Health and Care Bill

Baroness Stroud Excerpts
Baroness Walmsley Portrait Baroness Walmsley (LD)
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My Lords, I rise to speak on my own behalf; I am not representing anybody. The substantive issue is a conscience issue. I do, however, support the amendment in the name of the noble Lord, Lord Forsyth, because I think it is a discussion whose time has come. I am very impressed and pleased that noble Lords have resisted the temptation to discuss the substantive issue this evening, because all of us here understand—unfortunately, many outside do not—that this amendment is not about the substantive issue.

However, I am somewhat disappointed that the noble and learned Lord, Lord Mackay of Clashfern, wishes to knock it out on a procedural point. I think it is much more important than that. The noble and learned Lord is a wily old politician, and he knows very well that if you want to defeat something, it is often a very good idea to try to get rid of it on a procedural point. He suggested that we should use the Private Member’s Bill procedure. He has been in this House long enough to know that very few Private Members’ Bills are taken up by the Government and given time, and if they are not given time, they are going nowhere. But it is clear that this country wishes to discuss the matter and have Parliament decide on it.

The noble Lord, Lord Moylan, suggested that we cannot put anything in the Bill that the Government do not want to do. I remind him that every time we defeat the Government on an amendment, we are asking them to do something they do not want to do—and we did it 14 times last week on the policing Bill.

I have one other point. The right reverend Prelate the Bishop of Carlisle talked about vagueness. I think the noble Lord, Lord Forsyth, has been deliberately vague, because it is for the draft Bill to be specific. That is important because we need something very specific to discuss, with specific powers and safeguards that Parliament has put in. Without that, we would have all the fear that we have around the country, much of which has been expressed in our inboxes in these last few weeks. People are afraid of what might be in the Bill and what Parliament might pass, and only if we have a specific set of proposals in front of us can we amend it to put in the proper safeguards. Parliament can then decide, and people can take their view about it. I think that will take away a lot of the fears of people who believe that there will be no safeguards, because I am convinced that this Parliament would put in proper safeguards. If it did not, a lot of noble Lords would suggest some that jolly well should be there, and rightly so. For those reasons, I hope the Minister will consider the amendment in the name of the noble Lord, Lord Forsyth.

On the amendment in the name of the noble Baroness, Lady Meacher, again, I am so glad that she said it is a probing amendment, because other noble Lords have suggested that the drafting would need to be changed to avoid some unintended consequences. I am quite sure that the noble Baroness would do that if it was more than a probing amendment. She is asking for something that patients need: choice at the end of life. I hear what the noble Baroness, Lady Finlay, said about what is already in place. She is an expert on this. It could well be that a conversation needs to be had about whether there needs to be anything further in legislation to strengthen the availability of what the noble Baroness, Lady Finlay, talked about, which sounds absolutely excellent. So I am not expressing a definite opinion on that amendment.

I hope the Minister will consider the amendment in the name of the noble Lord, Lord Forsyth, because we, as practical politicians, know that in the real world—in this Parliament—the Bill brought forward by the noble Baroness, Lady Meacher, is not going anywhere, but we need to have the discussion.

Baroness Stroud Portrait Baroness Stroud (Con)
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My Lords, I believe it is really important to understand what Amendment 297 does and does not do. It is my understanding that this amendment instructs the Secretary of State—not Parliament—to lay before Parliament a draft Bill that would permit terminally ill, mentally competent adults legally to end their own lives with medical assistance. I listened carefully to my noble friend’s speech on the matter just before Christmas, and I hugely empathise with his own personal journey. But it is important for us to understand what this amendment actually does and does not do.

Covid-19

Baroness Stroud Excerpts
Thursday 15th July 2021

(2 years, 8 months ago)

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Baroness Stroud Portrait Baroness Stroud (Con)
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My Lords, on 9 July a Department of Health and Social Care press release claimed that, for those who are immunosuppressed, vaccine effectiveness after a second dose is 74%, with

“similar protection to those not in an at-risk group.”

