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Nick Fletcher (Don Valley) (Con)
I beg to move,
That this House has considered e-petitions 585304 and 589716, relating to food labelling and support for people with allergies.
It is a pleasure to serve under your chairmanship, Sir Graham. I thank the petitioners for their campaign; I know that they are here today. Together, the petitions have received over 33,000 signatures. The first petition states:
“The Government should appoint an Allergy Tsar to act as a champion for people with allergies to ensure they receive appropriate support and joined up health care to prevent avoidable deaths”.
The second petition, on Owen’s law, asks for a change in the law around labelling in UK restaurants. It has three parts. First, it asks that restaurants
“put all information about allergens in their food on the face of the main menu so customers have full visibility on what they're ordering.”
Secondly, it requires servers to
“initiate a discussion with customers about allergies on all occasions”.
Finally, it states that there should be a register for all anaphylaxis deaths.
Those are the petitions, and I will discuss why the petitioners are asking for these measures. Sadly, they have suffered unbearable losses. Natasha Ednan-Laperouse died in 2016 after eating a baguette that did not have a complete list of ingredients. The baguette contained sesame seeds, to which Natasha was allergic. That caused her to suffer an allergic reaction, which resulted in her death. She was only 15—so young. Natasha’s parents Tanya and Nadim have already been successful in their campaign for Natasha’s law, which enforces a requirement for all pre-packed sandwiches to contain a list of ingredients and which became law in October 2021.
The second petition was started by Owen Carey’s sister Emma. Owen suffered from multiple allergies all his life and was used to ordering meals for his restricted diet. In April 2017, he ordered a chicken burger at a restaurant. He explained his allergies to the server; with no other information available, he was assured that he was safe. However, the chicken was marinated in buttermilk, to which Owen was very allergic. He knew instantly that something was wrong. He had a massive reaction and, after 45 minutes, collapsed and died. He died celebrating his 18th birthday—again, so young. They were both young people with their entire life ahead of them. We can all clearly see why Natasha and Owen’s families want to stop anyone else going through this.
I spoke to the families of Natasha and Owen so that they could explain to me in their own words exactly what they are trying to achieve. I am grateful to them for that. It appears that both petitions go hand in hand. The petitioners believe that if we had a tsar, they would have a champion who could work with families who have suffered bereavement and with charities that want to help, along with frontline staff, proprietors, supply chain businesses, the Food Standards Agency and all Government Departments that share an interest. It is a straightforward ask.
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
The FSA has highlighted the fact that while young people are more likely to experience a food allergy, they are less likely to tell a café or restaurant about it, especially if they have eaten there before. Does the hon. Member agree that we must empower young people to speak up about their allergies and make businesses aware of the importance of proactively asking customers about their potential allergies?
Nick Fletcher
The hon. Member is exactly right. I was forwarded a list of many people who have fallen foul of that, and they always seem to be so young. I will definitely come on to what the hon. Member has mentioned.
The second petition seems relatively simple, too. How difficult can it be to put on a menu what allergens are in each piece of food? In fact there is already a law requiring that, but it falls short by requiring it “by any means”, which often means that allergen information is missed by those who need it most. The petitioners say that the law needs tightening up, but they are flexible in their ask: they say that allergens must be stated on the face of the menu, but that could be in paper format or electronic. For a server to make sure that a discussion is had seems another simple ask, and a list of the sad losses could be dealt with through the coroner’s office.
But as with many things in life, it is not quite as simple as all that. The industry is huge. Billions of pounds are spent each year on food from outlets of varying sizes. We have all been to a local caff or McDonald’s; some of us have been fortunate enough to go to some rather expensive restaurants in hotels with branches around the world. Then there are those in the middle, the squeezed small and medium-sized enterprises. Therein lies the problem: the variation among outlets and what and how they serve.
Fast food chains give a specification to their suppliers of the ingredients that their food is to contain, with no variations—that is what they ask for and that is what they get. But other outlets, big and small, often get swaps when they order their ingredients, pretty much like when we get an online supermarket delivery. A local caff may be able to cope with that, with a good proprietor keeping a check on what they are sent and very few menu changes throughout the year, if any. It may not be too much of a problem for them, but the large restaurants and some of the independents with fast-moving kitchens may struggle.
We have all seen a chef with 40 covers to do bellowing in someone’s ear, pots and pans everywhere, hot kitchens with hot atmospheres, young people trying to learn their trade, and impatient customers breathing down a server’s neck. These are high-pressure situations, often in open kitchens, and these people are all trying to make a living. Mistakes will happen.
Then there are menu changes. Many restaurants change their menu frequently to add to the customer experience. They have to offer a variety to keep it fresh, and hopefully in season too, but every change brings a problem—another allergy list and another place for an error to occur. It is not as easy as one first thought.
Margaret Ferrier
Data from 2022 published by the FSA shows that when dealing with a risk of food allergies, smaller manufacturers will focus on the physical separation and secure storage of ingredients. In comparison, medium-sized manufacturers will take further steps such as cleaning between production runs and managing the packaging, labels and transport of products. Does the hon. Member agree that businesses of all sizes should have access to personalised guidance on how they can improve their allergy awareness in risk assessment?
Nick Fletcher
I will be coming on to that point, but I believe that an allergy tsar, which the first petition asks for, will be able to bring those concerns together. That would help the industry immensely.
There are companies out there such as Control Catering that want to work with the Food Standards Agency and the industry to create a single source of truth. They want to work with manufacturers so that all data is seamlessly passed to the end user, the customer or diner. The petitioners believe that that is a sensible idea, as we have over 50,000 products across a huge supply chain going to many different outlets and 60 million-plus people across this land. The British Institute of Innkeeping and Hospitality Allergen Support UK feel it is sensible, too, but apparently the FSA is slow to respond when contacted about it. The industry believes that unless we have a joined-up approach, we could end up putting forward legislation that has the best intentions but turns out to be completely unworkable. I know that there is much more that the petitioners would have me say, but I must move on in the hope that other MPs will add their thoughts on the complexity of the issue.
The second part of Owen’s law would be for all servers to start a discussion with customers about allergies so that customers do not have to ask. My own experience is that that is happening anyway. However, I am fortunate enough to be able to answer no, so I am unsure how deep the conversation goes if the answer is yes. Stakeholders feel that training is required for all servers, but I understand that the industry suffers from a high turnover of staff, so that is not an easy task.
Ben Lake (Ceredigion) (PC)
I am grateful to the hon. Member for introducing this important debate. There is very often a high turnover of staff in the hospitality trade, but does he agree that technology such as electronic forms and QR codes might help? Even though staff members might work in a restaurant for only a couple of months at a time, such technology would enable them to quickly check when asked what ingredients are in the food they are serving.
Nick Fletcher
The hon. Member is right. As we move forward in the digital age, we will be able to put options on menus that the server can discuss with the diners and things like that. Maybe the conversation should always be instigated, but if the answer is yes and the server is not adequately trained, they should be assisted by a person with higher authority or even the chef. Again, that may be difficult to implement, but a conversation must take place with an outcome that protects anyone who suffers with allergies.
