Complications from Abortions (Annual Report) Bill [HL]

Baroness Finn Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

[Lord Moylan (Con)]

My Lords, it might be helpful if I spoke next so I could update the House on various developments that have taken place since Second Reading. I am grateful to the noble Baroness, Lady Thornton, for her remarks about the importance of improving data and the importance of that data for women’s health. Nearly all of the other points she made were dealt with and debated at Second Reading, which the noble Baroness was unable to attend.

However, the fact is that there is nothing in the Bill which exceptionalises abortion, because the statistics on abortion complications already have to be collected under the existing abortion regulations using a system that relies on data provided by the abortion provider. That might have been sensible when the regulations were put in place, but currently the majority of abortions take place by the use of pills at home. Therefore, if there are complications, they are presented, in most cases, at hospitals in A&E and they are not part of the abortion notification system, so the majority of those complications are no longer captured by the current system.

The royal college says it is impossible to capture the complication statistics, but it seems to be completely unaware that, in November 2023, the Office for Health Improvements and Disparities produced a report that, with some labour, did actually capture them and showed that it could be done. All that is in this Bill is a requirement that that report, which is being treated by the department as a one-off and not to be repeated, should be repeated. It is wrong to suggest that this cannot be done; it has been done, and it can be done again.

I want to be brief, as I am conscious of the words of the Chief Whip before we started. I will move on to some developments that have occurred since Second Reading, because at the end of Second Reading, thinking that perhaps the Bill would not proceed to Committee, I tabled some Written Questions on this matter. I had one reply from the noble Baroness, Lady Twycross, on behalf of the Cabinet Office, which effectively introduced me to Mr Ed Humpherson, the director-general for the Office for Statistics Regulation, with whom I have since had correspondence.

Before I read from his letter to me of 20 February, I will remark that, as was mentioned at Second Reading, these statistics are referred to as national statistics and they are required to comply with the statistics code. In that light, the last compliance check was carried out in 2012 and because of that, Mr Humpherson says: “We have agreed with DHSC that a compliance check of the statistics would be beneficial”. A great deal of what the Bill seeks to achieve is likely now to be pursued by the Office for Statistics Regulation in consultation with the DHSC. Since it is very unlikely that any compliance check would consider that the current system was successfully capturing complications arising from abortions, I am therefore very pleased with what Mr Humpherson said.

I will continue with his letter a little bit, because my pleasure at his agreement to carry out a compliance check is slightly modified by his timetable and approach. He goes on to say: “We plan to carry out this review in the first quarter of 2026/27, giving DHSC time to undertake its planned developments. These include supporting data providers to move to DHSC’s digital submission system and working with digital experts and system users to improve the design of the Abortion Notification System”. I am certain that the noble Baroness, Lady Thornton, and I would agree that that work would be very welcome. My only quibble with Mr Humpherson—and I have written to him to say this—is that I would have thought the sensible thing would be to have the compliance check first, in order to identify the deficiencies and agree between DHSC and the regulator what the deficiencies are, and then for the department to invest in the digitisation of the collection of the statistics in such a way that they will comply with the regulator’s requirements.

When the Minister comes to reply, I am sure she will say that she will collaborate fully with the Office for Statistics Regulation and its work, because I fully expect the department to do that—it is the responsible thing to do. Can she agree that she will consider whether this is being done in quite the right order? Would it not be sensible to bring the compliance check forward so that the developments being carried out, which will involve investment and time, are not wasted but achieve what the regulator will be satisfied with at the end of the day?

[Baroness Finn (Con)]

My Lords, I apologise for not being able to attend Second Reading. I begin with the observation that, as a healthcare service, abortion is highly regulated and subject to the same oversight as any other care. As a result of the Abortion Act 1967, it is also subject to additional oversight which predates many of the regulatory and monitoring systems in place across the health service today.

This context is relevant to the Bill before us, which seeks to build on this 58 year-old framework. I am wholly in favour of monitoring all forms of healthcare provision and entirely agree that further work needs to be done on the collection and analysis of large datasets relating to women’s reproductive health. However, I have concerns that this Bill in primary legislation is not the best way to approach this important work.

