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6.51 pm

The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): Everyone would agree we have had an excellent debate in which right hon. and hon. Members have rightly paid tribute to the many unsung heroes who make us proud of our constituencies and of our country.

In a world of perpetual change, the selfless dedication of volunteers and carers is a beacon of light that keeps alive the timeless values of compassion, solidarity and service. Those individuals shatter the cynicism of people who portray today’s society as one in which violence, antisocial behaviour and abuse are rife. Carers enable older and disabled people, as well as people with long-term chronic conditions, to remain at home with the dignity, autonomy and security that the rest of us take for granted. Whether it is the adult daughter or son caring 24 hours a day, seven days a week, 365 days a year for an ageing parent, or the friend who makes daily visits to an adult with a learning disability, carers are in the front line in ensuring that all our citizens have the quality of life that we demand in a civilised and fair society.

It is right to recognise that carers have their own practical and emotional needs, distinct from those of the people for whom they care, although that recognition is long overdue. We must strive to ensure that statutory and voluntary sector providers treat carers as equal and valued partners in the care and support offered to vulnerable people in all our communities. Volunteers are the living, breathing embodiment of a healthy civic society. Whether working under the auspices of a voluntary organisation, or simply making their own personal contribution, they are frequently at the heart of their communities. This month in my constituency, the Radcliffe carnival took place only because of the voluntary commitment of Ray and Hilda Veivers and Colin Jones. Next week’s Prestwich carnival has been made possible by David Curtis and his Sunshine Team of volunteers. Every day in every community, volunteers make a difference to the lives of vulnerable people. The much maligned younger generation is often at the forefront of that service. Through Millennium Volunteers, faith groups, schools and universities, young people demonstrate their
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idealism, responsibility and commitment to helping others, shattering the illusion that the vast majority of young people are engaged in antisocial behaviour—a point made by my hon. Friend the Member for Bedford (Patrick Hall) and the Parliamentary Secretary, Cabinet Office, my hon. Friend the Member for Doncaster, North (Edward Miliband).

The Government believe that the state alone cannot transform communities. We are committed to an enhanced role for third sector organisations in the development and delivery of high quality public sector services. The restoration of community solidarity and civic pride requires new, authentic partnerships between the state, third sector organisations, the private sector and active citizens. Professionals, volunteers and carers all have a distinct but crucial role to play in ensuring not only that we care for vulnerable people, but that they have a quality of life fitting in a civilised modern society.

I come to some of the excellent contributions made by right hon. and hon. Members. The hon. Member for North-East Bedfordshire (Alistair Burt), as usual, presented his argument in a reasonable and fair way, reflecting great credit on his contribution over many years, first in Bury, before he went, not entirely voluntarily, to North-East Bedfordshire. He rightly highlighted the contribution of sports volunteers. We ought to reflect on the massive contribution that volunteers made to the success of the Commonwealth games, which my home city, Manchester, was so proud to host. As we think about the World cup and our hosting of the Olympics, the careers of many of the successful footballers and athletes will start on Saturday and Sunday mornings, when volunteers enable young people to participate in sport. For many of our sporting heroes, that is how it all began.

The hon. Gentleman mentioned his pride in being Minister with responsibility for disabled people for some time. He did not refer to his time as Minister with responsibility for the Child Support Agency, which I know was a stretching and challenging period for him. He rightly drew attention to the success of the Eden project, which is an excellent example of best practice in terms of involving young people.

In debates such as this, I always say that at the age of 14 I became involved in voluntary work with people with learning disabilities. By the time I reached the age of 16 or 17, I had decided that I wanted to work professionally in the voluntary sector in social care. I do not believe that I would ever have gone into politics or that I would be standing at the Dispatch Box making this speech if I had not been connected at the age of 14 with that voluntary work with those people with learning disabilities, which made me think very differently about the kind of society I wanted to live in and the kind of contribution I wanted to make. That applies to large numbers of young people, who become involved on a voluntary basis and then decide that they want to make a contribution through public service. It is not just a matter of what people give, but of what they get through their own personal development and sense of satisfaction.

My hon. Friend the Member for Brighton, Pavilion (David Lepper) and the hon. Member for East Worthing and Shoreham (Tim Loughton) rightly spoke about young carers and our responsibility to identify their distinct needs, understand the pressures that they face daily, and recognise that in the education system and
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the health service we need to be better at identifying those young carers and providing the necessary support.

