Access to Salbutamol Inhalers — [Stewart Hosie in the Chair]

– in Westminster Hall at 4:30 pm on 29th November 2021.

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Photo of Stewart Hosie Stewart Hosie Shadow SNP Spokesperson (Cabinet Office), Shadow SNP Spokesperson (Constitution) 4:30 pm, 29th November 2021

Before we begin, I remind Members that they are expected to wear face coverings when they are not speaking in the debate, in line with current UK Government guidance and that of the House of Commons Commission. I also remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the estate, which can be done at the testing centre in Portcullis House or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

Photo of Nicholas Fletcher Nicholas Fletcher Conservative, Don Valley

I beg to move,

That this House
has considered e-petition 578676, relating to access to salbutamol inhalers.

It is a pleasure to serve under your chairmanship, Mr Hosie. I begin by thanking the creator of the petition, Brian McElderry, who took the time to speak with me recently, and Elaine Cunningham, whose daughter Lauren Reid died as a result of suffering an asthma attack while working in a commercial kitchen because she did not have access to her inhaler. I am also grateful to Asthma UK, which supports the petition and provided many of the statistics that I will reference.

More than anything else, Lauren was known for her generosity. On the day she died, she called her gran to say that she was buying lunch for 10 of her co-workers. She was a beloved Rangers fan and she loved music and, of course, cooking. She was devoted to her job and worked so hard that she finished her apprenticeship a year early. She was only 19 years old.

Lauren had suffered from asthma since she was an infant. At 16, she became an apprentice at a restaurant in Glasgow and, three years later, she was a fully qualified chef. Her mum has talked about how Lauren kept her inhaler with her almost everywhere she went; but with severe asthma, one attack can have life-changing consequences.

We do not know why Lauren did not have her inhaler with her, or what triggered the attack, but on this occasion she did not have it when her asthma flared up. The first Elaine knew of the incident was when she received a call from Lauren’s boss to say that Lauren was struggling to breathe and needed her inhaler. The asthma attack led to cardiac arrest and, although her manager gave her CPR, she could not be revived.

Lauren was hospitalised with severe brain damage. Her friends and family stayed by her bedside round the clock but, a few days later, Elaine had to make the heartbreaking decision to turn off her daughter’s life support after doctors said that she would never recover. Since then, Elaine has been campaigning for Lauren’s law, which would legally require salbutamol inhalers to be stored in commercial kitchens.

The UK has one of the highest rates of asthma in Europe, which costs the NHS £3 billion every year. Sadly, we also have one of the highest asthma death rates generally—nearly 50% higher than the European average—and for people aged 10 to 24, it is the highest. Unfortunately, the rates of asthma nationally are going up, not down.

In the UK, 200,000 people suffer from severe asthma. In Scotland, where Lauren lived, one in 14 people receive treatment for asthma and in England, the figure is one in 11. Those statistics demonstrate that asthma is a relatively common condition and, although it is manageable for most people, it remains a serious risk for those who have it. Most people with asthma are acutely aware of that and carry their inhalers with them, but Lauren’s story shows that one attack without an inhaler on hand is enough to cause serious harm or even death. We have all forgotten something in our time.

Working in a commercial kitchen poses more of a risk for people with severe asthma than most other settings, which is why the inhalers would be only for staff, not restaurant customers. Asthma UK considers a high-risk environment to be one where the triggers for an asthma attack on the respiratory system are exponentially greater than in normal environments.

In commercial kitchens, that includes the presence of inhalable materials such as powder, flour, dust and sometimes toxic fumes. Heat and humidity are also known to cause asthma attacks. Compounding those issues is the fact that stress can make a person more likely to react to asthma triggers; I think most people would agree that professional kitchens are not known as a calm environment. One might be tempted to argue that if kitchens are such a dangerous place, perhaps people with asthma should not work in them, but I do not think that is the only or best solution to the problem.

Inhalers are an effective way to treat asthma attacks. They are self-administered and do not require any previous training. Adding one to the first aid kit that professional kitchens already have would be an easy way to make them a safe environment for employees with asthma. At the same time, salbutamol inhalers are a prescription medicine, so keeping an emergency one on hand is not as simple as picking up a spare one from Boots. Keeping asthma inhalers in commercial kitchens would require an exemption from prescription control, which would have to be granted by passing legislation.

