| Previous Section | Index | Home Page |
Ms Julia Drown (South Swindon): The Government have a very good record on both debt reduction and the alleviation of poverty, but will my hon. Friend assure us that their determination to tackle those problems will not cease until millions of children no longer die unnecessarily every year because their countries have no basic health or education services?
Yesterday I hosted a very successful meeting with Christian Aid. There was a huge response from Members of Parliament, all of whom were very concerned about the Cologne summit. They were keen to back the Government--to urge them to go to Cologne and ensure that achievements were made, and the determination maintained, until real improvements were brought about for the benefit of the millions of people throughout the world who depend on the attaining of the goals outlined by my hon. Friend.
Mrs. Roche:
I thank my hon. Friend for making that point; I know that she takes a great interest in these matters.
We want to establish a new dialogue between debtors and institutions. Our commitment is essential. The IMF programmes clearly protect spending on health and education, and my hon. Friend need not doubt that we shall use our best endeavours in this regard.
Our actions have had a galvanising effect. Over the past few months, many developed countries--and all the G7 countries--have set their own proposals for reform of the HIPC arrangements. Although the emphases are different, the initiatives have a common theme: the need for a more ambitious framework that will provide faster, wider, deeper debt relief, remove unsustainable debt burdens and allow resources to be reallocated to programmes that reduce poverty.
In achieving those aims, we must work together. The days of unilateral action are gone. The best way forward is now through collective international effort, which means new co-operation and partnerships between donors and recipient countries. Working together, we can achieve much more than we can when working alone.
We also want debtor countries themselves to be involved in the debate on debt relief. That brings me back to a point that I made to my hon. Friend the Member for Clydebank and Milngavie. The HIPC capacity building programme that we are helping to finance is working with 21 countries to improve their debt management, so that they can understand their debt position, take control of it, and adopt the right policies on new borrowing. It is important for poor countries to take the opportunities open to them to press their own agendas.
Although debt relief is important, it is not an end in itself. The United Kingdom's bilateral aid programme for HIPCs is eight times as large as the receipts of interest payments. Debt reduction must be accompanied by appropriate aid programmes and economic management. The billions saved in debt-servicing payments must not be wasted on weapons or lost to corruption; they must be invested in health, education and economic development.
The international community is placing more emphasis on the assessment of the impact of policies and programmes on the poor. Greater efforts are being made to attend to their priorities, and to build consensus by means of consultation with civil society. However, much remains to be done. That applies to all development programmes, not just those that are funded through debt relief.
Mr. Cotter:
May I take up a point made bythe hon. Member for Clydebank and Milngavie
Mrs. Roche:
That is a good point. We are certainly committed to achieving that end.
Mrs. Cheryl Gillan (Chesham and Amersham):
Will the Minister give way?
Mrs. Roche:
Yes, very briefly. I have only a couple of minutes.
Mr. Deputy Speaker (Mr. Michael Lord):
Order. This is a half-hour Adjournment debate, and Opposition Front Benchers do not normally participate in such debates.
Mrs. Roche:
With your permission, Mr. Deputy Speaker, I will give way briefly.
Mrs. Gillan:
I thank the Minister. I merely wish to express the Opposition's support, to congratulate the hon. Member for Clydebank and Milngavie (Mr. Worthington) on raising such an important matter, and to ask the Minister to undertake to place in the Library, immediately after the summit, a report relating specifically to this part of the negotiations at Cologne.
Mrs. Roche:
We make sure that all our reports are disseminated in the normal way after a summit.
I am very pleased to have been able to reply to the debate. We must ensure that this item is placed at the top of our agenda, and that is what the Government are doing.
Mr. Mark Oaten (Winchester):
It is often dangerous to draw too many conclusions from statistics, but I start the debate by drawing to the House's attention a few alarming statistics. In the past 10 years in this country, the number of children with asthma has doubled. In the United Kingdom, 1.5 million children now have asthma. What is deeply concerning is that that is one of the worst rates in Europe. More troubling than that is the fact that the trend appears to be rising.
Those are harsh facts. I want to look in a little more detail at some of the reasons behind the increase in asthma and to give the Minister a chance to set out the Government's response to those alarming figures.
Earlier this year, I carried out a survey of schools and general practitioner practices in the Winchester constituency to try to establish whether what individuals were saying to me in surgery and in writing was true. There was clearly a perception in Winchester that the number of children seeing GPs about asthma had increased.
