The next item is the Member debate under Standing Order 11.21—the impact of migraine on children and young people. I call on Mark Isherwood to move the motion.

Motion NDM8074 Mark Isherwood, Rhun ap Iorwerth, Sam Rowlands, Tom Giffard, Mabon ap Gwynfor

To propose that the Senedd:

1. Notes:  

a) the impact that migraine has on the 1 in 10 children and young people who live with it, including at school and their day-to-day lives;

b) that young people who are affected often report that migraine makes it harder to do their schoolwork, meaning that without proper support, the condition can impact their educational attainment, as well as disrupt their family and social life;

c) that research by the Migraine Trust suggests that education and health professionals often do not understand migraine, or have access to training and resources to effectively support children and young people who are impacted;

2. Calls on the Welsh Government to work with The Migraine Trust and representative bodies for schools, health services, and parents/carers to:

a) strengthen guidance;

b) provide training on how to support and accommodate young people impacted by migraine; and

c) provide resources for the parents/carers of children living with migraine and for the young people themselves on how to take control of their own care.

Motion moved.

Diolch. Migraine is a common, painful and debilitating condition that affects an estimated one in 10 children and young people. According to Brain Research UK, the working name of the Brain Research Trust, migraine is one of the most common neurological conditions. Whilst migraine has a significant impact on the lives of adults who live with it, its early impact on children and young people can be even more severe. 

It is a complex condition, with a wide variety of symptoms. For many people, the main feature is a painful headache. Other symptoms include disturbed vision; sensitivity to light, sounds, and smells; feeling sick; and vomiting. The symptoms will vary from person to person, and individuals may have different symptoms during different attacks. Attacks may differ in length and frequency also. Migraine attacks usually last between four and 72 hours. Migraines can have an enormous impact on work, family and social lives.

The cause of migraine isn't known, but it's believed to be a combination of genetic, environmental and lifestyle factors. According to US research, if a child has one parent with migraine, they have a 50 per cent chance of developing migraine headaches. This jumps to 75 per cent if both parents are affected. A family history of migraine is also linked to earlier onset of migraine episodes.

Migraine is the third most common disease in the world, behind dental decay and tension-type headache, with an estimated global prevalence of 14.7 per cent—around one in seven people. According to NHS England, approximately 10 million people in the UK live with migraine. Migraine affects three times as many women as men, with the higher rate being most likely hormonally driven. Research suggests that 3,000 migraine attacks occur every day for each million of the general population. This equates to over 190,000 migraine attacks every day in the UK. 

There are different treatments available for children with migraine, and the most suitable one will depend on their medical history, age and symptoms. Further, migraine is protected under the law. As such, if a child's migraine recurs over a period of a year and negatively impacts on their ability to carry out their normal day-to-day activities, they may be classed as disabled under the Equality Act 2010, putting an obligation on schools to make reasonable adjustments for a disabled child to ensure that they're not put at a major disadvantage. And if an affected child or young person does not have an individual healthcare plan, it may be necessary to discuss developing a plan that identifies their needs and to make suitable tailored adjustments for them. 

The National Migraine Centre state that, because migraine in children can involve subtly different symptoms to adult migraine, half of those affected never receive a diagnosis. With migraines in children and young people, stomach pains are more frequent. Studies suggest that around 60 per cent of children aged between seven and 15 experience headaches, but a diagnosis of migraine may be delayed because tummy pain, vomiting, travel sickness, limb pain and episodic dizziness can all confuse the picture. Children may experience migraine without a headache, which is less common in adults. 

During last month's Migraine Awareness Week, the Migraine Trust launched new research, which found that children often feel left out of their own healthcare and think that their care is poor. The findings also suggest that migraine can limit their ability to take part in education, social activities and other important parts of growing up. Ninety per cent of affected young people report that migraine made it harder to do their school work, whilst 76 per cent of education professionals surveyed felt that their school did not provide information, resources and processes to help these children. It can also be hard for children to understand and explain their pain, and there are fewer treatment options for them than there are for adults. The Migraine Trust report, 'Dismissed for too long: the impact of migraine on children and young people', therefore calls for clearer guidance and training for both health and education professionals on understanding and supporting young people impacted by migraine, and for more resources for the parents and carers of children living with migraine. They suggest that young people themselves need more information about their condition and how to take control of their own care, and that pathways and reviews of local migraine care in the NHS should account for the impact on children and young people. 