Before I move on from this point, though, let me say that I believe that there is a responsibility on people who suffer with allergies to make that known. They must play their part. I know many are young, but I am a firm believer in personal responsibility and we must give the catering industry a chance. We must help it to help us if the system is not quite working as it should. All of us who are fortunate enough not to suffer should support those who do by being patient, by showing a caring attitude when ordering our food with guests and, if it is our child who suffers, maybe even by ordering what they order. That would help our children and the restaurateur, and it would show some skin in the game. If we want change, we should be prepared to bear a little cost ourselves and to make ourselves a little uncomfortable for the cause. The state cannot and should not be the answer to everything. We should all play our part.
Finally, Owen’s law asks that we maintain a list of all people who have died from anaphylactic shock. It would not necessarily be for the public domain or even name where the tragedy occurred, but it would be recorded to make the Government and all stakeholders aware of the size of the problem and to aid work on prevention as well as a cure. Professor Adam Fox believes that there should also be a list of near misses. Near misses are recorded in the construction industry; they should be recorded here, too. If we know the size of the problem, it may focus our attention on why there is a problem. Why are 40% of the population suffering with some kind of allergy? To me, that is the real question.
We can now see why the petitioners believe that the introduction of a tsar could help with the second petition’s aim of instigating Owen’s law. They believe that if we do nothing, we will see more tragedies, and if the industry simply states, “All our food may contain certain ingredients,” people with hypersensitivity will stay away. Some stakeholders believe that if we move too quickly with poor regulation, we will damage the industry and no doubt close businesses. So do we do nothing? Well, the petitioners and the industry at large agree that there should be a change, and appointing a tsar who could lead on solutions may just do that. It may help to bring forward legislation or ideas that will not only save lives, but save an industry that is battling on many fronts simply to stay afloat. I look forward to listening to what colleagues and the Minister have to say.
Jon Cruddas (Dagenham and Rainham) (Lab)
What we are talking about today matters a great deal to a great many people. Millions across the country suffer from some allergic condition: it is estimated that 44% of adults and 50% of children in the UK have one or more allergic disorders. While the prevalence, severity and complexity of allergies have increased on a global scale over the past 60 years, UK rates are among the highest in the world. There is a modern-day epidemic in allergy. I therefore very much welcome both petitions: one to appoint an allergy tsar as a champion for people living with allergies and the other in support of Owen’s law, a change in the law around allergy labelling in UK restaurants. I congratulate the organisers. Literally tens of thousands of people are mobilising and demanding a change both in public health and in corporate responsibility for labelling policy.
Why do we need an allergy tsar? No single person has overall responsibility for the wellbeing of allergy sufferers in the Department of Health and Social Care, NHS England or anywhere else in Government. There are no clear lines of accountability in relation to the overall NHS provision of allergy care. An allergy tsar would act as a champion for people living with allergies. As the national lead, the tsar would ensure that adults and children with allergies received appropriate support to prevent avoidable death and ill health. The lack of a national lead has been raised time and again by coroners at the inquests of those who have tragically died following severe allergic reactions. The need for an allergy tsar is supported by the National Allergy Strategy Group and across the allergy community.
Andy Slaughter (Hammersmith) (Lab)
I pose this question because my hon. Friend is an expert in the subject. There have been calls for a national allergy tsar for a long time. Does he understand why the Government are resistant to them?
Jon Cruddas
I will come on to that point. There have been 20 years of reports that agree about a common platform for policy change, and there is a unanimity across the community. It is bewildering that over the past 20 years, Governments have not responded in a proactive way, although over the past 18 months there have been a few changes, which I will come to later.
The need for an allergy tsar is supported by the National Allergy Strategy Group. In addition, the Natasha Allergy Research Foundation and the NASG are asking the Government to better support people with allergies through, first, an expert advisory group for allergy, which would actively support the growth and delivery of high-quality, comprehensive and geographically diverse allergy provision, and secondly a national allergy action plan.
Margaret Ferrier
A lack of societal awareness around food allergies is dangerous. For example, 600,000 people in the UK have coeliac disease, but there is a misconception that people choose to eat gluten-free food for its health and cosmetic benefits. Does the hon. Member agree that more needs to be done to ensure that the UK public are aware of the definition and dangers of different food allergies?
Jon Cruddas
I agree. I would suggest that that is part of the lack of an overall strategy and of key responsibilities at national level for making people aware about the differences and the public health needs across all our communities in every constituency that we represent here in Parliament.
The second part of the proposal is a national allergy action plan, which would join up GP and hospital allergy services, increase the number of specialist allergy clinics, train more specialist allergy doctors and consultants and provide mandatory training in allergies for all GPs. Owen Carey’s family want a change in the law to compel restaurants to state the allergens in their dishes, specifically on the face of main menus. That would build on Natasha’s law, which dealt with the ingredients and allergy listings on pre-packaged takeaway foods. Natasha’s law left an uneven situation in which people who buy pre-packaged foods have more protection than those who eat in restaurants, which is what the family are keen to sort out.
The family are also campaigning for better training for waiting staff, for more thorough and certified allergy and first-aid training and, as we have heard, for the proper recording of and a national register for anaphylaxis deaths. Those are all very sensible suggestions. Businesses are also responding: in March 2023, the bosses of 11 leading UK businesses, including Tesco and Sainsbury’s, called for clearer rules on food labelling following recent tragic and preventable deaths.
As for the general context, the figures speak for themselves. One third of the UK population, or 20 million people, are living with an allergic condition, and 5 million have a condition severe enough to require specialist care. Fatal and near-fatal reactions have increased over recent years. There has been a 615% increase in hospital admissions relating to allergic disease during the past 20 years. More than 200,000 people require the prescription of emergency adrenalin because of the severity of their allergic condition. Each year, births add 43,000 new cases of child allergy to the population in need. The figures are extraordinary.
What is so frustrating—touching on what my hon. Friend the Member for Hammersmith (Andy Slaughter) raised a few minutes ago—is that over the past two decades a series of reports have consistently demonstrated the prevalence of allergic diseases, the patient needs and the lack of UK service provision. The list of reports includes two Royal College of Physicians reports, in 2003 and 2010, on allergy: the unmet need. We had the 2004 House of Commons Health Committee report on the provision of allergy services, as well as the 2007 House of Lords Science and Technology Committee report on allergy. In autumn 2021, the all-party parliamentary group on allergy and the National Allergy Strategy Group published “Meeting the challenges of the National Allergy Crisis”.
All the reports have consistently highlighted how allergy remains poorly managed across the NHS because of a lack of training and expertise. All have recommended significant improvement in specialist services as well as improved knowledge and awareness in primary care. They have all talked about a national allergy action plan and the need for a national lead person responsible for allergy services—an allergy tsar. Yet in truth, very little has happened in 20 years. Change is long overdue.
Beyond the statistics, we are talking about a growing number of people living with allergic disease. Their condition can have significant and negative impacts on their lives and those of their families. It is frightening and restrictive to live with a condition that can cause a severe or life-threatening reaction at any time.
