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