Key findings of the report include that schools don't have the knowledge or policies in place to help children with migraine. A survey of parents and carers with a child living with migraine found that 70 per cent were concerned about the impact of migraine on their child's education. Asked how often their child had to stay home from school because of their migraine, over half—51 per cent—said at least once a month. And 85 per cent of parents and carers had spoken to their child's school about their migraine, but only 17 per cent were completely satisfied with the support from the school in managing their migraine. 

A survey of children with migraine found that 90 per cent said that their migraine made it harder to do their school work. However, when asked if they think that their school has the information about migraine to help them manage it at school, 64 per cent said no. When asked if they had ever been taught about migraine at school, 90 per cent said that they hadn't. A survey of 64 education professionals found that three quarters, 76 per cent, felt that their school did not have the information, resources and processes to help children in school with migraine. For example, school policies were often not geared towards helping children manage their migraine triggers and avoid being unnecessarily sent home. This compares to other common long-term conditions, such as asthma, which schools often have plans in place for. 

Children don't feel that they're getting the healthcare they need. Common symptoms of migraine in children, such as abdominal pain, often look different from adult symptoms and can be missed, which can slow down a diagnosis and may result in a child's symptoms being missed. Of the children and young people responding to their survey, 33 per cent felt that the treatment for their migraine was poor, 30 per cent said it was fair, 23 per cent said it was good, and only 8 per cent said it was very good. None described it as 'excellent'. Seventy two per cent of the children with migraine have said that it made them feel worried. Children, particularly younger children, often need help in explaining their migraine and need to be included in discussions about their treatment. There needs to be better communication, where possible, between health services and schools and colleges. As a case study in the report states,

'I missed a lot of school last year because of my migraines and I couldn't do the things I enjoy such as football and dancing and that made me sad.'

The report's recommendations on how problems could be addressed include that local health boards,

'must include children and young people in reviews of local migraine needs and ensure they have services to meet those needs.' and that local health boards,

'must ensure there are strong links between migraine care and mental health services. Mental health must also be a component of the healthcare pathway for children with migraine'.

The Welsh Government should explore ways that it could support pharmacists' training on the management of migraine in both adults and children, and work with education partners to ensure that teaching staff have training and information on this issue, so that they can support children and young people effectively. As a 2021 academic review into children and migraine states,

'Migraines negatively influence the quality of life of affected children. Early diagnosis and management decisions are needed to reduce the burden and maximize the treatment outcome.'

The Migraine Trust would welcome working with the Welsh Government and health boards on making progress in these areas, and as our motion states, we call on the Welsh Government,

'to work with The Migraine Trust and representative bodies for schools, health services, and parents/carers to (a) strengthen guidance; (b) provide training on how to support and accommodate young people impacted by migraine; and (c) provide resources for the parents/carers of children living with migraine and for the young people themselves on how to take control of their own care.'

Migraine in children and young people is common, with a considerable impact upon quality of life, yet it remains undiagnosed and poorly treated. Less than 10 per cent of children with problematic headache will seek medical help for their problem. Migraine can have severe impacts on the life of a child, affecting family relationships, school life and social activities.

The pattern of migraines in teenagers starts to change. Migraine affects boys and girls equally until puberty, after which migraine is more common in girls. A late or missed diagnosis can result in poor management of their symptoms, anxiety about future attacks, poor school attendance, inappropriate or ineffective medication use, a loss of confidence and low self-esteem. Severe pain and vomiting that aren't treated effectively can mean that children often have to remain at home during their attacks and are unable to participate in normal daily activities. I move and commend this motion accordingly.

I thank Mark Isherwood for that presentation to the motion. Of course, fair play to him—he's a very intelligent man; we've heard a great number of statistics relating to people who suffer from migraines. But there is a face for each of those statistics. There are lives being affected that lie behind all of those statistics, and I have loved ones who live with migraines, and who are therefore part of those statistics.

