Complications from Abortions (Annual Report) Bill [HL]

Baroness Miller of Chilthorne Domer Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Brinton (LD)]

My Lords, unfortunately, I too was unable to be at Second Reading. I speak today to support the stand part notice from the noble Baroness, Lady Thornton, and on what the noble Baroness, Lady Finn, said about the important review of data collection—actually, across the health sector, as I will explain, but particularly of data relating to abortions.

The noble Baroness, Lady Thornton, spoke of how some elements of this short Bill are inconsistent, which makes it unable to deliver what the noble Lord, Lord Moylan, hopes for, despite what he said—I will come on to explain why—even if it were the right thing to do. I agree with the points that the noble Baroness, Lady Thornton, made.

One issue at the heart of this inconsistency is the use of patients’ confidential health personal data. There is an absolute presumption by patients that their health personal data will always be kept confidential between them and their medical practitioners. Indeed, noble Lords may remember, when the then Government proposed care.data plans a few years ago, it became clear that we were likely to move to a US-type system of allowing researchers, insurers et cetera access to anonymised and pseudonymised data. I can tell the noble Baroness, Lady Lawlor, that, during that debate, it was important to note that it is possible to reverse most anonymised and pseudonymised data, particularly when dealing with an unusual circumstance. Once you have one or two identifiers, you can get to a very small geographic position very quickly—sometimes to a postcode, frankly. Therein lies the problem: confidentiality is lost.

More worrying were the original proposals in the Bill that became the Police, Crime, Sentencing and Courts Act 2022, which gave the police and the Home Secretary—then Priti Patel—the power to demand from any relevant person or authority, which included health authorities at the time, to see data that might be of interest in an investigation. I was working on that Bill and, when I queried this power in your Lordships’ House, it transpired that it was not just for suspects of crime but for anyone connected with the incident, who might or might not be a witness. That went completely against everything in a doctor’s sacred oath of confidentiality with regard to their patient. I am pleased to say that, following my amendments to that Bill and pressure from doctors, the then Clause 16(4)(a) was modified to prevent access to health data compared to data from other bodies, where it still sits.

That was followed by a debate, on the Health and Care Bill, about the use of patients’ personal health data for research. My noble friend Lord Clement-Jones, other noble Lords and I made it very clear that assuming that anonymised or pseudonymised data could not be reverse-engineered was not acceptable. Out of that, a new system of a black box, where the anonymity of patients is guaranteed, was introduced.

However, abortion data is different because it is not within these safeguards. The Abortion Act 1967 requires that the woman’s name and date of birth or a personal identifier must be submitted on every abortion and provided to the Chief Medical Officer via the abortion notification system. While, as others have said, this data includes complications prior to discharge, the “Hospital Episode Statistics” referred to in Clause 1(3)(b) of the Bill from the noble Lord, Lord Moylan, are based only on abortion data from trusts, which are not linked to abortion records. This means that the data is coming from two different sources, which are collecting different data. As the briefing from BPAS tells us, neither dataset actually captures all abortion complications, nor can the hospital episode statistics be analysed by methods of gestation or abortion—another difference, yet again. I do not think that the noble Lord, Lord Moylan, covered that point of disparity when he spoke earlier. My worry is that the annual report would not actually reflect the wider picture.

The second issue that I will raise is of those other delicate areas that might inadvertently be drawn into this type of reporting on complications of abortion. In the debate earlier today in your Lordships’ House, we discussed miscarriages and preterm births. Nearly 50 years ago, I had an early miscarriage and, when I went to the hospital, I was told that I was having a “spontaneous abortion”—a ghastly phrase. I still had remnants inside my body that needed to be removed to ensure a “complete abortion”—an even more ghastly phrase. In the middle of my grief at losing my first baby, the medics were talking about “abortion”.

The very helpful briefing from the Royal College of Obstetricians and Gynaecologists points out that the differing terms that can be entered into hospital coding are “induced miscarriage” and “spontaneous abortion”. It says:

“This can result in a code being applied for an abortion complication when it should have been for a miscarriage complication and vice versa.”


This is not just about words such as “spontaneous abortion”. Following on the speech from the noble Baroness, Lady Bennett, in the USA, since the Dobbs case, miscarriage has increasingly been brought into the debate about abortion. West Virginia has one of the toughest sets of abortion laws, allowing it only for cases of rape, incest or if the woman has an ectopic or totally non-viable pregnancy. But it gets worse. Last week, in Raleigh County, West Virginia, the prosecuting attorney, Tom Truman, advised women to get in touch with police, law enforcement or a doctor if they were worried that they might be charged with mishandling foetal remains. The example cited was the arrest of a woman for disposing of foetal remains in her bins. He said that a number of criminal charges under state code, including felonies, could be levied against a woman who flushes foetal remains, buries them or otherwise disposes of them following an involuntary abortion, also called a miscarriage. A West Virginian woman in my situation, which I talked about earlier, could well be prosecuted. The miscarriage that I referred to is not unusual. I lost the tiny foetus down the toilet, and I was distressed beyond measure. In West Virginia, you would now have to retrieve the foetal remains or be at risk of prosecution.

