HIV Care: Access

Baroness Sugg Excerpts

Wednesday 11th September 2024 Lords Chamber

[Baroness Merron (Lab)]

Yes, we will be looking at all the work currently going on and at the successes—and there are many. I believe that my noble friend is referring to Fast-Track Cities, an international initiative involving cities tackling HIV through a multidisciplinary, multi- sectoral approach. There are 13 signatory cities in the UK, and all are beacons of good practice that we must learn from, including in order to find out what is not working. I also want to emphasise peer support, which has been shown to reduce self-stigma, but also to improve engagement in care and the taking of treatment, and to having low levels of virus. This area will obviously very much feature in the new strategy.

[Baroness Sugg (Con)]

My Lords, looking at HIV internationally, the UK has long been a proud supporter of the Global Fund. In 2022 alone the Global Fund reached over 15 million people with HIV prevention services, including 710,000 HIV-positive mothers, who received medication to keep themselves alive and to prevent transmission of HIV to their babies. Will the Government commit to continuing to support the Global Fund?

Vaginal Mesh Implants: Compensation

Baroness Sugg Excerpts

Thursday 5th September 2024 Lords Chamber

[Baroness Sugg (Con)]

My Lords, I am grateful to my noble friend Lady Cumberlege for her significant work on highlighting the issues around vaginal mesh implants that have impacted at least 10,000 women, probably many more, and for her continued efforts to make some progress, in particular in tabling this Question for Short Debate. The evidence that your Lordships will have seen of women reporting severe complications from mesh implants, including chronic pain, infections, organ perforation and, in some cases, permanent disability, underlines how crucial it was that her work led to the pause on the use of vaginally inserted surgical mesh in 2018.

As my noble friend has set out, establishing a compensation scheme for women affected was recommended by her independent review First Do No Harm in 2020 and that was echoed by the Patient Safety Commissioner, Dr Henrietta Hughes, in her report in February this year. It has been a long-running concern and all the while many women are continuing to suffer the consequences of this treatment. I welcome the positive steps that were made by the previous Government, including the appointment of a Patient Safety Commissioner, but there remain many issues that, sadly, they were not able to resolve. I know that the Minister, as Minister for Patient Safety, Women’s Health and Mental Health, must have an overflowing in-tray, but I look forward to her response today in the hope that we will hear clear plans for progress.

As we heard, following a group claim, the financial settlement in August from three manufacturers of mesh implants was welcome news, but there is a clear argument that more needs to be done. Compensation is a tangible way to acknowledge the suffering of women and provide the support that they need to continue to live their lives. While that case in August was a success, and some women have pursued legal action individually, these cases have often been long, costly and emotionally draining. Many women do not have the financial resources or the legal knowledge to take on large medical corporations or hospitals.

In my research I was pleased to see that information on compensation was readily available on the NHS website, but it is clear that the existing approach is inconsistent and fragmented. Hundreds of women were prevented from making a claim due to the strict 10-year time limit that is in force from the date that the product was manufactured. I hope that the Government will consider looking at that. A national government-backed compensation fund would ensure a uniform and fair approach to dealing with claims, ensuring that all affected women have a fair chance of receiving the financial redress that they deserve without being forced into these lengthy legal battles.

I appreciate the complexities and the expense here and, of course, the importance of spending limited resources on improving health services. There are options for how compensation can be delivered and how it can be funded, and I know that other noble Lords will address that. Of course, financial compensation should go hand in hand with strengthening the regulation of medical devices and improving patient safety.

I pay tribute to the campaigners who have worked so hard to highlight this treatment over the years—the individuals, the women’s health organisations, and in particular the campaign group Sling The Mesh. I know that this work can be frustrating, exhausting and often thankless, but thanks to them, this issue, which can sometimes be seen as taboo, has been highlighted. We have seen some progress and will continue to push for more and I hope that they realise the difference that they are making.

