Pica Eating Disorder: SEND

Lee Pitcher Excerpts

Wednesday 9th September 2026 Westminster Hall

[Margaret Mullane]

The hon. Gentleman is right, and I thank him for raising that matter. While this debate will focus on training in schools and other educational settings, it is important to note that there is a desperate need for pica recognition and training across the NHS, local authorities, care providers and even housing providers. However, that is not the focus today.

Sadly, pica is still not fully understood, which often results in people being dismissed or the condition being treated as a behavioural issue. While there is a growing consensus that pica must be treated as the serious medical and safeguarding issue that it is, the lack of awareness means the condition is overshadowed. As such, it is not considered by policymakers. That has to change.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

I thank my hon. Friend for her work to champion this cause. I was also at that roundtable and she is quite right; every single one of us was brought to tears. Does she agree that, given the potentially serious health risks associated with pica—she mentioned the compulsion to eat glass or coal—we should not have a postcode lottery on whether teachers and SEND staff recognise the seriousness of the condition, and that there is a case for national guidance and training so there is awareness and we can help people at their most vulnerable times?

[Margaret Mullane]

My hon. Friend is quite right. That is ultimately what we seek in the long term. We do not want anyone to have to go through what some families have already gone through. Only if we adopt national training will that actually stop.

Earlier this year, I held a pica awareness parliamentary drop-in session with Suzy and the National Pica Advisory Service, representatives of which are in the Public Gallery. I met Tolu, Belinda and the team, who do amazing advocacy work to support parents of children with pica. Speaking to advocates and parents, the consistent theme was a lack of professional knowledge across sectors, whether at schools or—this is another important point—when people present at hospital. Parents are fed up of hearing, “The item will pass through; don’t worry about it.”

At my event, the National Pica Advisory Service told the story of a parent of a child with pica. Had that parent not persisted in pushing that their child did not just have an upset tummy, one of the child’s organs would have failed and they would have died. There was a screw lodged in the child’s intestines that was discovered only when the parent demanded an X-ray. That should have been the first port of call when the parent explained that their child had pica, not something that, once again, a parent had to fight for.

I heard another story of a child in a private-rented property who would lick paint. Sadly, due to the age of the property the paint had high lead content. In such circumstances, had the child continued and—again—had the parent not persisted, it would have led to the child’s death. Early diagnosis and early intervention are key, but so too is ensuring that adaptions are made, environments are made safe and that caregivers and educators are equipped with the knowledge and training to monitor those with pica.

In 2023, pica came to prominence in the media due to the tragic case of Owen Garnett, a student at Welcombe Hills, a specialist SEND provision school in Stratford-upon-Avon. Owen had pica and was in an educational environment that understood that, yet after choking on a paper towel unsupervised, Owen sadly died, aged 19. The coroner’s report highlighted that

“the school’s risk assessments…recorded that Owen should ‘Never be left alone when out’ and…in bold ‘NB due to Pica, a named person must watch Owen at all times’”.

The report concluded that

“Owen’s carer specifically raised concerns surrounding blue paper towels at a meeting…On 4 January 2023 Owen was discovered to have blue paper towel in his mouth and a message was sent to his carers saying this had occurred… On 9 January 2023, contrary to the…risk assessment, Owen was outside of the classroom and was unsupervised. When Owen was located, it was discovered that he had crammed a significant amount of blue paper towel into his mouth and throat and was choking.”

He was transported to Warwick hospital. He suffered a hypoxic brain injury. A decision was taken to remove life support and, sadly, he died on 11 January.

The Health and Safety Executive said that the school had failed to ensure that all risks associated with pica were identified and had failed to respond to family concerns. The multi-academy trust was fined £300,000 and told to learn from its mistakes but, let us be honest, people at the trust can move on with their lives; a family has lost a son and their lives will never be the same again. It was an exceptional case and not a common occurrence but it serves to highlight what can happen if pica is not taken seriously in an educational setting. All children deserve a safe, secure and happy educational journey, whether in mainstream education, a specialist school or other educational settings, but at present that is not being delivered for children with pica.

