[Relevant document: Summary of public engagement by the Petitions Committee, on food labelling and support for people with allergies, reported to the House on 10 May, HC 73.]
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.
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?
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.
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?
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.
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.
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.
4:44 pm
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.
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.
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”.
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.
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.
5:04 pm
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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.
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.
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.
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.
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.