In addition to the compensation scheme, Sling The Mesh is calling for a number of actions, from raising awareness of implant risk to tougher approval systems, regulations and oversight to protect public safety. In her response, I hope the Minister will also find time to comment on its calls for better databases to track the long-term harm of medical devices, which would help spot trends of harm, and for a sunshine payment Bill to improve transparency in the UK health sector by ensuring that the pharmaceutical and medical device industries declare all the money given to doctors, researchers, lobby groups, health charities, surgeon societies and teaching hospitals. That is not to stop that money being invested, just to be clear and transparent about what is happening.

I support my noble friend Lady Cumberlege’s call for action on implementing the recommendations in her First Do No Harm report and the more recent Hughes report. I look forward to the Minister’s response.

Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates

Baroness Sugg Excerpts

Monday 29th July 2024 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is quite right to draw the House’s attention to the important matter of sickle cell. We look to specialist midwives to assist us in this. I have been asked for a particular assurance and it is correct that the noble Baroness seeks that. I shall be pleased to look into it to be able to come back to her in much greater detail.

[Baroness Sugg (Con)]

My Lords, the previous Government introduced the first ever UK women’s health ambassador, who can help to co-ordinate the complex changes that are needed to reduce the mortality rate for black, Asian and minority-ethnic women and their babies. Can the Minister commit to continuing to support the ambassador’s work?

Health and Care Bill

Baroness Sugg Excerpts

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

[Lord Morrow (DUP)]

My Lords, I rise to speak to Motion N1 and Amendment 92B. I want to put on record that it is extremely regrettable that a profound change in the way that abortions are delivered has been rushed through at the end of this Bill, without the opportunity for scrutiny and consideration in Committee and on Report of whether additional safeguards needed to be added. I thank the noble Baroness, Lady Eaton, for proposing a modest, child-safeguarding amendment through Motion N1, Amendment 92B, to the amendment agreed in lieu to continue telemedicine abortion in England.

The concerns about the telemedicine regime were stated, albeit briefly, on 16 March. They focused on concerns about whether all pregnancies really are below the 10-weeks limit set out in Amendment 92A, that complications at home are not properly monitored, and that telemedicine abortions mean that women can be vulnerable to coercion. However, this revised amendment specifically and simply states that the consultation must be in person for a pregnant woman under the age of 18. I welcome that, and hope that young women who want such a consultation will not feel pressured into a remote consultation. As was said in another place last week,

“I do not think that many people in this House would think that a 14-year-old girl should be ringing up and receiving abortion medicines over the telephone, but that is indeed what the legislation allows”.—[Official Report, Commons, 30/3/22; col. 879.]


While either an in-person or a remote consultation meet the requirements of the law as drafted in Amendment 92A, it does not mean that they both meet the health requirements of all sections of the population. Two key organisations qualified to speak on this matter have specifically said that remote consultations do not work for children. Both the Royal College of Paediatrics and Child Health and the National Network of Designated Healthcare Professionals for Safeguarding Children have called for face-to-face appointments. In a letter to the Times last Friday, the president of the royal college said:

“However, the change in the legislation through the Health and Care Bill leaves a glaring gap. Children and young people are a distinct group, and telemedicine can present particular risks. We must consider their safeguarding and holistic wellbeing as well as their physical health needs.”


She went on to say that

“a face-to-face appointment would allow a healthcare professional to talk to them, examine them if necessary and spot any safeguarding issues”.

The concerns about telemedicine abortions are more acute for under-18s, so the proposal that we should make a further exception for children in the regime introduced through Amendment 92A on where abortions can take place seems entirely sensible. We do so on a wide range of legislative measures; indeed, the Labour Front Bench only last night advocated for different treatment for children under the modern slavery legislation debated as part of the Nationality and Borders Bill. I hope that the noble Lord, Lord Coaker, will forgive me and not mind me quoting him when he said, quite rightly:

“We do that in every area of law; we provide differently for children than for adults”.—[Official Report, 4/4/22; col. 1942.]


Amendment 92B does exactly that by requiring in-person consultations for under-18s.

