On average, one person dies a week in Ireland due to asthma. Sadly 90% of those are preventable if asthma is managed correctly. However, 60% of Irish asthmatics do not have their condition under control.
Every 26 minutes someone ends up in a hospital emergency department with a life threatening attack, a total of 20,000 ED visits every year. Asthma also accounts for 50,000 visits per annum to GP out of hours services.
On behalf of our members and the 470,000 asthmatics in Ireland, we are urging the Government to follow the recommendations to stop asthma deaths.
Asthma Society's Pre Budget Submission 2019 urges the Government to:
- Substantially reduce the cost of asthma medication;
- Provide a free annual asthma review with a patient's GP;
- Improve the number of dedicated paediatric asthma services;
- End the post-code lottery for people with severe asthma;
- Revisit the National Clinical Programme for Asthma;
- Improve regulations around administration of emergency reliever inhalers in schools;
- Eradicate outdoor air pollution;
- Protect indoor air quality;
- Reduce the tobacco threat
- Fund the Asthma Society’s essential programmes.
1. Substantially Reduce the Cost of Asthma Medication
It is essential that the Government in Budget 2019 move to lower the cost of asthma medication.
Given that asthma is a long term condition with no cure, asthma medication should be covered under the Long Term Illness scheme for all people with asthma. This would save lives, reduce pressure on our emergency departments, decrease hospital admissions and tackle the €500 million cost of asthma to the economy.
2. Free Annual Asthma Review with Your GP
Effective primary care is an essential component of asthma control. Under the National Clinical Programme for Asthma, everyone diagnosed with asthma was to receive free annual GP reviews. Doctors could check that the medication prescribed was the best option, review progress, and assess patients asthma.
We are calling for the scheme to be rapidly extended to everyone with asthma as per the original plan. We would like to see the Government put in place the review for anyone under-18 and for anyone diagnosed with severe asthma as part of Budget 2019 and ensure it is included in the HSE Service plan.
3. Specialised Hospital Doctors, Nurses and Diagnostics for Children
There is a shortage of paediatric respiratory consultants and nurses in Ireland, especially in regional centres (Cork, Galway or Limerick). Given that one in five children in Ireland have asthma, there is a huge disparity in the care experienced by children with asthma regionally.
There are also no dedicated paediatric lung function labs outside the children’s hospitals in Dublin. As a result, consultants in other hospitals are forced to try to assess children using adult equipment, even in the case with children who have severe and poorly controlled asthma.
We recommend that direct action be taken to fully fund and staff the services necessary for children with asthma in Ireland.
4. End the Post-Code Lottery for People with Severe Asthma
In Ireland, approximately 5-10% of patients with asthma have severe asthma. People with severe asthma require considerably more medication in order to try and keep a good quality of life.These people face enormous emotional and financial challenges in coping with the condition on a daily basis.
The only licensed treatment currently available is called Xolair, but access to the medication is extremely limited. Severe asthma patients must rely on the generosity of hospital pharmacy budgets, meaning access to this life-changing treatment is based on geographic location and is not guaranteed, even if it is the most suitable treatment.
The Government needs to put in place a national funding scheme for Xolair and other severe asthma treatments as they become available.
5. Re-Visit the National Clinical Programme for Asthma
The NCPA was launched in 2011 and the Asthma Society has continuously been involved as a key stakeholder. The vision of the NCPA was that every child and every adult with asthma in Ireland should reach their maximal health and quality-of-life potential through the prevention, early detection and effective treatment of asthma.
Over the last seven years, much has been achieved by the NCPA. However, with changes to the clinical programme structures within the HSE, the Asthma Society is of the view that the programme needs to revisit its original strategy to ensure it continues to drive improvements and continues to champion international best practise for asthma care in Ireland.
6. An Inhaler Can Save a Life
In the event of an asthma attack, having immediate access to a reliever inhaler could be the difference between life and death. It is imperative that staff and volunteers in schools, workplaces, sports clubs, and community organisations know how to assist someone having an asthma attack.
In October 2015, the Minister for Health signed new regulations allowing trained members of the public to administer life-saving rescue medicines such as epi pens, glucagon for diabetic hypoglycaemia and reliever asthma inhalers in emergency situations.
The Asthma Society has learnt through a parliamentary question submitted on our behalf that NO SCHOOLS HAVE REGISTERED FOR THE SCHEME TO DATE (June 2017). This means that in the event of an emergency, there may be no inhaler onsite to administer – this puts all asthma children and adults at risk. We believe that the scheme is not in use because the conditions attached are overly onerous.
7. Eradicate Outdoor Air Pollution
Air quality was recently described by the World Health Organization (WHO) as the world’s largest single environmental health risk, and Ireland is no exception to this problem. The European Environmental Agency estimates that 1,229 lives are lost prematurely in Ireland because of poor air quality in a single year.
While Ireland is largely within the EU limits for air pollution, it fairs poorly when measured against the World Health Organisation guidelines. We believe the Government should end the favourable tax treatment of motor diesel, in light of research showing that the emissions from diesel cars are just as high as those from petrol cars on short journeys.
The Government needs to adequately resource the EPA to provide an extensive air monitoring network across the country as per the EPA’s recent clean air strategy for Ireland.
8. Protect Indoor Air Quality
Where we live affects our health - this is especially true for people with asthma. Some indoor asthma triggers – such as dust, aerosol emissions and animal fur – can be managed relatively easily when a person with asthma is aware of their impact on their health.
Other indoor asthma triggers, like poor insulation, inadequate ventilation, serious mould, inappropriate heating systems and the use of carpet are more problematic. As a result, many low-income people with asthma are living in environments which are seriously damaging to their health – their home exacerbates their asthma.
The Government should fund the cost of essential home improvements for all low-income households (not just those on social welfare) where at least one person has asthma or COPD.The programme could be rolled out on a phased basis, starting with families of children with asthma.
9. Reduce the Tobacco Threat
Tobacco smoke is one of the most common and dangerous triggers of asthma symptoms. The Government in recent years has taken many positive steps in the ‘war against tobacco’, most notably the introduction of plain packs. However, new initiatives need to be introduced to reduce the threat from passive smoking.
The Asthma Society shares the World Health Organisation’s concern that vaping may undermine the success of anti-tobacco initiatives by re-normalising smoking and acting as a smoking gateway for young people. We believe the advertising, sale and use of e-cigarettes should be regulated in the same way as tobacco and that the workplace smoking ban should be extended to e-cigarettes.
Finally, we are aware that many tobacco companies plan to introduce Heated Tobacco products into the Irish market in the coming months. It is vital that these products are treated in the same way as traditional cigarettes when it comes to excise duty.
10. Fund the Asthma Society's Vital Work
The Asthma Society is the only national representative body for the 470,000 people with asthma in Ireland. We help save and improve the lives of people with asthma by providing a variety of supports and services to people with asthma, their parents/carers and health care professionals. We also act as the voice of people with asthma in ireland, lobbying the government on behalf of the 470,000 people living with the condition across the country.
However, our ability to do this work has been hampered by the loss of Government funding, particularly the Charitable Lotteries Fund. While we have had some success in attracting funding from other sources, including other statutory schemes, we have been unable to compensate for losing such a large amount of income.