Dr Luke Evans

I am very grateful to the hon. Gentleman for that offer. I congratulate the hon. Member for Blaydon and Consett (Liz Twist) on her work in the APPG. She was of course right to highlight smoking as a big problem, and health inequalities are also important. We also know that people experiencing health inequalities generally struggle to access healthcare, let alone healthcare for respiratory conditions—we have not even discussed the equipment and expertise needed to deal with such conditions. The hon. Member for Sherwood Forest (Michelle Welsh) spoke about pulmonary fibrosis, a really important condition that is not given the precedence it deserves given how debilitating it is for patients who suffer with it. I pay special tribute to her for raising that issue so powerfully and so emotionally. She is a true champion for doing something about a condition that is not thought about nearly enough. The hon. Member for Winchester (Dr Chambers) is absolutely right about holistic approaches. They are outside the remit of this debate, but housing, environment and smoking are of course all big factors. We have not even talked about comorbidities yet. We know that people over the age of 60 are usually on several medications and may have heart problems or musculoskeletal problems as well. That will have a really big impact. With regard to the hon. Member being a vet, I think I am right in thinking that he is still allowed to practise on humans, while I certainly am not allowed to practise on pets. That is not something for a debate today, but I think it is noteworthy; if there is a problem you should rush to him too, Mr Rosindell. What he said about antimicrobial resistance is really interwoven into everything, because there is a danger of over-prescriptions for chest infections that turn out to be viruses. That is a really problematic issue that is growing, and it is the next probable pandemic, with no easy solution. He is right to highlight that. I thank the members of the APPG for all the work they do, led by the hon. Member for Strangford. It is really important to be able to get a debate and raise these issues, and to have the infrastructure behind the members to support the team in dealing with and producing updates. I myself have a personal history with respiratory medicine, having ended up on the intensive care unit with bilateral pneumonia after an appendicectomy in my late 20s. It has left me, at previous times, at a brittle asthma clinic. There were many attempts to diagnose what was going on, but nothing was ever found. I had to be treated with repeated steroids and felt, full on, what it is like to suddenly not be able to breathe, not be able to exercise and have that ability taken away. When they are listening to this debate, the key thing for the public to realise is just how important our breathing really is. A breathing condition is so seminal to everything we do. There is a reason why in an emergency it is ABCDE, or airway, breathing, circulation, disability, exposure: because breathing is quite literally life. Many people have experienced having that taken away a little bit by getting covid; that has at least made people aware of just how bad viral illnesses can be. Turning to some of the other conditions that we have not talked about—I feel like I am back in one of my medical exams in the fifth year—we have heard about asthma and COPD, but we have not talked about pulmonary embolisms, pneumoconiosis or TB. We did hear about cystic fibrosis, but we have not heard about mesothelioma or sarcoidosis. Pneumonia is a really important one to talk about too, as is lung cancer, and there are probably some that I have missed. Respiratory conditions are really important: they make up the third place for all deaths, so they need that attention. I was therefore pleased to see the last Government come forward with the community diagnostic centres—170 community diagnostic centres going up across the country to get better access to MRI scans, CT scans or blood tests. Those will be really important, and I was lucky to have a £24 million investment for a CDC in Hinckley, which will have MRI and CT scanners, and is being built as we speak. That will be transformative for my community when they are caught between two big centres towards Nuneaton and Leicester. I hope those measures will mean that respiratory conditions play an important part in the hospital rebuild programme and the current review, and that we will ensure we have the apparatus and equipment to support them. Turning to the nitty-gritty of the debate, I entirely agree with the idea of prevention. The Conservatives brought forward measures to deal with smoking. I hope that as the Government step forward with further ideas of how to tackle smoking and push for a smoke-free generation, we will be looking at that very closely. The hon. Member for Strangford really hit on a point about data. Health policy must be driven by decent data, and the APPG’s work highlights how respiratory conditions tend to fall behind in that. I have questions for the Minister about what work is being done now only on the simple matter of how we record things, but on how we can join up that dataset. For example, in my constituency we have two boundaries; we are caught between North Warwickshire and Leicestershire when getting answers to tests. An asthmatic does not have an asthma attack directly where they live—they could be on holiday. Sharing information on what has happened with treatment and investigations is really important. That leads me on to spirometry. Spirometry is key, but where it is and how it is achieved is too sporadic, as is the skillset to deliver it. Then, of course, we have FENO—fractional exhaled nitric oxide—which can help to aid the diagnosis of asthma. That will be key, and the Opposition look forward to seeing what the new BTS guidelines, worked up with NICE, show on dealing with asthma. I have a couple more questions for the Minister. I appreciate that this is not her brief, so I should be grateful if she passed on any questions she cannot answer for a written response. We have heard that the likes of the RSV vaccine are really important; new vaccines are coming out to tackle this huge problem for the elderly and the young. The vaccine was introduced for those aged between 75 and 80, but it would be interesting to see whether there is scope to grow that and see who else is responsive. I gather from work done by my Opposition colleagues that there is still some debate to be had and evidence to be gathered on what that would look like. I would appreciate it if the Minister took that point away. What steps are the Government taking to increase the uptake of flu and pneumonia vaccinations? Prevention is better than cure. Finally, it was mentioned that the last Government looked at chronic health strategies. It appears that the new Government have decided to take a different tack with chronic conditions. I appreciate that that is their prerogative, but there is a danger that we could have a lag. The data that has been gathered, the research that has been looked at and the policies that have been structured for the past five years or so could fall by the wayside, even though we have heard how much of an emergency it is to deal with respiratory conditions. Could the Minister clarify whether interested parties will need to resubmit the work they have done, or whether the work will be a continuation within the new structure that the Government are planning? Is there any timescale on what that would look like? Clearly the Conservative Government were unable to get the long-term health strategies in place in time before the election. Time is ticking on, and we have a winter coming up. It is really important for organisations to understand where they stand. Christmas is coming up, and I well know from my time as a GP—I should declare an interest, as my wife is a GP as well—that Christmas is the busiest time, and respiratory conditions are one of the top reasons for that. If anyone out there is listening, getting vaccinated is imperative. I advise everyone to do so. We know that the staff of these organisations will go above and beyond when they see someone struggling for breath. They will take their time to get the right history and get medication and treatment in place. We give them our greatest thanks, from the Opposition side of the House, for all the work they have done and will do in the busy Christmas period. I am sure that that sentiment is shared by the Government.