But this was based on an extremely small sample size. In response, Blood Cancer UK’s chief executive Gemma Peters said that

“its ‘confident, definitive assertions’ about the level of protection given to the UK’s 230,000 blood cancer patients could not yet be supported by the ‘wider body of evidence on vaccine efficacy in the immunocompromised’”.

I am aware that my noble friend the Minister has already commented widely on this issue, but could he comment specifically on those with cancer, particularly those 230,000 blood cancer patients? What intention do Her Majesty’s Government have to clarify this guidance and ensure that the immunosuppressed have access to the necessary resources to help improve their understanding and decision-making?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the position of the immunosuppressed is one that we have a huge amount of sympathy for. Those who have blood cancer face a particular challenge. I was very grateful to meet Blood Cancer UK and discuss this matter. The PHE report makes the very clear point that those with suppressed immune systems may have a very strong vaccine response, particularly after two weeks after two doses. Just because someone has a suppressed immune system, it does not mean that the vaccine has left them completely unprotected. I completely accept that the responses of one group and another group may be quite different and it is difficult to lump everyone together. That is why we are investing in the OCTAVE study; I am hopeful it will be published by the end of the month. That will provide some, but not all, the information we need to elaborate on that guidance.

Covid-19: One Year Report

Baroness Stroud Excerpts
Thursday 25th March 2021

(3 years ago)

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Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, this moment in time is deeply significant and goes far beyond the immediate legislation we are debating today. Many of the actions taken by the Government and the provisions in this Coronavirus Act are welcome. The financial support for the furlough scheme, the protections against no-fault evictions during the pandemic and the rapid mobilisation of medical professionals, to name but a few, have actively protected vulnerable people. But this debate also marks one year since the Government first used the Public Health (Control of Disease) Act 1984 to enforce the first official lockdown and stay-at-home orders. As we gather here today, a year later, still living under those same restrictions, this moment acts as a milestone, a moment in time to pause and reflect on the approach we have taken.

The Government have found themselves at the helm during a rapidly evolving pandemic, bearing the responsibility of co-ordinating the nation’s response, requiring agility and dynamism to adapt to its spread, and I thank them for all their hard work and dedication. This pandemic was unprecedented in Britain’s recent history; we did not have the model of best practice in place to adopt and we knew little of this disease. My concern is not so much that we have needed to take action to find a way through this difficult time but over some of the tools that we have used to achieve the goal of public co-operation, and that the approach we have adopted over the last year could become the precedent for how we will respond to similar health crises in the future.

Rather than rely on the values that we know to be true, which define the success and prosperity of this great nation, of personal responsibility and trust, keeping calm and respect, we rather chose to follow the path of a more authoritarian regime, legislating for restrictions on our liberties and an unrelenting campaign of fear to engender compliance. At many points where we could have appealed to the British people to work with us and make responsible decisions on the basis of a health response, we chose a legislative response, and at many moments when we could have asked for responsible decision-making we drove behaviour change with fear. We are still doing it now.

When at the start of the pandemic SAGE’s SPI group on behaviours recommended the Government deliberately use psychological operations techniques to change behaviour, the use of the media and advertising was advised to “increase sense of personal threat”. SAGE thought this would be highly effective, although it warned there “could be negative” spill-over effects. Leading charities such as MIND were quick to warn the Government of the mental health pandemic that would ensue if they continued to pursue such a course of action. Experts have warned that

“the use of fear to control behaviour is dangerous and unethical, especially when combined with curbs of freedom of speech”.

There was even Ofcom guidance which cautioned its licensees against broadcasting

“statements that seek to question or undermine the advice of public health bodies on the Coronavirus, or otherwise undermine people’s trust in the advice of mainstream sources of information about the disease”,

which led to an absence of discussion and a daily broadcast diet of terrifying stories to achieve public compliance. But the public is all too aware of when there is a real threat, and they take the steps that are necessary to change their behaviour. You can see this from the mobility data, which changes as the numbers of hospitalisations and deaths gradually mount.