Now, I’m sure that we all hear people making light of migraines from time to time; maybe babbling to someone can bring on a migraine, as some people say, or when someone is suffering from a migraine, the advice is to sit in a corner and take a paracetamol. But it's not only a headache; a migraine is more than that. That does an injustice to the condition and to those who suffer from it, because it is so much more than just a headache, and as the motion states, it has a detrimental impact on people's daily lives, and the lives of children.

I had the privilege of hosting a drop-in event with the Migraine Trust recently—and I thank everyone who attended that event—and having an opportunity to talk to people who understand the subject and who specialise in the area, was eye-opening. From understanding the different things that can lead to a migraine, such as stress or even inconsistent eating patterns, to the fact, as Mark Isherwood said, that a migraine can be in the stomach, and that link between the brain and the stomach coming to the fore once again. But, unfortunately, not many people know why they are suffering from migraines, or what leads to an attack of the migraine. Understanding of the disease is very shallow in the scientific community, let alone among lay people, and if that understanding is so shallow in the specialised world, then how can we expect teachers or colleagues to recognize the symptoms and be able to ensure that steps are in place to help people who are having a migraine attack?

This motion is modest in nature, it's not asking for much. But it's an important first step in the right direction, which will help to increase understanding and awareness. Finally, could I therefore take the opportunity to thank the Migraine Trust for its work in the field and its willingness to collaborate with the Government, health boards and other authorities in order to achieve what it's asking for? Thank you very much.

I want to thank my colleagues for tabling this debate this afternoon. Migraine is a curse for those who suffer from it. In adults, it can be debilitating, but for young people, adolescents in particular, it can have a major impact on their schooling, their families and their social lives.

Deputy Presiding Officer, I am not entirely sure what the current Welsh Government guidance is for schools on managing migraine. I could not find anything on the Welsh Government website; Public Health Wales is also light on this subject too. There's a brief reference to migraine at work, but nothing I could see on schools and how to respond. My feeling is that the motion is right to call for strengthening of the guidance, and I believe that we should consider how to support schools and their teachers in addressing a range of issues that would positively impact on those who suffer with migraine.

In particular, I would like the Minister to consider: what can be advised around the nature of the school environment, especially the lack of ventilation; individual pupils being supported to eat and drink to address the risks associated with a lack of nutrition and dehydration, which could be a cause of migraine; and the development of school policies for those with enduring conditions, such as migraine and how the school can manage this, especially in supporting any treatment that a young person might be on. We should also attempt to learn more about the numbers of young people with migraine—what data do we have, what does it tell us, and what else do we need to know?

I'd like to think that some relatively straightforward steps might remind our schools about the challenges that young people with migraine encounter, and support ways in which the risk of a migraine attack could be mitigated. This is an important issue. It is not one that has had much attention, and I am pleased that we are considering this today. Thank you.

I was very pleased to co-submit this debate today. It's clear to me and to other Members, as we've already heard, that there is far more that needs to be done in order to assist the high number of children and young people who do suffer migraine regularly in Wales. It's a huge problem that's been ignored for too long, if we're honest, and, too often, it is treated like any other short-term illness, but it's more than that.

The truth is that migraine is a neurological condition that can have serious consequences in the long term on a child's educational performance, never mind their self-confidence and their social lives. Children who suffer migraine can miss up to three months of school per year—we see that in statistics. We need to do more to tackle that issue, clearly, and that's what we're calling for today.

The Migraine Trust and other organisations offer a way forward, including providing the right support, not just to those who are suffering, but also to teachers, parents and the carers responsible for those children.

Research also shows that teachers are uncertain when it comes to helping individuals with migraine, but simple steps can be taken in order to alleviate the pain—drinking enough water, having access to a dark room, possibly. But, at the moment, schools and teachers aren't adequately trained to help pupils through these experiences. Almost 17,000 unnecessary trips are made to hospitals every year because of migraine. By providing better training, I'm confident that that number could be reduced, reducing the stress on the health service, and of course ensuring that children don't miss school too, which is key.

