Asthma Outcomes

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate. This is in line with current Government and House of Commons Commission guidance. Members are also asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre in the House or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

I beg to move,

That this House has considered asthma outcomes.

Thank you very much for calling me to speak, Mr McCabe. This is an issue that is close to my heart and close to the hearts of others here. There are few families in the whole of the United Kingdom for whom asthma has not been a key issue; it has been an issue for my own, and I want to speak about that as well. I am grateful to the Backbench Business Committee for agreeing to have the debate. I am chair of the all-party parliamentary group for respiratory health, which recently completed an inquiry into this issue, so I am delighted to be able to raise the issue of improving asthma outcomes in the UK. I very much look forward to the response from the Minister. I am also very pleased to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place, and I wish her well in her new role.

What does asthma mean to me? My second son, Ian, had asthma. He was born with very severe psoriasis, which meant that we had to apply cream to him three times a day when he was a wee boy. The doctor told us that the psoriasis would eventually go away, but that it would be replaced by asthma. I am not sure of the medical connection—I am not medically qualified to understand it—and I know only what the doctor told me and my wife. Ian has had asthma all his life now—he is 30 years old—and has used salbutamol, the wee blue inhaler, which is always there. It is very clear, from our family’s experience, that those salbutamol inhalers are really important. They are important for Ian. Asthma did not stop him participating in sports, but it meant that he always had to have that inhaler close by, should he at any time feel shortness of breath or need a wee helper.

In Ian’s class at school, there were many others who had asthma issues. As an elected representative, whenever I help constituents with benefit forms, whether for attendance allowance, personal independence payments or whatever, I always ask them about their medical circumstances. More often than not, asthma features among the ailments that they confirm they have—even for those of a different generation. They have often had it for many years. Asthma is an incredibly important issue.

I congratulate the hon. Member on securing today’s debate. As with most conditions, research and development is key to improving outcomes. Does he agree that funding into asthma research must be provided from a clearly defined central source and that there must be increased capacity for trials in hospitals?

I absolutely agree with the hon. Lady. No matter what the sphere of health, early diagnosis and attention is key. Indeed, my son is an example of that, as a child born with the ailment. There was early participation in his treatment by the doctors, including our own GP and those in the hospital. It is clear to me that that helped him on the pathway to better health. The hon. Lady is absolutely right and I thank her.

We received a large number of written submissions, including evidence from across the numerous asthma disciplines. We were encouraged that there was such a high level of interest. The APPG tries to do a catch-up once a month with stakeholders and those with medical expertise. Each month, we aim to hear from between 16 and 20 people who have an interest in the subject. They bring all their information to us, which we are pleased to have. We were incredibly encouraged that there was such a high level of interest, and I thank every one of them for their help and expert advice.

Let us consider the impact of asthma on people in the UK. The number of people affected by asthma in the UK is among the highest in the world, with some 5.4 million people sufferers. I had never done an interview with GB News until yesterday morning, but they were interested in this debate and a former colleague in this House was the interviewer. It was nice to catch up with Gloria de Piero again in her new job, and it was a platform and an opportunity to raise awareness and the questions were clear. That figure of 5.4 million people suffering from asthma came up early on in that interview.

I congratulate my hon. Friend on securing the debate. On raising awareness, will he join me in congratulating and commending so many of the voluntary groups, particularly those working with issues around chronic obstructive pulmonary disease? I can think of one such group in my constituency, in the Causeway area, that highlights these matters and draws attention to them in the wider community, in order that there is greater awareness across society to try and help people cope with that debilitating condition.

I thank my hon. Friend and colleague for that point. He is right that there many charities and volunteers, as well as many people who have the disease. A great number of people have expertise, interest and keenness to help and assist them. COPD is one of the most debilitating diseases that I have ever seen. I never realised just how many people in my constituency suffer from COPD, but there seem to be a large number, some of whom are in the advanced stages of a deterioration in health. I have a very good friend who is an artist; we have been friends for many years. He is interested in rural and country sports, as I am, which is where our friendship came from. Today, he is completely dependent on oxygen 24/7 and rarely leaves the house. For a man who was active and fit, COPD has changed his life dramatically.