The reports that I mentioned, spanning 20 years, have all agreed on four key recommendations for change: a national plan for allergy, which would involve making allergy a priority and investing in a national plan led by a designated Department head, a national tsar; specialist care, which would involve expanding the specialist workforce as a priority; in primary care, ensuring that all GPs and other healthcare professionals have knowledge of allergic diseases; and, in terms of commissioning, ensuring that local commissioners understand the allergy needs of their population.
As I mentioned, I want to acknowledge some progress over the last year. The previous care and mental health Minister—the right hon. Member for Chichester (Gillian Keegan), who is now Secretary of State for Education—demonstrated real commitment in this area, and since 2021 we have established a work programme and an ongoing dialogue between civil servants and representatives from the NASG to support the development of a national plan. I hope that that work continues. It should be the right of every allergy sufferer to receive a quality standard of care, and every sufferer should be able to be confident about the food that they consume in restaurants, as is the case under the arrangements that successfully operate in other countries, such as the Irish Republic.
In December 2022, the Food Standards Agency executive said that as a result of the need to respond to the deadline imposed by the Retained EU Law (Revocation and Reform) Bill, it had to delay its planned work on Owen’s law. Supporting the petition this afternoon will, we hope, put pressure on the Department for Environment, Food and Rural Affairs to force the FSA to prioritise its work on Owen’s law before another person dies unnecessarily.
I congratulate all the organisers of both petitions and urge the Government to respond favourably to them, because lives literally depend on it. Government action is important, and I hope that the Government can back both petitions this afternoon.
Steve Brine (Winchester) (Con)
It is good of you to call me so early, Sir Graham. I was really keen to make a contribution to today’s important debate, the subject of which was ably laid out by my hon. Friend the Member for Don Valley (Nick Fletcher). Congratulations to the many people who signed the first petition: 13,000, as my hon. Friend said. I think the second highest number of people who signed it live in the Winchester constituency, and I will explain why that was the case.
This is a subject that I am interested in, not only because I chair the House of Commons Health and Social Care Committee and am a former Public Health Minister and who has sat many times in the seat where the Minister is today, but because I am the constituency MP of Emma, who is here today and whose lovely brother Owen gives his name to part of today’s debate—one of the petitions—and, of course, to the Owen’s law campaign. The House will wish to note that I met up with Emma on Friday in Winchester and heard a bit about her little brother, the tragic circumstances in which he lost his life and the brilliant campaign that she and the family have put together in his memory. They have hotfooted it from Manchester, where they were on the “BBC Breakfast” sofa this morning, so it is really great to have them here in the Public Gallery today.
As I have said a number of times in this Chamber, the Health and Social Care Committee recently launched a major new inquiry into prevention of ill health. It is a subject that I am passionate about, and it is one of my top priorities as Chair. Obviously, prevention covers a huge range of topics, and that is one of the reasons why we decided to theme the inquiry around 10 key workstreams, which we will be exploring over the remainder of this year and probably into next. A high number of the submissions that we received to our initial call for evidence were related to food. Although perhaps more obvious topics spring to mind when talking about food and prevention, such as the obesity agenda, it is important that we do not lose sight of how crucial preventive work is when supporting people with food allergies and intolerances. Today’s debate on the two e-petitions perfectly illustrates that point.
Owen’s sad death at the age of just 18 gave rise to the campaign for Owen’s law, and we have also heard about Natasha. These were simply avoidable deaths. They really could have been prevented if better information about allergens had been available. I agree with the hon. Member for Dagenham and Rainham (Jon Cruddas) about levelling that playing field—he put that very well. To avoid other families suffering the same awful loss that Owen and Natasha’s families have experienced, it is essential that the Government look at what more can be done to pull together all the work carried out over many years, to ensure that people with allergies have the information they need to make informed decisions about what they can and cannot eat.
I was encouraged to see in the Government’s response to the petition on Owen’s law that the Food Standards Agency met the Carey family to discuss their proposals, and that the agency committed to working with the Department to consider how to improve the provision of information to people with food hypersensitivity. That response, however, was issued back in 2021, so I hope that the Minister will provide us with an update on how that work is progressing.
Alongside improving the provision of information about allergens, it is important, as we have heard, that research continues into food allergies, so that there is an improved understanding of how to prevent complications relating to those allergies in the future. Ministers should look to the work proposed by Professor Adam Fox at the British Society for Allergy and Clinical Immunology. I was encouraged to see in the Government’s response to the second e-petition that the National Institute for Health and Care Research has allocated more than £2 million for research into food allergies over the preceding five years. Again, however, that response dates from 2021, so I hope we can have an update today.
I understand that the Food Standards Agency will discuss the changes proposed under Owen’s law at its June board meeting, which is very good news. Will the Minister ensure that the strength of feeling in the House today is fed to the FSA ahead of that meeting? Specifically—and specifics are important here—we are talking about regulation 5 of the Food Information Regulations 2014, which simply obliges restaurants to provide allergy information accurately “by any means”. That could mean anything—it could mean just a passing verbal reference. In short, the Owen’s law campaign wants to change the words “by any means” and to oblige restaurants to write that vital information on the menu. That is critical for the reasons we have discussed. Many people do not want to discuss their allergies and personal health circumstances when they are going for a birthday meal. That is not unreasonable.
I trust the Minister will agree that it is essential we make progress in this area, and do so fast. The hon. Member for Dagenham and Rainham talked about the work that has gone on over a decade or more. I say to the Minister that the bottom line is that the music stops when they sit in that chair. I have been in that chair, and it is a wonderful job—the best job in Government. It gives the Minister a great opportunity. He must grab it. As we have heard, the architecture for Owen’s law is already in place in the Republic of Ireland, so will the Minister promise the House that he will look at that example and learn from it?
We need to see changes in law, regulations, guidance and industry practices, as well as in research into allergies. I will not repeat every ask of the campaign, because my hon. Friend the Member for Don Valley did that when opening the debate. We intend to keep working until we get progress on this issue. I promise, as Chair of the Health and Social Care Committee, that I will put my weight behind the issue, and the Committee will look at it.
Owen had a range of allergies and, although he was just 18, he had become well versed in managing them. With school lunches, trips and holidays, I heard they had to work so hard to manage them. Owen did not have to die, but he did because he went out for a meal to celebrate his 18th birthday. I asked his big sister on Friday what she thought Owen would be doing today—he would be 23 years old. Emma said she thought he would be somewhere in Wales—the family’s spiritual home—probably on the Gower beaches where his brother Daniel, who is also here today, taught him to surf. He was due to go to Swansea University, and Emma thinks he most definitely would be working in something clever, probably tech or computing, living an outdoors life to the fullest and playing that guitar he loved so much. He cannot do any of that now and that is a tragedy, but we can do something to ensure that his death and Natasha’s were not in vain and to ensure that others do not end up in the same position.
There is a saying that I often like to refer to in this place—I used to have it on my desk when I had the Minister’s job—and that is, “For a moment like this.” That sentence can be completed with anything you like. For a moment like this, we are in Parliament—please let us seize the opportunity.
Sarah Green (Chesham and Amersham) (LD)
It is a pleasure to serve under your chairmanship, Sir Graham. I thank the hon. Member for Don Valley (Nick Fletcher) for opening the debate and all those who signed both petitions. I express my support for the appointment of an allergy tsar to act as a champion for allergy sufferers.
