School Pupils with Allergies

David Johnston Excerpts

Thursday 30th November 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Education (David Johnston)]

I thank the hon. Member for Strangford (Jim Shannon) for securing this debate. It is typical of him to bring to Parliament incredibly important issues that do not get the attention they should. He does so consistently in Westminster Hall and the main Chamber, and we all admire and appreciate that.

I start by offering my deepest condolences to the family of Benedict Blythe, who died two years ago tomorrow. No parent should experience what Helen has gone through. I was deeply saddened to learn of the story before I came here and to hear more detail today; the colourful picture that my hon. Friend the Member for Rutland and Melton (Alicia Kearns) painted of what Benedict was like moved us all. My heart goes out to any family experiencing that sort of loss. I just wanted to say that at the outset to Helen and her husband. As she knows, the coroner’s inquest into Benedict’s death is ongoing, so I am unable to comment on the details of his case, but officials from the Department met her in May to hear about the excellent work she has been doing through the Benedict Blythe Foundation to raise awareness of how best to protect children.

I can, of course, address the more general points that hon. Members made about allergies and our policies. I understand how worrying allergies can be for parents. As my hon. Friend the Member for Rutland and Melton said in her moving speech, when parents send their children to school, it is only right and natural that they expect them to be kept safe. If their child has an allergy, that adds a particular level of concern about what is happening in the school day.

Allergies are complex conditions that can range enormously in severity. Not all allergens are foods either, as hon. Members know, which makes it more complicated to manage them. I welcome the schools allergy code that the foundation launched this week, which will provide helpful guidance to schools on how to implement allergies policies; we would be keen to encourage schools to look at that code.

[Alicia Kearns]

I know that the Minister cannot commit to anything at this moment, but I would very much appreciate it if I could pick up that point about the code with him, maybe in a few weeks’ time; we could see whether that resource could be put on the Department for Education’s website or look at the best way to ensure that all schools around the country are aware of it, not just through the foundation but through the Department. That would be a meaningful way to spread that code across the country. I know that he cannot commit to that now, but would he be happy to pick that up with me in a few weeks?

[David Johnston]

I am very happy to have that conversation with my hon. Friend.

Turning to the statutory duties on schools, hon. Members have called for voluntary guidance to be replaced with a funded mandatory requirement. We have heard from each Member who has spoken in this debate about the four things that they would like to see: an allergy policy in place; the co-creation of an individual healthcare plan with all pupils with allergies and anaphylaxis; spare adrenaline auto-injector pens in schools; and the training of school staff and teachers in allergy awareness and allergy first aid.

Let me start with the first of those points. Section 100 of the Children and Families Act 2014 places a legal duty on schools to make arrangements to support pupils at their school with medical conditions. The accompanying statutory guidance from 2015—“Supporting pupils at school with medical conditions”—is not voluntary; governing bodies must have regard to that guidance when carrying out their section 100 duty. The guidance makes it clear that schools should ensure that they are aware of any pupils with medical conditions and have policies and processes in place to ensure that those conditions, including allergies, can be well managed. The guidance is clear that policy should also include how the processes will be implemented, what should happen in an emergency situation and the role of individual healthcare plans in supporting pupils. It says that

“The school, healthcare professional and parent should agree, based on evidence, when a healthcare plan would be inappropriate or disproportionate”

and that the policy should also set out

“how staff will be supported in carrying out their role to support pupils”

including

“how training needs are assessed, and how…training will be commissioned and provided.”

It states that

“any member of school staff providing support to a pupil with medical needs should have received suitable training.”

Members also raised the important issue of adrenaline auto-injectors. The regulations already allow schools to obtain and hold injectors and, in an emergency, they can be administered to pupils the school knows have a risk of anaphylaxis but whose own devices are not available or not working, perhaps because they are broken or out of date. To support schools to meet the needs of pupils with allergies, the Department of Health and Social Care has produced guidance on the use of adrenaline auto-injectors and emergency inhalers in schools, including the purchase of spare adrenaline auto-injectors.

[Alicia Kearns]

Will my hon. Friend give way on that point before he moves on?

[David Johnston]

Yes, but I am going to have to get through my speech.

[Alicia Kearns]

We have a little more time. On that point, would the Minister accept that there is a real problem that, while the auto-injectors are stored in schools, not many staff go through any form of training on how to use them? We have to be honest, in this day and age when we see Americanism being imported to our country, teachers are scared that they will end up in law courts. The Department has a responsibility to support staff so that they are confident enough to provide that life-saving aid. Does the Minister agree, therefore, that there should be funding or a process in place? Does he agree that training should be provided in some way, even if it is just a YouTube video that every single teacher must watch, so that teachers have the confidence to administer auto-injectors? That is a concern that we hear repeatedly, and there is currently no provision.

[David Johnston]

Staff should have training in it—that is absolutely right. That is part of what we are requiring. We continually review the policies in this area, and if we feel that there are deficiencies, or indeed inconsistencies, which I suspect is the biggest problem, we will do whatever we can to ensure that they no longer occur.

