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Peanut Allergies (Announcements on UK Flights)

Volume 592: debated on Monday 9 February 2015

Motion made, and Question proposed, That this House do now adjourn.—(Harriett Baldwin.)

A few months ago, my constituent Helena Erwin and her young daughter Emily visited me at my constituency advice centre in Ballymena. Helena told me of her desire as a mother to ensure that her child was kept safe while travelling. Emily has a very severe peanut allergy that requires her to be kept away from contact with peanuts for fear of anaphylactic attack, which could be deadly.

The family only became aware of this condition when they were on a family holiday and Emily was taken seriously ill. Subsequently, her consultant reported that she has

“an instant and extreme allergic reaction.”

Any parent of a child who requires special attention or care knows that that means constant care and attention daily, which has a broad impact. That is the case with this child, Emily. Her GP told her mother that in future, for all air travel, she will need to inform the carrier of her daughter’s condition. Her older sister has been taught how to recognise signs of anaphylaxis and what to do in an emergency, and her contemporaries—cousins, family and school friends—have had to be told what consumables Emily cannot be exposed to. The adult members of her family have each been trained to use an EpiPen and know how to administer her medication, which must accompany her at all times.

The Erwins go abroad for work and recreation, and as a result of their travel experiences, Helena contacted me to raise awareness of the needs, particularly when travelling, of the many people who, like her precious daughter, suffer from anaphylaxis and could be helped by greater awareness and safety announcements, particularly onboard aeroplanes.

It is important to put things in perspective. In 2013, there were 1,300 emergency admissions to A and E units in English hospitals following adverse food reactions and shock, and there have been six deaths in the past 13 months across the UK from anaphylaxis caused by food. Today, when we board a flight, we hear several standardised announcements, all of which we are very familiar with and are designed for our own safety: “Fasten your seatbelts”, “Put your folding table away”, “Stow your baggage”, “Keep window blinds up for take-off and landing”, and “Put down your seat’s arm rest”. There are also announcements about when and where smoking is permitted, and where and when a passenger can use a telephone or computer. We are well used to these announcements; those are just seven that I, as a regular commuter to Parliament, hear each week while flying.

From time to time, but randomly—the crux of the issue—I hear allergy announcements. When I do, I accept that they are made for my safety and that of fellow travellers, and that they should be obeyed. However, it is the random nature of the peanut allergy announcements that has prompted this debate. The Minister and his Government can do something practical and positive to help. He can ensure that tonight we begin a process to achieve a consistent style of announcement on all flights, so that public safety is increased. I am not campaigning for prohibitions; I am championing the case for consistent safety announcements when required or requested by a traveller.

Let me tell the House about the current inconsistent state of affairs. I have with me a report on 36 air carriers that fly to the United Kingdom and their policies on food allergies and announcements. Is there one consistent approach? No, there are 36 different approaches. To be fair, some airlines are doing their best, but a consistent, universal approach would actually be welcomed by the airlines as a beneficial starting point.

I want to tell the House a little about what Emily experienced on a recent flight. I asked her mother to write out the details, and it is important that they be put on the record:

“We incurred a 6 hour delay. An aircraft and crew were flown in from Paris to take us home. It was very obvious from when we stepped onto the flight that the crew were not happy at being there. We spoke to the crew member who knew nothing about us and didn’t even understand what a nut allergy was due to the language barrier. I do carry a translation card but this was in Spanish and not French.

Eventually with much explaining from ourselves and some other passengers seated around us, the crew understood what we meant but refused to make an announcement. Their reason being simply they didn’t have to. My husband and I were by now beginning to get distressed as was our 6 year old daughter Lucy. We repeatedly asked and asked for the announcement to made, eventually we were told in a minute, other passengers were now starting to pass the information back and shouting at the crew on our behalf. The doors of the aircraft had been closed and my husband and I were now thinking about asking to get off the flight rather than take the chance. At this point the crew member agreed to make the announcement and when he made it was given a round of applause by all the passengers. As a family this was a very humiliating situation to be in and very upsetting for Lucy. About 2 hours into the flight the crew member actually apologised to us but we did not get an explanation why he wouldn’t announce it to begin with.

On returning home I...called the CAA and got speaking to a Doctor from the medical department. He gave me a few pieces of advice. He felt any risk posed to my daughter would be from 3-4 rows in front or behind me and had I considered policing these rows myself to see what people are eating? All this while I am responsible for 2 small children and also adhering to the seatbelt signs. Another suggestion was just don't fly. Take a boat!”

I think that tells its own story about the inconsistency, and shows that airlines require what I am suggesting. They probably need an impetus to drive them to come up with a policy that will work.

Since I secured this Adjournment debate, I have been inundated with calls and e-mails from people across the United Kingdom. The story of Andy Hyams is well documented. He and his suffering daughter were alleged to have been bullied off a flight because no announcement was made. It is easy to understand why a parent would not want their child to stay on a flight in those circumstances; they could not move away if there was a problem. If the issue arises in a hotel or in public, people can at least leave, but they cannot get off an aeroplane when it is in flight.

