Asthma (Hansard, 6 May 2003)

§ Baroness Andrews
My Lords, we are currently developing a national service framework for children. Although it will not look at specific conditions, it has been agreed that asthma should be used as one of the exemplars that will accompany the main report. Delivering effective services for children will lead to better services for adults.

§ Lord Faulkner of Worcester
My Lords, I thank my noble friend for that reply. She will know that today is World Asthma Day and that the National Asthma Campaign has launched its charter—entitled A Charter for Fresh Air—today. First, does my noble friend endorse that campaign? Secondly, can she give the 5 million or so asthma sufferers in this country some hope that the Government will make all workplaces—including those in the hospitality industry—smoke free in the way in which Ireland, New Zealand and Norway are currently doing and most parts of North America have already done? Has my noble friend seen the latest evidence from the TUC which shows that if a ban on smoking in licensed premises were introduced the lives of 165 bar staff would be saved and, at the same time, the turnover in pubs would be increased as more people would be encouraged to eat and drink there because of the smoke-free environment?

§ Baroness Andrews
My Lords, I am pleased to play a small part in World Asthma Day. The Government have been working extremely hard over the past 10 years to reduce the incidence of asthma. We welcome 942 the charter, much of which matches what we are trying to do. We are always open to new ways of doing better with asthma and we listen to the National Asthma Campaign. As to smoke-free workplaces, we deplore the effect that secondary smoking has on people. That is one of the reasons why we are assessing the public places charter and considering an advisory code of practice to meet the needs of small and medium enterprises as well. We are doing a great deal to raise awareness of asthma and its links with smoking.

§ Lord Clement-Jones
My Lords, is the Minister aware that her answers in regard to an approved code of practice are distressingly similar to those given six months ago, a year ago. 18 months ago? Is it not high time that the Government recognised that the rate of death from passive smoking is three times that from ordinary industrial injuries? Is it not high time that the Department of Health and the DTI got their act together and approved a code of practice?

§ Baroness Andrews
My Lords, we are aware of the need to ensure that the code of practice meets the needs of the workplace. But, in addition to an advisory code of practice, we are doing a great deal to raise the profile of the dangers of passive smoking. For example, the new warnings on cigarette packets inform people that passive smoking affects and harms children and so on. The tobacco alliances are now prioritising passive smoking in order to drive better practice at a local level. So we are certainly doing a great deal.

§ Lord McColl of Dulwich
My Lords, will the Government use their influence to persuade the authorities in the Palace of Westminster to help noble Lords who suffer from asthma by making this workplace smoke free?

§ Baroness Andrews
My Lords, I know that a hotbed of contention surrounds this issue. As a very new stand-in Minister I fear to tread in that direction. However, I have witnessed the fact that sonic Members of the House have been directly affected not only by tobacco smoke but by accidental association with it. We have to be extremely careful. We should certainly consider referring the issue to the House authorities.

§ Lord Rogan
My Lords, I suffer from asthma. Does the Minister agree that education about asthma and its treatment should be delivered at a primary care level, thus reducing pressure on our hospitals?

§ Baroness Andrews
My Lords, the noble Lord is right. Most of our care and treatment for asthma is delivered at the primary care level. The chronically sick management programme has been in place for 10 years and has been assisted hugely by the guidelines issued by the British Thoracic Society. These excellent guidelines were updated this year and are absolutely 943 first rate. But it is in doctors' surgeries, with asthma nurses, where asthma patients are best identified and followed up.

§ Baroness Finlay of Llandaff
My Lords, do the Government have plans to free those with severe asthma from the costs of their prescriptions?

§ Baroness Andrews
No, my Lords. Eighty-five per cent of prescriptions are now free. Many of those with asthma, including young children and old people, receive free prescriptions. So we feel that people are being well treated.

§ Viscount Simon
My Lords, my noble friend knows that I am severely asthmatic. Is she aware of the study which indicated that very few GPs know how to use a puffer inhaler? Would not the education of GPs in this respect benefit asthmatics?

§ Baroness Andrews
Yes, my Lords. I do not know the research the noble Lord is referring to; I am sure he is right that GPs, in the normal way, would and should receive updated training. I know that the British Thoracic Society gives this sort of advice. I will follow up what the noble Lord has said.

§ Lord Rea
My Lords, my noble friend said that she would be using asthma as an exemplar in the national standards framework for children. How will this affect prevention and the treatment of children with asthma in the education system?

§ Baroness Andrews
My Lords, asthma has a whole section in the guidance issued in 1996 on supporting pupils with medical needs in schools, which I understand is working very well. The guidance stresses that children with asthma must have instant access to reliever inhalers when they need them. The staff are informed what to do, what triggers an attack, what treatment and support they can give and when an attack is sufficiently urgent to bring in medical advice and the ambulance. The guidance also promotes the idea of an individual care plan for children, and we are content that it is working well in schools.

§ Earl Russell
My Lords, can the Minister give the House an assurance that those who cannot in conscience accept pay for work done in a no-smoking environment will not be subjected to the penalty of voluntary unemployment?

§ Baroness Andrews
My Lords, as I predicted, I find it difficult to answer the question. However, we might test this out in the Department of Health; it has just declared all its workplaces smoke-free, and we are hoping to promote that across government. That may be the way to go rather than the apocalyptic vision of the noble Earl, Lord Russell.

§ Baroness Massey of Darwen
My Lords, will my noble friend reiterate the connection between asthma and smoking? Will she welcome the response given last 944 week in another place by the Secretary of State for Trade and Industry, Patricia Hewitt, who said that women's health was being severely affected by smoking and that women's health should be taken as a priority? She welcomed the Secretary of State's consideration that smoking should be banned in all public places, which would benefit women and children.

§ Baroness Andrews
My Lords, I certainly agree that smoking triggers asthma and makes it worse. There is no question about that. We also know that women tend to smoke more at different ages, so I certainly support my noble friend in that respect.