I am aware that both the Royal College of Obstetricians and Gynaecologists—the RCOG—and the British Pregnancy Advisory Service have shared with noble Lords their concerns that, as the noble Baroness, Lady Thornton, has said, singling out abortion for new legislation in this way exceptionalises it and fails to treat it like other forms of healthcare. This would potentially stigmatise abortion care for both women and the medical professionals who provide the care. It would also indicate that abortion is considered to be such a high-risk intervention that it is in need of particular oversight.

The RCOG points out that abortion is a “safe and effective procedure”. Some one in three women in the UK will have had an abortion before the age of 45 and international studies have repeatedly found that abortion is of less risk to women than complications that can arise from continuing a pregnancy to term and giving birth. As a result, I am concerned by any indication that this House considers abortion to require increased monitoring and oversight, over and above that of comparable healthcare, and indeed the message that it would send to the nearly 300,000 women who access abortion services across the UK every year.

I agree with my noble friend Lord Moylan that we need to improve collection of data, but this must be done across women’s healthcare more broadly, and I would be interested to hear from the Minister about what plans the Government have to achieve this. We know that in many areas, women wait a disproportionately long time for diagnoses of devastating conditions, such as endometriosis, and in that time often suffer complications that come from lack of treatment.

It was for this reason that the previous Government published the widely welcomed, first ever women’s health strategy for England, to take a holistic approach to women’s healthcare. I pay particular tribute to my former colleague, Emma Dean, for her tireless and excellent work to make this happen. We also appointed the brilliant Dame Lesley Regan as the first women’s health ambassador to support the implementation of this strategy. I was pleased to note that the Minister for Secondary Care confirmed in the other place the Government’s commitment to the women’s health strategy, though I am concerned about the lack of progress against the strategy’s widely welcomed commitments, especially the Government dropping targets for ICBs around the creation of women’s health hubs. The RCOG has said that the existing hubs have reduced unnecessary referrals, provided training opportunities for professionals and enabled women to access support quickly.

The NHS 10-year plan and monitoring of the women’s health strategy would, I hope, offer an opportunity to address the challenge of good monitoring without adding unnecessary legal burdens to the healthcare system. I hope that we can all agree that the purpose of this monitoring has to be to improve information and care for women, and that singling out abortion is unfortunately likely to do more harm than good.

Before I close, I want to touch on the practicality and operability of this legislation. I understand that the information currently used by the department to produce abortion statistics, such as the type of abortion, gestational age, and information about women accessing care, is separate in the majority of cases from a woman’s broader healthcare record. It seems incredibly important to protect this right to privacy for women accessing abortion care, particularly for women at risk of domestic abuse, honour-based abuse or reproductive coercion. I know that my noble friend will not want to place women at risk as a result of this legislation, so I wonder if the Minister can confirm that the department is able to link abortion records with wider healthcare records in the way this legislation would require, and if so, whether that would mean that abortion care would appear on a woman’s medical record, whether or not she had given consent.

Given my concerns about the impact of the proposals in the Bill on women and the wider healthcare system, I am not able to support it in its current form and support the noble Baroness, Lady Thornton, in her opposition to the clause standing part.

[Lord Weir of Ballyholme (DUP)]

My Lords, I join others in apologising for not being here at Second Reading—on medical grounds, in my case—which seems to be a consistent theme in this debate. In looking at the amendment and legislation today, it is important that we actually focus on what is there rather than debating—I appreciate that the noble Baroness does not intend to push this to a Division—something that is not there.

King’s Speech

Baroness Finn Excerpts

Thursday 9th November 2023 Lords Chamber

[Baroness Finn (Con)]

My Lords, it has been a pleasure to listen to so many eloquent, insightful and passionate contributions in this debate on the gracious Speech. I rise to speak in favour of the Government’s leasehold and freehold reform Bill, which represents a crucial step in eliminating the opaque management fees, exploitative ground rents and short leases associated with leasehold tenure. Many noble Lords and Members in the other place have campaigned on this for many years. I pay particular tribute to my noble friend Lord Young, the noble Earl, Lord Lytton, and the noble Lord, Lord Kennedy, for their tireless advocacy.

In moving the Motion for an humble Address, my noble friend Lord McInnes pointed out that leasehold reform was first announced in 1952 and that too little has happened in the intervening years. My daughter, who is pretty apolitical, announced that she would vote for any party that finally ended the unfairness of leaseholds; I am pleased that we are possibly giving her a reason to vote Conservative.

