Sir, – As a group of healthcare professionals from NHS Highland we were interested to read about the concerns of Martina Chukwuma-Ezike (rector of Aberdeen University) in your recent article regarding the plans by the Scottish Government to change the type of inhaler most commonly prescribed for patients with asthma and chronic obstructive pulmonary disease (copd).
In the UK most inhalers are provided in the metered dose inhaler (MDI) form. The propellant gases used in these inhalers are between 1,000 and 3,000 times as potent as carbon dioxide in their contribution to global heating. The use of just one MDI inhaler is equivalent (in greenhouse gas emissions) to driving for 175 miles in an average, non-electric car. For a dry powder inhaler (DPI) that distance is four miles. As great as the environmental concern is, MDIs are frequently also not the best inhaler for patients. Martina Chukwuma-Ezike raises concerns about patient safety with a change of inhaler, but MDIs are often used incorrectly.
Some patients have concerns about difficulties “breathing in”, impacting on how they can use a dry powder inhaler. However, there is very good evidence that almost all people who have asthma and copd can breathe in strongly enough to use this type of inhaler (including people who are having an asthma attack), as it is usually the breath out that is most affected.
There are some asthmatics who have particularly bad asthma attacks, and they will need to have an MDI inhaler and will continue to be prescribed them. However, their asthma may still be better controlled on a day-to-day basis using DPIs. Whichever inhalers are used, better asthma-copd control means a lower overall environmental impact. Decisions will be made in partnership with the patient.
We note that the article does not inform us that widespread use of MDIs in the UK is out of step with most other countries in Europe. In Sweden in 2017, about 13% of inhalers were MDIs in comparison to 70% for the UK. This seems to reflect tradition and marketing rather than clinical priorities.
We entirely agree with Martina Chukwuma-Ezike that reducing air pollution is essential in reducing chest problems, and we actively promote and support cycling, walking and wheeling where possible (as well as other measures such as electric vehicles) to improve air quality.
The Scottish Government’s plans to reduce MDI usage are not green-washing as the article suggests. There is potential for considerable reduction in greenhouse gas emissions from their reduced use, and the changes will be beneficial for many patients.
The most important thing in all of this is that patients with asthma and copd should ensure that they try to respond to invitations from their GP practice for an annual review. This will help us to ensure they are on the best treatment they can be, which is our priority.
Dr Stephen Thomas, consultant respiratory physician; Dr Andrew Dallas, GP; Dr Alice Scriven, GP, on behalf of Highland Healthcare for Climate Action.
Government crisis plan found wanting
Sir, – In recent interviews, politicians have been blaming price rises on Covid coupled with the war in Ukraine.
Over two years of Covid lockdowns, work furloughs and shortages of some goods, I don’t remember my electricity doubling in price and food costs rising 10% or 15%. This put the country in crisis.
The government, although it did not know the war in Ukraine was coming, should have had a crisis plan in place as Covid had taught them a lesson – “be prepared”, as every Boy Scout knows.
Don McKay. Provost Hogg Court, Torry.
UK lagging behind as world powers on
Sir, – Charles Wardrop’s letters (September 23 and 29) contain his usual mix of assertions about the problem of climate change.
Charles’ personal view that CO2 does not have a “significant” role in global warming is so absurd as to be hardly worth refuting. I merely refer your readers to a useful article by the Royal Society or the latest Summary For Policymakers from the IPCC
Charles refers again to “countries with a fixed policy not to curb any significant release” of CO2 and he apparently believes that “the eastern nations, China and India” are “non-compliant in decarbonisation” and “must be laughing at us” because of the UK’s efforts to develop renewable energy.
The facts about this situation may be found in the BP Statistical Review of World Energy: “Solar and wind capacity continued to grow rapidly in 2021, increasing by 226 GW, close to the record increase of 236 GW seen in 2020.
“China remained the main driver of solar and wind capacity growth last year, accounting for about 36% and 40% of the global capacity additions, respectively.”
Elsewhere the 2022 BP Review reveals that the average annual growth rate of “renewable generation” in the decade 2011 to 2021 of China was 27.2%, India was 15.2% and the Total Asia Pacific was 21.8%.
Meanwhile, the UK growth rate was just 14.7%, little more than half that of China, and even slightly below the world average of 14.9%.
If these countries really are laughing at us, maybe its because we are lagging behind while their industries and technologies power ahead into the inevitable future.
Roy Turnbull. Torniscar, Nethy Bridge.
Sturgeon ‘waffling’ on without a plan
Sir, – To dismiss real concerns about the SNPs 15-year dismal record in government as “fanciful generalisations”, and assert that his own big opinions are indeed facts, Alastair McLeish (Letters, October 1) is beginning to sound a lot like the arrogant Nicola Sturgeon.
The bold Nicola is a world champion at waffling the waffle (and can recite a wee poem also) but is incapable of producing a sustainable plan for her so-called “independent” Scotland, or build a couple of ferry boats, and cannot even provide toilet facilities for our iconic world-famous NC500 tourist route – how bad is that?
