Social Media and Health

Baroness Jolly Excerpts

Tuesday 30th April 2019 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for repeating this important Statement. This discussion provides a good backdrop to the debate to follow, on the online harms White Paper. There are essentially two matters of concern here: online harm and false news, which includes the health impact of anti-vax material.

After the scandal that followed the death of Molly Russell, and the bravery of her father in speaking out against the online harm perpetrated by platforms such as Instagram, we were promised decisive action, and the tragedy gave serious momentum to the content of the online harms White Paper. Mr Russell tweeted a link to a Telegraph article yesterday, saying that he had challenged Instagram and the company has said that it will now act. Coming out of yesterday’s hour-long meeting with the industry, the Secretary of State announced a few hundred thousand pounds in donations to the Samaritans for research into online harm, which is of course welcome. However, these social media platforms must be made to take responsibility for the harmful content and dangerous fake news they host.

Instagram said that it would ban all graphic and non-graphic images of self-harm in February. As far as I can see, it has not done so. Like my honourable friend Jon Ashworth MP in the Commons earlier, I did a test a couple of hours ago. To be more accurate, since I am not an Instagram subscriber, I got my researcher to demonstrate for me what happens if you type into Instagram’s search engine the term “self-harm”. You get several columns of results; the first is called “Top Results” and does not produce any links. It says that no content can be found, which is good, but I am afraid the content is still there. If you click on the next column, headed “Accounts”, there are hundreds of accounts concerning self-harm that you can access. If you click on the third column, headed “Tags”, there are 725,000 posts that mention self-harm. Some may direct you to get help but most will not, and some show graphic self-harm pictures and videos. Some of them romanticise, if you can imagine such a thing, this activity. As any health expert will tell you, for those youngsters—some are very young indeed—these are the triggers to self-harm.

The noble Baroness says that Instagram now has a policy of globally removing graphic self-harm imagery. As far as I can see, it has not done so yet. The same applies to websites concerning suicide. If you search for “#killmyself”, you will find huge numbers of results; ditto if you search for “eating disorders”. Research shows that 22 % of young adults report self-harm and suicide-related internet use. This is a crisis. There may be many reasons for this figure, and many solutions, but the internet must take responsibility for the content it contributes to this. Did the Secretary of State challenge Instagram on the assertion that it had taken down content? Has he done what my honourable friend and I did and tested it himself?

Did Instagram give a timescale, or is it waiting for the Samaritans’ research? That seems to me to be not an acceptable solution right now. I welcome the involvement of the Samaritans, but not if it means a further delay to action. It does not need research to know that the content of some of these sites is totally unacceptable and needs to be got rid of. Perhaps the noble Baroness can explain what the Samaritans’ research will be used for and its timescale? These are very, very rich organisations, and a few hundred thousand pounds to the Samaritans does not mean they can offload their responsibility to deal with this content; they have billions of pounds that can be used for this purpose.

The reason I am concerned is that these companies have form. Over many years of warm words and no change, they have consistently resisted taking responsibility for the content they carry. They have had to be pulled, kicking and screaming at every turn, into behaving with responsibility. I repeat: will the Secretary of State test this by looking at it himself?

The content of these platforms is why the White Paper is so urgently needed. I want to ask only one question about it; the debate will take place in a few moments and my noble friend will certainly pose many questions. However, if a young person even accidently accesses, for example, a self-harm image, there is a likelihood that the algorithms—which look at what every one of us is accessing online—will pick this up. While noble Lords may receive unwanted information about house extensions or the cost of flights, such a youngster may find that they are being led to more sites depicting self-harm. In other words, the algorithms can reinforce harmful content. How will the Government seek to mitigate this unintended consequence?

I turn now to the use of false information in anti-vax campaigns, which has led to a massive increase in outbreaks of measles, as the noble Baroness said in her Statement. The issue here is not just the dangerous anti-vax propaganda on platforms such as Facebook, or indeed Amazon. A story in today’s Guardian says that a young person was delivered a book, and inserted in it was an anti-vax leaflet. One has to ask how on earth it got there. The wider issue is that of public health policy and resourcing.