Last year, I was contacted by a then eight-year-old constituent who shared with me the harrowing experience she had had following an allergic reaction. She had been baking with her grandparents and ended up consuming what doctors suspect might have been trace amounts of either pistachio or cashew nut. The reaction led to her being rushed to hospital in an ambulance terrified and, in her own words, thinking she might die. Thankfully, my constituent was able to receive treatment in time, but her parents have told me how they have had to become food manufacturing detectives to keep their daughter safe. They routinely contact food companies directly to understand the company’s cross-contamination policies, which then allows them to make informed decisions on what food they give her. Surely, in today’s Britain, parents should not have to play detective to keep their children safe.
While there is a legal requirement to label products that contain any of the 14 most common allergens, such a requirement is sadly lacking when it comes to precautionary labelling on the risks of cross-contamination. That means there remains significant variation in whether and how food companies provide that information. Some companies that clean machinery between manufacturing different food products decide not to include precautionary labelling at all, despite the risk of cross-contamination from trace amounts of allergens. Where companies do provide such information, the way in which it is shared can vary drastically, including the location of labels on the packaging and the phraseology used. This lack of consistency can lead to confusion, as the Food Standards Agency identified in its report published last summer. Most importantly, it can lead to sufferers or their parents missing critical information that could help them decide whether a particular food is safe.
My constituents have also raised with me the fact that where there are warnings about nuts in particular, they are almost always generic, with statements such as “This product may contain nuts.” In some cases, where sufferers are allergic to some types of nuts but not others, the lack of detail means that large amounts of food products that otherwise might be suitable for them are automatically ruled out. As the Food Standards Agency report makes clear, this much-needed change is supported by industry. It says that food businesses
“want a standardised approach, with clear requirements that provide certainty and a level playing field, giving confidence that their risk assessments protect consumers.”
I therefore urge the Government to appoint an allergy tsar and to take action on precautionary labelling, to ensure that allergy sufferers are able to make informed decisions about what they eat and to reduce the risk that they will expose themselves to potentially deadly allergens.
Mrs Sheryll Murray (South East Cornwall) (Con)
It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate my hon. Friend the Member for Don Valley (Nick Fletcher) on leading this debate.
Paul Carey, Owen’s dad, is my constituent. His son was lost when he ate a burger that had been soaked in buttermilk, to which he was highly allergic. Minister, I will be repeating what has been said already, so that it hits home. Owen knew about his allergies, and he explained them to the server, who did not know that the burgers had been soaked in buttermilk. Owen died at the London Eye, which is just over the river from Parliament. That is why I think it is particularly brave for my constituent and his family to come to this debate. I thank them for that, and I thank them for their tireless campaigning to stop another parent going through what they have gone through.
Many restaurants, including small outlets in my constituency, already have allergy information on their menus. I thank them for that. I call on other places to do the same now, before a change in the law. Quite simply, it could save a customer’s life—a customer who could come back time and again because they feel confident in the information provided without having to ask for it or to rely on a server who may not have the full information. That works already. The Republic of Ireland implemented a change to its law in 2014. The Food Standards Agency has already done a fact-finding mission to better understand how that law works in practice. It is doing a workshop next month to go through its findings. It would not need to be a big change in legislation. Food businesses already need to make allergy information available. Putting it on the face of menus would stop those with allergies having to ask for it.
I call on the Minister and the Government to make that a priority and to make that change to the law now. I am sure the whole House would back that minor change, which would incur very little cost to the public purse. I also ask the Government to look at how the training of service staff can be improved so that they ask customers about allergies, and so that they know about allergens and what to do if someone has an allergic reaction.
I have relations and members of staff who have allergies of one sort or another. Minister, it is time we took action. I look to the Minister in his reply to confirm that he will tell us when his Department plans to implement Owen’s law.
Andy Slaughter (Hammersmith) (Lab)
It is a pleasure to serve under your chairmanship, Sir Graham, in such an important debate. I will echo the Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), and others. Through relatively small changes to how the NHS is organised and to legislation, this dramatic change would both improve and save the lives of millions, so I hope we will hear something positive from the Minister.
I also thank the hon. Member for Don Valley (Nick Fletcher), who opened the debate, for his comments about Natasha Ednan-Laperouse and her family, and for the sensitive and compassionate way in which he dealt with that tragic death. Natasha’s family are my constituents, and we have heard that Natasha died at the age of just 15 from eating an inadequately labelled Pret a Manger sandwich.
The afternoon I spent with Nadim, Natasha’s father, will stay with me for the rest of my life. He described his experience of how she went from enjoying a happy holiday—getting ready to go out, the excitement of getting ready to fly, taking the precautions she normally did as someone who knew about her allergies, in this case to sesame—to end in her awful death. I do not want to draw that out today, though.
I am very pleased to see Natasha’s mother Tanya here today. I feel huge sympathy and compassion for the family, but also huge admiration for them and everything they have done to commemorate Natasha’s life, going far beyond what many people have done to ensure that the lives of others are improved. Not only have they set up the Natasha Allergy Research Foundation, which we have heard about, but they pioneered Natasha’s law, which came into effect in 2021. It requires food businesses to include full ingredient labelling on foods that are pre-packed for direct sale. Natasha’s law filled an important gap in food legislation and food safety, and Owen’s law would do exactly the same in another respect. His family are here today, and I praise them for having courage and pursuing this matter. I hope that because of the efforts made by these families, we will see a positive response.
Although we have taken those important steps forward, there is still a lot of work to do, hence the petitions and the debates today and last week in this Chamber. The petitions received a very high number of signatures, and some of the highest numbers were among my constituents. That shows how a case such as Natasha’s can have a profound impact on not just a family, but a whole community.
I am grateful to my hon. Friend the Member for Dagenham and Rainham (Jon Cruddas) for securing last week’s debate marking Allergy Awareness Week and for his speech today. I looked carefully at the Minister’s reply, which I will come back to in more detail in a moment, from the debate last Thursday. I read nothing about steps towards appointing an allergy tsar in that response, which is unfortunate because that is something that the allergy community tell us is needed to keep people safe and to keep research moving forward.
As we heard in both debates, allergies in the UK are on the rise. About one in three people have an allergy-related disorder, and over the past 20 years there has been a more than 600% increase in hospital admissions due to allergic diseases. It is not just the numbers of allergy sufferers that are escalating, but the severity of the symptoms. Over 200,000 people in the UK require emergency adrenalin on prescription to manage their allergy.
The very real and ever-present risk of death from an allergic reaction is an ongoing trauma for families and parents of young children who have an allergy condition. As we have heard, about 50% of our child population now live with an allergic condition. Many of our schools have rightly become nut-free zones, due to the numbers of children who would be at risk if someone brought in a nut-based food in their lunchbox. Children go to school with medication bags including EpiPens and adrenaline, in case the worst happens. We should not underestimate the distress and anxiety that that can cause a child, who must learn from a very early age the consequences that can come from eating the wrong thing.
