Peanut Allergy

Orders of the Day — Petition – in the House of Commons at 10:30 pm on 30th March 1994.

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Motion made, and Question proposed, That this House do now adjourn.— [Mr. Kirkhope.]

Photo of Edward Garnier Edward Garnier , Harborough 10:31 pm, 30th March 1994

I am grateful for the opportunity to open this Adjournment debate. I thank my hon. Friend the Parliamentary Secretary for his attendance, and other hon. Members for theirs, at a debate which will be constructive and of interest to many people outside the House.

I accept that, at first glance, the subject of the debate is not one which immediately commends itself as suitable for parliamentary debate. It is legitimate to ask why the peanut should be allowed to keep the House at work beyond the conclusion of the main business of the day, on this of all days—the last evening before we break before Easter.

Before going any further, I must tell the House about the peanut, which is not a nut, but a vegetable belonging to the pea or bean family. It comes from a herbaceous plant that grows to about 2 ft tall and whose stalks, after flowering, bury into the ground, which is where the nut matures; hence its name of groundnut.

Groundnuts are native to Brazil—the home of all real nuts, although I am looking around me to see whether there are any others—and are grown all over the world, perhaps most famously by Mr. Jimmy Carter, the former President of the United States.

A less happy peanut growing enterprise was that set up in east Africa by the Labour Government after the second world war, to solve this country's food supply problems, which failed at the then enormous cost of £40 million.

Despite that setback, peanuts are increasingly popular in this country. In 1992—the latest year for which figures are available—we imported 138,000 tonnes compared with the 121,000 tonnes in 1988. Hardly a reception takes place in this Palace that does not feature the popular peanut and there is hardly a child in the country who does not have strong views about the desirability of peanut butter at teatime. The peanut is part of everyday life and is here, no doubt, to stay.

In introducing the subject, I intend to do no such damage to the peanut as was perhaps done to the egg on previous occasions.

I am not the first Member of Parliament to raise the subject of peanut allergy. My right hon. Friend the Member for Woking (Sir C. Onslow) raised it in a written question to our right hon. Friend the Minister of Agriculture, Fisheries and Food in January, and early-day motion 834, in the name of the hon. Member for Rossendale and Darwen (Ms Anderson) and some of her hon. Friends refers to it.

Peanut allergy has already been the subject of a number of press articles in the past few months, in The Times, The Daily Telegraph, the Daily Mail, the Sunday Mercury and the Leicester Mercury—my local newspaper—all of which reported on that issue generally or with reference to individual cases, some fatal, some nearly so, but all acutely distressing to the families concerned.

My interest in peanut allergy was provoked by a constituent, Mrs. Shirley Hammond of Oadby, whose six-year-old daughter Jessica suffers from that condition. Mrs. Hammond wrote to me in January, having seen a television programme that dealt with the allergy and its fatal consequence in the most serious cases brought about by anaphylactic shock. I shall read a little of that letter: 12 months ago my daughter … almost died with this condition. She had eaten a handful of peanuts at school. She was rushed to hospital in Leicester where, fortunately, her life was saved by speedy action by the medical staff who recognised the symptoms, but Mrs. Hammond was told that her daughter's condition was not only rare, but one which she would not grow out of. Her letter continues: My life and my family's life has since changed quite dramatically; life-saving courses taken at St John Ambulance and injecting lessons taken so that she now knows how to give Jessica adrenaline, the antidote to the allergin, in an emergency. Delay of as little as five minutes has, in some recorded cases, proved to be sufficient to kill.

My hon. Friend the Member for Dorset, North (Mr. Baker), who is in his place, has mentioned to me a case involving a little girl in his constituency who unwittingly ate a biscuit containing peanut and died as she ran the few yards to the school sanatorium—a young life literally snuffed out in seconds.

Photo of Lynne Jones Lynne Jones , Birmingham, Selly Oak

One of my constituents died from eating a pretzel which had peanut oil coating. The daughter of another of my constituents fortunately survived, but was very ill after eating fish that had been coated with a batter which had peanut oil in it. It is a very serious matter for those people who are affected.

Photo of Edward Garnier Edward Garnier , Harborough

I am grateful for the hon. Lady's support in this matter.