Are the Government considering banning unvaccinated children from schools in England, as the Secretary of State suggested on the radio last week? I hope not. Do the Government have a clear vaccination action plan? Public health services have been cut by £800 million and, in recent years, health visitors have been cut by 8% and school nurses by 24%. This will not help with the vaccination drive. Will the Government commit to reversing public health cuts and cuts to health visitors, and invest in general practice to meet the recommended 95% national vaccination coverage rate, as recommended by the World Health Organization?

[Baroness Jolly (LD)]

My Lords, I too thank the Minister for repeating the Statement. I am sure nobody in your Lordships’ House doubts the benefits, as well as the dangers, of social media. As the noble Baroness, Lady Thornton, has just stated, the tech giants really need to recognise their responsibilities by taking action now to remove material that could damage the vulnerable.

I would like to link the Statement with the NHS Long Term Plan. In it, there is a commitment to increase spending on children’s and adult mental health services. What figure will this amount to? How much of it does the department anticipate will be earmarked for technology? Where will it be directed? Who will receive the money? What does the department expect the NHS to do to support this move? What criteria will govern its use?

Vaccination uptake is clearly a current issue. How does the department anticipate that social media can help and not hinder the uptake of these life-saving shots?

[Baroness Blackwood of North Oxford]

I thank the noble Baronesses, Lady Thornton and Lady Jolly, for their questions. They are right: the Health Secretary has taken a personal interest in this issue and is determined to drive this policy forward, not only through the work of my honourable friend the Minister for Suicide Prevention but through the prevention Green Paper mentioned in the Statement. He will ensure that he keeps a personal eye on this issue.

I turn first to the question raised about the social media company Instagram saying that it has a global policy of removing graphic self-harm images—other sites also say that they have taken action—so that if you search today you cannot find such images, although on top searches you can find them through accounts in other places. It is recognised that there is much more to do and more content to remove. That was one reason why the Secretary of State convened these summits. A more coherent approach to this work is needed. While I recognise that the noble Baroness feels it is obvious what self-harm content is, the approach that has been taken as an outcome of the summit is encouraging. It has led to the strategic partnership, which will ensure that the policy that has come forward from the social media companies will now lead to effective implementation. Such companies will be held to account, not only through the strategic partnership but through the outcomes of the online harms White Paper. There will be not only a duty of care but a regulator associated with it. Those combined strategies are encouraging.

The noble Baroness asked about the unintended impact. This is where the second set of proposals to have come out of the summit is extremely important. As well as developing industry-wide standards on identifying harmful suicide and self-harm content and agreeing robust responses to it, it will lead to a clearer understanding of what is harmful content. It will also lead to better training for mediators to respond to it and to support vulnerable users, which I think is exactly the point she was after.

On the important questions about public health spending in response to anti-vax campaigners and ensuring that we have a robust vaccination programme, the noble Baroness is right that vaccination programmes rest on the basis of strong public health support. We have a £3 billion ring-fenced public health spend every year and we must ensure that that goes forward. It will be a key part of the public health bid in the spending review and part of the Green Paper that is to be published. I know she will look forward to holding me to account on the effectiveness of that Green Paper.

The noble Baroness, Lady Jolly, raised an important question about the effectiveness and benefits of social media. We do not think that compulsory vaccination at the moment is an evidence-based policy. The Health Secretary has said that nothing is off the table and this is the right response given the serious concerns of other countries. At the moment, in the UK, we operate a system of informed consent. This is the right thing to do, given our high uptake. There is no immediate plan to change it and we strongly encourage families to take up vaccinations when offered.

One of the ways in which we spread information about the effectiveness of vaccines, and shall continue to do so, is through our online accounts at nhs.uk, which are highly trusted. In the UK the public attitude to and confidence in vaccination is monitored through a series of annual surveys, including Public Health England’s annual attitudinal survey, which show high levels of trust in health professionals and the NHS. The public trust the NHS as a source of advice and that is why our digital media output, through the NHS, our social media outlets and nhs.uk, is a crucial way of encouraging and maintaining trust in vaccinations. We shall continue to drive it forward.