Another constituent, Francis, wrote to me to say that

“unless you actually go through the stages of death by anaphylactic shock until you are left with your lifeless child in your arms it is very hard to imagine what happens.”

Frank had that experience, and said that it was only when people saw it happening that they realised the huge need address this issue.

Another lady, Danielle Toner, wrote to me to say of airlines that

“yes some will make an announcement, others will not. When you have a child in a confined space with a life threatening condition I feel it is a must that airlines should be accountable for all passengers on their flights.”

I think she makes a very good point on behalf of her little six-year-old boy, who suffers from this condition.

These allergic reactions affect one in 50 children in the United Kingdom, and I think the Minister knows that something needs to be done about this now. Putting in place a requirement that a consistent announcement, agreed with the Civil Aviation Authority, be made on a passenger’s request should not be beyond the scope of this House, or the care of this Government.

I do not believe that new legislation is necessary, but if it is, there is an opportunity to make the Consumer Rights Bill, currently in the other place, the legislative vehicle to get this job done. I appeal to the Minister to put Emily’s law in place. Let us do something to make the airlines announce consistent messages on peanut and other food allergies, so that people can travel in safety and feel that they are not being hindered in any way or having their rights taken away from them. I appeal to the Minister to do something about this.

I congratulate the hon. Member for North Antrim (Ian Paisley) on securing this debate about announcements relating to peanut allergies on flights entering and leaving the UK. I genuinely thank him for raising this topic, which is an important one. The responses he has had from his constituents and others show that many people around the country have been affected and have real concerns about their own or their families’ health.

The Government take the health and safety of air passengers and crew extremely seriously. The UK is recognised throughout the global aviation community for its high standards and excellent record of safety in commercial aviation. Severe allergic reactions, such as those that may be associated with peanut allergy, can be frightening for those who experience them at any time, and particularly for parents and carers of babies and infants. Within the confines of an aircraft cabin, there are few options for relief. The distress can be particularly acute.

We have the greatest sympathy for those who suffer—or who witness the suffering of their loved ones—as a result of such extreme reactions, wherever they occur, but we must have regard to evidence relating to the incidence and cause of such reactions. There is little published scientific evidence concerning the risks of exposure during travel and the efficacy of any mitigating measures. The risk of nut or peanut allergy, including anaphylaxis, as a result of consumption by mouth is well documented, but evidence of allergic reactions resulting from the inhaling of the allergen is mainly confined to anecdotal case reports. However, I know that airlines try to reduce the risk of serious medical incidents, including allergic reactions, while people are on board their aircraft. It is already standard practice for carriers to request passengers to notify them before travelling if they have any medical conditions, including allergies, so that they can take appropriate action, such as ensuring that wheelchairs and other assistance are available.

Most airlines carry information on their websites which outlines their policy in relation to passengers with allergies. Some have taken additional measures, such as removing peanuts from their in-flight snacks—that has been done by British Airways, among others—or offering to broadcast requests to other passengers not to consume nuts that they have brought on board with them. EasyJet and Norwegian already deploy that strategy. However, few airlines are able to offer or guarantee peanut or nut-free meals. The Daily Mail website today draws attention to my hon. Friend’s constituents the Levitan family, and the problems that they experienced. There is a very fetching picture of the hon. Gentleman and me—and, on the same page, Madonna, who was attending the Grammys.

The International Air Transport Association, a trade body for airlines, has also published detailed information for allergen-sensitive passengers. It includes guidance on the applicable regulations, such as the requirements for aircraft to carry first aid and emergency medical kits, and for cabin crew to be trained in first aid. However, the guidance acknowledges that the detailed regulations are the responsibility of each country, and that there may be variations in the extent of the medical equipment that is carried or the training of cabin crew. Its advice to passengers includes recommendations that they contact a physician before travelling to discuss any related risks, contact the airline once the booking has been made, ensure that prescribed medication is carried in hand baggage, and arrive early at the airport to re-confirm any specific requirements that they have made. Comprehensive advice is also available on the Anaphylaxis Campaign and Allergy UK websites. The Government commend those organisations for their work, which supports the range of other practical help and advice that is available.

We recognise—and we have heard again tonight—that passengers sometimes face inconsistent responses from airlines when they notify them of their history of allergy, and we understand that that can lead to pressure to require all airlines to meet certain minimum standards of support. However, there is a very limited amount of evidence relating to the risk, and the efficacy of any specific mitigation measures. The Government would need to be certain that the benefits of introducing any new regulation, such as a requirement for airlines to make a pre-flight announcement, was proportionate, and would have a significant impact in terms of risk reduction.

I accept that air travel is qualitatively different from other modes of transport, in that there is less opportunity to seek respite from environmental factors by moving. However, aviation competes with other modes on some routes. The measures proposed by the hon. Gentleman would place a duty on one mode of transport—aviation—but not on others, such as ferries and international rail, which compete with it. We should also have regard to the extent to which any actions requested in an on-board announcement might unreasonably limit the freedom of other passengers. For example, a family might have brought their own food—such as peanut butter sandwiches —on to an aircraft, and might have no alternative food to give their children during the flight.

