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.