This highly-secretive disaster-prone SNP leadership are behaving more like an amateur dramatic concert party than a party of government, and after 15 years of failure at Holyrood are fast becoming an international embarrassment.
Scotland’s struggling taxpayers are the truly “cringed” ones, thanks to the rabble-rousing SNP squandering their money bribing the public with hand-outs, financing IndyRef2 and opening futile foreign embassies.
Our UK is a world-leading G7 and Nato powerhouse nation that tens of thousands of migrants regard as simply the best, and are desperate to call home.
For the wily Nats to keep having never-endums until they win only once, is full-blown Mafia democracy in action. It’s time for all true patriots of Scotland to reject this 13th Century Braveheart anti-English pea-brain nonsense from the scheming no-plan party.
George Emslie. Bridge Of Don, Aberdeen.
Let us accentuate the positive online
Sir, – The tragic story of young Molly Russell who took her own life after suffering from “negative effects of online content” left me with an overwhelming sense of sadness that advances in technology – thought of as science fiction in my youth – by the flick of a switch ought to have opened the gates to a new world of information on literature, history, science or any of a myriad of subjects that hold people’s attention, available to us only in books and newspapers, instead of having such a negative effect on the lives of so many of today’s youngsters.
Social media, a lifeline in communication for lost and lonely souls relating their innermost feelings to friends real or imaginary, is also a curse for others becoming addicted to such outlets, unable to avert their eyes from issues causing agony to a fragile mind.
A prime example is bullying.
While this was just as rife in schools in the 1940s as in the 2020s, in our case the perpetrators were there in flesh and blood, not spewing their bile anonymously at their victims watching on ever-present screens.
We fought our own battles for, in truth, bullies are cowards with inadequacy and jealousy festering within. By refusing to be intimidated, never showing a tear, they lost interest in tormenting an unresponsive victim.
We could proudly walk away relatively unscathed, bruised bodies soon to heal, while sadly for today’s victims the messages remain, always available to be viewed and agonised over.
In an age free from online technology my generation of youth walked with friends in the darkness, now unknown numbers walk alone in the light.
In many ways we were the lucky ones.
Ivan W. Reid. Kirkburn, Laurencekirk.
Climate gravy train needs to be derailed
Sir, – Don Carney thinks the good and bad about renewables should be transparent (Letters, September 30), so I hope the following will help.
The manufacture, transport and erection of wind turbines and solar panels create emissions which take years to recoup. Estimates of this vary between seven and 10 years.
The planning authorities should be demanding that the “payback” period of carbon emissions is estimated at the planning stage. Solar farms are being built on agricultural land when we need to be growing our own food instead of importing 46% of our needs. Farm land should be off limits.
Staff at universities, research establishments, local councils, quangos, climate committees, consultants and more are sitting comfortably on the climate gravy train and have no wish to get off.
Don Carney should read the Fraser Research Bulletin “Is Climate Catastrophe Really 10 Years Away? One snippet – “these 10-years to disaster” scenarios… are based on speculative computer models driven primarily by conjecture and assumptions of future events”.
Lots more in the bulletin to upset the climate apostles.
Clark Cross. Springfield Road, Linlithgow.
Tories badly in need of some experience
Sir, – Surely Conservative MPs and the grandees know they have to act immediately to get rid of the wacky, inexperienced duds that only just over half of their party members dumped on them and us when they voted for Liz Truss.
They should find a way to form a new government around Michael Gove, Rishi Sunak, Jeremy Hunt, Sajid Javid and Ben Wallace and fill the other ministries with some of the many experienced, common-sense heads like David Gauke and Dominic Grieve.
That would steady the ship and give both Tories and Labour time to create two competent, sensible options for a general election in 2024.
Allan Sutherland. Willow Row, Stonehaven.
Greens and industry must work together
Sir, – On the one hand we have green activists cajoling us to reduce carbon dioxide emissions to save the planet and on the other the food industry is bemoaning the shortage, and consequent huge food price increases, of carbon dioxide.
Why don’t these two parties get together and resolve each other’s problem?
GM Lindsay. Whinfield Gardens, Kinross.
Award case flawed
Sir, – In reference the report in Friday’s Grampian Chamber of Commerce that Aberdeen International Airport has won an award for the airport of the year, named by the members of the Scottish Transport Awards. I’m right in thinking this was not April 1?
Have any of these people ever travelled to Aberdeen on an international flight? I very much doubt it.
Would they be delighted to wait for, in all recent reports from passengers from Tenerife, more than an hour to reclaim their luggage. I don’t think so.
Who do these people think they are kidding? We all know that Aberdeen is commonly referred to as a “Mickey Mouse” airport.
On my last trip back from said Tenerife, I discovered that on a midnight arrival there were two people working to unload the aircraft. The same two people transported the luggage back to the terminal and then loaded them on to the carousel. Hence, in this case, I had an hour and 15 minutes to wait before I collected my luggage. This can’t be the criteria for an award-winning airport, or is it?
Gordon Bruce, Danestone.
Conversation