The salbutamol inhalers currently in use have been licensed for more than two decades. Their risks are well known. Side effects are typically mild and do not last long. When the Medicines and Healthcare products Regulatory Agency, whose representatives I met last week, looked at the effect of salbutamol inhalers on children, for instance, it found that they would not cause serious harm if accidentally given to a child without asthma or one whose sudden breathing difficulties were not caused by asthma.

Although overuse of salbutamol inhalers can sometimes cause problems, the petition seeks to keep them in kitchens only for emergency use, and their stocks could be easily monitored. We have a precedent for this already. Since 2014, an amendment to the human medicines legislation has allowed schools to store emergency inhalers for asthmatic students.

Asthma is not an uncommon condition, and working in the food industry should not be impossible for people with asthma. Keeping asthma inhalers in commercial kitchens would be a simple, inexpensive way of reducing the chance that anyone else will suffer the same experience as Lauren. I am therefore asking my hon. Friend the Minister whether the Government will commission research on the benefits and risks of requiring salbutamol inhalers to be kept in professional kitchens. That research could then be reviewed by the MHRA, which would make its own recommendation on whether to change the law. I know that that is a long process and today’s debate will not cause any immediate change, but I do hope that it raises awareness and is the first step towards creating Lauren’s law.

Photo of Margaret Ferrier Margaret Ferrier Independent, Rutherglen and Hamilton West 4:37 pm, 29th November 2021

It is a pleasure to serve under your chairship, Mr Hosie, and to follow Nick Fletcher—we keep meeting each other in Westminster Hall.

Today’s debate is of huge importance, and I am grateful to the almost 2,000 of my constituents who took the time to sign e-petition 578676. My constituency had the second highest number of signatories in the UK, clearly showing how strongly the community in and around Glasgow feel about the petition’s aims.

The events that prompted this petition are devastating. We have heard how Lauren Reid, who was just 19 years old, suffered a severe asthma attack at work. Tragically, she did not have her inhaler with her at the time and she passed away later that week in hospital after becoming starved of oxygen during the attack. Nineteen is no age to pass, and I cannot imagine how difficult it has been for Lauren’s family and friends in the time since. It is horrible to think of this as preventable, but I do hope that today’s debate can serve as a step forward to ensuring that these events are not repeated in the future. Jim Shannon has a debate next week on asthma outcomes, which I hope will further contribute to recognition of the seriousness of this illness and what can be done to protect sufferers.

Before moving on to more general points, I would like to commend Lauren’s mum, Elaine, who has pursued Lauren’s law tirelessly throughout what will undoubtedly have been an exceptionally painful and difficult year. Her loss is unimaginable and her commitment is admirable. She has my full support in her campaign for salbutamol inhaler provision in commercial kitchens.

Asthma is a common chronic condition. It is more common in Scotland and the UK than in most other places in the world. More than 8 million people, or 12% of the population, have been diagnosed with asthma. According to the National Institute for Health and Care Excellence, it accounts for 2% to 3% of all primary care consultations, 60,000 hospital admissions and 200,000 bed days per year. Interestingly, although it is more common in boys in childhood, it is actually most prevalent in adult women, such as Lauren. As we have heard, one in 14 people in Scotland is currently being treated for asthma. It is also estimated that occupational asthma accounts for 9% to 10% of adult onset asthma.

It is widely accepted that commercial kitchens can both aggravate existing asthma and trigger it in people who have previously never had any symptoms. That is because commercial kitchens have a number of irritants. The use of powder substances such as flour, which is in daily use in most kitchens, is one of the biggest triggers. Current advice for people who develop occupational asthma is to consider a change in role or career. That might seem like reasonable advice: why would someone continue to put themselves at risk once they know the triggers? Realistically, however, it is not—not when there are other options that could help people manage the problem and stay in the job they love. When reading about Lauren, her passion for her work shines through. Nobody should have to choose between their passion and their health; the two do not have to be mutually exclusive.

I said earlier that asthma is a common condition, and kitchens are not the only workplaces where occupational asthma is prevalent. It is also triggered by allergens that affect hairdressers, agricultural workers, mechanics and healthcare workers. If something can be done to mitigate the impact of occupational asthma or to ensure better outcomes when someone suffers an attack, it should be. Making sure that salbutamol inhalers are available in high-risk environments is an easy thing to do. We already know that it can be done, because we allow non-prescription inhalers to be kept in schools.