As I was saying, my hon. Friend the Member for Dorset, North has also referred to a case in his constituency, involving the daughter of a Mr. and Mrs. Crocker of Pulham. This is not the esoteric issue that some might think. My hon. Friend the Member for Chipping Barnet (Mr. Chapman) has recounted to me a similar incident in his constituency. As the hon. Lady has just mentioned, there will be other hon. Members with similarly tragic stories of sudden deaths caused by anaphylactic shock brought on by peanut allergy.

Mrs. Hammond's letter goes on: Having had 12 months of being educated on this subject I write to you, not as a paranoid mother nor as a scaremonger, but as someone who feels very strongly about it. I have now met Mrs. Hammond twice in my constituency surgery and can testify to her rationality, her calm and considered manner and to her deep and wholly natural concern for the health and safety of her child.

Jessica Hammond is not alone in suffering from that potentially lethal allergy. Mrs. Hammond tells me that approximately 600 cases of life-threatening reaction to peanuts have been recorded and that that allergy is the fastest growing variety of food allergy or intolerance. Seven other children aged between three and seven years old at her daughter's primary school have been recognised as sufferers and the school, thanks to the common sense and wisdom of the head teacher, Mrs. Sonja Hudson, has in place contingency plans to cope with any emergency brought about by contact with, or ingestion of, peanuts or peanut products.

You will not be surprised, Madam Deputy Speaker, when I tell you that Mrs. Hammond has started a support group, the Peanut Allergy Support Group, in Leicestershire, an organisation whose aims are, I believe, complementary to those of the Anaphylaxis Campaign based in Ash near Aldershot. The chairman of that association, Mrs. Reading, had a daughter, Sarah, who died at the age of 17 having eaten grated peanut sprinkled on the top of a piece of lemon meringue pie bought in a supermarket. The aims of those groups are to educate the public about potentially fatal food allergies, to increase awareness of them among health professionals, especially general practitioners and those working in schools, to encourage research into the causes, means of prevention and treatments for them, to campaign for legislation compelling caterers to the public to list the ingredients of all food and drink on sale, and to campaign for legislation to compel clearer labelling of food products containing peanut, peanut extracts and oils.

I agree with those aims, with the exception of those calling for legislation.

I do, none the less, want the Ministry of Agriculture, Fisheries and Food, the food industry, the retail trade, food scientists, dieticians and others concerned with public health to co-operate in an effort to ensure that practical steps are taken, and taken soon, to resolve the difficulties that legislation could cause, so that it is not necessary.

What does intolerance do to an affected person? Most commonly, it causes swelling around the mouth. If it causes only the lips to swell, that is unpleasant, but not necessarily dangerous. But if it causes the throat to swell, it can constrict it and inhibit breathing. It can cause a skin rash like a nettle sting and it can cause allergic reactions to the whole body—anaphylaxis, in which the blood pressure becomes dangerously low. It can also bring on an asthma attack.

Before discussing the worrying matter further, I shall put the risk in perspective. Without doubt, peanut allergy has been lethal in a small number of cases, but vast numbers of people with nut allergy manage very well without suffering a dangerous reaction. According to Dr. Martin Stern, a consultant clinical immunologist at Leicester general hospital, it is possible, with sensible precautions, for a sufferer from peanut allergy to be far more at risk from death from the ordinary incidents of life and old age than from the allergy. Only 2 per cent. of the population suffer from some form or other of food intolerance, and within that group are those suffering from allergic reactions, including the other forms of real nut such as hazelnuts and walnuts.

I have spoken to representatives of the Food and Drink Federation and, from what they have told me, I am sure that their members are only too well aware, not only of the concerns of people such as Mrs. Hammond, but of the need to do something about them in a practical way. There has been some useful work already.

Following the 1984 report on food intolerance by the Royal College of Physicians and the British Nutrition Foundation, those organisations were involved—with the British Dietetic Association, the FDF and the Leatherhead Food Research Association—in an initiative to establish a central source of information about the composition of food to assist in the professional management of food intolerance. That led to the establishment in 1987 of the food intolerance databank, which sought to list products that were free from one or more of the most common causes of food intolerance, such as milk, egg, wheat and soya.