The weight of that on a child is really quite unfathomable, yet we have nobody in the Department of Health and Social Care or NHS England who is responsible for a strategy to tackle allergies. We know that this is a growing problem and research is desperately needed, but to ensure that allergic conditions get the focus they need, someone must be appointed to champion the issue. Given the current state of the NHS, we all understand that resources are stretched, but if the Government committed to an allergy lead, along with funding, they would allow someone to take ownership of the matter and drive forward a strategy to improve the lives of those with allergies.
If I may, I will give a brief, or at least recent, history and timeline of the lack of progress made towards appointing an allergy tsar. Back in January 2020, an inquest was held into the death of another young person who tragically died as a consequence of an allergy: Shante Turay-Thomas. Following the inquest, Emma Turay, Shante’s mother, said:
“Nothing will ever bring our beautiful Shante back to us but what has kept me going throughout this process is knowing that she would want me to get answers and make sure the same thing doesn’t happen to anyone else…The coroner highlighted the fact that no one person in NHS England or the Department of Health is responsible for allergies, and it is quite clear we need an allergy tsar to co-ordinate and implement steps to prevent others from suffering avoidable deaths like Shante’s.”
It is interesting that we still do not have access to a compendium of prevention of future deaths reports. We rely on individual reports, which are very important, but if coroners’ reports were better organised, this issue would have much greater public attention. In Shante’s case, the coroner’s report said:
“there is no person with named accountability for allergy services and allergy provision at NHS England or the Department of Health as a whole”.
The response from the then Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), was:
“Although there is no single, named individual with oversight for all aspects of allergy policy, individuals and teams work closely together in the Department on all aspects of policy relating to allergies.”
The inadequacy of that response led to the petitions being launched and to the call by tens of thousands of people for the Government to appoint an allergy tsar to act as a champion for people with allergies and ensure they receive appropriate support and joined-up healthcare, and so prevent avoidable death and ill health.
In June 2022, following those events, the Natasha Allergy Research Foundation met a new Health Minister, who showed an interest and assured the foundation that meetings were ongoing with the National Allergy Strategy Group and my hon. Friend the Member for Dagenham and Rainham. Three months later, because of the carousel of Prime Ministers turning, the Health Minister was demoted to a different Department and the momentum was lost, notwithstanding the fact that my hon. Friend the Member for Nottingham North (Alex Norris), who was then the shadow Health Minister, tabled an amendment to the Health and Care Bill to create an allergy tsar. Although the Government refused to accept the amendment, the then Health Minister promised to raise the issue with NHS England.
There is a constant expectation that something is going to be done, and then it is dashed, either because of inaction by a particular Minister or because the Minister has simply moved on. Time and again, progress has stalled because of the musical chairs—the many Prime Ministers and the sacking, promotion and demotion of Ministers—and the allergy community has been left waiting patiently for the matter of an allergy tsar to be taken seriously once more.
This reminds me of the long battles we fought to have inquiries into Hillsborough and the contaminated blood scandal. Ministers constantly promise things, or at least say they will look into things, and then they move on and we are suddenly back to square one. I hope the Minister will give us positive news today, not just warm words, and that he will tell us about tangible steps he will take to appoint a lead person for allergies as soon as practicable.
I have not heard anybody coherently argue against the merits of having an allergy tsar, which is why I posed the question I did to my hon. Friend the Member for Dagenham and Rainham. An allergy tsar would be dedicated to and focused on the development of research into cures for allergies, and tasked with ensuring specialist allergy clinics and services up and down the UK. They would be a dedicated lead who works with the Government to implement mandatory reporting on all anaphylaxis events presented to hospital to support comprehensive investigations of fatal and near-fatal anaphylaxis events, and a champion and advocate for those who live with allergic conditions and need more specialist practitioners in their corner.
There is a lot more that I could say, but I will concentrate on two questions that I would like the Minister to answer. First, in relation to the appointment of an allergy tsar, may I remind the Minister what his colleague the Minister for Social Care said in responding to the debate last Thursday? She said:
“There have been calls over recent years—I have heard them echoed today—for stronger leadership on allergy. I am pleased to take this opportunity to outline the allergy leadership that we already have in place. In October 2022, Dr Claire Bethune was appointed national speciality adviser for specialised immunology and allergy. Dr Bethune chairs the NHS England clinical reference group that provides clinical advice and leadership on the specialised immunology services, and advises on how specialised services can best be delivered.”—[Official Report, 11 May 2023; Vol. 732, c. 264WH.]
That is not good enough. That is somebody who has a partial role—a part-time role—who may well do a good job in their own field, but who is not an allergy tsar. It is not a single person who is taking overriding responsibility for allergy.
Let me briefly give a few reasons why an allergy tsar is essential. The debate and the concern about the lack of a national lead on allergy has been going on for 20 years. During that time, clinical outcomes have barely improved, but the number of hospitalisations has tripled. An adviser who specialises in immunology and who simply chairs the existing clinical reference group does not meet the requirements for a national allergy lead. Allergy is currently managed by too many different professional groups. The immunologists do not see it as a priority and are more pathology-focused or laboratory-focused rather than clinically focused. That means that different specialties manage allergy disorders differently.
There is not a strong appreciation that allergy leads to severe symptoms that sometimes lead to death, for example through anaphylaxis or asthma. Allergy is too often trivialised and passed down to primary care practitioners, who are inadequately trained and over-committed in other areas. Allergy is equated with mild disease, but even hay fever has a much greater impact on those affected by it than is appreciated. It would be far better to have a national lead who could also be a clinical lead and who is an expert in managing allergic disease. Training in clinical allergy is minimal, whether for specialist clinicians or for primary care practitioners. We need special efforts to build this specialty. Finally, deaths from anaphylaxis are appreciably lower in those countries with a joined-up clinical allergy service, and in such countries population knowledge about allergy is more highly developed. The case for why we should have an allergy tsar is overwhelming and I would like a clear answer from the Minister today. I do not want a restatement of the current position, because the current position is clearly inadequate.
The second question for the Minister is whether he or one of his colleagues, ideally the Secretary of State, would meet the Natasha Allergy Research Foundation and other interested and expert parties. I ask for that meeting for three reasons. The first is that people at the foundation have personal experience, which to their great pain they have shared publicly, and they have a great deal to offer to the Government and to the NHS in explaining the needs of people with allergy.
The second reason is that the foundation and these other organisations have expertise. I have already indicated that the work done by the foundation since her death really puts the Government to shame. It is not just about the passage of Natasha’s law. The foundation also launched a £2.5 million Natasha clinical trial across six British university hospital sites, seeking to prove that everyday food products could be used in NHS settings as a cheap alternative to expensive pharmaceuticals, to provide oral immunotherapy treatment for children and young people. It has also funded bursaries over four years for students and healthcare professionals at the University of Southampton on the internationally recognised allergy master’s degree and PhD courses at this world-leading allergy research centre. The foundation also organised the global allergy symposium in September last year, which was hosted by the then Prince of Wales, now King Charles, at Dumfries House in Scotland, home of the Prince’s Foundation, to discuss allergy and the environment, which was attended by 16 of the world’s leading allergy scientists. That is the work of one family—one foundation. What have the Government done during that time to compare to it?