I am sure that there is absolutely no intention in the UK for this to happen, but the debate happening in the US is beginning to colour the debate we are having here. I am very clear that the problem is that some people want miscarriage to be treated as suspicious. They clearly are not medics. It is thought that 15% to 20% of pregnancies end in miscarriage. It is surprisingly common, and good luck to that prosecutor in West Virginia. He is going to spend his entire time on people reporting miscarriage. Above all, the issue of miscarriage and spontaneous abortion is yet another that muddles the data proposed in this annual report and demonstrates, sadly, that it is not fit for purpose.

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, I was here for Second Reading and I was here to hear the noble Lord, Lord Moylan, tell us about how the abortion landscape is shifting quite rapidly. Between Second Reading and today, we saw a vivid example of just how that landscape is shifting and why it needs to shift very rapidly, because we saw the conclusion of the trial of Nicola Packer. Thankfully, the jurors recently cleared the 45 year-old of illegally terminating her pregnancy. She suffered more than four years of police and criminal proceedings.

In fact, the number of women being prosecuted on suspicion of breaking abortion laws has increased over recent years, so the landscape is getting worse. That is partly why I am very pleased to support the noble Baroness, Lady Thornton, in opposing the clause standing part, because the Bill does nothing to improve the abortion landscape. Personally, I am quite surprised that the noble Lord, Lord Moylan, has brought it back today to Committee, because it was made evident to us at Second Reading by the Minister and other speakers, including my noble friend Lord Scriven, that it was absolutely unnecessary and very unhelpful. Indeed, we heard from the noble Baroness, Lady Freeman of Steventon, today exactly why that is.

I hope that this House will soon have the opportunity to debate and enact real change, along the lines of the two amendments tabled in the other place, referred to by the noble Baroness, Lady Bennett. I want to check something with the noble Lord, Lord Moylan. He said at Second Reading—and I expect he is thinking it again today:

“What is so strange about the advocates of choice in this debate is that they are so defensive; they speak as if they are surrounded by conspiracy ... If I thought I was surrounded by conspiracy, I would want to live in a world of facts and not hide myself from them”.—[Official Report, 13/12/24; cols. 1994-5.]

Support for Infants and Parents etc (Information) Bill [HL]

Baroness Miller of Chilthorne Domer Excerpts

2nd reading
Friday 6th September 2024 Lords Chamber

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Blunkett, and his very positive comments. Indeed, I congratulate the noble Lord, Lord Farmer, on using his high position in the ballot to continue his long-term campaign to secure a firm foundation for young families.

The Bill’s intention is excellent; my concern is that, given the extreme financial constraints on local authorities at the moment, loading them with extra duties may not be very easy or realistic. However, I hope that this Bill progresses and that I will have the opportunity to propose some constructive amendments to progress an absolutely foundational area for babies that impacts on their health for their entire life. The noble Lord, Lord Farmer, mentioned this, and it is, of course, feeding.

How babies are fed in the first months of their life is absolutely crucial. I am sure that noble Lords here do not me to spell out the advantages of breastfeeding in terms of health. But the shocking statistic for this country is that 81% of mothers start breastfeeding but by six months—and the World Health Organization and all the health organisations suggest that it should go on for six months—only 1% are still breastfeeding.

There was an infant feeding survey, which was discontinued in 2012 but then restarted in 2023, which is positive. Can the Minister tell me whether the results of that survey are expected shortly and whether the Government intend to continue this survey from now on? We need to do all we can to help those who breastfeed, at least for those first six months.

At the moment, however, the push all comes from the other direction, and has for 40-odd years—well, more. That was why the World Health Organization brought in the International Code of Marketing of Breast-Milk Substitutes, because the heavy way that the substitutes are marketed means that the incentive to breastfeed, the image of breastfeeding and the positive aspects of it are really undermined. In 2007, the previous Labour Government recognised how important this was and brought in the Infant Formula and Follow-on Formula (England) Regulations, which attempted to put the code on the books in the UK. The UK legislation on infant formula incorporates some but not all of the code into law. Would the Minister consider incorporating more of it into law?

UNICEF has some really helpful ideas specifically for the UK, including:

“Develop a National Infant Feeding Strategy Board … promote, protect and support breastfeeding in all policy areas”—


as the noble Lord, Lord Farmer, mentioned—and:

“Implement evidence-based initiatives that support breastfeeding”.


In 2023, the Lancet ran a very interesting three-paper series about the impact of the amount of advertising from the commercial formula manufacturers, which is used to target parents, healthcare professionals and policymakers. There are marketing practices which, on the face of it, comply with the law but actually undermine breastfeeding—that is the fact. The Lancet found that the monitoring and enforcement of UK legislation is very weak, which means that companies are rarely prosecuted for breaking the law. I cannot remember a case and I have been following this since about 1980.

That is an area where I would like us to be able to table some amendments to this very constructive Bill and make sure that the work of the WHO, the Lancet and UNICEF is underscored by our legislation.