There are examples of good practice in Wales. In north Wales, for example, patients have seen benefit from the opening of the Walton Centre in Holywell. It's reduced waiting times for patients with serious neurological conditions. But, unfortunately, the same services aren't available in all parts of the country, and that's a well-rehearsed story, of course. And, generally speaking, there are huge problems in terms of waiting times, the resources available to patients, including children. People can be waiting up to two years for treatment in certain cases. At the moment, only three of the seven health boards, I believe, have the resources to treat the most serious neurological cases. Simply, we need a national plan to enhance services for migraine, to correspond to the fact that so many people are suffering as a result of migraine.

But there are other practical steps that can be taken too to improve the quality of life of children and people who do suffer: improving training for teachers, as I've mentioned; sharing guidance with children and young people as to how to manage their own care; and, yes, improving the provision of care through the health service for those who suffer most. The Government needs to tackle what is the country's most common headache, but, as we've already heard, which is far more than that too, and that is to ensure that it doesn't have too great an influence on the educational and social lives of our children and young people. And that's why we're asking the Senedd not only to note the motion as it appears before us, but also to support the principles underpinning what we've brought forward today.

I call on the Minister for Health and Social Services, Eluned Morgan.

Diolch yn fawr. And I'd like to thank Mark Isherwood for raising this really important issue. Mark, I can always rely on you to teach me something new in these debates—you always have so many facts and figures at your fingertips, and they're always very useful for us to take note of, and certainly I'll be making sure that we take note of those and follow up some of those issues. Forgive me for not being in the Chamber today.

Migraine is, as we've heard, one of the most common neurological conditions, and yet we very rarely speak about it and its impact in this Chamber. Many of us will have had first-hand experience of migraine, or some insight into the enormously debilitating impact it can have on sufferers and their quality of life. And as we've heard this afternoon, migraine is a severe and painful long-term health condition—so much more than just a really bad headache. And unfortunately, for the majority of children and young people with migraine, this will follow them into adulthood.

And perhaps the cruellest aspect of the condition is its ability to strike with little or no warning, and with no rhyme or reason, disrupting and upsetting really special occasions and everyday events. And the potential for disruption to children, as many of you have noted, and young people's education, their ability to learn and their ability to take part in all other aspects of school life, can be clearly understood. And I understand this, as my eldest brother was someone who suffered migraines and took literally months off school, affecting his education considerably.

Now, in the time I have this afternoon, I want to highlight some important measures that are already in place to support children and young people in a learning environment. Now, under section 175 of the Education Act 2002, local authorities and governing bodies must make arrangements to ensure their functions

'are exercised with a view to safeguarding and promoting the welfare of children' in school or other places of learning. This includes supporting children with healthcare needs.

Now, to support this, our 'Supporting learners with healthcare needs' guidance contains both statutory guidance and non-statutory advice to support learners to ensure minimal disruption to their education. This emphasises the need for a collaborative approach from education and health professionals, placing the learner at the centre of decision making, and of course it's important also to involve parents. 

It's further supported by quick guides for staff, parents and young people. Health professionals would be involved in the preparation of an individual healthcare plan to address any health needs that impinge on the child's or young person's time at school. We've got some good examples of where requirements and the spirit of the Act and its guidance are being put into practice. Aneurin Bevan University Health Board has developed a recovering from illness paediatric service, designed specifically to meet the needs of children and young people who are coping with illnesses. The team works with children, young people and their families to support them in coping with the very real challenges of having a health condition and aims to help them manage symptoms that can get in the way of doing things that really matter to them. 

Almost all of the children and young people referred to the team have difficulty in reaching the required attendance rates in schools. A crucial element is collaboration with schools and primary care practitioners to help these young people to access education in a way that is appropriate to their needs. That includes having discussions with parents, of course. 

The team have planned a support pack which includes guidance to be used in school to help to identify, understand and support children and young people who may be having difficulty in accessing education and who need support or additional intervention. And although this was originally planned for children with symptoms related to long COVID and other illnesses that cause chronic exhaustion and pain, the package can be used with many of those children suffering with symptoms that can interrupt their education.