The third reason why a meeting is necessary is that we have waited too long. I have talked about the musical chairs of Ministers coming and going. The time is long overdue for a Minister to sit down and talk seriously to the Natasha Allergy Research Foundation and other interested parties, and to confront the issue. I would love to hear the Minister say that the Government are going forward with an allergy tsar. If he will not say that, I ask him to say that he will sit down and seriously listen in detail—he can do so far better than others in this room can—to the reasons why an allergy tsar is needed. Lives have been lost, and lives are at stake. As I said at the beginning of my remarks, the Minister’s response today can make a huge difference to how we go forward on the issue.
Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)
It is a pleasure to serve under your chairpersonship, Sir Graham. I thank the hon. Member for Don Valley (Nick Fletcher) and the Petitions Committee for bringing forward this vital debate. I pay tribute to Owen’s and Natasha’s families and to all the people who have come to the debate. I thank them for coming here, because I know how painful it must be for them. I also thank the many thousands who signed the petition.
Owen should have turned 24 last month. This should have been a time of joy and celebration for him and his family. Instead, because of a tragic and preventable failing, he died less than 300 metres from this building. Diagnosed with severe food allergies at just six months, Owen was always careful to manage his allergies and avoid triggering a reaction. On the day that Owen passed, he took the time to inform the waiting staff of his allergies, but because of a miscommunication the information was not passed to the kitchen. That led to his consumption of a chicken burger that had been marinated in buttermilk. Despite the presence of one of the most common allergens, dairy, the information was given only in the small print on the back of the menu, not alongside the product listing. That is in line with regulation 5 of the Food Information Regulations 2014, which requires restaurants to collate allergen information but allows the information to be delivered “by any means”. The regulations do not go far enough to inform customers about what allergens might be a part of their meal. Instead, the onus is unfairly placed on those with allergies to inform their servers. That cannot be right.
Since Owen’s untimely death, his family have campaigned tirelessly for a common-sense change to the legislation, so that it reads “on the face of a menu” instead of “by any means”. That would be much like the vegan and VE vegetarian symbols displayed alongside vegetarian and vegan products in restaurants. I praise the restaurants that acted unilaterally to display allergen information prominently on their menus. That is a straightforward step that could save lives.
The number of people with allergies in the UK has steadily risen, and an estimated one in three people are affected. Owen’s law would benefit the millions of people in the UK who are allergic to a food product or who care for someone who is. Those who suffer with even a mild allergy know the detrimental impact that it can have on their quality of life, the stress caused by social interactions in unfamiliar places, the diligence it takes to analyse everything that they purchase and consume, and the constant worry that their allergy might progress and get worse with little or no warning. It is no wonder that those who are diagnosed with an allergy are more likely also to be diagnosed with depression or anxiety.
At the inquest into Owen’s death, the coroner found that a lack of data collection regarding anaphylactic reactions contributed to a failure to learn from these tragedies. I am pleased that some progress has been made on this front with the establishment of the UK anaphylaxis registry in 2021, but we need to do more to support people with allergies. The past 20 years have seen minimal investment in NHS allergy services, and I support calls for an allergy tsar to advocate on behalf of those with allergies, alongside an increased number of allergen clinics. We cannot eliminate allergens entirely, but one thing we can do is advocate Owen’s law, which would build on Natasha’s law and ensure that allergen information is displayed alongside food products in restaurants so that the proper information is provided in the most accessible manner.
I beg the Minister to ensure that action is taken. No one here has disagreed today; everyone has been in favour of more resources being deployed in this area and of having a tsar who runs a proper strategy and has the proper financial resources to research why so many people are allergic to various products. Let us change the legislation. The Minister has the opportunity to stop many more parents having to face the unthinkable and lose a child or family member. These deaths can absolutely be avoided with the right services and legislation in place.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate the hon. Member for Don Valley (Nick Fletcher), who opened the debate on behalf of the Petitions Committee. It is an extremely important and very poignant debate for many here today and for people across the United Kingdom who have been affected by allergies and inadequate labelling and service provision, which have led to the tragic deaths that have been relayed by Members today. I thank the families for the work that they have done and will continue to do in this space until the allergy tsar is appointed—a proposal that has been supported by everybody who has spoken so far.
The hon. Member set the scene perfectly. He asked for the allergy tsar to be appointed to address the important issues that have been raised, and he highlighted why it is so vital that menus are explicit. The point was also made that although people can have a discussion about their health-related issues at the dinner table, it is perhaps something that not everybody feels comfortable doing. That is exactly why it is so important that menus are explicit and that the issue is taken forward with prominence.
The hon. Member spoke about the numbers of people affected and why it is so important that we have accurate data, which includes not only those who have been impacted, but the near miss cases. Only with accurate data can we understand the scale of the issue and the prevention measures that are needed. He highlighted some of the difficulties for the trade in implementing the changes needed, but, my goodness, when young people’s lives are at stake, it is vital that those changes are made and that we work together with industry to ensure that they happen.
I also thank the hon. Member for Dagenham and Rainham (Jon Cruddas), who highlighted that this is a corporate responsibility across Government and that we have been waiting for 20 years, which is far too long, with far too many lives lost in the interim. We must make sure that the strategy comes together, that the tsar is appointed and that Government implement the policies that are so desperately needed.
The hon. Member for Winchester (Steve Brine) said that Owen’s law has already progressed in the Republic of Ireland. That is very important because it shows that despite the difficulties outlined at the start, this can be done and progress can be made. This proposal therefore has to be implemented pragmatically. The hon. Member for Chesham and Amersham (Sarah Green) described her constituent’s near miss case very eloquently, saying that that is why it is so important that we have a standardised approach.
The hon. Member for South East Cornwall (Mrs Murray) spoke eloquently on behalf of her constituents, as she continually does in this House. She raised the case of Owen and spoke of the support she has given to the family. She has also ensured that constituents’ concerns are heard at the highest level. She called it an absolute priority, and asked the Government for changes to be made in law.
There were some very good interventions from the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), who is no longer in her place, particularly about the Food Standards Agency having been too slow to react. The hon. Member for Hammersmith (Andy Slaughter) spoke at length, reinforcing the need for the tsar to be put in place. His point that the clinical outcomes have not improved was so important: whatever has been done so far has perhaps made progress, but it is just not enough and is not making a difference clinically. He underlined the point that the current position is therefore inadequate. Finally, the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) said—this sums up the debate—that common-sense changes are needed, that we must work together and that no one has disagreed.
I would like to reinforce the asks that have been made of the Minister. I also think that much more testing should be available for allergies. I remember being tested, and the nurse saying to me, “Do you have any allergies, Lisa?” I said no, and I was so shocked when my arm started coming up with lots of little red spots and I was told that indeed I had quite a few allergies. We need to make sure that everybody can have that diagnosis and testing so that there are not accidental cases in which people may not even be aware that they have allergies.