However, how we go through a crisis is as important as getting to the other side of a crisis. The best way to protect the public from harm is to allow scientists, experts, journalists and others to vigorously challenge the Government and public authorities, without the threat of broadcasters being sanctioned by the state regulator if those views happen not to accord with the current government position. The public are sensible.

The torrent of fear with which we have hosed the British people has been devastating for mental health, but I am most concerned about our children. The statistics here are heartbreaking. Google searches for “panic attack” in the UK have reached record highs. The NHS’s own data suggests that lockdown has led to a 50% rise in children with mental health problems—the Times reports that there has been a surge in tics and Tourette’s amongst teenage girls. Domestic violence against children has doubled, and has surged among adults.

This strategy of fear and legislative control cannot continue. Fear damages the nation’s health, and legislative control is making rule-breakers of us all. You have only to go for a walk in the park on a Sunday afternoon to see that. We must respect the British people and empower our citizens, not terrify them. As the vaccine continues its remarkably successful trajectory, we need to transition from a legislative response to a public health response as quickly as possible based on the principles of honesty and personal responsibility. If we do not do this quickly, we will find that we have eroded the bonds of trust and responsiveness.

Baroness Scott of Bybrook Portrait Baroness Scott of Bybrook (Con)
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My Lords, there is a five-minute time limit.

Women’s Health Strategy

Baroness Stroud Excerpts
Tuesday 9th March 2021

(3 years ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I have previously referred to the challenge of gender-comprehensive clinical trials. There is growing evidence that drug prescriptions should be personalised a great deal more than they are, right across the board—not just on a gender basis but on genomic, ethnic, age and weight bases as well. The noble Baroness makes an extremely good point on this. I cannot guarantee that we will retrospectively conduct gender-specific clinical trials on the full library of medicines in the medicine cabinet, but we are keen to aspire to ensuring a future commitment to gender-specific clinical trials going forwards.

Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, in the ministerial foreword to the Women’s Health Strategy, the issue of data gaps has been highlighted. One such data gap I would like the Government to look at is the way in which abortion complication data is gathered. The Minister in the other place confirmed in a recent Written Answer that the only method the department uses to gather this data is via HSA4 forms. Between April and June 2020, from the 23,000 at-home abortions, these forms reported just a single complication, yet FOI requests to just six hospitals during the same period suggested that women were presenting due to complications at a rate five times higher than that reported by the Department of Health and Social Care. Moreover, there were 36 999 calls due to at-home abortion complications every month to the ambulance service. As part of the Women’s Health Strategy, will this gap be addressed, and does the Minister agree that the number of women who present to hospitals due to incomplete abortions requiring surgery or retained products of conception should be collected centrally?

Lord Bethell Portrait Lord Bethell (Con)
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My noble friend makes her case extremely powerfully, and the numbers she cites are extremely persuasive. I do not have a full brief on the treatment of abortion complication statistics at my fingertips, but she alludes to exactly the kind of data gaps that we wish to address in this consultation period and in the emerging strategy. If she would like to submit the evidence she has just described, we will definitely take it on board and use it as part of our strategy-drafting exercise.

Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021

Baroness Stroud Excerpts
Monday 1st March 2021

(3 years ago)

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Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, I add my congratulations to my noble friend the Minister on the enormous success of the vaccination procurement and rollout programmes. They reveal not only the extraordinary feats that can be achieved when the private and public sectors work closely together, but also how, when circumstances require it, we are able to unite as a nation to serve and protect those who are most vulnerable.

However, as encouraging as the initial vaccine rollout programme has been, the Minister is right to highlight that the virus has not yet been beaten. We are all only too well aware that the threat of further mutations means that the coronavirus is here to stay in some form or other. The question now shifts to: how do we live with the threat of Covid going forward, even in a vaccinated population? The answer has to lie in the form of a health response, not a legislative response, to empower individuals to make responsible decisions for their own health and their family’s and community’s health. But here we are today further strengthening restrictions, even as we have charted the way out of lockdown.

