World Asthma Day

Ashley Dalton Excerpts

Thursday 15th May 2025 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing this timely debate forward as we mark last week’s World Asthma Day. It shows real leadership from the chair of the APPG for respiratory health. In that spirit, I would be delighted to take him up on his offer of a meeting. We will arrange that as soon as we possibly can—I am keen to do it.

I thank hon. Members for their contributions. I am more than happy to meet the hon. Member for Birmingham Perry Barr (Ayoub Khan) to discuss the issues that he raised, including prescription charges. There are currently no plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. However, approximately 89% of prescription items are dispensed free of charge in the community in England and a wide range of exemptions are already in place. Eligibility depends on factors such as the patient’s age and whether they are in qualifying full-time education, are pregnant, have recently given birth or are in receipt of certain benefits. People on low incomes can apply for help with their health costs through the NHS low income scheme. Children are of course entitled to free prescriptions.

NHS England’s children and young people’s transformation team have been working closely with the MHRA on dose counters being added to inhalers. The “British National Formulary for Children” has been updated with guidance and supportive resources for patients and clinicians, which have been widely shared. We are awaiting an update on progress on making dose counter inhalers dominant in the supply chain from the pharmaceutical industry. I will be more than happy to update the House when we have it.

I thank my hon. Friend the Member for Bournemouth West (Jessica Toale), who focused on air quality, which is a priority for the Government and part of our prevention strategy, and the technology to help to manage asthma. There are a range of technologies available to help people to manage their asthma, and NHS England and NICE are exploring the potential for the platforms for digital self-management of asthma to be evaluated, but that depends on the technology readiness level. Guidelines developed jointly by NICE, the Scottish Intercollegiate Guidelines Network and the British Thoracic Society to harmonise recommendations across the organisations were published in November 2024, and I hope they are useful.

Before I respond to the Front-Bench contributions—if there is anything I do not cover, please let us know and we will endeavour to write with the relevant details—I want to pay tribute to charities and campaigners: people who are doing the hard yards of helping to equip our hospitals and supporting people to manage their conditions in their day-to-day lives. I thank Asthma + Lung UK, Beat Asthma and the Asthma Relief Charity, to name just a few. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), asked about the contributions by charities to the major conditions strategy. I reassure him that engagement with such stakeholders has been central to the development of the 10-year plan. All submissions made to the major conditions strategy have been taken into account—nothing was wasted.

As the hon. Member for Strangford outlined, asthma is the most common lung condition, affecting nearly 5.5 million people in the UK. Just under one in 10 kids live with asthma, and more than 12,000 people have died from asthma attacks in the last 10 years. World Asthma Day is not just about treating a condition; it is about shining a spotlight on inequalities. I strongly agree with the hon. Gentleman that everyone, regardless of where they live or how much they have in their bank account, has the right to access the inhaled medications they need to control their condition and treat attacks.

Nevertheless, statistics published by Asthma + Lung UK just this month show that Asian people with asthma from the most deprived quintile in England are almost three times more likely to have an emergency admission to hospital than their white counterparts. Black people with asthma from that group are also more than twice as likely to be admitted to hospital. This is a burning injustice. As if that were not enough, the annual economic burden of asthma in the UK is around £3 billion a year. Lung conditions collectively cost the NHS £11 billion annually. That is why we must act.

I will update Members on NHS England’s activities in this space before moving on to wider Government efforts. NHS England is taking steps to support integrated care systems to improve outcomes for people with asthma through its national respiratory programme by providing targeted funding, clarifying what systems should be doing to ensure that people with asthma receive a high-quality and timely diagnosis, and working with key partners, industry representatives, patient groups and clinicians to support improved respiratory disease management. That will include shared decision making on inhaler choice and making better use of inhalers to reduce the overuse of reliever inhalers and encourage the use of preventer inhalers.

The hon. Member for Strangford raised the issue of access to and roll-out of treatments. Healthcare Quality Improvement Partnership, on behalf of NHS England, commissioned a national audit across respiratory care, which includes asthma, and all data from the audit is published for open access. NICE is working with BTS, SIGN, NHS England and others to review the resources available to support implementation of the guidelines, and plans to publish a respiratory toolkit. To support implementation of NICE guidance, NHS England has been engaging with health system partners across the country to co-ordinate resources and implementation efforts to make sure that patients are on the appropriate treatment regime.

NHS England is also protecting our children and young people through the national bundle of care. It is putting asthma care at the top of the agenda by giving asthma a higher priority within systems, providing funding for regional leadership, and strengthening governance and accountability to improve outcomes. It has also played a crucial role in making training easier and more readily available for staff by bringing together existing guidance and resources with a structured training scheme. Since its publication there has been a noticeable reduction in hospital admissions.

The hon. Member for Strangford and the shadow Minister both raised spirometry, a diagnostic test for asthma as well as other respiratory diseases. NHS England is working with a range of partners, including Asthma + Lung UK, the British Thoracic Society, the Association for Respiratory Technology and Physiology and clinical leads to make sure that systems have everything they need to increase the number of people receiving early and accurate diagnosis for respiratory disease. In the past year the Government have made extra funding available to make sure that staff have the proper training and accreditation to use spirometry effectively.

On inequalities, NHS England is taking steps to uplift the most deprived quintile through Core20PLUS5. That initiative focuses on five areas of improvement, of which chronic respiratory disease is a key part. There are targeted interventions to detect and treat asthma. The PLUS population groups include ethnic minority communities, people with a learning disability, autistic people, coastal communities, people with multimorbidity and protected characteristic groups. Core20PLUS5 also has a dedicated workstream for children and young people. The primary focus is to address over-reliance on reliever medications while decreasing the number of asthma attacks. That has made some progress, with clear reductions in the over-prescribing of reliever inhalers over the past few years. Between April 2022 and February 2025 the proportion of patients with asthma who received six or more reliever inhaler prescriptions fell from just under 20% to under 16%. The Government are supporting systems to take innovative approaches to expanding access to their diagnostic services, with a particular focus on addressing health inequalities.

