Health: Allergy (Science and Technology Committee Report)

My Lords, this Select Committee report is particularly timely. Under the excellent chairmanship of the noble Baroness, Lady Finlay, it produced a thorough, thoughtful and constructive review of the rising incidence of allergies in the United Kingdom and, helped by its excellent secretariat and its specialist adviser, Professor Kay, produced a set of constructive and sensible recommendations. However, I found the Government’s response disappointing in parts and in some cases dismissive. I strongly endorse the remarks made by all the previous speakers, particularly by my noble friend Lady Finlay in opening the debate, and join with the noble Lord, Lord Haskel, in asking for the report to be read again, recognising that it contains important comments expressed thoughtfully by a lot of well informed people. I wish to relate my next point to a somewhat wider area that the noble Earl, Lord Selborne, covered in detail and elaborate on the decision made nine years ago to recommend to women that they avoid eating peanuts when pregnant and avoid exposing their children to peanuts. I thought then that the advice was not well founded but I recognise that that was debatable at the time. I am given to making gestures in the Chamber as a substitute for using PowerPoint, but this time I shall not distribute my papers all over the Bench in front of me. Since then we have seen a linear rise in the incidence of peanut allergies. I understand as well as the next person that correlation is not causation. There is also the hygiene hypothesis—we have heard about this and I shall not elaborate on it further—that we live in an excessively hygienic environment and people’s immune systems are more disposed to develop pathologies. I recognise that that is not proven, and even if it were, it would not necessarily conclude that eating peanuts was advisable. None the less, careful epidemiological studies show that in Israel, where infants are exposed to peanuts, there has been no corresponding rise in the incidence of peanut allergies. The rate is low and flat, whereas our incidence of such allergies has risen even with the advice I mentioned. In Africa, children are also commonly exposed to peanuts and have no allergies. There could be genetic differences. I realise none of those points amounts to a proof that you should tell people to rush out and expose children to peanuts, but in my mind they amount to a powerful argument for reviewing the advice not to. The Government’s response to that particular recommendation was to say that they did not think it appropriate to withdraw the advice without having alternative advice to replace it. Fair enough, but I think the advice that ought to be given now, in the light of the additional facts we have gathered over those nine years, is that we do not understand this well enough to issue advice definitely one way or the other, but the indications are that there is no harm in eating peanuts. From my five years as chief scientist, I realise how uncomfortable Governments are with saying that they do not know, and yet the protocols for science advice in policy-making—issued under John Major in 1996, reviewed by myself under Blair in 2000 and further strengthened by my successor—say that you consult widely and openly, you review changing circumstance and you admit uncertainty. That, in fact, engenders confidence in the public. That leads me to my final brief point. The noble Earl, Lord Selborne, elaborated very cogently the other piece of evidence that receives generally less attention—namely, that research into the fundamental aspects of how the immune system first creates itself somatically in the first three years of life is difficult and not fashionable. On the molecular details of some of the actual allergies that have arisen, we are among the world leaders, but the world as a whole finds it unfashionable to look at this question. The immune system is not coded in the genome. What is coded in the genome is a programme to assemble itself. The conjecture is that if it is not appropriately sufficiently challenged, it goes looking for inappropriate work to do, hence a rise in allergies. Maybe that is right; maybe it is wrong. This requires a fusion of people who work on non-linear dynamical systems with people who do careful clinical epidemiological work. As we heard in the report, and as was emphasised by the previous speaker, one of our recommendations is that it receives more attention. If I were the Secretary of State for Health, I would bring together an informal group of people from research in the National Health Service, the Wellcome Trust and relevant research councils—because this is not just a Department of Health responsibility—to ask whether there may not be some kind of coalition that puts a little bit more effort into soliciting this kind of unfashionable, multi-disciplinary research, where the potential researchers have told us they are finding difficulty getting funding.