Some 65% of people with asthma do not receive a yearly review—I am keen for the Minister to respond to that—despite recommendations by the National Institute for Health and Care Excellence that they should. I respectfully ask the Minister, if they are not getting a review, why not? Asthma has an impact on every patient’s quality of life. A recent pilot study for Asthma UK showed that the impact can be considerable: 68% said asthma attacks hold them back from work in school; 71% said severe asthma affects their social life; 54% said it holds them back from going on holiday; and 66% said severe asthma has made them or their child anxious. When the child is anxious, the parent is anxious—we all worry about what happens. The study also found 55% said having severe asthma has made them or their child depressed. The issue of depression and mental health has come up during the difficulties we have had with covid over the past year and a half.

Asthma deaths in the UK have increased by one third over the last decade. Three people in the UK die from asthma every day, which is among the highest in Europe, yet studies show that more than two out of three asthma deaths could be prevented. Three people die every day and if we had the right things in place, we could save two of those three lives every day in the UK. I put that challenge to the Minister, who I hope will give us the confident and positive reply that we would like to see.

Air pollution can trigger asthma attacks, and it is believed that it is linked to the rise in childhood asthma. Does the hon. Member agree that tackling air pollution could also bring public health benefits?

I absolutely agree. The hon. Member is making points that we all agree with. I am glad she has brought that to my attention. I come to London to work and am aware of the air pollution and the steps that the Mayor of London and others that are taking to try to address that, by restricting the number and type of cars coming in. As the hon. Lady rightly said, people have died in London from air pollution and we must address that. In large metropolises and population clusters, where vehicles and the economy are concentrated, air pollution is important.

I am fortunate to have lived in the countryside all my life. It means that when I go out of my back door there are green fields and the neighbours are about half a mile away, so there is a distance between us as well. However, some 14,000 vehicles a day pass by us on the road—the A20 from Ards to Portaferry—which, by its very nature, shows where the problem is.

Asthma exacerbations lead to over 77,000 hospital admissions each year. It is estimated that asthma leads to a direct cost to the NHS of £1 billion and an indirect cost to society of £1.2 billion due to time off work and loss of productivity. This goes back to the intervention by the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) when she referred to early diagnosis which can stop people losing work days and reduce the cost to the NHS. These factors cannot ignored be when it comes to addressing the health issues and helping to balance the books.

This year, the APPG’s intention was to produce a one-year-on report to highlight and emphasise the tremendous work that has been carried out by all those working in asthma. We intended to highlight the progress that has taken place in the past year, the actions of the Government, and any further areas that needed to be reconsidered. Our job will be to continue to note the progress—it may not be the progress we would like to see—and speak to the Minister to see how we can change that. However, covid changed everything. It changed our thinking dramatically. It has had a devastating effect on many lives and has impacted on asthma care. It affected the scope of our latest report, as well as concentrating on asthma outcomes one year on. We have also looked carefully at the impact of covid on respiratory health and asthma in particular.

It is a pleasure to serve under your chairmanship, Mr McCabe. I am delighted to follow the hon. Member for Strangford (Jim Shannon), and I congratulate him on securing this excellent debate. I thank him very much for what he has said. My speech will be less wide-ranging than his, but I want to deal with two particular aspects. First, I should declare an interest, in that my brother works in this industry. Having said that, we never talk about work, so that is literally as much as I can say about what he does. However, I have had several meetings with representatives of Kindeva, a company that deals in the asthma industry, and visited its site. It is based in my constituency, so I will refer to the company in some detail. I will first discuss the change in drug delivery that is proposed by DHSC, before talking about prescription charges.

Asthma can be an incredibly dangerous condition. As Asthma UK data show, there are around 75,000 asthma-related emergency admissions to hospital every year in the UK and, sadly, asthma causes the death of around 1,200 people every year. Thankfully, however, although there is no cure, there are simple and, importantly, accessible treatments that can help keep the symptoms under control, including inhalers. That being said, the fact that people are still dying from this condition shows that more work needs to be done, and I was encouraged by the response from the Minister for Care and Mental Health to the debate on access to salbutamol inhalers last week, during which she set out the steps that the Government and NHS are taking to improve asthma outcomes. I was particularly encouraged to learn that the NHS long-term plan includes respiratory disease as a national clinical priority and sets out a number of respiratory interventions, including plans for early and accurate diagnosis of respiratory conditions. I would welcome reassurance from the Minister that the Government will work with the NHS to achieve the aims set out in the long-term plan.