As has been said, training for staff in the hospitality sector and others is so vital in this case. The other thing that I am very interested in is the digital, technological advancements that we are making. I would like to hear from the Minister—he can write to me if he does not have this information today; that would be perfect—about the blockchain digital technology that I have heard can be applied to food labelling and distribution. That technological advancement might help us to move forward in this case. Finally, I echo everybody’s words and call on the Minister to please appoint an allergy tsar, because we will be saving very many people’s lives.
Andrew Gwynne (Denton and Reddish) (Lab)
It is a pleasure to serve under your chairmanship, Sir Graham. I am grateful to be responding to the debate on behalf of the shadow Health and Social Care team this afternoon.
I thank the hon. Member for Don Valley (Nick Fletcher) for his opening contribution and the compelling way in which he put the case to the House. I thank my hon. Friends the Members for Dagenham and Rainham (Jon Cruddas), for Hammersmith (Andy Slaughter) and for Sheffield, Brightside and Hillsborough (Gill Furniss) for their contributions, as well as the hon. Members for Winchester (Steve Brine), for South East Cornwall (Mrs Murray) and for Chesham and Amersham (Sarah Green), and the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who spoke for the SNP.
I begin by recognising the courage of Tanya and Emma, who are observing us from the Gallery. I know the etiquette is not to refer to the Gallery, but as we have heard, Tanya’s 15-year-old daughter Natasha died of anaphylaxis after unknowingly consuming sesame in 2016, and Emma’s daughter Shante died after a severe allergic reaction to hazelnut in September 2018. To both of you, I say: I cannot even begin to comprehend the loss that you have both suffered. We are incredibly grateful to be joined by you today, and I pay tribute to the exceptional work that you are doing via the Natasha Allergy Research Foundation. Thanks to the efforts of yourselves and others, full ingredient and allergen labelling on pre-packaged food for sale was introduced in October 2021—something that Members on all sides of the House agree is a vital step in the right direction.
But as has been rightly pointed out, there is still a very long way to go. The UK is now in the top three in the world for the highest incidence of allergies, with hospital admissions for food-induced anaphylaxis tripling over the last 20 years. The largest increase has been seen in children under 15, among whom there has been, on average, a 6.9% annual increase in admissions with a serious allergic reaction. Across all allergy sufferers, 20% live with a severe, debilitating form of their condition. The case for action could not be clearer.
We are here today to respond to two petitions. The first relates to Owen’s law, named after Owen Carey, and I pay tribute to Tanya and Emma. I also pay tribute to Paul, Emma and Owen’s family, who are in the Public Gallery. As we have heard, Owen was an 18-year-old who tragically died after eating a chicken burger marinated in buttermilk, to which he was allergic. Despite checking the menu and making his allergies clear to the server, Owen collapsed 45 minutes after his meal and could not be resuscitated. I know that the Food Standards Agency is considering what steps to take to increase the accuracy of allergen information on non-pre-packed food, but I would be grateful if the Minister provided an update on the development of Owen’s law and on what recent discussions he has had with the FSA on this vital issue.
The second petition calls for a specific allergy tsar, for which Members of different parties, but particularly my hon. Friend the Member for Hammersmith, have put the case so diligently. As the coroner highlighted following Shante’s death in 2018,
“there is no person with named accountability for allergy services and allergy provision at NHS England or the Department of Health as a whole.”
That is unfathomable, and this runs the
“risk that future deaths will occur unless action is taken.”
That warning was repeated recently by the coroner Heidi Connor following the death of Alexandra Briess in 2021. We have now had two senior coroners making a similar recommendation to the Government that someone —whether we want to call them a tsar, a lead or just someone with named accountability—should be appointed to take responsibility for allergy services in England. I would therefore appreciate it if the Minister outlined what assessment his Department has made or is making about introducing an allergy lead within NHS England or the Department of Health and Social Care, particularly in the light of the powerful interventions that we have heard from patients, bereaved families and coroners and in all the contributions to today’s debate.
The other point on which I would like to press the Minister is NHS service provision. Failings in care for allergic disease have been allowed to fester for far too long. My fear is that with the NHS under increasing stress in terms of waiting times, waiting lists and staff vacancies, the problem may well get worse, not better. What steps is the Minister taking to address the acute problems for allergy sufferers? The Natasha Allergy Research Foundation says that with many GPs not receiving training in allergies, with primary and secondary care services being disjointed and with a shortage of allergy specialists across the UK, there is a postcode lottery of care that is costing lives. That is being compounded by a lack of information, with more than half of integrated care boards not currently holding data relating to allergy disease and treatment. That is not acceptable. I hope the Minister agrees that we need rapid progress in the delivery of allergy care and the monitoring of prevalence and treatment.
Finally, on research, what steps are the Government taking to support potentially game-changing treatments for many allergy sufferers? I am sure that the Minister will agree that we want to see a world in which allergy diseases are eradicated. Members across the Chamber would greatly appreciate any update on research in the field. We all want improvements in allergy care and support for those living with allergic diseases. We owe it to Tanya, Emma, Natasha, Shante, Owen, Alexandra and all the families who have lost loved ones because of avoidable and treatable allergic reactions. I sincerely hope that today’s debate will instigate a step change and that together we can work towards a future in which allergies are cured and those living with allergic disease are properly supported.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
I thank my hon. Friend the Member for Don Valley (Nick Fletcher) for introducing this debate and for doing an excellent job of setting out the issues, and I thank all hon. Members who contributed. I found myself making copious notes; there was a lot for me to take away and work on. I also thank the thousands of individuals who signed the petitions that triggered this debate, which show the strength of the desire and the demand to improve treatment for those who suffer from allergies. Above all, I thank the victims’ families and friends who are here in the Public Gallery. I am terribly sorry for your loss; it was awful to hear about. I pay tribute to you and thank you on behalf of the Government for all the work that you have already done to improve safety and make sure that others do not suffer in the way you have suffered.
I will set out some of the work that is under way on different aspects of the issue in the Department of Health and Social Care and the Food Standards Agency. Food businesses are all under the same legal obligation to provide information at the point of sale indicating the presence of the 14 major allergens. Natasha’s law, which the Government introduced in 2021, requires all pre-packed direct-sale food such as grab-and-go sandwiches to have a label that shows the ingredients and allergens. That is important in helping people with allergies to feel confident that they are choosing safe food.
There are about 2.6 million people with food hypersensitivities in the UK. As hon. Members have pointed out, that number is rising. It includes people with food allergies, intolerances and conditions such as coeliac disease, which my mother suffers from, so I have some sense of the challenges facing people with that condition. The Food Standards Agency is working to address the needs of those consumers so that they can make safe and informed choices about the food they buy. For people with a potentially life-threatening reaction to certain foods, that trust is much more important.
The Carey family are already driving awareness on the issues that people with life-threatening allergies face. The FSA has met the Carey family several times in the past few years and it recognises the positive impact that the Owen’s law campaign is having. We need to consider changes to the law carefully to ensure that there are better safety outcomes for allergen sufferers and to avoid unintended consequences for consumers.
As hon. Members have mentioned, a workshop is taking place at the start of June with the families and others to look at how we can go further. To answer the question asked by my hon. Friend the Member for Winchester (Steve Brine), the FSA team have been over to Ireland to look at its law and study how it is working. I am not in a position to make an announcement today, but I am struck by the fact that everyone involved agrees that there is room to do better. Nothing is off the table at this point.
