Chronic Obstructive Pulmonary Disease

Jim Shannon Excerpts

Wednesday 17th November 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak on these issues, Ms Nokes. I commend the hon. Member for Weaver Vale (Mike Amesbury) for bringing the debate to the House.

I am my party’s health spokesperson, but it is not just a duty for me to be here—I also have a particular interest in this issue. As has been said, we all know people who have COPD, and I can think of a number in my constituency. One gentleman, Kenny Legge, has been a friend of mine for umpteen years. He has COPD and is on a 24/7 oxygen tank, which he takes everywhere with him. That means that if he goes to the shops or to the doctors he takes it with him. It is possible to carry it because it is a small tank, but he lives with it 24/7—his whole life.

My other introduction to COPD—I suspect the same is true of others in the Chamber—was filling in benefit forms. When filling in forms, we always ask the constituent what the issues are, and they explain them to us. Although we might need to know more about the COPD, the issue becomes clear when we are talking face to face with our constituent and he or she is gasping for breath. We are able to be agile and athletic. People tell me they go for runs, and others tell me they go for walks, but I am one of those who goes for a dander, which is the third category. But people suffering from COPD cannot even do that. That is the issue.

Throughout the pandemic we often forget about other health conditions that must be awarded awareness. Covid has taken over our lives; everywhere we look there is something related to covid. That is not a criticism; it is a fact—an observation. There must be sustainable support for those who, sadly, suffer from other respiratory diseases, such as bronchitis and emphysema.

The British Lung Foundation is the leading charity in the UK highlighting the impacts of chronic obstructive pulmonary disease. Statistics show that an estimated 1.2 million people in the UK—wow, that’s a big figure—live with diagnosed COPD, with thousands more not yet diagnosed. I wonder sometimes whether we are just scraping at the figure, which may or may not be there. That figure equates to 4.5% of all adults over 40.

Intense research by the British Lung Foundation shows that prevalence is growing. I hope the Minister will give us the answers we seek, and I know she will endeavour to produce them. One thing I always ask about is prevention, and it is important that we address it, because it prevents costs further down the line. Perhaps she can tell us what has been done on that. The research also shows that COPD diagnosis has increased by 27% in the last decade, so additional resources and funding are needed to improve research into it.

I always make the comment—although that does not make this any less of an issue—that research and development is so important in, hopefully, addressing some of the issues for those with COPD. Last Friday I had a lady in my office with severe COPD who has an issue with housing She is in a flat, and when she moved there I suppose the issue was not apparent, but she is now a prisoner in her flat and cannot get out unless someone takes her. She is overwhelmed by exhaustion whenever she goes anywhere, and I am trying my best to help get her relocated to a property at ground level that is nearer the centre of the town, where perhaps her quality of life can improve.

The Regulation and Quality Improvement Authority for Northern Ireland has stated that 37,000 people have been diagnosed as having COPD. Half as many as the number already on the COPD registers are thought to be living with COPD without the disease being diagnosed —a point I made earlier—bringing the total to approximately 55,500. Those figures are just for Northern Ireland, where 37,000 people have it, but 55,500 might have it—one third more. If that is replicated in the rest of the United Kingdom, the figures will be almost 2 million. I am not the greatest mathematician in the world, but I think those figures are fairly approximate.

The Northern Ireland Chest, Heart and Stroke charity, which does incredible work, has nicknamed COPD the “creeping killer”, as it is the fifth biggest killer in the UK, but very often people are completely unaware of its severity. When we see constituents in the advanced stages of COPD or living on 24/7 oxygen, we very quickly understand the severity of it.

The all-party parliamentary group for respiratory health, which I chair, has recently gained mass support from respondents for a lung cancer action plan to draw together all the different strands of respiratory policy and make them into one strategy. The British Lung Foundation has strongly supported that plan. The Primary Care Respiratory Society also supported the need for a national NHS action plan, claiming it would help to improve rates of earlier diagnosis and reduce the rates of death from lung cancer. If we adopt, pursue and fund those twin goals, we can try to address the issue, reduce the numbers and give people a better quality of life. It was also felt that any action plan should consider a pathway for people who are found to have non-cancer respiratory symptoms that need investigating.

We often find that constituents do not have just one issue; they have a complex number of issues, and central to that for those with COPD is the COPD. People with COPD who have been active for most of their days suddenly have issues with mobility, anxiety and depression and cannot be active any more. Some of the most prominent ways to help slow the progression of the condition are often the simplest.

The summarised treatment options from the NHS include encouraging people to stop smoking. We had a debate in this Chamber yesterday morning on the tobacco control plan and it was clear—certainly to me as a Northern Ireland MP—that the figures for those stopping smoking have not reached the targets we hoped they would. The consensus among parties on both sides of the Chamber yesterday was clear.