These regulations, which came into force on 29 January, introduce a new fixed-penalty notice for those attending a gathering of more than 15 people and amend the self-isolation regulations to provide the police with further tools to identify and enforce self-isolation orders. It is odd that at a time when we should be championing the success of the vaccine programme and restoring our civil liberties, we are passing statutory instruments that further restrict our freedoms.

Will the Minister tell the House what impact on the numbers of people self-isolating has been achieved by this SI? What other proposals were considered to achieve the same policy objective, such as a full salary replacement strategy? A recent study by Oxford University found that Britain is experiencing one of the strictest lockdowns in the world. Only two Governments—Venezuela’s and Lebanon’s—have introduced tougher responses. Why do we think that these powers are needed when the British people have done such a good job at complying? They have not complied because of the threat of legislation, but because they have acted responsibly to protect their own health and the health of their family and community. They have responded to the information that they have been given and made wise choices.

I have enormous faith in the character of the British people. Mobility data clearly indicates that the public responded to public health advice and largely restricted their own behaviours, even prior to official lockdown enforcement measures. There is much to be rebuilt for all Governments around the world as we come out of this lockdown, but one aspect that will need to be rebuilt is the Government’s trust in the people of this nation. I strongly encourage the Government to refrain from further statutory instruments that would seek to limit personal liberties in response to the virus. With the vaccine programme under way, it is time to wind back these measures and empower the British people to take the responsible steps to build back their own prosperity.

Vaccine Rollout

Baroness Stroud Excerpts
Monday 25th January 2021

(3 years, 2 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the amount of research that we have on the Pfizer vaccine and all other vaccines is huge. Most, though not all of it, is published. I assure the noble Baroness that we have all the data needed to make the decision that we have. She is right that we are doing the pharmacovigilance that is necessary to understanding the efficacy of the vaccine and any possible side effects. That research will be shared with international partners in the way that she suggests.

Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, the Prime Minister revealed on Friday the great news that 10% of all adults have now received their first dose of the Covid vaccine, with two-thirds of elderly residents of care homes now meeting that first milestone. This wonderful effort now needs to be matched by a strategy to ensure that it is not only the elderly who are protected but the young, with a commitment to reopening our schools as soon as possible. Social mobility gains that have given a lift to disadvantaged children over the past decade are at risk of being wiped out by Covid lockdowns. The gap between disadvantaged pupils and their peers has already increased by almost half, with 12% of 11 to 18 year olds not having access to the internet at home. Given that the rollout of the vaccine to the most vulnerable is set to reduce deaths by 88% by mid-February, what steps are Her Majesty’s Government taking to increase NHS capacity to ensure that schools can open as soon as possible?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, it is indeed very good news. I pay tribute to the work of my noble friend and of the Legatum Institute in championing the need to address social inequality. She rightly draws attention to the horrific impact that this pandemic and the associated lockdowns are having on social mobility. It is a massive priority for us. The problem that we are wrestling with is not just hospitalisation but the transmission associated with schools, but I assure her that this is a number one priority for us.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 5) Regulations 2020

Baroness Stroud Excerpts
Tuesday 20th October 2020

(3 years, 5 months ago)

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Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, I have the greatest respect for my noble friend Lord Bethell, but I ask him to rethink the Government’s approach to the pandemic. China was the first country to be impacted by Covid-19 and its response has framed the context for the rest of the world. Its approach moved to withhold information about the virus, restrict the freedoms of a people and lock down its economic engine. Such actions are consistent with ranking 90th in the index for governance and 159th for personal freedom, but these are not the actions that build prosperity; they are the ones that weaken it.

As a democratic nation built on the principles of good governance and personal freedom, we should be finding ways through this crisis that speak to the power and strength of who we are and the values of our democracy. We need to have our eyes focused on what builds prosperity so that we emerge out of this crisis intact. Prosperity is built when Governments make decisions in such a way that engenders trust and with integrity, respecting the freedom of their citizens. Prosperous nations are ones where Governments govern with the agreement of the people and where citizens take responsibility. This should be borne in mind as discussions take place with Manchester and other cities.