I want to take the opportunity to mention an issue that has been raised with me by Kindeva, a pharmaceutical contract development and manufacturing organisation, when I visited its state-of-the-art research, development and manufacturing facilities at Charnwood Campus in my constituency, which is the very first life sciences opportunity zone that is based in the UK. During my visit, I saw the production of pressurised metred-dose inhalers, or PMDIs, and I heard about Kindeva’s work to transition to green propellants. I am delighted that as part of this, Kindeva and Loughborough University formed a knowledge transfer partnership to proactively address the inhalation drug delivery industry’s move to develop PMDI propellants with lower global warming potential, or GWP, than exists currently in marketed propellants. That is a fantastic example of universities and businesses working together to turn a cutting-edge idea into a marketable product, and it reflects the success of Charnwood Campus.

It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate. It is incredible that the subject of asthma has not been discussed more often in the House, given that it affects to so many people.

I would like to start with some key statistics on severe asthma: 5.4 million people in the UK currently receive treatment for asthma, including 5,282 people in my constituency of Blaydon, where we have a sad history of respiratory conditions, including asthma, affecting the lives of too many people.

Around 200,000 people in the UK have severe asthma, which is the most debilitating and life-threatening form of the condition, and which does not respond to conventional treatments. Four out of five people with suspected severe asthma, who should be referred to a specialist, are not getting the care that they need; 46,000 people are missing out on life-changing biologic treatments.

The north-east region has the highest oral steroid prescribing rate at 20%, prescribing two or more courses of oral corticosteroids in the previous 12 months compared with the 14% average. As we have heard, oral steroids can have very nasty side effects, including osteoporosis, weight gain and diabetes.

Severe asthma has a devastating impact on every part of someone’s life. Living with severe asthma is so much more than asthma attacks and occasional hospital admissions. People may feel isolated, lonely and scared, left without hope or the right support. The covid pandemic has clearly shown that for many people that is a very real concern, leaving many of them in isolation.

One person with severe asthma reflected on how it impacts on them:

“It’s really restricted me. I have suffered because there was a point when I refused to leave the house… So, it really affected my work, my lifestyle. Meet your friends, just even speaking to them, I would get really out of breath. I was trying to avoid all of that.”

It is a pleasure to serve under your chairmanship, Mr McCabe, in what is an extremely important and timely debate. I thank the hon. Member for Strangford (Jim Shannon) for securing it, and I know that the issue is very close to his heart. He exerts such energy, enthusiasm and dedication through his work with the all-party parliamentary group on respiratory health, and the issue also has a very personal resonance for him, as we heard, given that his son has been diagnosed with asthma. The hon. Gentleman has first-hand experience of asthma’s impact on a young person and a family, of the concerns that it brings to the whole family and of the need for improved, ongoing care for everybody affected.

The hon. Gentleman set the scene extremely well, and in a detailed manner. He raised with the Minister the issues that clearly need to be addressed, and ensured that we are all aware that we should be speaking more about asthma and its implications, given its impact on so many people across the United Kingdom. He gave some startling figures, including that three people a day die as a result of this treatable disease. We should be doing far more to ensure that those deaths do not happen and that the interventions required are delivered in a timely manner. Those who need additional support must get access to the trained nurse clinicians and the annual reviews that they so desperately need.

I also thank the hon. Member for Loughborough (Jane Hunt). I do not believe I have had the pleasure of speaking to her personally in this place yet, because of our absence during the covid pandemic. I look forward to speaking with her about her particular interest in health. I say that as a clinician, as the chair of the all-party parliamentary health group and as someone with an interest in taking these issues forward. She raised such important matters, including the move towards climate change-friendly, net zero alternatives. She said that the move must be staged so as not to be too quick for the people who desperately need the medication to catch up, and that it must be done in a very pragmatic way so that it does not impact on those UK organisations that she spoke about, including in her own constituency. Those organisations are working so hard to ensure that science is at the forefront and that, while we achieve net zero, we put patient health at the forefront of all of the decisions that are made in this context. She spoke extremely well on that matter.

The hon. Member for Blaydon (Liz Twist) always speaks eloquently on health-related matters, and I very much welcomed her person-centred approach to the debate. She detailed the impact of asthma on people’s lives, and contributed that first-hand information to the debate. Asthma has a devastating impact on individuals, and people must have access to the biologic treatments that she described. Where there is innovation and excellence in our NHS, it must be available to everybody who needs treatment. That is why, importantly, she told the Minister that individuals must have access to community hubs for diagnosis, linked with early prevention and prescribing. There should be no postcode lottery; no matter where people live in the United Kingdom, they should have access to the treatment that they so desperately need.