In conclusion, I am sure the Minister and her Government colleagues support these measures but they have to abide by the human medicines regulations. I urge her to commit to a review and ask the relevant bodies to explore whether inhalers can be provided to commercial kitchens.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 4:42 pm, 29th November 2021

Thank you, Mr Hosie, for giving me the opportunity to speak in the debate. I am very pleased to see the Minister in her place, and I am convinced that I will get a decent response from her on the issues I raise. I think we are all convinced of that, and I look forward to her contribution. I thank Nick Fletcher for setting the scene so well, as he always does, on a matter that is of some interest to me.

I am the Democratic Unionist party’s health spokes- person at Westminster, so I want to be involved in these issues. I am also the chair of the all-party parliamentary group on respiratory health, so this is a topic in which I have a particular interest. As Margaret Ferrier said earlier, we will have a debate on asthma next week, and it could well be that the Minister will respond to that debate as well—I suspect that she will.

Why am I interested in this issue? As I said, I am my party’s health spokesperson, but also my second son Ian—he is a young man of 30 now, so this is a long time ago—was born with a combination of asthma and psoriasis. The doctor informed us at an early stage that the psoriasis and skin problems that he had would diminish as the years went by, but that his asthma could increase. In a way, that is probably what has happened. He takes an inhaler with him every day and manages to control his asthma. It is a very personal matter for our family, as it is for many others. When I am in my office, which is very busy—everybody’s office is busy—I get lots of referrals on this issue.

As hon. Members will be aware, I have been intimately involved in the drive to have asthma inhalers available in school so that a qualified person can administer salbutamol and other relief inhalers for a child who has a medically documented need. It is essential that if a child forgets their inhaler, the school nurse or equivalent has the ability to provide an inhaler and supervise its use. I am pleased that this endeavour was successful back home in Northern Ireland.

Prescriptions are prepared for a specific person only. If someone other than the person named on the prescription were to buy or use the drugs, that would be illegal. The provision within schools for emergency inhaler use has various safeguards, and it is important to have them in place. A clinically trained and responsible person—usually the school nurse or someone equivalent—acts as a guarantor of the appropriate use. The inhalers are held for specifically named children, people cannot use someone else’s inhaler and the school nurse is legally permitted to prescribe the inhaler. With covid-19, those safeguards are even more important and the restrictions are more stringent now than perhaps they were a year ago or further back.

Therefore, in theory, I understand and agree with the impetus behind this petition. However, I believe it is right and proper that we highlight the difficulties that there clearly are. Safeguards need to be in place and there needs to be care in the widening of allowing prescription-based relief inhalers to be available to anyone, on any occasion.

With asthma, undoubtedly prevention is better than cure. That is always the case with health issues, alongside early diagnosis. In June 2020, The Pharmaceutical Journal reported a substantial increase of 60% in inhaler prescriptions in 2020 from the year prior to covid. I think we are all convinced that those increases are down to the pandemic, the problems people have had and the dangers that they perceive there to be.

NHS data showed a similar large increase in inhaler prescribing across the United Kingdom of Great Britain and Northern Ireland. In March 2020, 2.77 million prescriptions were made for salbutamol inhalers, a rise of 63% from the previous February. I know that this led to supply issues. Can the Minister reassure us that supply issues for inhalers have been addressed? We all have constituents who use their inhalers monthly, and in Northern Ireland there were some who were worried that they could not get their inhaler. I hate to bring it up, Mr Hosie, but the Northern Ireland protocol is to blame for many things, including access to salbutamol inhalers. Can the Minister give us some indication that that will not be a problem in the future?

People whose asthma had been well controlled for years and who did not use their inhalers were getting one, as they said, “just in case”. We all know that prescriptions are not handed out just in case, but given only when the case is fully justified. I am concerned if prescription medication is to be given out not as needed by a dedicated healthcare professional but at random and different buildings; such an extension, as proposed in this petition, would have to be carefully considered. It is about making it safe, getting it right, and doing it the right way. We want to make sure that that happens.

We would need more information to ensure that there was appropriate regulation, as there is with the current prescription service through which the GP prescribes, and then the pharmacist checks the dosage and informs people about how and when to take the medication. I believe this is imperative for medicinal safety. It is a safeguard for the young children who get the medication, and gives their parents peace of mind.