Finally, the NHS rightly offers the flu vaccine free of charge to people with severe asthma as seasonal illnesses pose more of a threat to them than others. NHS England has been working with the severe asthma collaborative to develop the capacity of severe asthma centres to improve patient access to biologic treatments and to reduce variation in prescribing and patient management. That work has shown improved identification of patients with potential severe asthma in primary and secondary care, resulting in referral to severe asthma centres for consideration of their eligibility for biologic therapy. For four in 10 asthma patients with severe asthma those treatments can significantly improve their quality of life. However, it is vital that biologics are prescribed only following specialist assessment. Currently, the NHS is deploying six biological treatments approved to treat severe asthma.

The shadow Minister raised the issue of vaccines. I reassure him that a strategy and action are being delivered to increase vaccination uptake, including RSV and flu, because that is a priority for the Government. Returning to biologics, significant work was undertaken to drive uptake and access to them through the NHS England severe asthma collaborative, and patient outcomes are submitted to the UK severe asthma registry. That has improved the identification of patients with potential severe asthma, and has resulted in those people being referred to the relevant care pathways.

Every member of the Government is committed to raising the healthiest generation of children in our history. We are taking steps to protect our kids from obesity and smoking, which are major risk factors; each one is responsible for roughly a third of asthma deaths. We are taking action through the Tobacco and Vapes Bill, which I am pleased to say has just passed Second Reading in the other place.

In her autumn Budget, my right hon. Friend the Chancellor took steps to ensure that the soft drinks industry levy remains effective. We have not just uprated the levy to bring it in line with inflation; we also published a consultation just last month on two proposed changes—reducing the lowest sugar tax threshold from 5 grams to 4 grams of total sugar per 100 ml, and removing the exemption for milk-based and milk substitute drinks. Finally, my right hon. Friend the Secretary of State for Energy Security and Net Zero is cleaning up our air with Great British Energy and a raft of other measures.

My Department will shortly be publishing its 10-year plan for health to make our NHS fit for the future. We will shift the focus of our NHS from sickness to prevention, hospital to community, and analogue to digital. Until then, we are already taking steps on prevention by helping people to lose weight and quit smoking or vaping, and by helping to clean up our air. We are helping people to get diagnosed closer to home by requiring community diagnostic centres to provide spirometry tests. The Government remain committed to ensuring that existing CDCs, where they are not already, are rolled out at full operational capacity at their permanent site.

[Dr Luke Evans]

The Minister mentioned spirometry. Could she comment on FeNO, and if not, could she write to us? The guidelines are built around that, but access is going to be an issue.

[Ashley Dalton]

Yes, I confirm that I will write to the shadow Minister on FeNO at a later date. NHS England is also piloting a digital annual asthma check.

I am sorry, Dr Huq, this is highly irregular, but I am feeling extremely unwell; I need to go and make myself okay. [Interruption.] Thank you for your forbearance, Dr Huq. Crohn’s is not something that we have debated in this Chamber; if we did, no doubt I would be the responding Minister, and I can assure you that I would be able to speak from personal expertise.

[Jim Shannon]

I used to have close contact with a guy called Simon Hamilton, who was an MLA for the constituency that I represent. He had Crohn’s disease—my knowledge of it came through him—and he was caught short many a time, if that is the way to put it.

May I ask the Minister a wee question? I asked about CDCs once NHS England is abolished—[Interruption.] I can see that she is coming to that. That is grand.

[Ashley Dalton]

Yes, I will come to many of those issues.

As I was saying, NHS England is piloting a digital annual asthma check, which, if successful, will mean that fewer people miss that valuable check and will keep the monitoring of their asthma up to date.

The Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), asked about the public health grant. The grant has been increased and local directors of public health are best placed to identify where to target resources in their communities. As I have said, the 10-year health plan will be published next month. It will cover all conditions and will consider lung health. I have talked about the stakeholder engagement that was really important in that, and I can guarantee that, with the 10-year strategic plan for the NHS, we will look right across the board at how we can make sure that all conditions get due consideration.

During our short interruption, I was able to get a little more information for the shadow Minister on FeNO. Wessex Academic Health Science Network has created a FeNO rapid uptake product delivery toolkit, which is providing downloadable tools and resources to support NHS organisations with the adoption and implementation of FeNO testing to improve outcomes. Anyone can access that toolkit, which contains case studies of best practice identified through the programme. I hope that is helpful.

On the changes to NHS England, we are abolishing NHS England in itself, but none of its functions is disappearing. We are working really closely across the Department and NHS England, as well as with our ICB colleagues, to ensure that all services are transferred in an appropriate way. The purpose of the changes is to make things as efficient and targeted as possible and to ensure that they get to the people who need them the most.

Ensuring that community diagnostic centres are supported is really important to the Government, as it is very much part of one of our three shifts: from hospital to community. Those shifts—the other two are from sickness to prevention and from analogue to digital—are at the very heart of the 10-year plan.

I thank the hon. Member for Strangford for bringing forward the debate. I am sure that he would agree that World Asthma Day is not just for raising awareness; it should also be a celebration of the great things that people with asthma have accomplished. I did not know this until I saw the research for this debate, but past asthmatics have included Dickens, Disraeli and Beethoven. If those examples seem archaic, I can also point to Harry Styles, Jessica Alba and David Beckham, as well as to many prominent Olympic medallists. People with asthma achieve great things. It is our job in this place to help them to reach their full potential, with a particular focus on addressing how respiratory conditions affect people in deprived communities.