I thank the hon. Lady for letting me intervene. I understand her point about Scotland, but there is available an annual prescription charge, which is far less. However, my point was really about the fact that asthma sufferers cannot help it, essentially. Is there something we could do there?

Absolutely, and the hon. Lady makes an excellent point. While the choice in Scotland has been to abolish prescription charges, I note that she did not suggest that to the Minister. However, she did suggest—perhaps because we know that asthma often starts in childhood and is not something that people have much control over—that an exemption could be applied. Following that recommendation from the hon. Lady, I would be interested to hear the Minister’s thoughts on the matter.

Cost itself should not mean that someone cannot access healthcare, and in a developed country such as the United Kingdom, there should be no prohibition owing to charges and costs, particularly for something for which people often need daily medication. We have heard from Asthma UK that that is happening—people are skipping doses and many are struggling to pay for their prescriptions in England.

In 2021, the Scottish Government published their respiratory care plan, which is a care plan covering 2021 to 2026. It includes a workstream specifically on asthma, and I am pleased that that is being taken forward at that level. We know that asthma attacks across the UK, including Scotland, have increased by a third over the last decade, and the number of people affected in the UK is among the highest in the world, with about 5.4 million receiving treatment for asthma. That is equivalent to one adult in every 12, and one child in every 11, so we know that asthma is widespread and that it needs to be a priority for Government action.

Asthma affects people of all ages, as we have heard, and often starts in childhood. I must declare that I have been diagnosed with asthma and have had asthma since childhood. I say to the Minister that there is absolutely nothing worse than the feeling of struggling for breath. I have found wearing a mask difficult at times, but I have continued to do so, and there are exemptions for people with severe health conditions. However, asthma comes upon people suddenly and can leave them with a feeling of such a lack of control, so it is important to have specialist advice from the nursing staff, which the hon. Member for Strangford spoke of.

I do not believe that I received such advice when I was younger; I think I was given an inhaler, told to go off home to practice and learn to use it myself. I wonder whether the issue that the hon. Gentleman raised—people overusing their inhaler medication—is down to there not being enough early intervention and education on how to use an inhaler properly.

I say to the Minister that although the recommendations have been raised on the Floor of this debating Chamber, we need meaningful data. We need to know about overuse, and the rationales and reasons for that overuse. Do people need more education and intervention from clinical nursing staff in the community hubs? Does the cost mean that people in poverty struggle to access treatment, and is that contributing to the death toll? That data is crucial.

It is a pleasure to serve under your chairmanship, Mr McCabe.

I thank the hon. Member for Strangford (Jim Shannon) for securing this Backbench Business debate on improving asthma outcomes and for setting out so comprehensively the issues and challenges faced by the UK’s asthma sufferers. He said there are not many families in the UK who are not affected by asthma—his own son is an asthma sufferer—and I absolutely agree with him. I have a cousin currently in hospital who is a severe asthma sufferer; his covid was made worse by his severe asthma. It is a condition that affects many of us.

The hon. Member also set out some sobering statistics about asthma, which should shame us all. He made three asks and set out the areas where he believes the Government need to do more, which was echoed by many other speakers. They relate mainly to the overuse of blue inhalers, the conflicting guidelines and the need to improve them, and biologic therapy, which I will touch on.

We also heard from the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), who raised the issue of air quality and air pollution. We know that air pollution exacerbates asthma. Most Members will know the case of Ella Kissi-Debrah, the nine-year-old asthma sufferer who died, and the coroner said air pollution was a factor in her death. We know that air pollution affects asthma sufferers really badly and more needs to be done about it.

The hon. Member for Loughborough (Jane Hunt) set out very well the great work being done by businesses and the university in her constituency, and also raised the important issue of prescription charges and the need to have a medical exemption from them. Others raised that issue, too, and I absolutely agree.

Finally, my hon. Friend the Member for Blaydon (Liz Twist) set out the facts and statistics—the really terrible statistics—that the UK has on asthma and the challenges around gaining access to biological medicines. She also told the stories of some asthma sufferers.