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which was published by my right hon. Friend the Secretary of State for the Environment earlier this year. That provides a framework within which effective policies can be developed to improve air quality, and some of the key legislation needed has been included in the Environment Bill.Public health policy for asthma is aimed at keeping sufferers free of asthma symptoms, to enable as normal a life as possible. That is achieved by sufferers knowing what their individual trigger factors are and how to avoid them, and knowing what practical steps and medicines they may take to control their symptoms. Asthma is combated by provision of health care resources to enable people to manage their own conditions as far as possible.
It is, of course, a matter for the professions concerned, and the British Thoracic Society produced revised guidelines in March 1993 which included advice on how patients should manage their asthma. The Department of Health drew the guidelines to the attention of health authorities in December of that year. I remind the House that it is for local health purchasers to determine the priority to be given to asthma services for their own populations.
The Department of Health has provided a national framework for the provision of primary care for asthma in the new arrangements for health promotion and chronic disease management which we introduced in July 1993. Asthma is one of the target areas of that programme. Under it, general practitioners are eligible for fixed payments for setting up and overseeing an organised programme of care for asthma. Over 90 per cent. of all GPs have been approved to run such a programme.
The advisory group on the medical aspects of air pollution episodes has also examined the evidence relating to the effects of episodes of elevated concentrations of individual air pollutants upon normal and asthmatic individuals. Since the publication of its reports, new evidence has been continually reviewed by another committee, the Committee on Medical Effects of Air Pollutants, for a range of pollutants including ozone, oxides of nitrogen, sulphur dioxide and particles.
That committee has been asked for advice on links between asthma and exposure to low levels of air pollution. A sub-group was set up last year to examine the relevant evidence, and we expect its definitive advice in the autumn, after which a report will be published.
Across Government more widely, my Department is working closely with the Department of the Environment and other Departments. The two Departments are organising a one-day conference in November on the causes of asthma and what everybody can do to alleviate its effects. In October last year, my Department, together with the Department of the Environment and the Medical Research Council, announced a major research initiative on air pollution and respiratory disease, including the possible links between air pollution and asthma. Over the next few years, a total of up to £5 million will be available if suitable high-quality projects are presented.
Proposals were invited on a range of aspects, including the role of air pollutants, either individually or in combination, in respiratory disease, particularly asthma, and their possible interaction with other causes of respiratory disease. My hon. Friend referred, for example, to the role of factors such as house dust mites and tobacco smoke in asthma.
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The effects of air pollution on health has also been identified as a priority area in the environmental health theme of my Department's programme, and a strategy for research is being developed. A number of relevant research projects are already being funded under the programme.The Health and Safety Executive, which is the responsibility of my right hon. and learned Friend the Secretary of State for Employment, is responsible for policy on prevention of occupational asthma. I know that the HSE is giving a high priority to reducing the incidence of asthma in that field. Its "Breathe Freely" campaign has raised awareness of the dangers of respiratory sensitisers, which are substances that create an allergic reaction in the respiratory system.
It has also reminded employers of their duty under the Control of Substances Hazardous to Health Regulations to control exposure to them. The HSE continues to focus on respiratory sensitisers under its management of health risks campaign which it launched on 1 May.
Mr. Tredinnick: It is interesting to hear about the range of research that is taking place. Is my hon. Friend's Department co-ordinating that research? When the Medical Research Council work and the other projects are complete, will there be a publication in which the findings will be amalgamated, so that they may be readily available to those who are concerned about asthma?
Mr. Sackville: The principal body for carrying out research is the Medical Research Council, but there is a centrally commissioned programme in my Department, and we work closely with the Medical Research Council. I take note of what my hon. Friend says about the need to bring all these matters together, so that there can be some readily understood document which will tell all those concerned what is being done and outline the level of success that has been achieved.
I turn to the question of public information, which relates to what my hon. Friend the Member for Bosworth has just said. More information certainly needs to be available to the public. I am sure that my hon. Friend is aware of the marvellous work of the National Asthma Campaign--the leading voluntary organisation in the subject--in offering support and information to people with asthma and their families through its national network of 200 branches.
The NAC publishes leaflets, publications and videos, and has an asthma help line staffed by specialist asthma nurses. I understand that the help line received 20,000 calls last year. My Department is giving the NAC a grant to fund a member of staff to co-ordinate its work for children with asthma.
In that connection, the Department for Education is in the process of drawing up a draft circular on the management of medication in schools. Its officials have
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been working closely with my Department on this and talking to interested outside bodies, including the National Asthma Campaign. We certainly favour children with asthma being encouraged to manage their own condition as early as is consistent with their development.My hon. Friend called on the Government to include asthma as a key area in "The Health of the Nation". The House will be aware that that is the subject of a recent early-day motion. I should say, however, that, although the White Paper designated asthma as a strong contender for key area status, it was recognised that research was needed into its causes and into what could be done to prevent it. There are three criteria for key areas status. First, the area should be a major cause of premature or avoidable ill health, which asthma clearly is. Secondly, the area should be one where effective interventions are possible. There are, of course, known interventions for asthma which can potentially improve the prognosis of people who already have asthma, but much less is known about the factors which lead to the disease developing in the first place.
Thirdly, it should be possible to set objectives and targets and monitor the progress towards them. That is certainly the most difficult of the three criteria for asthma to meet. Mortality targets, which would be one measure, would be of limited value by themselves, as--fortunately--deaths from asthma are relatively uncommon. Morbidity targets based on routine statistics would be difficult to interpret. For example, improvements in service provision could lead to an increase in numbers treated. Clearly it is important to identify effective interventions and ways of monitoring outcomes before considering whether it is appropriate to set targets.
An ad hoc expert group has recently reported to the chief medical officer on possible interventions and targets for asthma so that it might be reconsidered for key area status in "The Health of the Nation". I assure my hon. Friend that we shall give that report full and careful consideration, together with the further reports on asthma that I have already mentioned, which are expected shortly. I reassure my hon. Friend and the House that the Government take the problem of asthma extremely seriously. I mentioned the range of national initiatives, and I am pleased that they are being developed locally in his area of Leicestershire. He suggested the need for a co-ordinated national policy. I shall therefore summarise our policy, which is quite simple.
We will continue to improve our knowledge of the causes of the disease and do everything that we can to make life as normal as possible for those who suffer from this very distressing condition. Question put and agreed to.
Adjourned accordingly at two minutes to Eleven o'clock.
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