Members' Business — S6M-02730 Jackie Dunbar: My Breath is My Life - 25 January 2022

Members' Business — S6M-02730 Jackie Dunbar: My Breath is My Life - 25 January 2022

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I remind members of the Covid-related  measures that are in place and that face   coverings should be worn when moving around  the chamber and across the Holyrood campus. The final item of business is a members’  business debate on motion S6M-02730,   in the name of Jackie Dunbar, on my  breath is my life. The debate will be   concluded without any question being put.  I ask those members who wish to speak in  

the debate to press their request-to-speak  buttons or enter an R in the chat function. I am very proud to bring this members’  business debate to the chamber tonight.   I thank everyone for the cross-party support  that has ensured that the debate can take place. In Scotland, around 368,000 people  are being treated for asthma,   including more than 72,000 children. That is not  the total amount of folk who suffer from asthma.   A lot of folk have the condition but are not  diagnosed, because it is not an easy diagnosis   to make. I went to the doctor about nine or 10  years ago and was diagnosed as having borderline   asthma and borderline chronic obstructive  pulmonary disease. At the time, the doctor was  

unable to tell me which condition it was,  and I was given three different inhalers:   two to be taken once a day—one for asthma  symptoms and one for COPD symptoms—and the   blue inhaler that most people associate  with asthma, for as and when needed. I am not alone in that kind of diagnosis. Many  times, it is about trying to see what works for   the individual. I am not proud to say that I was  a smoker. However, I quit more than two years ago,   and I am very pleased to report that my  lung capacity increased and, as a result,   my medication strength was decreased, That is  not something that happens if someone has COPD,   so I take it that I am just  borderline asthmatic now. Respiratory conditions, including asthma,  account for more than a third of all   acute hospital admissions and are among the most  commonly presented conditions within primary care.   I was pleased by the Scottish Government’s launch  last year of the respiratory care action plan,   which focuses on ensuring a consistent  approach across Scotland to the   management of respiratory conditions in  the five key priority areas: prevention,   diagnosis, management, care,  and supporting self-management.

In 2020, there were 113 asthma-related  deaths in Scotland, 90 per cent of which   could have been prevented. In the north-east,  the work of the Asthma and Allergy Foundation   has been transformational in increasing the  awareness of people who live with and care   for those with asthma. My motion lays out all  the fantastic work that it has achieved so far. All members who are here will know  someone who has asthma.? However,  

would they know how to support someone who was  having an asthma attack? I did not. In 2020-21, 49   people out of every 100,000 were hospitalised  for asthma at least once. In comparison with the   rest of the world, Scotland—like other United  Kingdom countries—has a high prevalence of asthma. An asthma attack is caused by the  inflammation of the breathing tubes   that carry air into and out of the lungs.  Asthma makes those tubes highly sensitive,   so that they narrow temporarily. The condition  affects the airways, and can affect people of  

all ages. Although it often starts in childhood,  it can also develop for the first time in adults.   The main symptoms of asthma can be wheezing,  breathlessness, a tight chest and coughing;   however, that can change from person to  person. Asthma is currently incurable but, as   I have said, symptoms can be managed through  medicines such as inhalers and steroids. The my breath is my life project was  launched in 2018 and has worked across   Aberdeen and Aberdeenshire to provide  asthma awareness and education in schools.   With support from national lottery funding,  the project has delivered workshops to staff,   students, parents and carers, to  raise awareness of the condition   and to help people become confident and capable  of managing the illness within a school setting   and not only to recognise the signs of an  asthma attack but to know how to deal with it. Recently, I was delighted to meet the  founders of the Asthma and Allergy Foundation   and to hear about its most recent national  lottery funding, which will allow it to   expand its workshops into the Greater Glasgow  and Clyde Health Board area—again delivering   workshops for children and young people, but  also exploring the transition into adult services   and ways in which young people can manage their  condition in a range of different environments.  