I shall end with the closing paragraph of the letter to the Times, which said:

“The bill is nearing its final stages. The government and parliamentarians must make sure this vulnerable group is taken into account.”


I urge your Lordships to adopt this Motion.

[Baroness Sugg (Con)]

My Lords, I rise to speak to Motions N and N1. I fully support the Government’s Motion N; it delivers the same outcome as the cross-party amendment supported by your Lordships’ House and received cross-party support from the other place last week. I am grateful to the Health Secretary and my noble friend the Minister for their engagement on this issue, and to the officials and lawyers in the department for their assistance in drafting.

Motion N makes the provision of access to telemedical early medical abortion permanent. It is supported by the vast majority of medical professionals, vulnerable women’s groups and by women themselves. Following the largest ever abortion study, the service was shown to be safe, effective and compassionate.

I cannot support my noble friend’s Motion N1 for two reasons. First, it was debated in full in the other place, including substantive discussions on whether under-18s should be included. MPs voted in support of this service in its entirety, without requiring any changes. Your Lordships’ House also supported making this service permanent. Both Houses are in agreement, and I do not believe we should reopen an already considered and agreed position.

Secondly, I cannot support it for safeguarding reasons. It is absolutely crucial that we protect young people—I am sure all noble Lords agree on that—which is why the Royal College of Paediatrics and Child Health, the Royal College of Obstetricians and Gynaecologists, the DHSC and abortion providers have already agreed to produce a set of best practice standards on safeguarding and abortion care for young people. I appreciate the Minister reassuring us on this; it is how clinical guidelines should be developed. It is standard professional activity for medical royal colleges and does not warrant any additional legislation.

If Motion N1 is agreed, as a result of the inequitable provision, young women will be more likely to have poorer access to and experience of abortion care. It would mean that young women who are physically unable to make it to a clinic, as a result of a health condition, or who live in a very rural area, have no access to transport or are at risk of violence and abuse, will have no legal way to access abortion services in England and Wales. They would be forced either to access illegal pills online or to continue with their unwanted pregnancies.

I will address a couple of the points that have been raised. I also have anecdotes about how this has helped women and girls, but I do not believe it is helpful to share individual cases—we should listen to the experts on this—but the poor girl in the terrible case raised by my noble friend Lady Eaton was actually seen in a clinic, so my noble friend’s amendment would not have helped. On the point raised by my noble friend Lady Verma, of course we want to avoid sex-selective abortions, but this goes up to only nine weeks and six days, and it is not possible to find out the sex of your baby until after then. That would not be possible in early telemedical abortion.

Children must be protected. I appreciate and agree with my noble friend Lady Eaton’s desire to do this. However, as my noble friend the Minister has set out, this should be done through clinical guidelines and safeguarding best practice. I am pleased there will not be a vote on this, as I could not support it.

[Lord Alton of Liverpool (CB)]

My Lords, I made my substantive points when we debated this on Report, so I will not be tedious in repeating all those arguments about the nature of abortion, why I feel there should be a more thorough consideration of the way the law works in Britain today and why there have been 9 million abortions—one every three minutes. That does not suggest a lack of access to abortion in this country. But I support what the noble Baroness, Lady Eaton, said to us about the lack of safeguards in the amendment that we passed, against the wishes of Health Ministers, during the tail end of the Report stage consideration of the Bill.

If the noble Baroness, Lady Sugg, was right that there had been substantive discussion, I would feel easier about this, but she will agree that there was no discussion of this at Second Reading or in Committee here, and there was no discussion of it in another place. When this was voted on in another place, there was a relatively close majority at the end of a very short debate—215 votes to 188. This demonstrates that this question is not settled.

If one winds back the clock to 1967, only 29 Members of the House of Commons voted against the Abortion Act 1967. That demonstrates that not only is this not settled but there are deep concerns about the way that this public policy has been enacted. That is why I pleaded, on Report, that rather than making policy on the hoof, it would be far better if—despite our differences of opinion, some of them fundamental, on the substantive issue—at some point, there is a review of the legislation, in which we can at least talk to one another, in a civilised way, about the best approach.