Parents with children who have pica live their lives in a state of constant vigilance, and they need the assurance that their child is being cared for with the same vigilance at school. That is why, alongside parents in my constituency and across the country, and the National Pica Advisory Service, I believe that educators who are responsible for a child with pica must receive mandatory pica training. This will support teachers to grow their knowledge of the condition and how to support anyone who has pica.

Training must be about planning for pica. Classrooms are full of potentially life-threatening dangers to children with pica. Risk assessments should take account of all harmful and hazardous substances, including staples, batteries, glassware, sharp or poisonous items and magnets. They should be replaced with safer items where possible, such as non-toxic Play-Doh, paints and crayons.

It is crucial that all educators who are responsible for a child with pica must have knowledge about that individual and have read their plan. That is to help them to develop a good understanding of the child’s pica behaviours, how to keep them safe and how to redirect them. It should include completing a pica monitoring form regularly. Through this process, if an individual has particular pica items, those can be identified and removed from the space as part of an ongoing risk assessment.

Finally, all educators must learn to understand the signs of choking, poisoning and possible blockages in individuals with pica, so they can seek medical assistance as soon as possible if something goes wrong. Herein lies one of my main worries about the Government’s proposal to reform SEND provision. I have heard many stories of pica oversight in specialist schools—places that have very good, well-trained professionals who should be able to risk-assess and keep children safe. However, because of the lack of specific pica training and the significant pressures in any SEND environment, there are justified parental concerns that pica is treated as an afterthought. As many local authorities are pushed to deliver SEND provision in mainstream settings, there is every possibility—given larger class sizes and more general training—that the new model will not build in specialist training on pica or other specific disorders.

I will end as I started, by requesting that pica training is considered for inclusion in any SEND reform, making it a statutory requirement across educational settings and under SEND provision.

--- Later in debate ---

[The Minister for School Standards (Georgia Gould)]

It is a pleasure to serve under your chairship, Mr Betts. I thank my hon. Friend the Member for Dagenham and Rainham (Margaret Mullane) for bringing this deeply important discussion to Westminster Hall. The story she told shows her effectiveness as a local MP. I know that she has listened to parents, professionals and school leaders at a number of different events in her local community. Bringing their voices directly to us is much appreciated.

I am grateful to the parents and professionals in the Public Gallery for making the time to be here today and for their leadership in campaigning on this issue. I would be keen to sit down with the hon. Member for South Devon (Caroline Voaden), my hon. Friend the Member for Dagenham and Rainham and campaigners to discuss it in more detail. We have heard powerfully the profound impact that pica can have and the huge stress it can bring to parents who are desperately monitoring their child’s circumstances and safety.

As I have been going around the country talking to parents and visiting schools, I have seen schools with brilliant and extraordinary provision, and young people with pica who are really thriving. I have also spoken to parents who present stories similar to those we have heard today and who feel that support is not in place, leaving them in fear. Sometimes they have had to give up work to support their children.

The tragic cases we have heard today show how important this issue is: it goes to the heart of the relationship between special educational needs and health. All Members, I think, mentioned the importance of us working in partnership and having clarity on the role of teachers in supporting and safeguarding pupils, and the role of health professionals in diagnosing and giving advice and guidance. My hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) talked about the importance of that guidance and of roles and responsibilities of health and schools.

Earlier this year, we consulted on revised statutory guidance on supporting children and young people with medical conditions. That reflects our commitment to ensuring that every child or young person can participate effectively in education, notwithstanding their medical conditions. Schools, colleges and early years settings should understand the risks that a medical condition poses and manage them proactively. That includes ensuring that staff understand the relevant medical conditions and their impact and can recognise and respond to an emergency.

We had a really positive response to the consultation and are still working through the responses. We had a lot of detailed feedback, including on specific medical conditions. The draft guidance did not make reference to pica. Given the conversations we have had, the responses to the consultation and today’s discussion, I can confirm that we will rectify that when we finally publish the guidance, to provide clear information and guidance around pica for schools.