We say that an Englishman’s home is his castle, but that is sadly not the case for the owners of more than 5 million homes across England and Wales that languish under leasehold covenants. Some examples of exorbitant charges include: a £60 consent fee for replacing a doorbell; a £360 charge for a new doormat; and, unforgivably, a £250 consent fee to have a pet dog. The leasehold system has been described as feudal, but such mercenary practices would give even the Sheriff of Nottingham a run for his money.

This has been a long debate and several noble Lords have already spoken on these points, so I will restrict my comments to three important reforms in this Bill. The first concerns service charges and management fees. The Bill will bring such opaque fees into the light by requiring transparent, standardised service charges. This will end exploitative practices, such as charging a 50% commission on buildings insurance, and will prevent management companies treating service charges as profit-making schemes.

Secondly, I turn to ground rents. In the past decade, developers of new-build homes have sold leaseholds to unsuspecting customers, promising low ground rents while auctioning the freehold to investors. These investors can then exploit the new home owners with unfair and opaque service charges, as well as charging them a fortune to rectify the situation. This Government have already legislated to cap all new ground rents at a peppercorn rent; this Bill takes the next step. In England and Wales, all new houses will be freehold. This will ultimately sound the death knell for leasehold houses and put an end to sharp practices by predatory developers and investors.

Thirdly, on short leases, ending the creation of leasehold houses is welcome but will do nothing for existing leaseholders. Currently, leaseholders have a right to extend their tenure by 90 years, but that is perilously close to the 80-year cut-off where people face exorbitant marriage value costs to secure their home. This has been tolerated by the housing system for too long, so I welcome confirmation that the Bill will abolish marriage value. This Bill will increase the standard lease extension tenfold, from 90 to 990 years, and will remove the requirement for two years’ ownership from eligibility for lease extensions. These are all welcome changes, but they beg the question as to why the Government do not simply finish the business and abolish the leasehold system entirely.

On that note, I turn to the main area of weakness in the Bill. Of the 5 million leasehold properties in the UK, 70% are flats. I am disappointed that this Bill neither stops the creation of new leasehold flats nor sets out a path out of leaseholding for existing flats. There is an alternative system, as many noble Lords have pointed out, which is commonhold. Unlike leasehold, with commonhold there is no limited tenure and no requirement for a third-party overseer, while the home owners have total control over the management and administration costs. In 2021, the then Secretary of State committed that the legislation was the beginning of even more fundamental change to English property law through the widespread introduction of the commonhold tenure.

Despite the commonhold model being widespread in Scotland—they abolished their feudal rent and feu duties in 2004—we have only 20 commonhold developments. The Law Commission’s 2020 report into commonhold states that it is the preferred alternative to leasehold. I would therefore have welcomed a commitment by the Government, by the Minister, to restate that we are moving towards the commonhold tenure system and to implement the Law Commission’s recommendations in full. Is that indeed the Government’s final intention?

The debate today also encompasses public services. Like many people, I have been dismayed by the accounts of the growing debacle of HS2. It is a sorry story of poor planning, mismanagement and overspending. I read that the Cabinet Secretary had received a request from a senior government adviser for an investigation into the Permanent Secretary at the Department for Transport over the mismanagement of this project. Astonishingly, it is alleged that he forwarded the request directly to the Permanent Secretary for a response. I cannot verify whether such an account is correct, but the root cause of this debacle is a lack of accountability, which is felt through our increasing inability to get the basics of public services right or to build large infrastructure products on time or on budget. My noble friend Lord Maude recently—well, actually, a while ago—completed his review into the governance and accountability of the Civil Service. We look forward to the recommendations with keen anticipation, and I hope that the Government will not delay its publication any longer.

The NHS

Baroness Finn Excerpts

Thursday 5th July 2018 Lords Chamber

[Baroness Finn (Con)]

My Lords, I thank the noble Lord, Lord Darzi, for introducing so beautifully this important debate. In an age where some view suggestions of NHS reform as heretical, I welcome the opportunity to put down ideological swords and approach the NHS and the issue of social care with the clarity of debate that our healthcare system so desperately needs.

Lots of people, including my family and close friends, rightly testify to the wonderful care that they have received from the NHS. I do not yet have grandchildren and congratulate the noble Lord, Lord Winston, and my noble friend Lady Morris on their recent arrivals, but St Mary’s in Paddington looked after me very well when I had both my children on the NHS, so I understand the emotional attachment that we have to the noble ideal of the NHS and the numerous examples of superlative care experienced.