I would not for a minute try to claim that my constituency office, with all its volunteers, is anything like MORI, the opinion survey organisation, or Government scientific advisers, although these days one is never quite sure, but we carried out a survey of schools and doctor practices in the constituency. Thirty-three schools and seven GP practices responded. Two thirds of the practices stated that, in just the past couple of years, there had been an increase in the number of children with asthma coming to their practice. Similar results came from schools. Over half the teachers involved claimed that there was a much bigger increase in children coming to school with asthmatic problems.
As I say, the findings in Winchester are certainly not scientific, but they appear to be backed by national research work, particularly by the National Asthma Campaign. I am sure that hon. Members on both sides of the House will know that, last week, the campaign revealed the results of its most recent audit; it audits asthma trends annually. It announced that a study in Leicester had found that asthma and wheezing in children under five had doubled in that location in less than a decade. In 1990, only 12 per cent. of children had been diagnosed with asthma. By 1998, the figure had risen to 21 per cent. Wheezing attacks within a 12-month period had doubled from 12 per cent. in 1990 to 23 per cent. in 1998.
The National Asthma Campaign concludes that approximately one in seven children aged between two and 15 have asthma symptoms that require treatment; that is where we draw the figure of 1.5 million children from. Although I want to concentrate purely on the effects of asthma on children, we should not forget that more than 1.9 million adults--those over 16--suffer from asthma.
All those figures and findings suggest that we have a major problem with asthma among children. I conclude that it will be in danger of getting seriously out of control if the trend goes upwards.
As well as the obvious distress and suffering that asthma causes children and their parents, the increases have other severe implications, not least the cost and
burden to the national health service. The total cost of asthma to the health service is estimated to be about £709 million, at today's figures. In addition, we should consider the cost involved in providing inhalers and asthma prescriptions, which is estimated to be about £500 million.
The National Asthma Campaign says that, if we go beyond child asthma and take into consideration the number of days lost and the burden on society that asthma brings, the figures increase dramatically and society has a major problem in relation to the costs involved in the health service. That, in itself, should be an argument for some urgent action to tackle the problem.
There are other hidden costs, particularly the cost to a child's education. The rising number of children with asthma means a rising number are off sick, missing school days. Having asthma is one of the most common reasons for children missing school or pre-school nursery.
In 1995, "Blue Peter" carried out an asthma survey. More than 10,000 children responded. Eight per cent. said that they had missed at least a month of school as a result of problems with asthma. A recent large study of school children aged between 12 and 14 found that a substantial proportion of adolescents had asthma symptoms that interfered with their schooling and day-to-day lives. Another concern was that many of them were not receiving treatment for that asthma. One third of the children who took part in the survey and had experienced asthma symptoms said that they were not receiving some form of medical support to back them up. That under-diagnosis of asthma and the consequential missed school days cannot be good for the children's education, or their social relationships
The most worrying factor is that we do not really know, or we do not appear to know, why all that is taking place. After we carried out the survey in Winchester, I was surprised at the findings and asked to see a Dr. Roberts, who is the asthma specialist at the Royal Hampshire county hospital in Winchester. Politicians always seek a simple answer. I just asked, "Why is it happening? What are the reasons? There must be a simple explanation."
In addition, we were involved in a battle to try to persuade the public that it would be sensible to build a park-and-ride facility in Winchester. I wanted to be able to use the asthma results to support the case for the park-and-ride facility to keep cars out of the city centre, but clearly it is not as simple as that.
The doctor explained--and my research since explains--that there are endless theories as to the cause of the big increase in asthma. Pollution and traffic are obviously the simplest arguments that people can advance, but one of the most compelling arguments that I have heard is that living in a cleaner society has an impact. In the past 10 or 15 years, facilities in homes have meant that they are cleaner. Whereas before, in a dirtier house, children had a chance to build resistance to viruses, in a cleaner society, individuals and children do not build up resistance and then are more vulnerable and susceptible to asthma.
Other theories have been put forward. Only yesterday, the World Health Organisation announced details of a study that it had undertaken in Europe, which led it to claim in the press:
We know that, recently, farmers have turned much more to growing oil-seed rape. Indeed, one of ways in which to decrease transport pollution is to have transport run on oil-seed rape, but by growing more of the crop we could create asthmatic problems. An organisation representing hyperactive children, which has concerns about food additives, has raised concerns to the effect that changing diets, and the things that we are adding to food and giving to children, may be a cause.