I was advised that, on average, there are two  children with asthma in every classroom. I repeat:   two children, in every classroom, in every  school. That is a lot. That is why it is important   that teachers and staff in every classroom are  comfortable and confident in managing asthma   in schools, and that they have the knowledge  of what to do if someone has an asthma attack. For example, before meeting the Asthma and  Allergy Foundation, I was unaware that someone   who is having an attack should never  be put into the recovery position,   as doing so constricts their airways  further and they may stop breathing.  

I learned a valuable lesson from our hour-long  meeting, and I am positive that the foundation’s   expansion work will help to inform and  educate many more people throughout Scotland.? As many members know, I donate my councillor’s  salary to charities and good causes in my   constituency of Aberdeen Donside, and I was  delighted to be able to donate my December salary   to the foundation, to help pay for further  training for its staff and volunteers. I thank everyone who has supported the motion, and  thank in advance the members who will be speaking. Last but not least, I will try to be  helpful by explaining what someone should do   if they or someone near them has an asthma attack.  First, the person suffering the attack should   sit up straight and try to keep calm—I know  that that is easier said than done. Secondly,   they should take one puff of their  reliever inhaler—usually the blue one—every   30 to 60 seconds, for up to 10 puffs.  Thirdly, if they feel worse at any point  

or do not feel better after 10 puffs, they  should immediately call 999 for an ambulance. I congratulate my colleague and old friend—with  the emphasis on friend, rather than old;   I meant it in the most respectful way—Jackie  Dunbar, for bringing forward the motion.   I know that this is an initiative  that she has been committed to   as it has been developed locally  in Aberdeen city and Aberdeenshire. I refer members to my entry in the register  of members’ interests, which states that I   am a councillor in Aberdeen City Council.  I thank the Asthma and Allergy Foundation   for its helpful briefing ahead of the debate.

I shamefully admit that, despite living  in the north-east, I had not crossed paths   with the my breath is my life  initiative until Jackie Dunbar   lodged the motion. The notion of a learning  resource that delivers training to children and   young people on how to cope with an asthma attack  seems logical and, as Jackie Dunbar highlighted,   the statistics speak for themselves. In  Scotland, around 368,000 people live with asthma,   around 72,000 of whom are children. Tragically,  2020 saw 113 asthma deaths. I cannot imagine   the loss and the sense of tragedy that is felt  by the families and friends who are affected. Prevention plays a vital role in many  aspects of our lives, particularly in our   health and wellbeing—for example, our daily  multivitamin tablets, our free eye tests and,   of course, our flu and Covid vaccine jags and  boosters. We are fortunate to be able to access   a wide range of resources and educational  opportunities to enhance our confidence and   skills, which help us to respond to unforeseen  events in which we might need to remember the   recovery position from our first aid training,  or, for cases of suspected stroke, the   FAST mnemonic—facial drooping, arm weakness,  speech difficulties and time. It therefore stands  

to reason, given the potentially serious  consequences of an asthma attack,   that education on how to respond—for  those living with asthma, their carers,   families and teachers—could, literally,  mean the difference between life and death. The commitment of Martina Chukwuma-Ezike in  establishing the Asthma and Allergy Foundation,   and in developing the my breath is my life  resource, is inspiring. She has turned her   traumatic personal experience into an opportunity  to educate and empower those who live with asthma.   It was fantastic to learn that the my breath is  my life workshop has been delivered to almost   15,000 pupils, just under 600 teachers, pupil  support assistants, parents, and others,   teaching learners to understand asthma,  identify symptoms and triggers and,   importantly, how to manage their condition.  It is truly a fantastic achievement. However, the my breath is my life project  is not just about raising awareness;   it is about supporting people to have a good life  in which they are in control of their asthma,   rather than their asthma controlling them.  Although it is currently a local initiative,  

the project will be making its own valid  contribution to ensuring that children can   stay in education, play sport and experience  strong mental health, and, further on in   their lives, can access skills development,  educational opportunities and positive outcomes. In that regard—and in conclusion—I note  that the motion calls for the my breath is   my life project to be made available  nationally. Having spent many years   in volunteering roles with  children and young people,   there is no doubt in my mind that such a project  merits every consideration for wider roll-out   across Scotland, and I will do everything  that I can to support efforts in that respect. I am delighted to speak in this debate  and I pay tribute to Jackie Dunbar for   bringing to our attention the work  of the Asthma and Allergy Foundation.

