(1 week, 4 days ago)
Lords ChamberMy Lords, it was 19 years ago that I had the privilege of chairing the Science and Technology Committee’s inquiry into allergy for this House. I remind the House that, even then, we were saying that half of those who died from an allergic reaction had not had any previous serious reaction, and we highlighted the need for adrenaline auto-injectors and the fact that they were not being used effectively. The failure of pens was for several reasons, usually that the injection was not given intramuscularly, there was poor training or pens had passed their expiry date, were being used too late in a reaction or were not available at the time of the reaction. The amendments in the name of the noble Baroness, Lady Morgan of Cotes, and of my noble friend Lord Fryberg are incredibly important and are 19 years overdue. We really cannot carry on like this.
There is guidance on the use of adrenaline auto-injectors in schools from the Department of Health in 2017, but it states:
“This guidance is non-statutory”.
It goes on to say:
“The Children and Families Act 2014 requires governing bodies of English schools to make arrangements for supporting pupils with medical conditions”.
The problem is, of course, that the management of allergies is not statutory, and children present with a very wide range of medical conditions, but there are not that many that present the medical emergency that an allergic reaction can present.
The summary states that schools are not required to hold adrenaline auto-injectors. If they do not have one when a child is collapsing, even if the child has their own with them, the risk of that child’s death goes up significantly. The guidance is also very clear that the MHRA expert group from 2020 said that adrenaline should be administered at the first sign of a reaction, and that the risk of delay outweighs harm. I suggest that the cost of delay is absolutely massive and must be properly considered in terms of the cost of providing these pieces of equipment that can be stored, and incorporating training, as we have already heard.
The guidance is very clear: if in doubt, give adrenaline and, if there is no improvement after five minutes, give another dose. Children’s schools must have the ability to recognise allergy wherever that child is and react rapidly, because five minutes is not very long. You cannot run from one side of a school to another to try to find somebody who knows what to do because, by then, tragically, the child may have had a cardiac arrest.
My Lords, I support Amendments 209, 210 and 212 and declare my interest as the chief operating officer of the Natasha Allergy Research Foundation, the UK’s food allergy charity.
While some schools manage food allergies well, too many do not and, as the noble Baroness, Lady Morgan of Cotes, expertly put it, with around two children in every classroom living with a food allergy, and one in five food-related allergic reactions occurring at school, the absence of clear policies and consistent staff training continues to place children at risk. These failings also affect attendance and undermine inclusion.
Amendment 209 seeks to address these long-standing gaps. If it is accepted by the Government, that would represent a fitting tribute to five year-old Benedict Blythe, who tragically died from anaphylaxis at school, and to his mother Helen, whose tireless advocacy has brought us to this moment.
Earlier this week, as others have said, Helen Blythe and representatives of national allergy charities met with the Minister for early years to discuss the urgent need for a robust statutory approach to allergy management in schools. The response and commitment from the Minister were extremely welcome and I hope that, tonight, those commitments from my noble friend Lady Smith of Malvern will be confirmed from the Dispatch Box. At the outset, I shall list quite a few points where confirmation and clarification are needed, so, if my noble friend is unable to cover all these points today, will she commit to write to me and place a copy in the Library for all noble Lords to see?
For the benefit of campaigners, allergy charities, clinicians and parents and carers of food-allergic children following this debate, I would be grateful if my noble friend Lady Smith of Malvern could confirm the Government’s position on a number of points. First, will my noble friend confirm that it is the Government’s intention to address the long-standing and well-evidenced gaps in the management of allergies in educational settings, and that this will be taken forward through statutory guidance?
Secondly, will my noble friend confirm that such statutory guidance will require schools to have a whole-school allergy policy, and ensure that all staff on site receive training in allergy awareness, risk reduction and the recognition and emergency management of anaphylaxis, and that school will be required to hold accessible, in-date, spare adrenaline auto-injectors on site for emergency use?
Will my noble friend also confirm that the Government intend to ensure leadership and accountability for implementation of such a policy, including the expectation that school governors will take a leadership role and that Ofsted will be asked to take allergen management into account in its inspection framework?
On emergency response, will my noble friend confirm that, alongside a requirement to hold spare, in-date auto-injectors, the existing 2007 guidance on the use of AIs in schools will be revised to make it explicit that, where an adult suspects anaphylaxis, they should call 999 immediately and administer the AI without delay, whether with a prescribed or a spare device, and that administration of the second AI will not cause any harm and may be life-saving?
Will my noble friend also confirm whether the Government intend to bring forward an SI to enable schools to take advantage of the new adrenaline delivery devices, including nasal sprays, as they become available?
With regard to policies and training, I support Amendments 210 and 212 in the name of the noble Lord, Lord Freyberg. Will my noble friend confirm that training and policies are intended to apply to all staff on site, including external providers operating on school premises, and in particular school caterers? Food provision remains a significant risk area for pupils with food allergies. Effective management requires clear systems, and it should be a shared school responsibility.
