Chamber and committees

In the overall consideration of the bill, I am suggesting that we amend the rural support plan to explicitly put the food security issue at the heart of the plan.

Members around this table agree that it is important that food security is considered. We have heard about amendments relating to the issue earlier. Having it explicitly put at the heart of the rural support plan is something that I am sure members would agree to support, and we have heard representations for doing so. I would like to see it made explicit that food security is of paramount importance. For those reasons, I ask members to support amendment 47.

Amendment 47 would ensure that the need for sustainable food systems and supply chains to deliver food security was explicitly considered right at the heart of the rural support plan. I am pleased to hear of the cabinet secretary’s support for that.

The issue of food security has gained prominence recently, given the impacts on it from conflict and climate and the interest in it among members of Parliament, stakeholders and the public. After the conflict in Ukraine started, we began to hear the term “food security” much more often, and that conflict continues to highlight the fragility of the global supply chain and of global food systems. The conflict in Ukraine has hit the agriculture sector hard, leading to some significant changes to gross margins. Input costs have risen sharply during the past 12 months, with the hike in fertiliser and fuel prices impacting agricultural businesses and increased feed costs affecting livestock margins.

I recognise that the objectives of the bill lend themselves to ensuring that consideration, but I am sure that all members must agree—

In the cross-party group, we have talked about how pulmonary rehab and singing help with chronic obstructive pulmonary disease. Does Alexander Stewart agree that PR and singing can help folk with asthma, too?

I welcome the opportunity to lead this important debate to recognise world asthma day 2024, which took place yesterday, 7 May, with the theme “Asthma Education Empowers”. I thank members who have supported my motion, allowing the debate to go ahead today. I also thank Asthma and Lung UK Scotland for its briefing and for all that it does in respect of research, advice and support for persons with an asthma diagnosis and their families.

Gareth Brown from Asthma and Lung UK Scotland serves as the secretariat for the cross-party group on lung health, which I co-convene with my colleague Alexander Stewart. Gareth does a great job, and I thank him for all his work. The CPG has done work relating to asthma previously, and the input from clinicians, asthma support groups and those who are living with asthma is welcome. My thanks go to the Minister for Public Health and Women’s Health for her active engagement with our cross-party group. One of our CPG members, Olivia Fulton, chairs a group that focuses on severe asthma, which meets online—I will say a wee bit more about Olivia later in my speech.

As my motion indicates, world asthma day is organised by the Global Initiative for Asthma, which is a World Health Organization collaborative that was founded in 1993. There is a lot of great info on the GINA website, which I encourage people to visit to find out more.

Asthma is a very common long-term lung health condition. In the United Kingdom, 5.4 million people have an asthma diagnosis—that is one in every 12 adults and one in every 11 children. In Scotland, 368,000 adults and about 71,000 children live with an asthma diagnosis. People with asthma might have sensitive, inflamed and irritated airways. Asthma symptoms can come and go; sometimes people might not have symptoms for weeks or months at a time. However, asthma needs to be treated every day, even if someone feels well, in order to lower the risks of their symptoms being exacerbated and of having an asthma attack.

The most common symptoms of asthma are coughing, wheezing—which is a whistling sound when you breathe—breathlessness and chest tightness. Experiencing one or more of those symptoms could mean that you have asthma. It is more likely to be asthma if your symptoms keep coming back, if they are worse at night or if they occur when you react to a trigger such as exercise, weather or an allergy such as pet hair or pollen. Anyone who experiences those symptoms should speak to their general practitioner as soon as possible.

The seriousness of asthma varies from person to person. There are different types of asthma—indeed, there is an important difference between severe asthma and uncontrolled asthma. Uncontrolled asthma improves with treatment changes such as steroid inhalers and good inhaler technique, but someone with severe asthma, which affects about 5 per cent of people with asthma, can have symptoms most of the time and can find them very hard to control.

Poorly controlled severe asthma takes a toll on people’s physical and mental health, leading to an average of four asthma attacks per year. Among people who live with severe asthma, 55 per cent report depression, 66 per cent report anxiety and 68 per cent say that it impacts their work and education. Where people live also has a bearing on outcomes, as those in the poorest areas of Scotland are, on average, three times as likely to be admitted to hospital as a result of their asthma.

There is a huge financial cost. In Scotland, the cost of treating respiratory disease is estimated to be £500 million each year, and asthma care represents £97.5 million of that spend. Flare-ups of severe asthma can result in patients presenting in the costliest part of the healthcare system: accident and emergency departments. Data suggest that people with severe asthma attend A and E departments roughly four times more often than people with non-severe asthma.

However, the situation can improve. Earlier, I mentioned Olivia Fulton, who is a great example of how improvement in severe asthma care can be achieved. She had serious challenges with her severe asthma, but thanks to proper care and treatment, she is now playing for Scotland’s women’s wheelchair rugby team. Asthma education has certainly empowered Olivia.