At that time, it was felt that peanuts were fairly easy to exclude from the diet, so it was not seen as a priority to include foods that did not contain peanuts. The databank is updated annually, and consideration was given earlier this year to extending its scope to include such foods. However, given the lack of understanding about the precise cause of the reaction, and thus the difficulty in identifying which part of the peanut is responsible, it was impossible to establish a medically correct definition of "free from" in the case of peanuts. Therefore, it was not possible to extend the databank.

For similar reasons, it is understood that the anaphylaxis support group has recently abandoned its attempt to produce a list of products that sufferers from peanut allergy may eat with safety. The group also appears to share the view that the establishment of a list of products that are free from peanuts per se would be of limited value and, more critically, potentially dangerous to any individuals who might react adversely to peanut oil.

Photo of Martyn Jones Martyn Jones , Clwyd South West

I am grateful to the hon. Gentleman because this is an important subject, and I congratulate him on raising it.

Although there are difficulties involved, we could have a labelling system that includes foods such as the nuts that the hon. Gentleman mentioned. Peanuts are not the only food to which people are allergic, although peanut allergy is one of the fastest growing food allergies. Apparently, until 1992 there were no deaths from peanut allergy in this country, but we have had five or six in the past year. Does he agree that labelling is an answer to some degree, and perhaps the Government should consider that?

Photo of Edward Garnier Edward Garnier , Harborough

No doubt my hon. Friend the Minister will return to that issue, but there are problems with labelling, and I shall seek to develop them in the few minutes left to me.

Notwithstanding the proven success of the food intolerance databank in assisting professional dieticians to provide positive advice to those who suffer from food intolerance, the option of improved labelling of the ingredients of foods has also been explored as a means of assisting those who are allergic to peanuts. That is not likely to be particularly helpful, because, while an indication of the presence of peanuts, or their possible presence, may alert sufferers to avoid such products, labelling cannot provide assurance about products that are not so labelled. Furthermore, until the causative agent has been identified, such labelling would have to embrace not just peanuts but all their derivatives, including minor components, which would be an impractically complex task.

Moreover, it is the nature of the oil refining industry's processes that oils can be unintentionally but unavoidably mixed within a product. It is therefore possible that not just a generic vegetable oil but a specific single oil may contain a minor admixture of peanut oil which, other than to the individual who might react adversely to its presence, would have no other consequence for the user or consumer.

Peanut oil is particularly stable and thus, in its refined and de-odourised form, is frequently chosen as a carrier for colours, flavourings and vitamins, as well as the essential lubrication of food processing equipment. The search for, and validation of, alternatives will inevitably take a considerable time, to ensure that there are no untoward effects on product quality.

While the industry is prepared to extend the labelling of products where the presence of peanuts is not currently required by labelling legislation, it is hesitant to do so because, on current evidence, it would be of limited value to those who suffer from peanut allergy. Extending such labelling to include all peanut derivatives would, given manufacturers' reluctance to guarantee the suitability of products to sufferers against current medical uncertainties, mean that many products could be identified as "possibly" containing peanut derivatives. That would almost certainly embrace products that sufferers had previously consumed without adverse effect and, thus, serve only to confuse and diminish the value of labelling the presence of peanuts.

What should we look for? To address the medical background, I understand that the Ministry of Agriculture, Fisheries and Food will shortly initiate work with Professor John Warner of Southampton, a noted clinical allergist and paediatrician. In addition, the oil processors' association is considering funding complementary work designed to clarify the allergenicity of variously refined and processed peanut oils.

In the meantime, educating the public and those involved in preparing and providing food should be a priority. The Food and Drink Federation is assisting the Ministry to increase awareness both among the public and within the industry. I welcome the liaison between the various interest groups, including the Ministry and the anaphylaxis group, and trust that they will continue to search for ways of assisting those who suffer from food intolerance, including peanut intolerance.

May I place on the record my gratitude to the Parliamentary Secretary for his close interest in this subject?

Photo of Nicholas Soames Nicholas Soames Parliamentary Secretary (Ministry of Agriculture, Fisheries and Food) 10:47 pm, 30th March 1994

I warmly congratulate my hon. Friend the Member for Harborough (Mr. Garnier) on making such a steady, sensible and well thought-out speech about this extremely difficult and emotive matter. I am grateful to him, as the House of Commons will be, for raising the issue of peanut allergy for debate. I have been interested to hear his account of the problems experienced by his constituents, particularly Mrs. Hammond and her daughter Jessica. Mrs. Hammond sounds like a remarkably sensible and level-headed woman. The letter that she has written to my hon. Friend about her daughter is similar to many received by me and other hon. Members.

