NHS: Allergy Specialists (Hansard, 27 July 2000)

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Health)
My Lords, the new allergy specialty was established in June last year. We are currently assessing how many consultants the National Health Service will need in this specialty, in discussion with the relevant Royal Colleges and NHS management.

§ Viscount Simon
My Lords, I thank my noble friend for that Answer. Is he aware that of the 100 so-called allergy clinics, only six are currently run by those who have been specially trained to cover the breadth of allergic disease, which is quite considerable? Is my noble friend also aware that one in 200 four year-olds suffers from a peanut allergy which is the cause of the commonest food-induced fatal or near fatal reaction? Of those people who die unnecessarily, none has been seen by a specialist allergist. Because allergy is so common, having increased twofold or threefold over the past 20 years, why are so few allergists available?

Lord King of Kings Heath
My Lords, I certainly recognise the rising trend in the number of people affected by allergies. So far as concerns the new clinical specialty of allergy, it was established only last year. The Royal Colleges have advised us that we shall need one allergy specialist per regional centre—there are six regional centres in England. Three allergy specialists are already in post. We are training more and the centres will be fully staffed by 2005. It is also worth making the point that many other specialists are involved in the treatment of allergies, including dermatologists, gastroenterologists and immunologists. We need to look at the picture in the round and not consider only the number of specialist allergists.

§ Lord Clement-Jones
My Lords, is it not the case that since 1994 the Department of Health has had an opportunity to assess how many specialists are needed in this area? Perhaps I may refer him to the report entitled Good Allergy Practice, published in 1994 by the Royal College of Pathologists, with a foreword written by his noble friend Lord Turnberg. The document recommended, at least one specialist in clinical immunology and allergy for every three health districts". Is not that the correct test here?

§ Lord Hunt of Kings Heath
My Lords, I am grateful to the noble Lord for referring to that report. I understand that currently 106 consultants in immunology are in post. That figure is expected to rise to 135 by 2006. I believe that we have seen an expansion in that field. We are also seeing increases in 575 the numbers of dermatologists and gastroenterologists as well as in other specialties. I recognise that there are still issues surrounding waiting times for people to be seen at such clinics. It is clear that we shall need to redouble our efforts to ensure that we are aware of the demands being made on those services. I can assure the House that we shall be doing that.

§ Earl Baldwin of Bewdley
My Lords, is the noble Lord aware that there exists a large range of intolerances and sensitivities to foods, air and water which lie outside the classical definition of allergy, but which, similarly, appear to be on the increase and for which patients are not receiving the help they need within mainstream medicine? In particular, is the noble Lord aware of the allergy unit which has been doing good work at the Middlesex Hospital, but which is likely to close down on the retirement of the present incumbent?

§ Lord Hunt of Kings Heath
My Lords, it is my understanding that, as regards food intolerances, the Committee on Toxicity yesterday produced a report on adverse reactions to food and food ingredients which strongly recommended raising awareness of such problems in the food industry. I shall be happy to send a copy of the report to the noble Earl. As regards the general issues, we need to ensure that our research programme is comprehensive. I should be glad to discuss that programme with the noble Earl.

§ Lord Colwyn
My Lords, does the Minister recall the case of Mr Patrick Webster, the serial sneezer, who sneezed several hundred times a day for 35 years? He consulted more than 60 doctors, but it was not until he saw an allergist that his treatment was successful. It turned out that he was sensitive to oats. What steps are being taken by the Minister to ensure that general medical practitioners are made aware of the work undertaken by allergists?

§ Lord Hunt of Kings Heath
My Lords, this issue needs to be addressed on a number of levels within the health service. We already have in place 100 clinics, along with six regional specialty clinics which can provide the type of comprehensive service that is needed. However, I certainly accept the noble Lord's point that we need to redouble our efforts to ensure that those working in primary care—GPs and nurses—are able to deal with allergy issues. The Royal College of Physicians and the Royal College of Pathology have been involved in producing standards of care which will be of great assistance to the primary care sector.

§ Lord Geddes
My Lords, I should like to reinforce the point made by my noble friend Lord Colwyn. Can the Minister ensure that the maximum possible co-operation takes place between allergy specialists in the private sector and the NHS? I speak as one who was sceptical in the extreme until approximately six 576 months ago when, on the advice of my noble friend Lord Colwyn, I visited an allergy specialist. I am now totally cured of the allergy from which I suffered.

§ Lord Hunt of Kings Heath
My Lords, I am very glad to hear that. Of course I believe that where the private sector has specialist services to offer, it is right that the NHS should look to see whether that is relevant. I also believe that, when seeking to ensure effective services, local health authorities, in producing health improvement programmes, need to ensure that they have considered the full range of services available for allergy sufferers.

§ The Countess of Mar
My Lords, does the Minister agree that the noble Lord opposite was not the only sceptic? Many working in the medical profession have been sceptics for years. For example, multiple sclerosis was regarded as the "idle man's disease". Following on from the question put by the noble Earl, Lord Baldwin, has the Minister considered the problem of multiple chemical sensitivities? Because this condition is now accepted in many states in America, can the Minister say what is being done in the United Kingdom to confirm that multiple chemical sensitivities exist and that they can be treated?

§ Lord Hunt of Kings Heath
My Lords, it is certainly the case that many explanations have been put forward for the rise in allergies in this country. We need to ensure that our research programme is sufficiently geared so that we are able to identify all the causes of allergies. So far as concerns the use of complementary and alternative therapies outwith the NHS, it is absolutely clear that where the NHS and individual clinicians feel that such therapies would provide the appropriate treatment, they are able to refer patients on to those services.