To conclude, while the drive behind this petition is laudable, there is much work to be done to make it safe. In her response, can the Minister reference the concerns I have raised, as we seek to get the delicate balance of the availability of salbutamol inhalers exactly right? That will save lives in the process and make sure that everyone is safe.

Photo of Anum Qaisar Anum Qaisar Scottish National Party, Airdrie and Shotts 4:48 pm, 29th November 2021

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank Nick Fletcher for leading this important debate and all those who signed e-petition 578676, including the 981 in my constituency of Airdrie and Shotts.

As Margaret Ferrier said, this is a perfect tragedy that has impacted many people in the wider Glasgow area, including my constituents. In common with Jim Shannon, this subject is close to my heart as I was diagnosed with asthma at a young age. I could not say the whole phrase when I was younger, so I always used to call it “my blue inhaler,” and I have used a blue inhaler since I was a child.

I start by expressing my sadness over the death of Lauren Reid, who tragically died at the age of 19. Lauren was working in a Glasgow city centre bar in February 2020 and although she usually carried her inhaler everywhere with her, on that day she unfortunately did not have access to one. She suffered a devastating cardiac arrest and was rushed to hospital, but the damage inflicted to her brain by the asthma attack was simply too severe. Her mother, Elaine, was left with a decision that no parent should ever have to face—to turn off Lauren’s life support. If Lauren had had access to an inhaler, she might still be with us today.

Lauren worked in an environment that posed a high risk to those suffering from asthma. The fumes and dust in commercial kitchens increase the likelihood of an asthma attack. A recent study estimated that 30% of asthmatic attacks are linked to the work environment, yet for most workplaces an emergency asthma kit is not available. Like others, I welcome the heroic efforts of Lauren’s mum, Elaine Cunningham, whose campaign has attracted widespread public backing, including 1 million views on TikTok. That is important because the campaign is reaching younger people, ensuring that knowledge about the impact of asthma and the use of inhalers is widespread.

The campaign has highlighted the need for a change in the law around access to inhalers. Currently, there are no healthcare provisions that allow commercial kitchens to hold an inhaler. I understand that there are hurdles to placing these types of inhalers in the workplace. The inhalers contain prescription drugs that can pose a serious health risk if they are overused, but we might be able to overcome these hurdles.

Parliament passed the Human Medicines (Amendment) Regulations 2014 to allow schools to hold inhalers for emergency use, and the changes in the regulations allowed inhalers to be stored in schools without a prescription. That change has almost certainly saved lives. As has already been stated by the hon. Member for Rutherglen and Hamilton West, asthma is one of the most common allergies across the UK, with millions of people diagnosed —myself included. Every 10 seconds, someone has a potentially life-threatening asthma attack. Sadly, three people die every day. It is estimated that two thirds of those deaths could be prevented by routine care. An estimated four out of five people with suspected severe asthma who should receive specialist care are unable to, meaning that they miss out on life-changing treatment. That has anegative long-term impact on the NHS, with treatment for asthma patients costing the NHS £3 billion a year, making it one of the costliest conditions to treat.

As the hon. Member for Don Valley stated when he introduced the debate, deaths caused by asthma are 50% higher here in the UK compared with the EU. We have the worst death rate in Europe for young people aged 10 to 24 with asthma. We are not doing enough, and we can do more. Improving access to inhalers in commercial kitchens might be just one small step, but it could make a huge difference.

We can do more across the four nations to combat asthma. In Scotland we are taking steps to make the changes. When changes to the regulations occurred in 2014, the Scottish Government consulted Asthma UK and worked alongside it to implement the policy. Guidance was developed in partnership with key stakeholders from NHS Scotland and education authorities to ensure that inhalers were used correctly in schools.

Elaine’s campaign has already received the support of Unichef, the national union that represents kitchen chefs, which shows that there is a level of support in the industry for the proposed changes. I hope that the Government will engage with stakeholders and have the important conversations to make the changes happen, and I would welcome the Minister’s comments on that.