Legislation, advice and guidance are important, of course, but the work developed by colleagues at Aneurin Bevan health board gives us an example of how to translate this into something practical that makes a very real difference to people and their outcomes. The work developed within Aneurin Bevan has been peer reviewed across all health boards, and plans are in place to develop this in a 'once for Wales' support plan. 

Dirprwy Lywydd, any interruption to a young person's education can have a life-long impact, but with the right support this can be mitigated. Together, we all have an important role to play, and we must play our part together to create the necessary environment to allow this to happen. Measures are already in place to allow professional and agency collaborations with organisations such as the Wales Neurological Alliance. We as a Government are supportive of the work of the Migraine Trust, but it's important that our partners that deliver services on the ground can be flexible in the way they create their own partnerships. 

Migraine is one of over 250 neurological conditions, many of which are supported by third sector organisations, which do excellent work, of course. But it would be impossible for us as a Government to work with each and every one of those individually. Representatives of the Migraine Trust could ask to become members of the Wales Neurological Alliance, and this would create a mechanism whereby they could work closely with the Welsh Government. 

Children and young people who have any healthcare needs, including migraines, must be supported to deliver their full potential, and that is what we will be doing within Welsh Government. Thank you.

I call on Sam Rowlands to reply to the debate. 

Thank you, Deputy Presiding Officer, and in closing today's important debate I ought to thank my colleague Mark Isherwood for submitting today's Member debate and also my fellow co-submitters Tom Giffard, Rhun ap Iorwerth and Mabon ap Gwynfor. I also thank the Minister for her response in appreciating today's points. As outlined by Mark Isherwood in opening today's debate, amongst a number of statistics that Members have commented on, one that really struck me was the simple fact that it's one in 10 children and young people who live with migraine. And, of course, this has a significant impact on their day-to-day lives, along with their time in school. I'm sure many Members—and it's already been mentioned—in this Chamber know of family members or friends on whom migraine has such a significant impact and suffer from it greatly.  

As outlined by Rhun ap Iorwerth, if a child suffers from migraines, this can often lead to children struggling to complete to their schoolwork, showing that, without proper support, migraines can severely impact educational attainment. And one thing that struck me during this debate this afternoon, as mentioned by Mabon ap Gwynfor, is the fact that research by the Migraine Trust has suggested that education and health professionals, regretfully, don't often understand migraines, and, as Altaf Hussain outlined, it's those professionals perhaps who sometimes don't have access to the training and resources to effectively support children and young people who are impacted by migraines. 

Of course, there are actions that can be taken to help those children and young people who are suffering, and these have been eloquently outlined by Members during today's debate. Minister, whilst you outlined some of the current work and shared a clear understanding of the concern around migraine, I'm not sure we'd be having this debate today if we felt that all those actions were working, and working well right across Wales. As today's motion outlines, now is the time to see Welsh Government working with organisations like the Migraine Trust and representative bodies for schools, health services and parents and carers in whatever forum works best. Minister, you outlined that there's perhaps an opportunity for the Migraine Trust and others to come alongside other forums to understand this issue more clearly; I'm sure that would be welcomed. 

But it's clear to me—and in the motion today it's outlined—that we need to see the migraine guidance strengthened, we need to see training provided to support and accommodate young people impacted by migraines, but also provide resources for parents and carers of children living with migraines, and also enable children and young people to learn how to take control of their own care at the same time as well. 

So, Deputy Presiding Officer, in concluding today's debate, I thank all Members, along with the Minister, for their contributions. It's been, I would say, an extremely useful and insightful debate, and, in addition to this, Members of the Senedd today have a great opportunity in supporting this motion that will do so much in providing support and guidance to young people and children who suffer from migraines. So, I call on all Members to support today's motion. Diolch yn fawr iawn. 

The proposal is to agree the motion. Does any Member object? No. The motion is therefore agreed in accordance with Standing Order 12.36. 

Motion agreed in accordance with Standing Order 12.36.