Since 2013, Asthma and Lung UK Scotland has surveyed people with asthma, and, earlier this year, it launched its “Life with a Lung Condition” survey for the second time. The survey results highlighted that 24 per cent of Scots received all three recommended aspects of asthma care: an annual review of their asthma care and treatment, a check-up on their inhaler technique and a written asthma action plan. In particular, 75 per cent of those who were surveyed said that they received an annual review, 50 per cent said that their inhaler technique was checked and 40 per cent said that they had received a written asthma plan.

I would welcome an update from the minister regarding what further steps the Scottish Government could take to increase awareness of asthma education in Scotland so that people know what their entitlements are and are empowered to press for them.

In 2021, the Scottish Government launched the “Respiratory Care Action Plan 2021-2026”, which sets out a vision for driving improvement in prevention and in the diagnosis, care, treatment and support of people living with respiratory conditions in Scotland. One aspect of the plan is that the pillars of asthma care should be available to everyone, so I would welcome an update from the minister on the implementation of the RCAP.

I will touch briefly on the link between asthma and inequality. We know that people from the most deprived areas of Scotland are much more likely to receive an asthma diagnosis. Managing a variable lifelong condition with complex treatments such as inhalers is difficult; managing asthma while juggling multiple jobs, family responsibilities and financial pressures is even harder.

I welcome the Scottish Government’s commitment to tackling health inequalities, and it is important to note that good-quality housing, sound state welfare support and good air quality are key components of achieving health equality. With regard to air quality, 57 per cent of those who are living with asthma in Scotland say that air quality makes them feel more breathless.

In closing, I highlight one final point: the importance of working across countries to learn from experience and ensure good practice. The International Coalition for Respiratory Nursing—of which I am a member, as I am still a registered nurse—was created in 2021. The ICRN is a global network of advanced respiratory nurse practitioners, with the aim of working together to improve care for people who live with lung conditions and to educate and empower patients. I support this year’s world asthma day theme, “Asthma Education Empowers”, as educating people empowers them to receive improved care and, consequently, have healthier outcomes.

Again, I welcome the debate, and I look forward to contributions from colleagues.

It is really about the wider recommendation on supporting young people right through the process. The information that we have says that it has been said to be based on dubious science. I would be interested to hear how that is one of the misrepresentations of the report.

It does help, actually—it shows the power of correct words. Thank you.

Good morning to the witnesses. From what you have just described, Food Standards Scotland’s remit is pretty huge and broad-ranging, and I am really interested in the work that Food Standards Scotland does on a range of issues, as you know.

I will come on to issues around ultra-processed foods in a wee minute but, first, I will talk about the University of Edinburgh’s research and recommendations on red meat consumption. We keep hearing about beef being really bad for the climate, and I worry that our farmers in Scotland are condemned for beef production, although they do it really well. Scotland is just a wee country that, compared with China, the USA and Russia, has really low carbon emissions.

I am interested in hearing about the recommendations for a reduction in red meat consumption. To achieve a 20 per cent reduction in the average intake, the previous recommendation of no more than 70g a day has been reduced to no more than 60g a day. There are a lot of figures around that, so I am interested to hear what consideration Food Standards Scotland has given to the findings from the University of Edinburgh’s research into recommendations for reduction in red meat consumption.

That is great; thank you. I know we might have to get some further information from you.

There are alternatives to meat. I looked up what 70g means. A plate of spaghetti bolognese has about 100g of meat; a quarter pounder beef burger has 90g. I was trying to work out what that all means. A full Scottish breakfast can also have about 90g, so you get your whole daily recommendation in one meal. However, if you were vegetarian for the rest of the week, that might be acceptable.

I am interested in how we support people to replace red meat with things such as eggs, legumes and other vegetable options to give them the nutrients that you talked about. What could Food Standards Scotland do to recommend alternatives to people?

I am conscious that there is loads to cover, but I want to focus on ultra-processed foods.

Henry Dimbleby and Jemima Lewis were co-authors of a book called “Ravenous”. Recently, Henry Dimbleby gave a presentation at the shaping the science for the Scotland’s food future event at Dynamic Earth. It was really interesting to hear him talk about his research and his work on a proposed food strategy.

We know that the food system is really complicated, but is it a good idea to replace Scottish lamb and Scottish beef that are produced to high welfare standards with meat replacements containing chemicals such as stabilisers, emulsifiers, xanthan gum, guar gum, colours, flavourings and stuff that has been labelled as “industrially created enteric substances”? Is that really food? Given that we produce meat to the best welfare standards, I would be interested to hear your thoughts on replacing that with ultra-processed food that has unpronounceable chemicals in it, and how that links with, for example, the issue of the high levels of fat, sugar and salt in food.