We need a strong lead on allergy diagnosis

May 9 2008 Agenda

Professor Lord Kumar Bhattacharyya, director of Warwick Manufacturing Group, shared his experience during an allergies debate in the House of Lords

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My Lords, while I am no medical expert, I am glad this debate has been scheduled for today, as I've recently experienced an allergy - and can offer a layman's perspective on this excellent report.

There is great interest in this debate, and I think I know why. I was reading the report this morning when my daughter asked me what I was doing. When I told her I was going to speak on allergies, she laughed and said "Well, everybody's allergic to politicians".

My own experience was in line with the analysis of the report.

Last year I noticed a rash on the left of my forehead which I assumed was an insect bite. Within a fortnight a blister developed, so I consulted to my GP, who thought I had shingles.

The treatment for shingles did not help and the lesion worsened. I was then diagnosed with cellulitis and treated with intravenous penicillin but the lesion did not heal.

My GP referred me to a consultant dermatologist who diagnosed me with an allergy, probably to an 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 vaccine treatment.

Although I was lucky enough to be diagnosed with an allergy relatively early on, my case illustrates that a full diagnosis of allergies still requires a significant delay, private care or a lot of travel - or all three.

I want to be clear. I am proud of what my party's achieved in the NHS.

The West Midlands Strategic Health Authority under the leadership of Cynthia Bower has totally transformed the landscape of medical care in my region. We have made great strides over the last few years, with new hospitals and improved patient care.

Wanting services to improve is not a criticism of the NHS, but a debate about where it should improve next.

Today allergy treatment has waiting times that are unacceptably high and a quality of diagnosis which is unacceptably low.

As Dr Pumphrey of Research Councils UK says: "Patients are unlikely to get ideal advice from any but the best informed of specialist clinics."

Indeed the Department of Health began its report on allergies with a summary of the problems: "People can wait three to nine 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."

The Government tells 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.

These issues define the problem. Doctors don't have sufficient expertise to diagnose allergies and there aren't enough specialists to treat the patients that are diagnosed.

This means patients who go to a GP with asthma will have to attend seven times before they get a diagnosis and only 30 per cent of those with asthma are given an allergy test.

This might be understandable if we were talking about a rare malady, but allergies affect a third of the population and cost the country a billion pounds a year.

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.

We do 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 Para 7.27 which says: "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 both treatments and GP training.

The Government is right to say in its 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 primary care commissioners sometimes respond best to a strong lead from the centre, as the Government has proved so successfully on 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 do more to help consumers by making it easier to detect allergens they might come into contact with.

I support the committee's recommendation in paragraph 6.11 for better labelling of allergens, and while I do not want to create "scares" in the food industry, products such as aerosols, shampoos and detergents should have clear labelling of known contact allergens.

My Lords, when you suffer from an allergy you will first look for a cure from those you trust, but if none is forthcoming you will look anywhere.

If the NHS can make the correct diagnosis and identify the right treatment, patients will no longer require the alternative remedies that have so exercised the committee.

Equally, if we ensure labelling is clear for those who suffer allergies, consumers will not be susceptible to peddlers of snake oil.

I hope the Government responds constructively so we can make great strides in the treatment of allergies.

Otherwise, we will see more patients fall into the arms of any who will offer them relief, no matter how far fetched their claims.