The hon. Member for Somerton and Frome (Mr. Heath) spoke about the definition of carers under the Department of Trade and Industry flexible working legislation. The Department is consulting on that legislation and will take account of views about such a definition before reaching a final decision. My hon. Friend the Member for Aberavon (Dr. Francis) has made a massive personal contribution in advancing the cause of carers during his period as a Member of the House. That was based on his own experiences. The Carers (Equal Opportunities) Act 2004 will make a tremendous difference to carers’ lives.

The right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) made some valid points about the difference between small and large charities, but I do not believe there is any need to attack larger charities. We must build the capacity of smaller charities in local communities. I remember that when I worked in the voluntary sector we had a slogan: “Voluntary does not have to mean amateur”. Vulnerable people depend on the activities of charities, so it is important that we do not think that voluntary organisations should not be accountable.

My hon. Friend the Member for Stourbridge (Lynda Waltho) spoke about the contribution of the Orchard partnership in her constituency, which sounds extremely innovative in its work. The hon. Member for Newbury (Mr. Benyon) raised a number of issues relating to work-life balance and family-friendly policies. I am sure he welcomes the Government’s contribution in that respect.

As we look ahead to the future, carers and volunteers know that the stakes are high. The Labour party in government is strengthening Britain with social justice as our eternal mission and as an integral part of our national success, whereas the Conservative party views the word “compassionate” purely as a political strategy to win power, not as the expression of common values. It is right that today, from all parts of the House, we pay tribute to the contribution of carers and volunteers.

Question put and agreed to.


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Canvey Island (Housing Development)

7 pm

Bob Spink (Castle Point) (Con): There is a serious problem in Castle Point as elsewhere in south Essex relating to the overdevelopment of our communities, and in particular the proliferation of flats, which puts intolerable pressure on our infrastructure, including water supply and treatment, and our roads.

The petition, organised by Mr. and Mrs. Barham, is signed by only the neighbours to the development site, but it is representative of the feelings of the general public across my borough and much further afield.

The petition states:

To lie upon the Table.

Disabled Services (Exmouth)

7.1 pm

Mr. Hugo Swire (East Devon) (Con): My petition follows on rather appropriately from the debate on volunteers and carers and concerns the Liberal Democrat administration at county hall in Devon, which has agreed to become a fully commissioning organisation. There is deep concern in East Devon about the quality of future provision and the time scale of these changes, and my petition is signed by more than 2,000 concerned local people.

The petition states:

To lie upon the Table.

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Asthma Services

Motion made, and Question proposed, That this House do now adjourn. —[Huw Irranca-Davies.]

7.2 pm

Willie Rennie (Dunfermline and West Fife) (LD): I would first like to thank Mr. Speaker for selecting asthma services as the subject for this Adjournment debate. It is a subject close to my heart and I gather, although not from the number of Members present, that it is also a subject in which hundreds of thousands of people throughout the country are interested.

I should like to introduce the background to the debate. World asthma day was on 2 May, and like many other hon. Members I attended a reception given by Asthma UK in this House. The Secretary of State for Health also attended the event and made encouraging noises about the need to improve health care provision for people with long-term conditions.

I am grateful to the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton), for coming here today to expand on the Secretary of State’s comments, and I will be sure to leave her ample time to deal with the detail of the Government’s thinking.

My hope and intention is that today’s debate can be a constructive one in which as many Members as possible are able to feed to the Minister some of their thoughts and concerns about asthma services in the UK. There is much to be commended in the work that the Government have done for people with asthma. If that is not clear later on in my speech, it is only because time is tight and I am keen to flag up gaps in provision and procedures that could be improved. In particular I wish to pass on what people with asthma have said to me, because there is no doubt that they are among the best judges of what does and does not work, and what could be improved.

I have lived with asthma all my life. My sister, Caroline, had undiagnosed asthma for many years, and her quality of life suffered as a consequence—at one point, she ended up in hospital with pneumonia. Through my sister’s experience, my shovel-like cough was identified as a symptom of asthma, which was diagnosed at the age of two. My elder son, Alexander, has had two extended visits to hospital in years two and three of his life. My other son, Stephen, who is just two, is showing all the signs of asthma, but he is yet to be diagnosed.

In my previous life, I worked with Asthma UK—at the time, it was known as the National Asthma Campaign—on a number of campaigns, including a campaign on smoking in public places. I am delighted to see that a similar ban to that in Scotland will be introduced in the rest of the country, which will make a big improvement to the quality of life of people with asthma. Other important issues include the administration of medicines in schools and the redesign of asthma services.