More generally, the Scottish Government will continue to do all that they can to combat asthma. Recently, the Scottish Government announced the respiratory care action plan, which sets out a vision for the Scottish NHS and prioritises the need for more preventive measures to combat respiratory conditions, including asthma. The need for action on asthma has increased since the pandemic, with the number of undiagnosed cases increasing since last year. The Scottish Government are committed to ensuring that meaningful data is provided on asthma cases, to help understand where people’s needs are not being met. To deliver the most effective person-centred care, the Scottish Government will continue to work with stakeholders on the implementation of this plan.

The UK Government should follow the lead of the Scottish Government in the provision of free prescriptions. Since 2011, those in Scotland suffering from asthma have had access to free inhalers, meaning that no person is left without an inhaler. A recent survey conducted by Asthma UK found that three quarters of people living with asthma in England struggled to pay for their prescriptions. Individuals have often turned to skipping doses of their inhaler to cut costs, posing a risk to their health. The UK Government should follow the Scottish Government’s lead and provide free prescriptions to those who suffer from asthma.

It has been almost two years since the tragic death of Lauren. What the petition is proposing will save lives. We simply need to do more to ensure that there is more access to inhalers—for Elaine, for Lauren and for all those who, like me, suffer from asthma.

Photo of Alex Norris Alex Norris Shadow Minister (Health and Social Care) 4:56 pm, 29th November 2021

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful for the chance to speak for the Opposition in this important debate.

I start, like others, by paying tribute to the young chef Lauren Reid, whose tragic passing last year has led to this debate. Described by her mum as

“the most amazing, kind, beautiful and caring person”,

may we turn this family’s heartache into action and look at ways we can prevent this from happening again.

I also pay tribute to Lauren’s mum, Elaine, who has been spearheading this campaign, and I send my thoughts and prayers to Lauren’s family and friends. I also send them to her colleagues. Hearing what Nick Fletcher said about their experience in that moment, and their efforts, I send them my solidarity, too.

Securing a debate through the petition route is a very hard thing to do—100,000 signatures is an awful lot. That speaks to the seriousness of this case, and to how strongly people feel about it. I commend those who promoted it and organised it, and all those who signed it.

The hon. Gentleman had the difficult job of opening this poignant debate, and I thought he did a very good job and made a thoughtful case. I was particularly struck by two things, which I might also speak about. The first was the context of asthma in this country, and the second was the risks in commercial kitchens, which is what, beyond the broader national messages about asthma, makes this individual case very compelling.

There were similarly thoughtful contributions from other colleagues. Margaret Ferrier set out just how common asthma is. It behoves us, as a national legislature, to act on behalf of that significant portion of our population. I agree with her comments against the argument that those at risk should change roles—I do not give that view much succour, either. I would not want to give up my dreams for something that a reasonable adjustment could prevent, and I would not want anybody else to do that, either.

We look forward to the upcoming debate on asthma secured by Jim Shannon, where we will be able to continue talking about some of these themes. He made very interesting points about schools, which offer an analogous example—a read-across—showing that what Elaine and her family are asking for is working somewhere else. That is very useful. Moreover, I think we all share the hon. Gentleman’s views on safeguards, because we are conscious of the risk regarding prescription drugs.

At the root of this issue is a simple argument, which is to permit the availability of salbutamol inhalers in commercial kitchens. This campaign is backed by Unichef—the chef’s union—and others, such as GMB, my trade union. They are calling for an exemption to be made, whereby commercial kitchens can be supplied with inhalers and administer them in emergencies. In their response, the Government have said that that is something that the regulator would need to approve, and if it sees a benefit a public consultation will be launched. I hope that the Minister will update us on the progress of her discussions with the licensing authority. Similarly, has she engaged with the Royal Pharmaceutical Society about the production of draft guidance once the licencing authority has finished its consideration? It would be very interesting to know what progress has been made in the period between the Government’s official response to the petition and today.

Turning to asthma more generally, 57% of healthcare professionals have had patients who have had an asthma attack or needed emergency care because, for whatever reason, they did not have their medication with them. Life happens: these are errors that any of us could make, particularly when living busy lives, and as we have heard, this is a big group of people. Some 5.4 million people in the UK are receiving treatment for asthma, leading to 41,000 hospital admissions last year due to asthma-related concerns alone, and 1,300 deaths. That is a really significant issue and it requires significant action in this place. As Ms Qaisar has said, the rate of asthma deaths has increased recently, and we are an outlier relative to our neighbours, with a death rate that is 50% higher than the average in the European Union. Again, we are called upon to understand the challenges in our country and to look at what we might do differently, and this is certainly one of the things we could do differently.