[Jim Shannon]

I wonder if I am following you correctly—you will confirm whether that is true or not. We have asked for this provision to be not just voluntary, but mandatory. In other words, we are seeking for it to be put down in legislation—given the cost factor is so small—to make it happen and change lives. I suppose the core question that we are asking, Minister, with great respect, is whether you can confirm that that is something you are prepared to look at. It is really important.

[David Johnston]

We have a difference of opinion about the requirement on schools. The Department’s view is that what is set out in the statutory guidance should require schools to do most of what is being described, and the question then is whether that is happening in every place or not. If what we expect to be happening under the Children and Families Act and so on is not happening, then we definitely want to ensure that it does happen.

[Jim Shannon]

I thank the Minister for that response; I think that gives us some clarity. From what we have all said in our contributions so far, there are cases where that is not happening—wee Benedict is an example of a case where, with respect, it did not seem to happen. And if it did not happen, then we wish to see it happen.

[David Johnston]

Yes. The question with these things is always whether the laws are already there. Do you need new laws, or are the laws already there but not being enforced? I have heard from Members today that we are clearly not seeing in every case the practice that we want to see. I will discuss with officials what more we can do on that, including in promoting the code.

[Alicia Kearns]

Can I ask the Minister one very last question? It will be the last one, I promise—that is not something I have ever said before in this room. [Laughter.]

[David Johnston]

Well, I have a bunch of witnesses to that. I will give way.

[Alicia Kearns]

If the point is around the Department believing that this is being done rightly, does the Minister know whether Ofsted, when it reviews schools, takes into account whether or not the allergy guidance and section 100 is being upheld adequately? I am aware that this falls between two briefs; it is not just the Minister’s brief. If that is not the case, could he write to me? That may actually be the solution: we say that when Ofsted inspects schools, because the loss of life is so high—66 children—this should be part of its reviews. That way, it can say it is meeting its requirements and commitments to children—to keep them safe and ensure it is doing everything to look after them in every single way it can, as we would all wish it to be doing. That may be the solution that fixes this gap that, between us, we seem to be coming to.

--- Later in debate ---

[David Johnston]

I will write to my hon. Friend to clarify that particular point. Ofsted has a role in inspecting safeguarding, which incorporates a wide range of vulnerabilities that children may have. I do not know the answer to her specific question about section 100, so I will write to her on that afterwards.

I have no idea where I was in my speech at this point, so I will turn back to the code. On the points in the code on taking a whole-school approach and having clear governance and risk management, the statutory guidance makes it clear that all state-funded schools should have a policy for supporting children with medical conditions. This should be reviewed regularly and be accessible to parents and school staff.

The hon. Member for Washington and Sunderland West (Mrs Hodgson) talked about school catering policies. Schools are expected to make reasonable efforts to cater for pupils with particular requirements—for example, as she touched on, to reflect medical, dietary and cultural needs.

In deciding what is reasonable, schools and their caterers are expected to take into account factors such as the type of diet required by the child with allergies, the number of children in a similar position and the cost of making suitable food available. In exceptional circumstances it may be considered reasonable for the school not to make special provision for particular children—for example, where this would be very difficult and costly to achieve.

Turning specifically to younger children, the early years foundation stage framework sets the standards that all registered early years providers must meet for the learning, development and care of children from birth to age five. It states:

“Before a child is admitted to the setting the provider must also obtain information about any special dietary requirements, preferences and food allergies that the child has, and any special health requirements.”

Providers must have

“a policy, and procedures, for administering medicines”

and

“systems for obtaining information about a child’s needs for medicines, and for keeping this information up-to-date. Training must be provided for staff where the administration of medicine requires medical or technical knowledge.”

Within all early years settings there is a requirement for at least one person who has a current paediatric first aid certificate to be on the premises and available at all times when children are present, and who must accompany all children on outings. The PFA criteria is clear that the training should include being able to

“help a baby or child who is suffering from anaphylactic shock.”

In September, we changed the adequate supervision requirement within EYFS to be explicit that adequate supervision while children are eating means that children must always be within “sight and hearing” of an adult; not within sight or hearing, as was the case previously. This will help practitioners to be able to notice the signs of an allergic reaction as soon as they present themselves, and allow them to act quickly. The new early years educator level 3 qualification will come into force next September. That will ensure that early years practitioners have an understanding of allergies and anaphylaxis.

I will have to write to the shadow spokesperson, the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), about the expert advisory group on allergy—this is the first time I have heard of that. Likewise, I will write to her about monitoring the effectiveness of the allergens policy. I think her question on research into life-saving treatments is probably better directed to the Department of Health and Social Care, but I will obtain for her the information about what that Department is doing in that regard.

Having outlined the various legislation and guidance that covers allergies in schools, the Government’s overall position, given the complexity and individual nature of allergies—which was set out very clearly by the hon. Member for Dagenham and Rainham (Jon Cruddas), who chairs the APPG—is that the legislation we have in place is proportionate, and allows schools to respond to individual circumstances and the specific needs of their pupils, but, as I said earlier, we keep these policies under review. We welcome feedback on how we can better support schools’ implementation and awareness of these polices, particularly to try to remedy any inconsistencies between what we require from them and what is happening.

I will write to hon. Members about those points, and will meet my hon. Friend the Member for Rutland and Melton. I thank the hon. Member for Strangford again for securing this important debate.