Treatment options also include taking up the use of inhalers and tablets, lung rehabilitation and transplants. The NHS long-term plan addresses the need for early diagnosis and more suitable treatment. Given the figures stated earlier, the long-term plan must be implemented as soon as possible. I ask the Minister—I usually try to ask a couple of questions in my contribution—when will the long-term plan be implemented? We need to see a timescale for that so that we know whether the right strategy has been adopted. I am not criticising anybody—I want to make that quite clear—but if we are committed to the long-term plan, can we have the timescale, please?

Much of our time and funding has been dedicated to covid, and there is no doubt that it falls under the umbrella term of respiratory disease. Our lungs are one of our most vital organs—needed to keep us alive—and there must be better awareness of the symptoms of COPD. The main ones include increasing breathlessness and a persistent phlegmy cough—we get that with colds or flu, but those with COPD have it every day of their lives, and every hour of every day. Those are not normal symptoms to have for a prolonged period.

I want to conclude by thanking the charities that do significant work in providing support for those who suffer from COPD, such as the British Lung Foundation, the National Association for the Relief of Apnoea—the breathing charity—and the COPD Foundation. I call on the Minister and the Government to study the figures and strongly consider allocating additional funding. We must help those constituents and patients with COPD. That, if we can do that, is the most essential way of preventing serious illness or even death. Our lung health is something that we should all make a priority.

--- Later in debate ---

[Gillian Keegan]

Of course, access to GPs’ services is a concern that all Members will have heard a number of their constituents raise. That is why we put in place £250 million to increase access to face-to-face GP appointments as part of the recovery plans, which are quite extensive for the NHS.

The guidelines I was talking about aim to highlight ways to support people with COPD, such as signposting charities and support groups for better health and wellbeing. They recommend using technology to reduce some in-person appointments, while making sure not to provide a service that would increase health inequalities through a lack of digital access—it is additional, not instead of—as well as offering advice on how to modify care during the pandemic.

A number of questions were raised about the recovery plan, and how to restore services for patients and restore the diagnostics to pre-pandemic levels, or above them. The 2021-22 priorities and operational planning guidance set the priorities for NHS England and NHS Improvement, and includes tackling the backlog for non-urgent treatment such as services for lung disease patients. That plan aims to stabilise total waiting lists, and eliminate waiting times of two years or more and the increase in waiting times of more than one year. We have made £1.5 billion available to assist local teams to increase their capacity and invest in other measures to achieve those priorities, and the 2021 spending review announced £2.3 billion to increase the volume of diagnostic activity and open community diagnostic centres to provide more clinical tests, including for patients with lung disease.

Targeted lung health checks are running in the parts of the country with the highest rates of mortality from lung cancer. However, those projects will not just identify more cancers, but pick up a range of other health conditions, including COPD. People aged between 55 and 74 who have ever smoked are now offered a free lung health check closer to where they live. They may then have a lung cancer screen scan if that check shows that they need one. A review undertaken by Professor Sir Mike Richards highlighted that patients with respiratory symptoms would benefit from community diagnostic centres, due to the number of diagnostic tests that will be made available. As well as supporting patients with COPD, the Government are committed to strategies that will help to prevent that condition, as a number of Members have mentioned.

[Jim Shannon]

Just for clarification, following on from the question that the hon. Member for Halton (Derek Twigg) has asked, does the Department of Health proactively—perhaps even aggressively—contact smokers to follow through, rather than those smokers contacting the health service? I am not sure whether that would always happen. What is the Government’s policy on that?

[Gillian Keegan]

Obviously, there would be a relationship between the GP and the smoker, but that can go either way. Anybody who is in those age groups needs to be made aware that they are entitled to this free lung health check, and it is the responsibility of us all to make sure those checks are available. I am sure we will all ensure that that is understood.

In 2019, 85% of deaths due to COPD were attributable to smoking, and in 2019-20, 84% of hospital admissions with COPD were attributable to smoking. The proportion and the number have remained quite similar over the past five years, and as has been mentioned by a number of hon. Members, smoking is a key factor in many cases of COPD. This Government are committed to reducing the harms caused by tobacco, and have made good long-term progress in reducing smoking rates, which are currently 13.9%, the lowest on record. However, with 6.1 million smokers in England, tobacco is still the single largest cause of preventable mortality, and a radical new approach is needed to address the stark health disparities associated with tobacco use. As such, we have set out the bold ambition for England to be smoke free by 2030. To support that ambition, we have announced the publication of a new tobacco control plan, which will include an even sharper focus on tackling health disparities and will support the Government’s levelling-up agenda.

The NHS long-term plan commits to delivering NHS-funded tobacco treatment services to all inpatients, pregnant women and people accessing long-term mental health and learning disability services by 2024. COPD is responsible for around 33% of annual deaths from respiratory diseases and is the single largest cause of occupational lung disease. There are an estimated 17,000 annual new cases of self-reported, work-related breathing or lung problems, which is why our colleagues in the Department for Work and Pensions are also helping to tackle the causes of COPD in the workplace.