Lastly, the Bill makes provision for a unique number for every child in England to support the sharing of information for safeguarding purposes. Is allergy data being considered as part of the pilot project in Wigan testing the use of the NHS number as a unique identifier in children’s care? If not, will my noble friend consider allergy health information within that work? Will she facilitate a meeting for me and relevant representatives of charities, including school caterers, to explore this issue further with colleagues in the relevant departments?
Lord Mendelsohn (Lab)
My Lords, I thank the noble Baroness, Lady Morgan of Cotes, for moving this amendment, and I associate myself with the excellent speeches made in support of it and the other amendments in the group. I also associate myself with the high praise for the Natasha Allergy Research Foundation, for which I have the highest regard, and for the Benedict Blythe Foundation and the remarkable dedication of Helen Blythe. Her son Benedict was five years old when his milk allergy took his life. A plan was in place, but it was not followed.
My son was five years old when we first discovered that he had a severe nut allergy. We had no idea—there were no signs or indications. He suffered a severe anaphylactic shock and we did not know what was happening to him. His life was saved by our extraordinary good fortune that it took place on a cruise and immediate hospital-level treatment was available. I am profoundly struck that his life was saved by being in proximity to the crucial care that he needed.
For the most severe, like my son, auto-injectors are only a means of providing enough time to get necessary hospital treatment. At that time, if he had had such an attack in school, it is most likely that he would not have survived. Some 30% of children affected have their first reaction at school, the most frequent location outside the home setting. While progress has been made in some schools, as the Benedict Blythe Foundation research has shown, school preparedness for dealing with allergies is dangerously and tragically low, as evidenced by the fact that half of all schools have no spare auto-injectors. However, I stress that auto-injectors are not enough; it is strategy, training and other elements that will ensure that lives can be saved.
The amendment proposes a sensible and comprehensive approach to create the right capacity and capability in all schools. I hope the Minister will provide reassurance that the Government are committed to a mandatory and comprehensive allergy safety policy framework, as set out in the amendment, and either are open to accepting the amendment or can provide details of how these objectives can be achieved.
(4 months, 4 weeks ago)
Lords ChamberIn responding to the noble Baroness, I can speak as a former school governor, and I have my own opinions of Ofsted. I want to put it on record that the Green Party wishes to abolish Ofsted, so that is where I am coming from.
It is important that we speak in support of Amendment 502YG about allergies. I also went to an event with the Benedict Blythe Foundation where I learned about this crucial issue, and the work of that foundation absolutely needs to be acknowledged.
There are two amendments in this group that have not yet been introduced. The first is Amendment 502B in my name, kindly backed by the noble Lord, Lord Farmer, and the noble Baroness, Lady Willis. I am also going to speak to Amendment 502Y, which was tabled by the noble Baroness, Lady Willis, and backed by the noble Baronesses, Lady Parminter and Lady Boycott. The noble Baroness, Lady Willis, apologises greatly that she is unable to introduce her own amendment. Like me, the noble Baroness had a train to catch and, while I have now given up on mine, she had to catch hers, so she has departed.
Both amendments focus on the importance of nature in the physical spaces in and around school buildings, and to promote active-based learning and teaching in the school curriculum. It is important to say that far too often that is seen as a “nice to have”—an additional something for schools that have the resources to get money from parents to plant trees, make nice gardens and so on. It is a great pity that the noble Baroness, Lady Willis, is not here because this is something that she has literally written the book on. I am sure that many noble Lords already know that the title of her book is Good Nature: The New Science of How Nature Improves Our Health.
I shall highlight the difference between the two amendments. My Amendment 502B says:
“The Secretary of State shall have a duty to promote school pupils’ access to nature”,
and says there should be one hour of access to nature each week for every pupil. This is something on which there is bountiful evidence. The amendment from the noble Baroness, Lady Willis, is much more limited but still important: it would require a review to be conducted on the benefits of nature-based learning to children’s health and well-being.
I have vast amounts of notes here that noble Lords will be pleased to know I am not going to read out, but it is worth focusing on just one study from 2015 that the noble Baroness, Lady Willis, highlights, focusing on 3,000 primary-aged children in four standard urban schools in Barcelona. The test scores of children who were looking out of the window at green space were better than those of the children who did not have that view of green space. We are not talking here about forest schools; they were normal inner-city schools. The addition of trees and green infrastructure in the playground has real impact on exam results. More than that, there is significant evidence about improvements in anti-social behaviour, levels of mental health and teenage anxiety, and even reduced truancy, something that noble Lords and the Government are very concerned about.
The second part of the noble Baroness’s amendment is about nature-based skills. In other parts of the economy, in the Planning and Infrastructure Bill, we are focusing on the need to look after green spaces in our communities. Who is going to do the work of looking after that? It is crucial that we have the training.
The noble Baroness, Lady Willis, has given me a great deal more information and I feel guilty that I am not going to pass it on, but in the interests of time I am going to sit down now and urge noble Lords to read the noble Baroness’s book.