That brings me to this amendment, which was introduced with such sensitivity and compassion by the noble Baroness, Lady Eaton, and which deals with safeguarding issues. I will not repeat the quotation that was just given to us by the noble Lord, Lord Morrow, but it comes from a royal college. The royal colleges may be divided about this too—I do not dispute that—but that is exactly the sort of thing that should be laid before a commission of inquiry or a Select Committee of this House to examine the workings of the legislation.

We have heard the quotation about the safeguarding, well-being and physical needs of children from the Royal College of Paediatrics and Child Health, but I was also struck by what a designated doctor for child safeguarding said in a briefing which many of us have been sent by the National Network of Designated Healthcare Professionals for Safeguarding Children. Dr Helen Daley says:

“The considered expert position of the NNDHP is that all children (i.e. those under 18) and looked after individuals under the age of 25, should be seen face-to-face when applying to take both sets of abortion pills at home so as to prevent coercion, child sexual exploitation and abuse, and so that clinical assessments can be made to check the risk of an inadvertent mid- or late-trimester abortion.”


I note what the noble Baroness, Lady Barker, said about specific individual cases. I do not know about the individual cases, other than that one was cited, and one is enough. It struck me, as a parent and someone who has worked with children with special needs, some of whom had significant emotional problems, to think how it would be if, in a home abortion, someone was to abort a late-trimester baby and the children in that household saw what happened. I think that would remain with them for the rest of their lives and it could have a deeply distressing and traumatic effect on them. That is why we should listen to Dr Helen Daley when she says

“We have very real concerns about the harm”


that this amendment to the Bill

“(which would allow girls to take abortion pills at home without a prior face-to-face consultation for any early abortion) will do to children.”

There is one other point, which was not referred to in our early debates. There is evidence about the physical effects on women. For me, this is not a choice between the unborn child and the woman—both lives matter. One in 17 women, or 20 a day, who had taken at least one abortion pill at home in 2020 needed hospital treatment for side-effects. This evidence was provided through a freedom of information request by the previous global director of clinics development at Marie Stopes International. There are significant risks.

I plead with your Lordships: when we make laws on issues such as this, let us always be respectful of each other’s opinions, attitudes, beliefs and principles, and listen to each other carefully, which we are doing in this House tonight; bluntly, I think we are a very good example to others about how this debate should be conducted. When the noble Baroness, Lady Verma, talks about the risks of, for instance, sex-selection abortions, we must take that seriously, because there have been examples of it and we know to what it can lead; we have seen that in other jurisdictions and countries. When the noble Baroness, Lady Eaton, tells us there could be risks to children over safeguarding, we must take that seriously. I promised to be brief and will now sit down.

Health and Care Bill

Baroness Sugg Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

Moved by

[Baroness Sugg]

183: After Clause 164, insert the following new Clause—
“Permitted locations for abortion treatment
(1) The Abortion Act 1967 is amended as follows.(2) In subsection 1(3) after the first “section” insert “, or section 1A of this Act”.(3) After section 1 insert—<strong>“1A</strong> Approved places(1) The home of a registered medical practitioner is approved as a class of place for treatment for the termination of pregnancy for the purposes only of prescribing the medicines known as Mifepristone and Misoprostol to be used in treatment carried out in the manner specified in subsection (3).(2) The home of a pregnant woman who is undergoing treatment for the purposes of termination of her pregnancy is approved as a class of place where the treatment for termination of pregnancy may be carried out where that treatment is carried out in the manner specified in subsection (3).(3) The treatment must be carried out in the following manner—(a) the pregnant woman has—(i) attended an approved place,(ii) had a consultation with an approved place via video link, telephone conference or other electronic means, or(iii) had a consultation with a registered medical practitioner, nurse or midwife via video link, telephone conference or other electronic means; and(b) the pregnant woman is prescribed Mifepristone and Misoprostol to be taken for the purposes of the termination of her pregnancy and the gestation of the pregnancy has not exceeded nine weeks and six days at the time the Mifepristone is taken.(4) Nothing in this section should be taken to affect any approval otherwise made by the Secretary of State under subsections 1(3) or 1(3A) of this Act.(5) For the purposes of this section—“approved place” means a hospital in England or Wales, as authorised under section 1(3) of this Act, or a place in England or Wales approved under that section;“home” means, in the case of a pregnant woman, the place in England or Wales where a pregnant woman has her permanent address or usually resides or, in the case of a registered medical practitioner, where a registered medical practitioner has their permanent address or usually resides.””