My hon. Friend mentioned the letters received by my hon. Friends the Members for Dorset, North (Mr. Baker), who is in his place tonight, and for Chipping Barnet (Mr. Chapman), who is also here. The hon. Member for Birmingham, Selly Oak (Dr. Jones) mentioned two such tragedies in her constituency. Those letters from people who are allergic to peanuts or with dependants who are so allergic have often portrayed harrowing stories. The many letters that I have received have confirmed the picture that I have built up over the past few months, which was entirely unexpected by me.

First, may I express, on behalf of the Her Majesty's Government, myself and all my colleagues in the Ministry of Agriculture, Fisheries and Food, my profoundest sympathy to all those who have lost loved ones as a result of a severe reaction to peanuts or other nuts, or as a result of other food allergies. The people who have to cope with the problem daily have my deepest admiration for the way in which they endure what is inevitably a nightmare scenario.

Secondly, I pay tribute to the efforts of various people around the country who have formed action groups. Mrs. Hammond's group is particularly concerned with the peanut allergy. Last week, the anaphylaxis group came to see me with my right hon. Friend the Member for Woking (Sir C. Onslow), who has taken a keen and close interest in the matter, through his constituent, Mr. David Reading, a remarkable man who has so tragically lost his daughter Sarah, as my hon. Friend said tonight.

I was most impressed by the balanced, sensible and pragmatic approach that those groups have adopted in increasing our knowledge and the depth of knowledge of all those involved in this matter throughout the United Kingdom by their sensible, balanced and thoroughly responsible campaigning methods. We are grateful to them and my Department looks forward to working closely with all those groups in future.

It is extremely difficult to be precise about the prevalence of peanut allergy in the United Kingdom. My hon. Friend dealt with the matter extremely well and I shall not go over it again; suffice it only to say that the foods most likely to be associated with intolerance reactions are more extensive than my hon. Friend mentioned. In addition to the nuts, there are cows' milk, hens' eggs, wheat, soya, chocolate, fish and citrus fruits.

Only a small proportion of the 2 per cent. who are affected will be allergic to peanuts and an even smaller proportion will have life-threatening reactions. We believe that the number at risk could be around 5,000, though there are arguments about that figure because of the difficulty of finding a satisfactory model.

My hon. Friend mentioned the research to be carried out at Southampton university by Professor Warner to establish how widespread the peanut allergy may be and to identify what parts of the peanut are allergenic, but the results will not be available for at least a year or probably longer.

The House may recall that, on 13 January, we announced an initiative by the Government to raise awareness of the problem in the food industry. On the instructions of my right hon. Friend the Minister of Agriculture, Fisheries and Food, I wrote to the leaders of the main trade associations concerned. Subsequently, their representatives have met officials of the Ministry and the Department of Health to learn more about these issues and to consider what best could be done to help.

Officials from both Departments have also met representatives of consumer bodies and the enforcement authorities, and several of the parents most directly involved in dealing with this affliction.

I am pleased to say that the response has been positive, and all those we have contacted have expressed willingness to spread the word within their organisation, through trade journals, training courses arid seminars. We have provided material to help them do so.

Some food companies have started to take action with voluntary labelling. I have been particularly impressed with the example that one major retailer has shown me, though there is much work being done by many others. Also, some in the food industry have been investigating alternatives to the use of peanuts and peanut oil. I am pleased that enforcement authorities' representatives have offered to distribute our information notes to the small and medium-sized businesses that their officers visit. It will mean that awareness of the problem will become widespread.

We are keeping in close touch with all those contacts so that we can, in the near future, assess the results of the initiative.

Photo of Lynne Jones Lynne Jones , Birmingham, Selly Oak

Although the efforts by the food industry are commendable, as are the efforts to publicise problems with peanut and other allergies, has the Minister had discussions with the British Medical Association which says categorically there should be mandatory food labelling in this area?

Photo of Nicholas Soames Nicholas Soames Parliamentary Secretary (Ministry of Agriculture, Fisheries and Food)

I personally have not had discussions with the BMA, but the Department of Health and the Minister of Agriculture, Fisheries and Food are in constant touch with all the relevant bodies that we consult as a matter of course. I am sure that they have talked to the BMA, but I shall let the hon. Lady know the nature of any substantial discussions we may have had.

