Baroness Finlay of Llandaff (CB)

My Lords, it was 19 years ago that I had the privilege of chairing the Science and Technology Committee’s inquiry into allergy for this House. I remind the House that, even then, we were saying that half of those who died from an allergic reaction had not had any previous serious reaction, and we highlighted the need for adrenaline auto-injectors and the fact that they were not being used effectively. The failure of pens was for several reasons, usually that the injection was not given intramuscularly, there was poor training or pens had passed their expiry date, were being used too late in a reaction or were not available at the time of the reaction. The amendments in the name of the noble Baroness, Lady Morgan of Cotes, and of my noble friend Lord Fryberg are incredibly important and are 19 years overdue. We really cannot carry on like this. There is guidance on the use of adrenaline auto-injectors in schools from the Department of Health in 2017, but it states: “This guidance is non-statutory”. It goes on to say: “The Children and Families Act 2014 requires governing bodies of English schools to make arrangements for supporting pupils with medical conditions”. The problem is, of course, that the management of allergies is not statutory, and children present with a very wide range of medical conditions, but there are not that many that present the medical emergency that an allergic reaction can present. The summary states that schools are not required to hold adrenaline auto-injectors. If they do not have one when a child is collapsing, even if the child has their own with them, the risk of that child’s death goes up significantly. The guidance is also very clear that the MHRA expert group from 2020 said that adrenaline should be administered at the first sign of a reaction, and that the risk of delay outweighs harm. I suggest that the cost of delay is absolutely massive and must be properly considered in terms of the cost of providing these pieces of equipment that can be stored, and incorporating training, as we have already heard. The guidance is very clear: if in doubt, give adrenaline and, if there is no improvement after five minutes, give another dose. Children’s schools must have the ability to recognise allergy wherever that child is and react rapidly, because five minutes is not very long. You cannot run from one side of a school to another to try to find somebody who knows what to do because, by then, tragically, the child may have had a cardiac arrest.