minutes on this Question and I do not think that we should continue with it.