A shocking disparity

It’s World Asthma Day and once again Asthma UK is complaining about the asthma divide – the astonishing lottery that leaves some people with asthma much more vulnerable to emergency hospital admissions than others.

The figures are no better than before. Although the NHS in England has been re-structured (making direct comparisons difficult) the headline figures tell the same story of wide differences in the level of admissions.

We know that 75% of emergency hospital admissions for asthma are preventable, yet it appears that some parts of the country are much more effective at stopping unnecessary admissions than others.

Why is that?

The obvious answer would be that those parts of the country with the best primary care services have the lowest admissions. In essence, if you are getting good care from your local doctor and asthma nurse, then you are much less likely to have the traumatic experience of a bad asthma attack that requires emergency hospital attention.

But that doesn’t tell the whole story by any means.

Our data reveals a strong link between high levels of hospital admissions and areas of poverty and disadvantage. The places at the top of our list are ones with deeply ingrained health inequalities. Most have high rates of poverty. Some have large minority communities with English as a second language. Some are ‘under-doctored’ areas, which means that they have fewer doctors per head of population than more affluent neighbourhoods, despite having higher levels of ill-health.

What is the answer?

The best way to end the asthma divide would be for government to set national standards for asthma services. Standards are needed to drive up performance to at least a basic minimum level.

However, standards won’t be a priority for ministers unless those of us affected make enough fuss.

But in its 60th year, these figures show that the NHS has unfinished business in addressing the original reason it was set up: to make sure that everyone – regardless of means – has access to the same quality of healthcare.

Now is the chance for ministers to ramp up their efforts to make sure the NHS delivers for people on low and modest incomes, including those people with asthma who are currently at much greater risk of an emergency hospital admission because of what they earn and where they live.

Let’s hope I am not making the same complaints at World Asthma Day in 2009.

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