I am, of course, very aware of the issue of freedom. I do not think that anyone is campaigning for a prohibition, which is an important point. However, I have not once met a family who, having been told by others, “One of our children suffers from peanut allergies—please do not eat those peanuts,” would wilfully want to eat peanuts in front of them, I think that most people would comply with such a request if they knew that the health of someone who was exposed to peanuts would be at risk.

I am sure the hon. Gentleman is right. Indeed, the way ventilation works on aircraft may mean that a person who is seated well to the back of a plane and well away from the person with the allergy problem will not pose a risk. There is also interesting information about the effect on people when they smell peanuts. Their reaction may not be entirely an allergic reaction; if a person has had a bad experience before, they would certainly be feeling a degree of stress, which could be a risk to them. We should also not forget situations when peanuts have been served on a previous flight or people have had peanuts on a previous flight. Parents might sometimes want to check the seat so a toddler cannot find peanuts in between the upholstery and then consume it, thereby causing a problem.

We should not impose restrictions on other passengers without evidence that this would be necessary and effective. We should also consider that a carrier is unlikely to be able to guarantee an environment totally free of the trigger substance. For example, an aircraft may have had only superficial “turnaround” cleaning following a previous flight that day, possibly operated by a different airline, and a passenger on the previous flight might have consumed a product containing the allergen as other passengers may bring their own food with them which can contain the allergen.

Furthermore, the effect of such an announcement may be limited. I am slightly ashamed of this, but I am sure that I am not the only airline passenger not to devote my entire attention to each part of the announcements made every time I fly. In some cases language difficulties may also mean that some passengers do not understand the announcements.

Another issue is that if an announcement was to be made in relation to peanuts without clear evidence that the action sought reduced a real risk, there could be pressure to make announcements on other topics, for example other foodstuffs such as cooked fish and chickpeas, which have been linked to severe allergic reactions, or dog hairs which may be present on the clothing of passengers, or indeed an assistance-dog on the flight. The list of substances potentially causing an allergic reaction is long and includes strawberries, eggs, soya, milk and sesame seeds. Also, photosensitive epileptic reactions could be linked to some movies or video games that could be played by a passenger on a device during a flight in the vicinity of a person subject to such attacks.

Where action is to be required by regulation there needs to be an evidence base that it is necessary. I have today asked officials to write to the British Air Transport Association, which represents 80% of UK carriers, asking what its current policy is: whether the declaration should be made as a ticket is booked, which is the current situation; whether carriers should ban nuts from the foods they provide on their flights; and what type of announcement they should make and the practicality of that on some aircraft where the announcements are made via a drop-down video screen rather than by cabin crew over a microphone. I have asked my officials to try and get that information from BATA as a direct result of this debate.

Finally, it is only practical for any requirement to make such an announcement, if introduced under UK domestic legislation, to apply to UK airlines. As a result significant numbers of passengers flying in and out of the UK on foreign-owner carriers would not be covered by such a provision.

I welcome the fact that the Minister has been prompt in deciding to call for the gathering of that information. Will he go a bit further and give me a commitment that when he has that information he will turn that research into some serious policy that will allow for a change, if the evidence is there—I accept that the evidence must always be there to make a decision?

I hope we might not have to introduce legislation. I get the impression that, given the sensitivity surrounding this subject and the publicity it has received as a result of the hon. Gentleman’s actions, many airlines in this country, and indeed around the world, are looking at this and looking at what standardised announcement might be made. I therefore hope we can make progress without the need for legislation, but we will keep all options open, of course. Several of the cases that have received recent media attention and been the subject of correspondence with the Department for Transport have concerned foreign-owned airlines.

I mentioned earlier that the Government take passenger health and safety very seriously. We are aware of the concerns expressed in Parliament on this matter. When it was discussed in another place at the end of last year, I had the pleasure of meeting the noble Lord Mendelsohn and the noble Baroness Kennedy of Cradley on 18 November to discuss and, I hope, allay some of their concerns.

In order to inform this debate, the Department for Transport and the aviation health unit of the Civil Aviation Authority have committed to work with medical specialists in allergies to develop evidence-based guidance for airlines. As a first step, it is intended to commission a review of the scientific literature to evaluate the evidence for a link between environmental exposure to aerosolised food particles and serious allergic reactions, including anaphylaxis, in subjects who have been diagnosed with a food allergy.

The objective of the scientific review will be to identify what, if any, steps could be recommended on the basis of the existing evidence and to identify the need for any further research. In that way, the industry could not reasonably object that the regulation was arbitrary or unwarranted. The regulation would have clear benefits in terms of reducing risk, and it would be easier to secure consensus on any international action necessary to offer protection to those at risk. Once again, I thank the hon. Gentleman for securing this debate and for providing the opportunity to bring this issue to the attention of the House.

Question put and agreed to.

House adjourned.