As numerous hon. Members have said, the reason why the distinct setting of a commercial kitchen deserves special consideration is that it is a potentially risky environment, with triggers such as flour, fumes, heat, dust, odours and a lack of decent ventilation. It is perfectly reasonable for us to consider whether we might do better in that setting, because everybody should be safe at work and have safety nets to help them. The example in the case of schools is clear: it has been possible to make an exemption in schedule 17 to the Human Medicines Regulations 2012 to allow the sale and supply of salbutamol inhalers and EpiPens to schools for use in emergencies, so the petition is not asking for something that cannot be done.

I will make a couple of very brief points about the regulator itself. We in this country are very well served by the Medicines and Healthcare products Regulatory Agency, which will be an exceptionally important body for all of us at some point in our lives. Whatever medicine or medical device we may need, the MHRA is the regulator that tells us that it is safe for us to use, so we all rely on it. However, it is also a very busy regulator. The pace of change in that market is significant, both domestically and globally, and recently we in this place have put a significant number of new responsibilities on the MHRA through the Medicines and Medical Devices Act 2021, which received Royal Assent earlier this year. That Act was, in part, a response to our exit from the European Union and the change in the regulatory environment that arose from it. The MHRA is on a high wire and it is not overhyping it to say that it has a life-and-death job, but we are going to make a 20% cut to its staff. The MHRA’s income from the European Union has dried up so we are reducing its staff, yet we are asking it to do more, and that cannot be wise. I hope that the Minister will reflect on that and assure us that Ministers are actively looking at that decision so as to ensure that that cut does not happen, because it does not support patient safety in this country.

To conclude, it is right that we first listen to the MHRA before we act, but the petition’s proposal is reasonable and, because it has a comparative example, feasible. I hope that the Minister will address my questions and those of colleagues, and give us a sense of the conversations taking place and of the timetable, because people are watching today’s debate. I hope they will feel that we have done this really important issue justice—I think we have—but they will want to know where it goes next, so I hope we will hear that from the Minister.

Photo of Gillian Keegan Gillian Keegan Minister of State (Department of Health and Social Care) 5:04 pm, 29th November 2021

It is a pleasure to serve under your chairmanship, Mr Hosie. I will start by acknowledging the tragic death of Lauren Reid, aged just 19 with so much to live for, having achieved so much already, and to offer my sympathies to her mum Elaine and her family and friends. I also thank my hon. Friend Nick Fletcher and all those who signed this petition for ensuring that this issue has been brought to the attention of the House, and thank all Members who have taken part in today’s debate.

On 25 August the Government responded to the petition, which seeks wider availability of non-prescribed salbutamol inhalers. I will build on that response in my speech. Asthma inhalers are a mainstay treatment for patients with acute asthma. Ready access to prescribed inhaler can save lives in an emergency. The safe sale and supply of prescribed medicines, including inhalers, is carefully and thoroughly regulated in the UK, through the Human Medicines Regulations. Some medicines are classified as prescription only because they could result in harm if used without medical supervision, even if used correctly, or they are frequently used incorrectly and may cause harm as a result. Prescription inhalers are in that category.

The Medicines and Healthcare products Regulatory Agency, as the licensing authority in the UK, has advised that exemptions can be made in the relevant Human Medicines Regulations, and that any such change would depend on the careful and thorough review of evidence supporting it. As Jim Shannon says, we need to do that very carefully and ensure that safety is at the heart of everything. We would need to ensure that the benefits of such a change would outweigh any risks, and any change would also depend on the advice of our independent expert advisory committee, the Commission on Human Medicines.

I am pleased that the MHRA met my hon. Friend the Member for Don Valley on 25 November to provide detailed advice on the type of information needed to support a change. I understand that the discussion focused on the evidence needed to enable a full assessment of benefits and risks by the MHRA and the CHM. I hope my hon. Friend found that helpful.

For the benefit of the House, and for the record, I will give some detail. A full assessment would need evidence clearly showing the intended benefits, including an outline of the magnitude of the issue, such as how many people are affected by serious asthma attacks and the locations where having such medicine available would be of the greatest benefit. The evidence would also need to consider any risks and how they could be managed—for example, that the medicine could be stored, handled, and used safely in an emergency.