I have found ways to manage my asthma and, like many others with the condition, enjoy a number of sports and activities in which I would be unable to participate without proper medication. At this point, I challenge other hon. Members to join me in the
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Scottish coal-carrying championship, which takes place at the end of June. Competitors are required to carry a 1 cwt bag of coal for 1,000 m along the undulating main street in Kelty, my home village. Given the marathon sittings that hon. Members endure in this House, I imagine that they would find that a stroll in the park.

I consider myself lucky that my asthma is relatively mild and controllable and that I have the wherewithal to pay for repeat prescriptions. I believe that the person should control the asthma rather than the asthma controlling the person. When GPs, nurses and pharmacists ask people with asthma whether their condition is under control, the people often say, “Yes.”, but if they are asked whether they can climb stairs without wheezing, whether they can sleep for a whole night without wheezing and whether they can run for the bus, they often say, “No.” People accept far too much of their condition, and awareness needs to be raised among people with asthma about the quality of life that they could live.

I have personal experience of the benefits of modern medicines and the value of asthma clinics. When I was in my 20s, I did not control my asthma well, and when I went to the asthma clinic, the nurse told me that I would die if I continued not to control it. That information was dramatic, and it shook me up. The nurse explained that if I did not manage my asthma, the blue inhaler would not work and my lungs would collapse during my next asthma attack. I took that information to heart and have controlled my asthma much better—the modern medicines are fantastic. Nurses and pharmacists play as an important part as GPs, and they are skilled health professionals who should be encouraged to do even more. They are in the front line and face people with asthma all the time, and we should encourage them to do more to provoke people to reassess whether their condition is acceptable.

Asthma is a disease of the lungs in which the airways are unusually sensitive to a wide range of triggers, including house dust mites, cold air, viral infections—in my case, it is usually colds—or cut grass. Common triggers also include tobacco smoke and animal fur—interestingly, people who live with a cat or dog in their early years tend not to suffer from animal sensitisation in later years, so not all animals are bad for people with asthma. The airways react to those triggers and become inflamed, resulting in symptoms of tightness and wheeziness in the chest. People suffering severe attacks find it nearly impossible to breathe and require rapid medication. Approximately 1,400 people die every year from asthma, and 90 per cent. of those deaths are preventable, which is a huge percentage that needs to be tackled.

There are about 5.2 million people with asthma in the UK, which is one of the highest rates in the world. It affects one in eight children and one in 13 adults. An estimated 8 million people in the UK have been diagnosed with asthma at some stage in their lives—an average of one in seven of the population. There are now three to four times more adult people with asthma in the UK and six times more children with the condition than 25 years ago. There is a big debate as to why that is the case. Asthma is a serious problem encountered by a large proportion of the population. There is currently no cure for it. Some people say that
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the problem largely disappears when they enter adulthood; many, however, live with it for life. It is a condition that they manage through their medication and lifestyle adaptations.

At the end of January this year, the Government published their White Paper on health care outside hospitals, entitled, “Our health, our care, our say”, which came out of the consultation exercise, “Your health, your care, your say”. There is much to applaud in that White Paper and much for which people with asthma have been calling for many years. In particular, I welcome the recognition that better community-based care can reduce hospital admissions and thus costs. I will, however, press the Minister to take that logic further in relation to prescription charges.

Several specific proposals will have come as welcome news for people with asthma. First, there are the plans to develop so-called information prescriptions and personal care plans for those with long-term conditions. They constitute an important recognition that people can be the best judges of their own needs. I hope that the Minister can confirm that information prescriptions will be just one part of a larger drive towards self-management of long-term medical conditions. I am sure that she will know that my colleagues have long espoused the value of self-management for the estimated 17.5 million people in Britain living with chronic conditions.

The potential benefits of such an approach are considerable. For example, a person aware of the nature of their condition and empowered to control it should be less likely to require regular emergency treatment, thereby reducing the burden on stretched NHS resources. Asthma UK estimates that for every £1.60 spent on personal asthma action plans, £7 is saved on NHS care. Many people with asthma resent the feeling of powerlessness that comes with the uncertainty about when attacks might occur. A successful self-management programme should improve a person’s mental health and self-esteem as well as promoting their long-term physical well-being. Self-management programmes could be integrated with greater use of voluntary sector organisations such as Asthma UK. There is no doubt that people with asthma looking to develop self-management programmes would benefit from the expert advice that voluntary sector organisations can offer and from the chance to talk to other people with asthma within that context.

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