My Lords, I support Amendment 502YG. I declare my interest as the chief officer of the Natasha Allergy Research Foundation, the UK’s food allergy charity.
Regrettably, we have an education system completely unprepared for the growing numbers of food-allergic children in the UK, with safeguarding standards varying widely from school to school. Recent incidents underscore the urgent need for thorough staff training and well implemented allergen management policies. Food allergy-related deaths, which for the most part are preventable, while uncommon, tragically occur in school.
A few months ago, as the noble Baroness, Lady Berridge, noted, the inquest into the death of Benedict Blythe, who was aged just five, concluded. Today, as we discuss this amendment, I know that Benedict is in our hearts and our minds, as is his mother, Helen. She is the driver behind Amendment 502YG, which would be a critical addition to the Bill.
There are of course excellent examples of food allergy management in some of our schools. However, with two children in every classroom having a food allergy, and one in five allergic reactions to food occurring in school, too many schools lack policies for effective allergy management and staff are inadequately trained. There is also a lack of understanding around allergy in our schools. That all impacts on children’s attendance and puts them at risk.
At the Natasha Allergy Research Foundation, we regularly hear from parents about schools that ignore their requests for reasonable adjustments or, worse still, are dismissive about a child’s allergy. These persistent challenges are faced by thousands of allergy families across the country, and they reinforce that allergies should be treated with the same seriousness and attention as other medical conditions in school settings. That is why, at the Natasha foundation, we launched Allergy School, which offers free practical resources to help teachers create inclusive and safe environments for children with food allergies.
However, charities and foundations cannot deliver change alone. The Government need to do more to help schools and early years settings be better equipped to manage food allergies, from improved staff training to safer food management practices. This amendment would achieve that. It would ensure that all schools had proper staff training; effective policies in place; data—I emphasise that for the sake of the noble Lord, Lord O’Donnell—on allergic reactions, which is woefully lacking; and spare AAIs, or adrenaline auto-injectors.
There are very few chronic conditions that can take a child from perfectly fine to unconscious in 30 minutes, but food allergy anaphylaxis is one of them. Who can disagree with life-saving medication being on site and quickly and easily accessible to save a child’s life? I look forward to my noble friend the Minister’s reply.
My Lords, the hour is late. I have my name on some of these amendments. I simply say that the Royal College of Paediatrics and Child Health has highlighted that around 16% of children aged five to 16 now have a mental health disorder. CAMHS cannot cope with this. The amendment in the name of the noble Baroness, Lady Tyler of Enfield, is certainly trying to plug that large hole.
I also remind the Committee that it has been estimated that in every class, on average, there is a child who has been bereaved of a parent or sibling. That is not trivial trauma; it is major. They need support and help, but they are often not getting it.
On collecting data, it is essential that we know what we are doing. However, we must use validated measures that have been properly evaluated, so that schools are measuring what people think they are measuring and they do not contain leading questions and so on. In addition, good-quality data allows a school to understand whether it is improving.
I declare my interest as having chaired the Science and Technology Committee’s sixth report on allergy, and I strongly underline all the comments made in it. During that inquiry, we heard about children being bullied by other children who put peanuts in their pockets, and about staff sometimes confusing anaphylaxis with panic attacks because they have not had training. It is a very simple measure to train staff and to make sure that they can access an EpiPen. With that, I hope that the Government will adopt the suggestions in these amendments.
(5 years, 8 months ago)
Lords ChamberMy Lords, I too support this order and these regulations. Automatic enrolment into workplace pensions should continue for maritime workers and seafarers. They should have the same access as other workers in the UK economy. As acknowledged by other noble Lords, including my noble friend Lord Blunkett, auto-enrolment, introduced by the last Labour Government, was a landmark achievement. The welcome continuation of the policy between Governments has meant that 10.2 million people are now saving £90 billion a year via auto-enrolment.
However, there are issues that it would be remiss not to mention in this debate: the £10,000 threshold, the starting age of 22 and the problems for the self-employed. I hope the Government will look at these issues sooner rather than later, especially the age threshold. This change, implemented earlier than the mid-2020s, will help young people to start saving as early as possible and give their pensions more time to grow.
During the Covid-19 crisis, the Pensions Regulator has relaxed the requirement for employers to consult on cutting pensions contributions in some circumstances, and the period in which schemes must report payment failures has been extended from 90 to 150 days. Has an assessment of these changes regarding the pension pots of individuals been made?
Recently, a leaked Treasury document suggested that one way to ease the debt burden accumulated due to the lockdown would be to scrap the pensions triple lock. Are the Government considering this policy change?
As we discuss the regulation for the offshore sector, as noted by the noble Lord, Lord Purvis, we need to recognise the pressure this industry is under due to coronavirus. The recent business outlook report from the UK Oil and Gas Industry Association says that up to 30,000 jobs could be lost in the next 18 months. What action are the Government planning to support offshore sector workers?