There are a number of issues relating to improving labelling for people with serious allergies. They are not arguments against doing anything; they are just issues that we must grapple with as we work out how to make progress. One is how we avoid potentially dangerous out-of-date information on menus, particularly for smaller restaurants, which change their ingredients more frequently. We cannot have false reassurance. When I worked in a Chinese restaurant, I was often sent out to a supermarket to find ingredients on the day, and that would often change what was in what we were serving up. Small businesses absolutely cannot have out-of-date information on menus.
Mrs Sheryll Murray
Will the Minister explain how some small outlets in my constituency list the allergens on their menus when, as he says, doing so is an obstacle?
Neil O’Brien
To reiterate what I said at the start of my remarks, I am mentioning some of the issues that we have to solve, not presenting them as insuperable obstacles to doing what a lot of people are calling for.
Another challenge that we have to grapple with, and are grappling with, is how to avoid some smaller businesses taking away a lot of choices for people with allergies by simply labelling too many items as containing allergens. Such businesses may have small kitchens that work with lots of different products and multiple allergens. We cannot take away lots of choices for people with allergies; we want them to have the freedom of choice that everyone expects to enjoy, but to have safety at the same time.
Dr Cameron
The Minister is making some good points, but on his last point, even if some outlets are being over-cautious, surely it is more sensible to be over-cautious than to put people’s lives at risk.
Neil O’Brien
That is a perfectly reasonable point. Of course, safety has to come first; I am merely laying out some of the challenges that we are grappling with as we think about Owen’s law and how we go further.
Even as we work on these issues and think about how we go further in providing information, we are getting on with improving training and knowledge for people in the food industry. Since September 2020, 380,000 people have signed up for allergy training through the FSA, which is a huge improvement in the provision of information and the correct treatment of people with severe allergies. Over the past 22 years, the FSA has invested about £22 million into researching these issues. Its scientific and social research, which improves the understanding of the views of those who are affected, of food businesses and of other key stakeholders, underpins our approach. To underline what I said a few moments ago, although I am not making an announcement today, nothing is off the table. We continue to look at and work on these issues at pace.
Let me turn to some other issues that have been raised in the debate. We have heard the calls for an allergy tsar, a form of leadership to advocate on behalf of those with serious allergies and their families. We already have parts of that leadership role in place, although, to address the point made by the hon. Member for Hammersmith (Andy Slaughter), that responsibility is not squarely on one individual’s shoulders. We will look closely at the proposal and at how we get to a more joined-up approach. The hon. Member asked directly whether I would meet with expert groups and those representing families who have been affected. The answer is yes, absolutely. I am extremely keen to meet and learn from those who have done lots of work on the subject.
It is worth setting out a bit about how the current NHS England operation works and what it is doing, although I recognise that that operation is not what those who are campaigning for a single joined-up tsar are asking for. In NHS England, there is a clinical reference group chaired by the national specialty adviser, Dr Claire Bethune. The group provides clinical advice and leadership on specialised immunology and allergy services. Its members include clinicians, commissioners, public health experts and patient and public voice members to try to capture the insights of those who are most affected by the issues. The members use their combined knowledge and expertise to advise NHS England on the optimal arrangements for the commissioning of specialised services. That advice includes the development of national standards in the form of service specifications and policies. As hon. Members know, those are tremendously important in defining what NHS services must be available.
The CRG is in the process of commencing a review of the current service specification for specialised allergy services. The output of that review will be an updated specification that makes reference to up-to-date guidance and takes account of the very latest evidence to clearly define the standards of care for commissioned specialised services, including transition into adult services.
The CRG is just one tool that we have at our disposal to address the multifaceted challenges that people with allergies face. Officials across Government are working with the National Allergy Strategy Group to consider how we can work more effectively together through things like an expert advisory group for allergy. The arguments that I have heard today will strike a chord with many people listening across the country. I am certain that it is right that we continue the conversation about how to work in a more joined-up way in future.
On ensuring that we have the right mix of staff to support people with allergies, in recent years there has been a 100% fill rate for doctors going into the two most relevant training pathways, allergy and immunology. NHS England will continue to identify priorities for investment in this space, in line with the expressed service priorities of the NHS across all medical specialties and the wider workforce. That work will be complemented by the forthcoming long-term workforce plan that we have commissioned NHS England to develop for the next 15 years, which we have committed to publishing shortly. It will include projections for the number of doctors, nurses and other professionals that will be needed in five, 10 and 15 years’ time, taking full account of improvements in productivity and the need for particular specialisms and skilled people to deal with things like immunology and allergy.
Most people with an allergy can be cared for in primary care settings, with services planned and commissioned by their local ICB. Specialised allergy services, however, are also provided for patients with the most severe allergic conditions, or those who have common allergic conditions for which conventional management has failed or for whom specialised treatments are required. In the current financial year, 2023-24, those services are jointly commissioned by NHS England specialised commissioning integrated care boards, in line with the published service specification.
All patients have access to those specialised services. Specialised services are required to be compliant with the service specification, including the need to have physicians, dieticians and nurses who are specially trained in allergy or have had long specialist expertise in the practice of allergy management and have up-to-date, continuing professional experience. All that work is serving to improve the lives of millions of people who have been affected to a greater or lesser degree by allergy.
There is clearly much more that remains to be done. The Government and those who have personal experience and great expertise working together will be central to driving forward continuing improvements, building on the work that has already been done and the changes that have been made. In future, we want to work closely with those who are most affected to improve the care and service provision for those who have serious allergies, so that they can live full, meaningful and safe lives.
Nick Fletcher
I hope the petitioners believe that they have heard a good debate today. We have heard an awful lot from people who understand this subject. They all want to help to bring everything together and ensure that the incidents and tragedies that have happened to the petitioners do not happen again. It seems to me that there is a lot of work going on, but in many cases it is siloed working, and a tsar would be able to bring it together. We could pick up the pace with that and prevent tragedies like those we have discussed from happening again.
One of the easiest things that restaurants could do would be to say that all their menus may contain something. Although that would cover them in some ways, it would take choice away for a lot of people. We need to get ahead of the issue. We need to look at it and see what we can do so that there is as much choice for everybody, and everybody can dine and eat safely. I believe that a tsar is probably the best way forward to start with. I appreciate the Minister acknowledging that there is an issue there; he has made copious amounts of notes to take away and work through with his Department.
I refer back to the part about personal responsibility. Obviously there is still work to be done, so to ensure that tragedies do not happen we must all work together to support and help individuals who we know suffer and ensure that those questions get asked if somebody forgets to say something. It is not something that should be ridiculed; it is massively important to people. We have a duty to look after everybody in society while we get food labelling to the place where it should be. May I finish by thanking the petitioners for all their work, hon. Members for contributing—I appreciate it, and I am sure it is appreciated by the petitioners—and the Minister for his comments?
Question put and agreed to.
Resolved,
That this House has considered e-petitions 585304 and 589716, relating to food labelling and support for people with allergies.