The only conclusion that I can draw from all that information is that the only thing individuals agree on is that no one really knows what the causes of the increases in asthma are. That needs to be the starting point for Government action. We need to be able to have more research to establish what exactly the cause is.
I am aware that the Government are active on the issue. I make it clear that I did not secure the debate to criticise the Government for any inaction. Rather, I should like to press the Minister for some more information about the research that is taking place.
In a written answer to me last Friday, the Minister was helpful in explaining what the Government were doing in relation to research. He said that they were supporting a major initiative on the relationship between air pollution and respiratory diseases. Will the Minister use the debate to confirm when that report and the conclusions will be made available, and if they will be made available publicly? Will he go further and explain why the link is being made between air pollution and respiratory diseases? Are the Government planning any research to look at the connection between respiratory problems such as asthma and other issues apart from air pollution, some of which I have touched on; or is it the Government's conclusion that air pollution must be the main reason--which is why they are putting energy into research in that particular area?
I should be grateful if the Minister let me know whether the Government had plans specifically to examine the number of children who have asthma. I have quoted some data and a figure, but judging by a written reply that the Minister gave me, which looked at the number of children going into accident and emergency departments and having in-patient care in hospitals, it appeared--unless I misread the data--that there had been a decline in the number of children going into hospital with asthmatic problems. There seems to be a contradiction between research done by campaign groups and some of the Government's data. Is it perhaps worth while investing additional resources in detailed research to discover whether the increases that I have described are indeed occurring?
The Government commission an annual health survey for England. According to the 1997 survey, 29 per cent. of boys and 18 per cent. of girls aged between two and 15 have been diagnosed with asthma at some time.
I should be fascinated to know--perhaps the Minister will write to me on it--why boys feature so much higher than girls in those figures, and how those figures compare with previous studies done by the Government on the matter.
We should certainly be reassured that the Government are taking the issue seriously, and that their programme to address it includes much research. For me, however, the critical issue is whether the scope of the research is sufficiently wide. If it is not, the research will raise more questions than it provides answers.
I should like also to consider ways in which the Government might assist those working in the public health field, and particularly in education, in dealing with some of the consequences of childhood asthma. Currently, the response of various local education authorities to the growing problems of asthma in schools is very mixed. A recent study examined specifically how LEAs were tackling the problem, by sending, in late 1998, a questionnaire to more than 200 LEAs. Although only preliminary research has been done, and the results of the study have not yet been made public, those results are a matter of concern.
One third of LEAs said that they do not have a policy on how to deal with asthma in schools, and less than half of LEAs and schools said that they had in place a protocol on what to do if a child has an asthma attack in school. To my surprise and horror, almost half the LEAs said that they did not have a commitment to a no-smoking policy in school--which is surely one of the causes of asthma attacks.
I hope that, when the study is complete, the organisation involved will send the findings to the Government for consideration. Today, however, I should like to press the Minister to have a word with his colleagues in the Department for Education and Employment, to ascertain what advice the Government are giving to LEAs. Perhaps he will also use his reply to clarify who is responsible and accountable for securing health in schools. Although I know that there have recently been Government announcements on that issue, it would be tremendously helpful if he could say who has responsibility as the lead organisation in addressing it.
I hope too that the Government, when they are considering good health in schools, will consider also the issue of asthma, and good practice across England. Some local authorities have been working with local asthma groups to establish very good practice.
Something is wrong--and it is always very troubling when one does not know the cause of a problem. Moreover, recent trends seem to be going in entirely the wrong direction. The problem has to be tackled, not only because of the uncomfortable and unpleasant nature of asthma both for children and for parents seeing their children suffering from asthma attacks, but because it is becoming an increasing burden on the health service. The problem has to be tackled also because it is affecting children's ability to have an enjoyable childhood and to play their full part in the education system.
1.29 pm
"Car fumes kill more than crashes."
16 Jun 1999 : Column 367
Again, it had clear evidence that there was a link between pollution from cars and increased cases of asthma.
I have heard the other argument--particularly in a rural constituency such as Winchester--that changing farming patterns are one of the causes. Of course, the most obvious link that people are making at the moment is with genetically modified crops. They are asking whether those crops will have an impact. Letters from constituencies following publicity about the survey suggested that oil-seed rape was an increasing concern.
| Next Section
| Index | Home Page |