Asthma is one of the most prevalent health  conditions in Aberdeenshire. It is also the   most common lung condition in children, affecting  around one in 11 children across the UK. Indeed,   as members have stated, 72,000 of  those children live in Scotland.   However, although asthma is a widespread  condition, its symptoms are not always seen   or understood by others. Difficulties  with breathing, wheezing, coughing  

and tightness and pain in the chest are all  commonly experienced by people with asthma,   and when such symptoms escalate,  it can be very frightening. Fortunately, asthma can be managed  effectively through the right treatment plan,   but nevertheless a diagnosis is worrying for  sufferers and their families. That is why the my   life is my breath project is so important.  It has helped children with asthma manage   their condition better, from giving  them an understanding of what triggers   symptoms to showing them how and when to use  their inhalers. They might sound like small  

interventions, but the right inhaler technique is  crucial for the medication to work effectively.   The project has also helped to empower children,  parents and teachers through targeted education   so that they can better support  their peers who have asthma symptoms. Too few people are aware of how  suddenly an asthma attack can come on   and how life threatening it can be, but the  fact is that someone in the UK has an asthma   attack every 10 seconds. When a child has an  asthma attack, it is not just their breathing  

that is affected. Young children might report  a stomach ache, be unusually quiet, look pale   or not be able to complete sentences. Knowing  how to respond in such a situation can   save lives. Indeed, 90 per cent of  deaths from asthma are preventable. Of course, the Covid-19 pandemic has brought  respiratory illnesses into sharp focus,   and I thank organisations such as Asthma UK for  providing information and support to people with   asthma during the coronavirus outbreak. The  reality for some children and young people   with asthma is that having to wear a mask for  a prolonged period of time, such as at school,   as a result of the pandemic can be difficult, and  asthma sufferers can experience anxiety and panic   attacks from face coverings as they can amplify  the feeling of not being able to access air.  

Removing masks in classrooms can therefore impact  positively on the mental health of children   who might already be feeling anxious about wearing  them. With the threat posed by Covid-19 receding,   I agree with Professor Devi Sridhar, who argued  last week that children should be at the centre   of a return to normality and the first to  have measures such as masks in schools eased. Finally, as general practitioner surgeries  resume work that was deferred by the pandemic,   I urge patients who are due an asthma annual  review to accept the invitation, even if they   feel that their condition is under control.  This respiratory condition can be worrying for   people of any age, but the work of the Asthma and  Allergy Foundation has demonstrated how beneficial   patient-centred education can be and, for that,  I sincerely commend its staff and volunteers.

I, too, congratulate Jackie Dunbar on  securing this really important debate. Asthma is a common complaint—so  common, in fact, that we   often take very little heed of it, even though it  impacts just under 10 per cent of the population.   Moreover, although most people live with  the condition, it can be fatal; indeed, it   takes the lives of three people in the  UK every day. As Jackie Dunbar has said,  

most of those deaths could have been  prevented with better guidance and monitoring.   Good management is therefore crucial, and  the motion sets out how that can be done. The my breath is my life project helped  young people, their parents and teachers   to understand the condition,  its causes and its management. I grew up aware of asthma, because my grandmother  had it. I remember her having terrible attacks   and being taken outside the house in the hope of  helping her to get her breath. As a young person,   that was frightening to watch, and it must  have been terrifying for her. Therefore, even  

by simply raising awareness, the  project has been very worth while. The pandemic has been very challenging for those  with asthma. Not only have they had the fear of   catching Covid-19, but their lives have been  disrupted much more than those of the general   population have been, as they have had to shield.  The pandemic has also impacted on their families,   who have had to take measures to protect them.  In particular, children, who have been told by   their parents and those in authority for two  years, which is a huge portion of their lives,   that it is risky for them to  be out and mixing with others,   are much more likely to have had  their mental health impacted.  