Economic decisions must be taken responsibly to sustain an enabling environment for productive employment, sustained economic growth and personal development. Given that only 3% of reported cases come from the hospitality sector, we need to think again and at the very least make a distinction between restaurants and late-night activity, as the Minister referred to. The ease with which he listed the practice of curfews across different nations is chilling in the least. This should concern us.

The principles of personal responsibility and freedom go hand in hand. Citizens must be free and order their lives to take responsibility for their own families and communities. If we keep announcing rule after rule to our citizens, we will not allow the people of Britain to take responsibility and work with us.

Prosperous nations are built on trust and respect. Let us find a way to keep our restaurants open and businesses going. Let us create a way of working with the people of Manchester—

Baroness Penn Portrait Baroness Penn (Con)
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My Lords, I need to remind the noble Baroness about the time limit.

Baroness Stroud Portrait Baroness Stroud (Con) [V]
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Let us trust people to work with and take care of their own health. This is the sort of nation I believe us to be.

Covid-19: People with Learning Difficulties and Autism

Baroness Stroud Excerpts
Monday 5th October 2020

(3 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness puts the plight of those with autism extremely well. Who could not feel sympathy for those with special needs and autistic sensibilities, with the distress and trauma of changes and the unfamiliarity of the Covid regime? I do not know the precise status of a personal plan for all those transitioning back to school, but I would be glad to inquire back at the department and write to the noble Baroness with a reply.

Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, prior to the pandemic, the Social Metrics Commission’s report found that half of all people in poverty live in a family that includes a disabled adult or child. Given that education is one of the key drivers to transitioning out of poverty, could my noble friend outline the work he has been doing with the Department for Education and the Department of Health to address the skills and education gap created by Covid for disabled children who have special educational needs and to ensure that these children’s needs are the focus of any pandemic measures in the coming months?

Lord Bethell Portrait Lord Bethell (Con)
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My noble friend Lady Stroud speaks very movingly of the tough figures around the prevalence of disability among those in poverty. I completely take on board her recommendations about training in education. The Prime Minister spoke last week about the opportunity that Covid presents for a reboot around skills. That reboot will include provisions for those with learning difficulties and disabilities. I would be glad to inquire at the department exactly how developed those plans are and to update the noble Baroness with the information that I have back at the department.

Coronavirus Act 2020: Temporary Provisions

Baroness Stroud Excerpts
Monday 28th September 2020

(3 years, 6 months ago)

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Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, in my four minutes I want to thank the Government for their tireless work to keep the people of this nation safe, add my support for the legislation that was needed when it was introduced, and make a plea for a clearer strategy going forward.

My thanks go to the Government for all their work steering a balanced course through incredibly difficult waters. This was not the 2020 that anyone envisaged. If one looks back to the December election, the challenge ahead of us was Brexit. Most thought that was a pretty tall order, even the greatest challenge of this generation, but little did we know that a greater challenge lay around the corner. We must ensure that in this debate we focus clearly on the virus as our enemy and not the Government, who have had a herculean task to balance many competing voices, contradictory advice and demanding dynamics. We are grateful for all their hard work.

I add my support to the Government as we approach the six-month review of the Coronavirus Act. When it was passed on 25 March, it was against a backdrop of people quite literally dying on the streets of Wuhan and on hospital floors in Italy. We knew that we needed to move fast and that we would need the flexibility of the legislation. The Government have, for the most part, used it appropriately and in as limited a form as possible, to secure and ensure our safety, as was intended.

My concern does not lie so much with this Act as with the Public Health Act, and with actions that the Government have taken that people believe are within the powers of this Act, but which are not. I call on the Government to clarify their strategy going forward. They must be clear on what instructions have the weight of the law behind them and what instructions are guidance only, and, when they issue guidance, what the intention is. Most members of the public are not skilled in government speak.

