Health: Allergy (Science and Technology Committee Report)

My Lords, when the hunting legislation was going through your Lordships' House I was asked by another Peer whether I had ever hunted. When I said no, that Peer was rather disparaging. I redeemed myself only by saying that I had not done so because I am severely allergic to horses. The one and only time in my life I have been on a horse I looked about as good as the noble Lord, Lord Lipsey, does today. As I have that very common battery of allergies, I was delighted to spend last weekend reading the noble Baroness’s excellent and thorough report. I want to focus on the issues that noble Lords have raised but put them into a context. The context is that there will in future be nothing like the level of funding in the NHS that there has been in recent times. Therefore, for any service, particularly a specialist one like this, it is a question of how we redesign services in order to make what we have more effective. From data gathering and management at the beginning of this report right through to the end, the noble Baroness and her committee have offered the House and the noble Lord, Lord Darzi, an excellent blueprint for how services can be redesigned. I am not a scientist or a historian, but other noble Lords have referred in their speeches to population conditions 100 years ago. Forgive me if I am wrong, but I think we need to be a bit careful. The survival rates from anaphylaxis 100 years ago would have been pretty near to zero. Although great advances have been made, the noble Baroness is right that the overall picture on prevalence is, when set against advances in public health, truly disappointing. I would go further and say that, if anything, some of the figures in this report and in previous reports by the Royal College of Physicians and the Health Select Committee are probably underestimates. Why? Because most people, like me, do not have severe and acute reactions and manage the condition themselves. Therefore, I suspect that the NHS really gets to see only those who are towards the more acute end of the spectrum. Moreover, those who have allergies are increasingly using the internet to find ways round and manage things for themselves. The report is a disappointment in that very little appears to have changed in the 40 years since I sat in my GP’s surgery with pinpricks up my arms, watching all the reactions take place, and was sent off home with a list of things to avoid and a tin of Betnovate for when the eczema got really bad. The only thing that has changed is incidence. I thought one of the most interesting findings in the report was the observation by Professor Custovic of Manchester University that the genetic background of the population has not changed dramatically and yet the incidence of allergic disease has. That is worth noting. I know something else anecdotally; I have tried desperately to find data on it but have been unable to. I understand that in the Italian population there is a high and growing incidence of coeliac disease. As a very good friend of a member of my family has coeliac disease, I know that you can go to Italian restaurants even in this country and find gluten-free pasta. That is increasingly the norm in Italy. It is interesting because in the past 20 years people in this country have adopted a diet with a lot of Italian food in it. I just wonder whether it is another form of allergic disease for which we should be taking preventive action. I agree with the noble Lord, Lord Rea, that the issue of food labelling is tremendously important. The only thing that one can do with a food allergy—and they tend to be very violent—is avoid the substances that you know you are allergic to. It is useful that EU directives are increasingly updated, but they are unclear. The food industry needs to know that it is not in its interest to have unclear labelling. I hope that, with the FSA, work can be done to improve that. As somebody who frequently has reactions to skin products and soap, it was a delight to have my own anecdotal feelings set down as being right—namely, that the terms ““hypoallergenic”” and ““dermatologically tested”” are meaningless. There is absolutely no way of knowing whether a particular product will set off an allergic reaction. I shall make one point which for obvious reasons is not in the report. As someone who experiences such reactions, I have always wondered why it is impossible, when one has a mild allergic reaction to a product, to draw that to the attention of the manufacturer. I suspect that I am like thousands of other people; I do not want any kind of redress, I do not want money and I do not want to pursue them through the courts. I simply want to tell them that something has happened to me in the hope that they will record that systematically and begin to build up a picture that, somewhere down the line, will either make their product better or help other people. I wish that somehow the Government could encourage especially the cosmetic industry to do that. I speak at some risk about alternative therapies, because I know that my noble friend Lord Taverne has very strong views on them. A large number of people are turning to alternative therapies, principally because they fear prolonged use of steroids. I cannot blame anyone for seeking relief from some of the symptoms of allergy. If they choose to do that, they should do it in a way that is integrated with conventional medicine. I hope that the department responds to that. In the National Health Service, we have an unprecedented facility to study allergic disease and not only to conduct trials, but to do population-controlled trials. This morning, someone in my house asked me what I was going to do today, and when I told them about this debate, they said that they developed an allergy when they went to a particular university. Apparently it happens to loads of people who go to that university, because it is surrounded by fields of rapeseed which is a very potent allergen. If we can do nothing else with the regional allergy system, we could look at the incidence of that kind of condition. Regional allergy centres are important, and they will have to be formed not by the creation of specific new posts but by drawing together and clustering experts who already exist across the field. The key importance of regional allergy centres is twofold. First, they deal with those who have acute and life-threatening conditions, as the noble Lord, Lord Lipsey, said. Secondly and importantly, they can increase the skills in primary care, because that is where the bulk of people who have such conditions go for diagnosis, reassurance and treatment. I wish the report well, and I hope that the Minister accepts its recommendations.