[Baroness Sugg (Con)]

My Lords, Amendment 183 in my name, if accepted, would maintain the existing provision of at-home early medical abortion following a telephone or video consultation with a clinician. It is very late in the evening, but this is an important issue which will impact hundreds of thousands of women. The existing provisions, which the amendment simply transcribes into the Bill, were adopted in March 2020. It is a straightforward and narrow amendment with the sole purpose of retaining a service that has been in place for the last two years.

Early medical abortion, which can take place up to 10 weeks into a pregnancy, involves two medications. Previous government policy in England was that only the second pill could be taken at home, with women having to attend an abortion provider in person to take the first pill. The approval that was put in place simply enables women to take both pills at home. This was a pandemic-led shift to telemedicine, but the clinical benefits of telemedical service were known even before Covid-19, with NICE recommending it in September 2019. Sadly, following a government announcement a few weeks ago, this approval is currently set to be removed in August this year.

At this point, we should briefly be clear on what removing the existing provision would affect. It would have no impact on the requirement for face-to-face consultation, for face-to-face safeguarding, for ultrasound scans or to be seen in person by both doctors. Any of those changes would require amending existing regulations and that is not what we are debating tonight. The only thing impacted by this amendment is the requirement for women to visit a clinic and then leave again. I hope noble Lords agree that we can focus on just that.

There is no medical reason why telemedicine, alongside interpersonal appointments, should not remain a permanent option. There is overwhelming evidence that allowing women the option to access early medical abortion at home, where clinically appropriate, has created a safer and more effective service. During the pandemic, the largest ever study of UK abortion care, published by the British Journal of Obstetrics and Gynaecology, found that this service shortened waiting times and enabled women to receive care much earlier in their pregnancy. Some 150,000 women have received telemedical abortions since March 2020 and the data on the number of women presenting to NHS services with complications has shown a decrease. Renowned medical bodies support its use, including the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners, the Royal College of Midwives, the British Medical Association, the Academy of Medical Royal Colleges and many more. Just last week, the World Health Organization made it a key part of its global guidance on abortion care.

It is not just the medical experts who want to see this service made permanent—women do too. A recent study in the British Medical Journal found that 89% of women who have used a remote abortion consultation would choose to have treatment at home. It helps women who may struggle to find the time and travel the distance to an abortion provider. This includes those who have childcare or caring responsibilities, who struggle to take time off work, who live in remote or rural areas with little transport and many other logistical, social and economic reasons. Importantly, it can also be a lifeline for women in vulnerable situations. Maintaining the service is fully supported by women’s groups, including Women’s Aid, the End Violence Against Women Coalition and Rape Crisis, which say that it enables women in controlling and abusive relationships to access essential medical care. Removal of telemedical abortion provisions would almost certainly lead to a resurgence in women seeking to access unregulated pills bought online. Without telemedicine, waiting times will rise and current staffing levels would be insufficient.

There is a serious risk that some women would, as a result, be unable to access legal abortion care, either because the providers do not have the capacity or because increased waiting times push some women over the legal limit. Of course, face-to-face services must still be provided for all women who require or request it. However, to take away from women a service that has proven safe, accessible and compassionate, and which enables women to deal with a difficult situation in the comfort and privacy of their own homes, is not the right way forward.

This amendment follows the guidance of medical professionals and would deliver on the Government’s aim to listen to women and put them at the heart of the women’s health strategy. I believe the case is clear and hope that the Government will accept this amendment. I beg to move.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, in speaking to this amendment, I apologise for not having spoken in Committee. I want to do so because I have received hundreds of emails urging me to vote against this amendment. I want to explain why I will vote for it—if there is a vote—and why the people who emailed me are worrying about the wrong thing. I emphasise that this is not about changing the law.