As part of the SEND reforms, we are looking at developing national inclusion standards that will provide a baseline of ordinarily available provision that we expect of all schools. We have an expert panel working on those standards and on specialist provision packages, which will determine the support needed in an area for a range of different special educational needs and disabilities. Currently, our independent panel, which sits across health and education, is leading that work. I commit today to ask the panel to take a specific look at the issues that my hon. Friend the Member for Dagenham and Rainham raised in relation to pica, specifically those that relate to research and identifying gaps in support.

More broadly, a number of questions were asked about the SEND reforms, including about how we will support early intervention and ensure that the right training is in place and that we have the right professionals in schools. As part of the SEND reforms, we are investing £4 billion in early intervention. That includes £1.6 billion going directly into mainstream schools, and all schools are being asked to develop inclusion strategies. We are putting £1.8 billion into an experts at hand service, which includes occupational therapists, educational psychologists and specialist teachers. I had a brief conversation, just outside this Chamber, with an occupational therapist who specialises in pica. We talked about their critical role, and it is important to reflect on that as part of the experts at hand service.

We are also developing a new package of teacher training, into which we are putting £200 million. The purpose of that training is to support all schools to be inclusive, including by identifying needs and adapting classroom practice to support children. It will not be detailed training on specific conditions, but it will include how to provide wider support and adaptions for pupils. We should also give teachers the tools and strategies to find the relevant information about specific issues as they occur in the classroom. We are currently working with parents, disabled children’s organisations and teaching organisations to develop that training, and I welcome Members’ thoughts about the process.

Many Members mentioned the importance of engaging with parents. One of the components of the training will be ensuring that teachers are listening to the voices of parents and having strong relationships with them, so that schools can pick up on what is happening at home and put that into their plans.

[Lee Pitcher]

I thank the Minister for all the work behind the scenes prior to the debate to allow some commitments to be given today; it is absolutely phenomenal. We can see the impact that is having on people in the Public Gallery and how much it is welcomed.

On sustainability and thinking about the future, I am a very “head and heart” person, and I talk a lot from the heart, but in terms of the head, if we are to continue to provide funding, support and resources for things like pica, we first need awareness, so that we can start to understand the numbers, and for that we need a record. I realise that the Minister cannot answer this right now, but can some thought be given to recording the number of people with pica so that we can use that in future business cases and when funding is considered?

[Georgia Gould]

I will absolutely take away the issue of reporting.

Members spoke about the need to invest in inclusive spaces. We are continuing to invest £3.7 billion in the creation of new specialist places. That money can go into new special schools, inclusion bases or adaptions in mainstream schools. I have visited really high-quality inclusion bases, and I know that part of that investment has been about creating safe spaces for children with pica. We have also issued new guidance about how to create estates that are inclusive by design, which includes guidance to schools about how to work with children and understand their experience of the school. That will make sure that schools are genuinely inclusive for those young people. That is another area that is relevant to the conversation.

The hon. Member for South Devon made a really important point about accountability across our systems and about working in partnership. We are working closely with Health Ministers on this issue, as we recognise how critical that is. The hon. Lady also spoke about experts at hand and the workforce. We are investing £40 million in training up new ed psychs and speech and language therapists, and a lot of work is going on with Health colleagues about workforce planning to ensure we have a sufficient workforce to support experts at hand and specialist settings. It is critical that we have that specialist resource to deliver early intervention.

I was asked about how the funding will work in the new system. It is envisioned that for children with individual support plans, schools will get dedicated funding that is ringfenced for pupils with SEND, so that the necessary staff can be employed and the right support can be put in place. At the moment, the funding often comes quite late in the day after a huge battle for support, and it leaves with the child. The idea is to give schools sustained budgets so that they can build the necessary provision. For pupils accessing a specialist provision package, the funding will come with the package and the child into the school. Depending on where the child sits in the system, the funding will flow differently.

I welcome the tone of the debate—there has been cross-party recognition of the scale of the issue—and the way that Members throughout the House are working together to address these really difficult questions. I have heard so many stories of families who have been badly let down. We all acknowledge that things need to change and that we need to get it right. I am committed to continuing to work in partnership with all Members, and really appreciate their bringing stories like the ones we have heard today to me, so that we can continue these really important conversations. Critically, we must talk to young people and families. I really hope this is just the start of the conversation, and that we will have a longer conversation soon so that we can look at the issues raised today.