Doctors call for review of `patchy' asthma treatment

BRITAIN'S 3.4 MILLION asthma sufferers are caught in a treatment lottery because of the Government's failure to set minimum standards, medical organisations said yesterday.

The Royal College of Physicians and the National Asthma Campaign said attempts to improve treatment were doomed to failure without government backing.

In a letter to Tessa Jowell, a Health minister, the two organisations called on the Government to establish a national service framework for asthma, similar to those already established for diabetes and coronary heart disease, to help to cut the 85,000 hospital admissions for the disease each year.

Medical experts were dismayed at the exclusion of asthma from the Government's public health White Paper Our Healthier Nation, published in June, which set targets for cutting heart disease and cancer. In the letter to Ms Jowell, Dr Martyn Partridge, chief medical adviser to the National Asthma Campaign, and Professor George Alberti, president of the Royal College of Physicians, wrote: "The efforts of individual organisations to improve asthma care will only truly benefit all people with asthma if they are supported by a national programme."

A survey by the National Asthma Campaign showed that only 18 of 70 health authorities planned to include asthma in their health improvement programmes, the letter added. "With such a common condition causing so much morbidity [illness] and costing the NHS pounds 672m a year, we believe this has to be acted upon."

The two organisations published guidelines yesterday, under which all asthma patients would be asked the same three questions each time they attended a doctor or nurse. The aim is to build up a national picture of the effectiveness of treatment and the extent of disability caused by the disease.

The three questions are: t Have you had difficulty sleeping because of your asthma symptoms (including cough)? t Have you had your usual asthma symptoms during the day (cough, wheeze, chest tightness or breathlessness)? t Has your asthma interfered with your usual activities (housework, job, school)?

Dr Mike Pearson, director of the Royal College of Physicians' clinical effectiveness unit, said present assessments of the burden of asthma were based on crude statistics such as hospital admissions.

"Now we have a measure that applies to all asthma patients regardless of severity and which focuses on their ability to lead a normal life. It costs nothing to ask the questions and the results are simple to understand. We need to ensure it is built into every GP's computer so that the results are used to reduce the substantial impact that asthma has on the lives of patients."