It will also be a lot more difficult for them  to mix again with others with any confidence. People’s careers will have been affected  because they have been required to   shield. Not every job can be done  remotely. That means that some   people will have lost their job or given  it up due to the requirement to shield.   We need to target support towards them to  bring them safely back into the workforce.

There is an argument about how masks make  people with breathing difficulties feel.   If that is lined up against the benefits  of wearing masks for the most vulnerable   to Covid-19, there is a very  difficult decision to take. The project looked at the triggers for asthma  attacks. We would all benefit from understanding   those. Many attacks are triggered by atmospheric  conditions and pollution. We must cut pollution   and emissions for the good of the planet and  to stop climate change, but we also need to do   that to help people with breathing issues, such as  asthma and chronic obstructive pulmonary disease.

The project should show the way to  how we can build greater understanding   in Scotland. Raising awareness of  asthma allows us all to play our part   in preventing it and supporting those  who live with the condition every day. As co-convener of the cross-party group in  the Scottish Parliament on lung health and a   registered nurse still, I welcome the  opportunity to speak in this important   debate, and I thank my colleague Jackie  Dunbar for securing it. She has covered   asthma and associated treatment extremely  well, and I have learned a lot myself. It is important that we raise awareness  of activities in our constituencies   and regions by people and charities  that focus on health issues.  

That work, which can ultimately  save lives, is really important. I thank Jackie Dunbar for highlighting very well  the important work of the Asthma and Allergy   Foundation and the my breath is my life project.  That project has achieved outstanding success   since its inception, and it has delivered  workshops to more than 14,000 pupils   and trained more than 700 teachers  and support assistants on asthma.   The project has demonstrated excellently that,  when education is provided to persons with   asthma, their parents or carers, teachers,  classroom assistants and the wider public,   better knowledge and understanding are achieved.  The workshops that the project carried out   included ones on what asthma is, how  to identify symptoms and triggers,   education and learning, how to manage the  condition and how to manage breathing emergencies.

I watched the my breath is my life project  video on the   website. In that video, the clinical  specialist Professor Stephen Turner   said that education is extremely important, that  it needs to be person centred, and that simple   messaging needs to be provided, such as that the  blue inhaler that a person has been given is to be   taken only when they have asthma symptoms, and  the brown inhaler is to be taken all the time.   The blue inhaler contains the rescue medication,  which should be taken when asthma symptoms,   such as wheezing or shortness of breath, occur.   It provides an immediate effect or immediate  relief. The brown inhaler contains prevention  

medication, which should be taken every day as  prescribed. That can mean more than once a day. I agree that simple messaging is key.   Many people do not realise that  people can die from an asthma attack.   I cannot imagine the grief that is suffered  by those who have lost a loved one to asthma. The British Lung Foundation has  created a number of lung health   champions in the Scottish Parliament. Members  from across the chamber have taken on the role   to help to raise awareness of  the many lung health conditions.

I am the asthma champion, and I have learned a lot  from many people, including Asthma UK, the BLF and   Dr Tom Fardon, who is a respiratory and asthma  consultant at NHS Tayside. Dr Fardon played a   lead role in developing the Scottish Government’s  “Respiratory Care Action Plan 2021-2026”. I have   had good advice and support from Damian Crombie,  who, until recently, was AstraZeneca’s public   affairs manager for the Parliament. He sponsored  an asthma round-table session that I chaired   prior to the pandemic, which had a particular  focus on the importance of inhaler education,   the different types of inhalers that can  be used and how we can best support people   to engage with their specialists  to review the care that they need. I also acknowledge the help that I have received  from respiratory nurse consultant Dr Phyllis   Murphie. Many members will have heard me talk  about her in the past, as she is my big sister.