As I have said, we shall keep in close touch with all whom we have consulted to ensure that we follow up our initiative. We are also acting on many other matters. We are funding research, which my hon. Friend the Member for Harborough has already mentioned—particularly that led by Professor Warner. We are producing information for consumers, including an excellent booklet—to be published in April—which will advise people on how to deal with food allergies: it refers to nut allergy in some detail. We are collaborating with allergy experts to produce better information for sufferers, particularly on how they can use food labels to avoid problem products.

We are also issuing updated guidance to general practitioners. That is one of the most important things that have emerged from consultation with families—and one of the most important things impressed on me by David Reading, of the anaphylaxis group, was the vital necessity of ensuring that when doctors see a patient suffering from such a reaction, they can identify it. Thank God, in the case of Jessica Hammond there was a doctor to hand, who knew what he was dealing with.

It is not the doctors' fault that they are expected to know everything about everything. I think that we owe it to them, and to all sufferers, to ensure that the symptoms of anaphylaxis are immediately available to doctors as part of their training and on-going knowledge. I assure the hon. Member for Selly Oak that the Department of Health has taken steps to ensure that doctors have that information at their fingertips, through its excellent system for disseminating such information.

We are issuing guidance to other health professionals as well, to raise their awareness of these allergies and of the appropriate treatment for people who may be at risk from anaphylactic shock. We are consulting the Food Advisory Committee, which advises the Government independently on such matters and which will consider the issue next month. I know that many of the groups that have made representations to the Government have also made submissions to the Food Advisory Committee, and I very much hope that that includes the anaphylaxis group. I saw the group last week, and I know that it was going to make a submission; I hope that it did so earlier this week.

The complicated issue of labelling is at the heart of the debate. The labelling of pre-packed foodstuffs is already extremely comprehensive: as a general rule, if peanuts are an ingredient they should appear on the label. However, there are one or two exceptions—stemming from the EC directive on food labelling—which might mean that the peanut component is not properly identified. We should like those exemptions to be removed or considerably reduced; last year, we vigorously argued the case for such action at two meetings with our European Union partners.

I regret to say that we have not made much progress so far, but there are signs that an agreement to list specified food allergens whenever they are added to food—even when they might have qualified for exemption—may be possible. We shall support such a change, but achieving it may take a considerable time. I have warned those who have been to see me; it is important for hon. Members on both sides of the House not to delude themselves about the time that it may take us to reach a conclusion.

I must consider very carefully how far we should get ahead of the rest of the Community. If we took unilateral action, we would come under pressure not to apply our new rules to imports from other member states. As the origin of pre-packed products is not always stated on labels, there would be a risk of misleading consumers into thinking that all products on the retail shelves were subject to the same rules, whether they were or not—with potentially disastrous consequences for people in the difficult position that we are discussing. That would be very dangerous and unsatisfactory for some people, which is why better co-ordinated action by the Community is so much more worth while. Indeed, such action is essential, and we shall press for it.

So far, I have dealt with pre-packed foods. Let me now deal briefly with foods that are sold loose: for example, cakes and baked products sold in bakers' shops, and foods sold in catering outlets. The hand of labelling legislation falls lightly in those sectors and for good reason. First, intending purchasers can ask for information from shop assistants and waiters. Secondly, imposing full labelling rules on what are often small businesses would place an unproportionately heavy burden on them. Thirdly, there is the simple and practical problem that notices can become separated from the foods to which they apply. We have spoken to experts in the catering sector and their advice has been that, although there is scope for greater awareness and information availability in catering outlets, detailed labelling is simply not practical.

As I have said, the Food Advisory Committee will look at these issues further in April and we shall not hesitate to consider with care, as we always do, the advice that it gives.

My hon. Friend the Member for Harborough has done a signal service in a measured and dignified way. This is a highly emotive and difficult issue which causes untold anxiety and great worry to rather more people than any of us had any idea about. My hon. Friend has done an important service and I want to assure him that the Government are thoroughly committed to trying to find a sensible, pragmatic and workable way in which we can make life easier for these people.

Question put and agreed to.

Adjourned accordingly at Eleven o'clock.