Health: Allergy (Science and Technology Committee Report)

My Lords, while I am no medical expert I am glad that this debate has been scheduled for today as I recently experienced serious allergy problems and can offer a layman’s perspective on this excellent report. There is great interest in this debate and I believe that I know why. I was reading the committee’s report this morning when my daughter asked me what I was doing. When I told her that I was going to speak on allergies she laughed and said, ““Well, everyone is allergic to politicians””. My own allergic experience was in line with the report’s analysis. Last year, I noticed a rash on the left of my forehead which I assumed was an insect bite. As I often visit the tropics, one gets a lot of bites. However, within a fortnight a blister developed, so I went to my GP, who thought I had shingles. The treatment for shingles did not help and the lesion worsened. I was diagnosed with cellulitis and treated with intravenous penicillin, but the lesion did not fully heal. In addition, I developed a rash all over my body. My GP referred me to a consultant dermatologist who diagnosed me with an allergy, probably to the original insect bite. Penicillin was replaced by steroids and my skin improved. I then decided to get tests to find out what I was allergic to. I will not bore the House with the details of my treatment, but as Birmingham has only two immunologists, I went to a specialist London clinic to fully identify my allergies and have immunisation treatment. I was lucky to be diagnosed with an allergy relatively early on, but my case illustrates that a full diagnosis of allergies still requires a significant delay, private care, a lot of travel or all three. I want to be clear. I am proud of what the Government have achieved in the NHS. The West Midlands Strategic Health Authority under the leadership of Cynthia Bower has transformed the landscape of medical care in my region. We have made great strides in the past few years, with new hospitals and improved patient care. Wanting services to improve is not a criticism of the NHS. There should always be a debate about how public services should improve next. Allergy treatments currently have waiting times that are too high and a quality of diagnosis which is too low. As Dr Pumphrey of Research Councils UK stated, "““patients are unlikely to get ideal advice from any but the best informed of specialist clinics””." The Department of Health began its report on allergies with a summary of the problems. It said: "““People can wait 3 to 9 months for an appointment to see a consultant in secondary care ... some may be passed around a number of different clinical departments for the different symptoms ... which can make diagnosis and optimal treatment difficult””." I had no problems. I went to one clinic and very quickly all the experts were there and I was diagnosed early. The Government tell us that 81 per cent of GPs say NHS care for allergies is poor quality and only half of GPs are trained in managing allergic problems. My experience backs that up. These issues define the problem. Doctors do not have sufficient expertise to diagnose allergies and there are not enough specialists to treat the patients that are diagnosed. This means that patients who go to a GP with asthma have to attend seven times before they get a diagnosis, while only a third of those with asthma are given an allergy test. I was born in India, so I never had all the benefits of hygiene when I was young; therefore, I never had any allergy problems until I faced this one. Therefore, I endorse the conclusion that we need more training for GPs to diagnose allergies and an increase in clinical specialists based in a regional allergy centre. If we do not do that within the regions there are travel problems. I could afford private care, but the majority of people will have an enormous problem in accessing the sort of expertise that I experienced. We have strengths in allergy research and courses for diagnosis in the UK—for example, at Southampton and the medical school at my own University of Warwick. I am struck by paragraph 7.27 of the report, which states: "““We are concerned that the knowledge gained from cellular and molecular research is not being translated into clinical practice. We therefore regard allergy research directly related to healthcare as an area of unmet need that requires greater priority””." Perhaps we should kill two birds with one stone by combining the regional allergy centre with an existing training location. This would best relate allergy research to treatments and GP training. The Government are right to say in their response that, "““Local need is what will determine how allergy services should be provided””." We should not be recreating a ““command and control”” system in the NHS. I hope that Ministers also accept that local commissioners sometimes respond best to a strong lead from the centre. The Government have proved that successfully with waiting times. Launching the first regional allergy centre would be a strong lead from the centre. I welcome the Government’s conclusion that a lead strategic health authority is a worthy idea and I urge action on it. We also need to help consumers by making it easier to detect any allergies that they might come into contact with. I now know what I am allergic to, both in chemicals and food—but it is a hell of a job to find out. When it comes to products such as aerosols, shampoos and detergents, one avoids all of them; because there is no clear labelling, one is scared. When you suffer from an allergy, you first look for a cure from those you trust. But if none is forthcoming, you look anywhere. If the NHS makes the correct diagnosis and identifies the right treatment, patients will not require the dubious remedies that have exercised the committee. If we ensure that labelling is clear to those who suffer from allergies, consumers will not be susceptible to the pedlars of snake oil. I hope that the Government respond constructively, so that we can make great strides in the treatment of allergies. Otherwise, we will see more patients fall into the arms of anyone who will offer them relief, no matter how far-fetched their claims.