Senedd Cymru | Welsh Parliament
Y Pwyllgor Cydraddoldeb a Chyfiawnder Cymdeithasol | Equality and Social Justice Committee
Ymateb gan: Asthma + Lung UK Cymru | Evidence from: Asthma + Lung UK Cymru
Post Legislative Scrutiny- Well-being of Future Generations Act 2015
About Asthma + Lung UK Cymru
At Asthma + Lung UK Cymru our vision is for a world where everyone has healthy lungs. A world where lung health is prioritised through better understanding, research, treatment and support. We are dedicated to helping create a world where good lung health and the ability to breathe freely are a basic right enjoyed by all.
We will be the driving force behind the transformation of lung health. From research and campaigning to advice and support, as the nation’s lung charity we are on a mission to change the way that lung health is perceived.
Right now, the situation needs drastic improvement. We need change to improve the lives of millions of people with lung conditions.
Introduction
Asthma + Lung UK Cymru welcomes the opportunity to contribute to the post-legislative scrutiny of the Well-being of Future Generations (Wales) Act 2015 (the Act).
We support the Act’s vision to embed the sustainable development principles in public service delivery and to improve long-term health outcomes across Wales. However, progress in addressing respiratory health has been limited since the inception of the well-being goals.
Respiratory health affects a significant minority with 1 in 5 people in Wales living with a lung condition such as asthma or COPD. Also external factors such as air pollution have a negative impact on the health of the population at large with the impact being acutely felt by children whose lungs are still developing.
While the Act’s seven well-being goals are clear and measurable, we do not see this taken forward into legislation design to affect this principles.
Health and Well-being:
The Act requires public bodies to work toward a “healthier Wales”. Yet this ambition has not been realised in respiratory care. Wales has the highest mortality rate for respiratory disease in Western Europe. Individuals in our most deprived communities are five times more likely to die from COPD and three times more likely to die from asthma than those in wealthier areas.
The avoidable mortality rate is the number of deaths that could be avoided either by preventing disease or through effective healthcare. This has declined by 4% for respiratory disease in the last 20 years, whereas cardiovascular disease has improved by 56% in Wales.
Despite the publication of the Quality Statement for Respiratory Disease in 2022, implementation remains weak. Just 30% of people with asthma receive NICE recommended basic care[1], this is only 1% higher than the number surveyed in 2015.[2]
These figures highlight the urgent need for clear accountability mechanisms and improvement plans that translate national ambitions into practice. The current guidance does not go far enough to ensure the equitable delivery of respiratory care. The lack of performance indicators in the Quality Statement undermines efforts to monitor and improve services at the health board level.
Quality Statements and delivery plans do not provide guidance for Health Boards on how to implement them. They also do not set any measurable targets leading to subjectivity and no clear standards.
Clean Air
The Act’s goals of “a resilient Wales” and “a globally responsible Wales” require urgent action on air pollution. Air quality is a major public health concern, contributing to around 2,000 premature deaths annually in Wales. It disproportionately affects children, people with lung conditions, and those living in poverty[3].
However, action at the local level has been inconsistent. Our analysis found that no local authority in Wales has taken enforcement action under Smoke Control Area powers in the past five years. This represents a systemic failure to operationalise legislation intended to protect public health[4].
The ongoing implementation of the Environment (Air Quality and Soundscapes) (Wales) Act 2024 has so far been lacking clarity and ambition. What we have seen fails align with the Healthy Air, Healthy Wales strategy, while there are significant delays in the majority of the expected secondary legislation. On this area the Act is not going far enough to ensure Welsh Government’s actions truly have the best interests of future generations at heart.
Cross Governmental Working
While the Well-being of Future Generations (Wales) Act 2015 should act across all areas of government, and despite the introduction of Health Impact Assessments, we have not seen this affect how government departments relate to each other.
For example, in recent guidance regarding air quality and smoke control, very little consideration has been given to the public health implications of air pollution.
Conclusion
The Well-being of Future Generations (Wales) Act 2015 remains a pioneering piece of legislation. However, its potential to deliver transformative change in health and environmental outcomes has yet to be fulfilled. To realise its ambition, respiratory health must be prioritised through stronger accountability, improved local implementation, and targeted investment in services and public health.
For further information, please contact Bec Miller at xxxxxxxxxxxxxxxxxxxxxxxxxxx