However, although we are often told that the NHS is the envy of the world, it is not the envy of the developed world. The UK healthcare system consistently receives mediocre rankings in international reports. Even the Commonwealth Fund report ranked us last but one for healthcare outcomes. We need outcome-driven improvements to our National Health Service, as those matter most to patients.

There have been and will be many important contributions today from those with direct experience of the NHS. I shall therefore limit myself to three short observations. We must invest in early diagnosis. The UK has lower cancer survival rates than comparable health systems. The cost of late diagnosis can be up to four times that of early diagnosis, which in turn dramatically improves the chance of cure and survival.

Secondly, we need to help to transform a culture in the NHS that can be resistant to innovation. Without this, reform will prove ineffective. Healthcare professionals must absolutely be able to speak up for the benefit of patients without the risk of victimisation. The national guardian, Dr Henrietta Hughes, is leading a positive culture change by publishing case reviews to support the proper treatment of whistleblowers. Our remarkable NHS staff are our greatest asset and a rich source of knowledge. They must be empowered to identify concerns and provide solutions.

Finally, we must have a proper debate about the funding of the NHS. It is simply wrong to perpetuate the myth that any alternative to the current system is a malicious attempt at privatisation. It is not a binary choice. We all agree that healthcare in this country should be universally accessible. This was the original and great gift when the NHS was created. Although every developed economy now provides its citizens with universal access to healthcare, none has copied the UK model. Other healthcare systems—in Germany, the Netherlands and Switzerland—offer feasible alternatives that deliver not only better value for money but better outcomes for patients. We know that the NHS needs more money, but we should not presume to know how to get it.

I welcome the proposal of a cross-party commission, but if we seek a sustainable future, we must keep an open mind, fairly evaluate alternative regimes and resist the narrow dogma that hampers rather than protects the NHS.

NHS: Cancer Treatments

Baroness Finn Excerpts

Thursday 25th January 2018 Lords Chamber

[Baroness Finn (Con)]

My Lords, I pay tribute to the noble Baroness, Lady Jowell, for calling such an important debate. She shows the dignity and courage in confronting her illness that have characterised her approach throughout her inspiring career in public life. It is typical of her selfless determination that, passion and energy undimmed, she is still fighting to ensure that everyone receives the best care.

Cancer is one of the most feared words in the English language. It represents a terrifying diagnosis. It is the number one cause of untimely deaths in Britain. Cancer has touched all our lives, and we should fully support anyone who wants to try an innovative drug or treatment. When confronted with dreaded words such as “malignant”, “inoperable” and “advanced”, surely any alternative that offers hope is better than none. There is another important reason to allow patients to take the risk of different innovative treatments. Quite simply, there will be no cure for cancer unless patients can receive them.

Many cancer patients talk of the wonderful care they receive from the NHS, but, as others have pointed out, this should not blind us to the fact that, of the top 30 countries that offer universal access to healthcare, the UK is in the bottom third for cancer survival.

Time is necessarily short, so I will make three brief observations. First, we fail to invest sufficiently in the early diagnosis of cancer. If caught early, the chances of cure and survival are dramatically improved. In some states in the USA, there has been a concerted effort to try to catch lung cancer with CT scanning and the pioneering use of keyhole surgery.

Secondly, the Government need to help transform a culture in the NHS that can be resistant to innovation. When a patient is handed a terminal diagnosis and only standard treatments that do not work, the patient dies, and so does any chance of finding a cure. We need to ensure that our remarkable NHS staff are developed and empowered to adopt and interact quickly with the innovations that become available, both in the UK and overseas.

Thirdly, there needs to be a broader argument about the reform and funding of the NHS to put this on a long-term sustainable basis. My honourable and, indeed, very good friend Nicholas Boles, who has been cured of cancer twice, rightly praises the outstanding treatment he received from the NHS. He has proposed that the NHS should be given its own stand-alone funding stream, perhaps through hypothecated national insurance contributions. The debate is certainly urgent and long overdue.

To quote Dylan Thomas, from my native Swansea, most patients when confronted with terminal cancer and the possibility of dying do not want to go gentle into that good night. Like the noble Baroness, they want to focus on staying alive and take the risk of adaptive trials. They should be able to rage against the dying of the light by trying innovative treatments to keep their hope alive.