Since the inception of the cross-party group  on lung health, along with the great work that   has been carried out by many of the people  and organisations that I have mentioned,   great progress has been made to improve  treatment and outcomes for people with asthma.   The Scottish Government is implementing its  respiratory care action plan, which provides an   overarching strategy for health and social care  services on dealing with respiratory conditions.   The plan identifies key priorities  and commitments to improve outcomes   for people in Scotland with respiratory  conditions such as asthma. By enabling   all health and social care staff to have a  firm understanding of respiratory health,   it will improve clinical and wellbeing  outcomes for people with such conditions. I welcome the work of the my breath is my life   project and the work that the Scottish Government  has undertaken to improve asthma education,   and I again thank Jackie Dunbar for  bringing the debate to the chamber. I thank Jackie Dunbar for  lodging her important motion,   and I welcome the opportunity to  respond on behalf of the Government.

Asthma is a very common long-term lung condition  that affects people of all ages. It is estimated   that 368,000 people in Scotland—296,000 adults and  72,000 children—are affected by the condition, or   7 per cent of adults and 8 per cent of  children. Asthma symptoms can come and go,   and some people might not have symptoms for weeks  or months at a time, but asthma usually needs to   be treated every day, even if the person is well,  to lower the risk of symptoms and asthma attacks. We recognise the difficulties that are  experienced by people who live with a   respiratory condition such as asthma, which  is why we remain committed to ensuring that   people who have asthma or other respiratory  conditions receive the best possible care   and treatment. We want to enable them to live  longer and healthier, and independent, lives. We will do that through the priorities and  commitments that we set out in our first   respiratory care action plan for Scotland, which  was published in March 2021. I thank all those who  

made invaluable contributions to  the plan’s development. The plan   sets out the key priority areas for driving  improvement in prevention, diagnosis, care,   treatment and support for people who have  a respiratory condition such as asthma. A key part of the plan is ensuring early and  accurate diagnosis of asthma. When people are  

given information about their condition at an  early stage, they have a greater opportunity   to explore self-management techniques and,  potentially, to avoid more intensive treatments. I want to thank the Asthma and Allergy Foundation  for its work on the my breath is my life   project, which included the delivery of an asthma  training and awareness workshop to children,   parents and teachers across Aberdeenshire,  to help them to understand asthma,   identify symptoms and triggers, and  learn how to manage the condition. The Scottish Government is committed to  providing the best quality tools and support   to enable people to deal with all respiratory  conditions. We will work in partnership with   key stakeholders, including the third sector, to  ensure that people who have respiratory conditions   have access to tools, resources and information  that support them to manage their condition. We   will also ensure that people with lived experience  of respiratory conditions are closely involved   as we make progress against the commitments that  are set out in the respiratory care action plan. As clinical guidelines evolve, we will also  work with key partners, including NHS Education   Scotland, to ensure that the relevant training  is made consistently available to a wider group   of healthcare professionals, increasing  understanding of asthma for all involved.  

Education is so important for this condition. It is also important to recognise the impact of  Covid-19 on the delivery of care and treatment   of people who have asthma. It continues to be  significant in terms of access to respiratory   services, and because the longer-term impact of  the pandemic on lung health could be generational.   Respiratory services have continued throughout the  pandemic, with hospital and community respiratory   teams playing a key role in the Covid-19  response. Third sector organisations have   also continued to provide invaluable support  and information through this difficult time   to our NHS and to those who are living with  the respiratory conditions. For example,   the Asthma and Allergy Foundation my  breath is my life project has helped   to support people to manage their  asthma during this difficult time.

The Scottish respiratory advisory group has  been established to support and oversee the   implementation of the respiratory care action  plan. Members include clinical experts from a   range of respiratory conditions, including asthma,  as well as key stakeholders from across health   and social care and the third sector. We are  working to develop an implementation programme,   and our one-year priorities include the transition  from child to adult respiratory services. We  

will work with key partners to understand and  improve the pathways for a successful transition. Alongside the Scottish respiratory advisory  group, we are working with the alliance, and have   established a lived experience group to ensure  that people living with a respiratory condition   are involved in the design, the development and  the roll-out of the service improvement project. Once again, I thank Jackie Dunbar for  lodging the motion for this important debate,   and I thank the Asthma and Allergy  Foundation for the work that it does   to support people who live  with conditions such as asthma.

2022-01-29 11:49

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