Let us take the last round of announcements on Tuesday. There were new, legally enforceable changes made concerning restaurants and pubs. However, in the same breath there was an update to guidance asking office workers to work from home. The way that this announcement was made left most office workers with the distinct impression that the Government had given them a legal instruction to work from home. Many have taken steps to comply. However, the Chancellor of the Duchy of Lancaster said it differently:

“We are stressing that if it is safe to work in your workplace, if you are in a Covid-secure workplace, then you should be there if your job requires it. But if you can work from home”.


The Prime Minister said that we were once again asking office workers to work from home where possible but stressed that this was

“by no means a return to the full lockdown”—[Official Report, Commons, 22/9/20; col. 798].

Government guidance was equally confusing, saying that:

“To help contain the virus, office workers who can work effectively from home should do so over the winter. Where an employer, in consultation with their employee, judges an employee can carry out their normal duties from home they should do so. Anyone else who cannot work from home should go to their place of work.”


As an ex-special adviser, I hear what the Government are saying: if you are a driver of your project or need to work collaboratively with others, then the Government do not want the effectiveness of your work damaged, but rather that your focus is on ensuring a Covid-secure environment. However, the Government are focused on risk reduction. Therefore, if the tasks that you undertake are less collaborative in nature and do not have numbers of interrelated dependencies, and if your employer is content with this, then we would want your employer to enable you to work from home.

Yet up and down the country this is not how people have interpreted it, and at a time when the Government are seeking to balance people’s health with maintaining an effective business drive so that we emerge Brexit ready, ready with momentum for growth, this needs to be said. I therefore thank the Minister for all his hard work. I will support the Government today but ask him to clarify their intent in his closing remarks.

Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020

Baroness Stroud Excerpts
Monday 15th June 2020

(3 years, 9 months ago)

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Baroness Stroud Portrait Baroness Stroud (Con) [V]
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My Lords, I thank my noble friend the Minister for the way in which he has worked tirelessly throughout this crisis. Tonight, I want to draw attention to an issue that has arisen under the health protection and coronavirus restrictions legislation, amendments to which we are debating today. It is an issue that I had hoped to see addressed in the amendment that we are debating this evening.

During the passage of the original health protection legislation, two amendments were laid in this House. These amendments were to allow abortion-inducing medication to be self-administered by pregnant women, within their homes, after one virtual medical consultation—a departure from the need for two doctors. These provisions were initially firmly rejected in the other place, with a statement by the Secretary of State for Health that

“We have no proposals to change any abortion rules as part of the covid-19 response.”—[Official Report, Commons, 24/3/20; col. 244.]


Further remarks were made in this Chamber by the Minister, my noble friend Lord Bethell, that it is not right to rush through this type of change in a sensitive area such as abortion without adequate parliamentary scrutiny. The amendment to approve this procedure was therefore withdrawn by the Chamber.

However, a later response to questions I posed to the Department of Health said that the department had in fact taken the power and made this change. In doing so, the Government stated that the intention was to ease the pressure on health professionals during the Covid-19 pandemic by allowing registered medical practitioners to prescribe both pills for the treatment of early medical abortion, up to 10 weeks, from their own homes. This meant that women would be prescribed this medication without being seen by a doctor and without the gestation period of their child being verified.

The tragedy of this confusion is that it is women who have suffered. This confusion has led to poor health outcomes for vulnerable women, with known cases of complications, such as incomplete abortion and continued bleeding. This confusion has led not only to the suffering of women but to abuses and misadministration, with no way of knowing whether or not the gestation period was in fact under 10 weeks. There are nine known cases of women who were provided at-home abortion pills beyond the end of 10 weeks’ gestation, including one case where the unborn child was at 28 weeks’ gestation—four weeks past the legal limit, as set out in the Abortion Act 1967.

Does my noble friend the Minister agree that, with the reopening of non-essential shops and the resuming of normal medical services, it is now time that the care of women by two doctors is restored in person? Will he agree that the next time these regulations are reviewed, this will be included within them?