Once adequate information is collected, the MHRA seeks independent advice from the CHM. At that stage, it would also consider guidance to stakeholders on the safeguards that would need to be in place. Feedback from a public consultation would be considered before a final decision on implementing any legislative change. The MHRA welcomes any submission of evidence from interested parties and is committed to ensuring that the UK becomes an even greater place to develop, manufacture and supply medical products, and that, most importantly, we have continued access to safe medical products.

As many hon. Members have mentioned, an amendment was made to the Human Medicines Regulations in October 2014 to allow schools to procure and store non-prescribed salbutamol inhalers. At that time, the potential advantages and disadvantages were tested through pilot schemes placing inhalers in some schools and tracking their usage. Information was collected by surveys of patients, teachers and schools, and was analysed by the MHRA and CHM.

The Health and Safety Executive owns guidance on reducing the risk of asthma in the workplace. The Department will be looking further into this matter, along with HSE and MRHA. Once that information-sharing exercise has taken place, the Department will be in a better position to decide whether further action needs to be taken. It will explore commissioning research to examine this issue further.

I have heard the concerns in this House, and indeed among the wider public, about this issue. I thank all those who have taken part in this debate, and mostly the 102,058 people—patients, stakeholders, and families of asthma sufferers—who signed the petition.

I will also update the House on additional public health measures that we have put in place to improve outcomes for people with asthma. The 2019 NHS long-term plan sets out commitments and objectives for the NHS for the next 10 years. It includes respiratory disease as a national clinical priority and aims to improve outcomes for patients, including those with asthma. The respiratory interventions proposed in the NHS long-term plan include early and accurate diagnosis of respiratory conditions, because the earlier diagnosis of conditions may prevent avoidable emergency admissions for asthma. Pharmacists in primary care networks will undertake a range of medicine reviews, including educating patients on the correct use of inhalers.

Since 2019, several initiatives and publications have been announced in support of the long-term plan. NHS England and Improvement’s national patient safety team has prioritised work on asthma as part of the adoption and spread safety improvement programme. That will support an increase in the number of patients in acute hospitals receiving every element of the asthma discharge care bundle from 38% to 80% by March 2023.

Since April, the academic health science networks in England, in partnership with the patient safety collaboratives, have been working with provider organisations to improve the uptake of all elements of the asthma care bundle for patients admitted to hospitals in England. Compliance with the elements of good care, as described in the bundle, is measured as part of the national asthma audit. The care bundle includes actions that should help to reduce the number of patients who are readmitted following discharge and ensure that all aspects of the patient’s asthma care are considered. The bundle assesses inhaler technique and includes care follow-ups. Those interventions should prove more beneficial than relying on emergency use inhalers to provide temporary relief.

To the question asked by the hon. Member for Strangford, the Department works closely with the MHRA, the pharmaceutical industry, NHS England and Improvement and others operating in the supply chain to help to prevent shortages. The team has advised that there are currently no shortages in the supply chain.

I would like to take a moment to remember Lauren and to send our sympathies to her family and friends. I thank all those involved in bringing forward this important debate. I hope that what I have set out demonstrates our commitment to the issue. We want to facilitate changes that will protect public health, so we will look into it with the relevant bodies. We are working hard to ensure that asthma care improves for all, as outlined in the NHS long-term plan, and that asthma sufferers have access to the best care available.

Photo of Nicholas Fletcher Nicholas Fletcher Conservative, Don Valley 5:12 pm, 29th November 2021

I thank all Members for contributing, and the Minister and you, Mr Hosie. I thank the petitioners and the MHRA for meeting me. Most of all, however, I thank Elaine, Lauren’s mum. As I said when I met her, I cannot promise that Lauren’s law will become legislation, but we have a wonderful Minister who has given a wonderful speech and an awful lot of work is going on to look after people with asthma.

I am sure that if Elaine continues to campaign, with the support of many Members, including me, Lauren’s law will be passed. The loss of a daughter is something that no one should go through, but by raising the issue I hope that Lauren’s memory will be a lasting one that gives many people the opportunity to work safely in commercial kitchens doing what she loved so much.

Question put and agreed to.

Resolved,

That this House
has considered e-petition 578676, relating to access to salbutamol inhalers.

Sitting adjourned.