Hansard

I welcome the opportunity to lead this important debate, which recognises that world asthma day took place on 2 May 2023. This year, the theme was asthma care for all. I thank members from across the chamber—in fact, from all parties—who supported my motion and so allowed the debate to go ahead. I also thank Asthma and Lung UK Scotland, and its policy officer Gareth Brown, for its briefing and for all that it does to support people with an asthma diagnosis and their families.

In particular, as the co-convener, with my colleague Alexander Stewart, of the Parliament’s cross-party group on lung health, I thank everyone who is involved in that group. In the past, we have carried out a lot of work on asthma, and the input from clinicians, asthma support groups and people living with asthma, such as Asthma and Lung UK ambassador Olivia Fulton, has been absolutely invaluable. It is worth noting that Olivia, who thought that she could never participate in sport because she has quite severe asthma, is now playing wheelchair rugby and loving it.

As the wording of my motion indicates, world asthma day is organised by the Global Initiative for Asthma, which is a World Health Organization collaborative that was founded in 1993.

Asthma is a very common long-term lung condition. In the United Kingdom, 5.4 million people have it—that is one in every 12 adults and one in every 11 children. In Scotland, 360,000 adults and around 72,000 children have an asthma diagnosis.

People with asthma often have sensitive, inflamed airways. Its symptoms can come and go. Sometimes people may not have symptoms for weeks or months at a time. However, asthma needs to be treated every day, even if sufferers feel well, to lower their risk of symptoms and asthma exacerbations and attacks.

The most common symptoms of asthma are coughing, wheezing—a whistling sound when the sufferer breathes—breathlessness and chest tightness. When, as a nurse, I looked after people with asthma, they would sometimes describe it as feeling as though a brick was weighing down on their chest, making it difficult for them to breathe. If someone experiences one or more of those symptoms it could mean that they have asthma, and they should speak to their general practitioner as soon as possible. There are nurse specialists in asthma care and respiratory medicine in many of our GP practices, so there are great experts out there.

There are lots of things that can make asthma worse, but not everyone will be affected by the same things. If people finding out what sets off their symptoms, whether it is colds and viruses, pets, pollen, pollution, house dust mites or stress, they can work out ways to avoid the triggers if possible.

There are certain stages in people’s lives that might affect their asthma, too. For example, some women find that hormonal changes at puberty, pregnancy or menopause can affect their asthma, and research is under way that is looking at the issues that face women with asthma and whether asthma is exacerbated by those changes.

The best way that someone can cope with their asthma triggers is to always take their preventer inhaler as prescribed, even when they feel well.

How serious asthma is varies from person to person. There are different types of asthma, too. Someone with severe asthma, which affects around 5 per cent of all people with asthma, can have symptoms most of the time and find them really hard to control, but we now have new biological medicines that target the processes that cause inflammation, and those meds are helping. Asthma can kill. It is serious and it needs continued action.

As my motion states, Asthma and Lung UK Scotland carried out a survey that showed that only 25.4 per cent of people with asthma said that they received all the elements of basic asthma care. Part of how we can address that issue is through ensuring that people have their own personalised asthma action plans and that those plans are being reviewed at appropriate times.

Correct inhaler technique is key, and up to a third of people with asthma are not using their inhaler correctly. That was noted when we did some research ahead of the debate. People with asthma who are unable to use their inhaler correctly are at an increased risk of poor asthma control, potentially resulting in an attack, which may lead to the person being hospitalised.

My go-to person, Garry McDonald, who is a community pharmacist who specialises in asthma, said in a conversation with me that most people can have their inhaler technique checked at their community pharmacy and that community pharmacists are often the only healthcare professionals that people with asthma see.

Recently, when I hosted a lung health event in Parliament to mark that the respiratory care action plan has been running for two years, I met Paul Wilson, who has had many, many hospital admissions for treatment and resuscitation for his poorly controlled asthma. His asthma improved when his inhaler technique improved, and he has had zero further hospital admissions since he had his inhaler technique check and then had his personalised asthma action plan put in place. He is now giving back to the national health service by training to be a nurse, and I hope that Paul will be a respiratory nurse. That is a good news story that we have heard in relation to the work that community pharmacists can do in supporting people.

Inhaler technique is part of the personalised action plan for people’s asthma control. I would be interested to learn how those inhaler techniques and personalised asthma action plans are being communicated to patients, as they are both absolutely necessary, and whether the Scottish Government would consider further awareness-raising efforts in order to support that.

Following lobbying from the cross-party group, the Scottish Government launched the respiratory care action plan 2021 to 2026, which I just mentioned. The plan sets out the vision for driving improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions in Scotland. It identifies five key priorities for respiratory care and is intended to be an enabling document that is driving continuous improvement.

One of the key areas that the plan focuses on is asthma, and it mentions pulmonary rehabilitation. The evidence shows that PR has beneficial effects in patients with asthma, at any stage of the disease, improving exercise capacity, asthma control and quality of life, and reducing wheezing, anxiety, depression, and bronchial inflammation. However, many patients report waiting lists of up to 18 months to access PR referrals and appointments. I ask the minister whether targeted support could be considered to improve waiting times for pulmonary rehabilitation and asthma referrals, as requested by Asthma and Lung UK Scotland.

There is a link between asthma and inequality. We know that people from the most deprived areas of Scotland are much more likely to receive an asthma diagnosis. Managing a variable lifelong condition with complex treatments such as inhalers is hard enough. Managing asthma while juggling multiple jobs, family responsibilities and financial pressures is even harder. I welcome the Scottish Government’s commitment to tackling health inequalities, but it is important to ensure that good-quality housing, sound state welfare support and good air quality are key components of achieving health equality.

Asthma is a serious health condition. We need to ensure that people are aware of its signs and symptoms and that we are taking all the action possible to support people who have been diagnosed. We must ensure that there is the right inhaler for the right person, as that is one of the ways forward. Importantly, we need people to know how to use their inhalers properly.

I look forward to hearing other members’ contributions.