I will not make a long speech because the noble Baroness, Lady Sugg, explained the amendment brilliantly and thoroughly. I will make just a couple of points. Over the past two years, the Department of Health, the Government and SAGE—everyone—have told us to follow the evidence. The truth is that this telemedicine, pills-by-post approach to termination pre 10 weeks’ gestation is simply a medical practice innovation that is safe, effective and follows the best clinical practice. So I want to follow the evidence.

About the only positive outcome of the pandemic I can see is that an enforced pilot scheme has given us evidence of the efficacy of this. We also know, as has been mentioned, that many women appreciate this option because there is no clinical need for them to attend a clinic for this procedure. I really cannot see why the Government cannot see that women who do not need hospital care or in-clinic services to access a procedure should not be forced to take up valuable appointment slots and staff time and unnecessarily squander resources that would be better used to intervene in genuine medical emergencies.

Despite all this, I understand that, for many people, the issue of abortion cannot be reduced to evidence or medical practice because they have moral concerns. I assure them that nothing in this amendment, which is literally about the location where a woman swallows a pill, touches on moral values. This is not a law change. Who can and cannot have an abortion remains exactly the same. The grounds on which abortion is legal remain exactly the same. It is common sense and pragmatic as a matter for women but, if you are morally opposed to abortion, you will still be morally opposed to abortion because nothing in this amendment will change your moral objection. Be reassured: you must have a different fight but not on this amendment, which is total common sense. The Government should accept it.

Medical Abortion Pills

Baroness Sugg Excerpts

Thursday 10th February 2022 Lords Chamber

Asked by

[Baroness Sugg]

To ask Her Majesty’s Government what plans they have to extend the availability of the home use of pills for early medical abortion.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

We are carefully considering all evidence submitted to the Government’s public consultation on whether to make permanent the temporary measure allowing for home use of pills for early medical abortion. We will publish our response as soon as possible and before the end of March to give providers sufficient time to plan for whatever the outcome is.

[Baroness Sugg (Con)]

I thank my noble friend the Minister for that Answer. The consultation on this finished 12 months ago and the current regulations expire next month. Abortion providers have made it clear that without telemedicine services, we will face enormous demand pressures resulting in longer waiting times, later abortions and even women having to resort to unsafe abortions. It would be very helpful to understand the delay to a permanent decision and why it cannot be reached when the evidence is so clear.

[Lord Kamall (Con)]

One of the reasons, as my noble friend would acknowledge, is that we had lockdown and then we were let out, and then we had more restrictions. We did not want to announce something and then have to go back on it. All I would say is that it was always intended to be a temporary measure. We have looked at the responses to the consultation in order to reach a decision, and we will be issuing our considerations later.

Health and Care Bill

Baroness Sugg Excerpts

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

Reading and reflecting on this must lead us to the conclusion that we should not be allowing our public authorities to do business in this way. I really hope the Government will be sympathetic to this.

[Baroness Sugg (Con)]

My Lords, I rise to speak briefly in support of this amendment and, in doing so, I apologise that I was not here at the Second Reading, although I have followed the progress of the Bill carefully.

Last Thursday at Oral Questions, in response I think to the noble Lord, Lord Rooker, the Minister spoke of the importance of examining the provenance of health equipment that comes to the UK. He said his department was working

“to ensure that it is not from regions where there is slave labour, or where the Muslim Uighurs are being persecuted by the Chinese Government.”—[Official Report, 27/1/22; col. 439.]

We must of course ensure that the products and equipment in our supply chain are ethically sourced. Last week, my noble friend acknowledged that we need to do more here, and this amendment gives us the opportunity to do just that. Noble Lords speaking before me clearly and comprehensively laid out why we should avoid procurement from such areas.

All UK government departments need to do more to look carefully at their supply chains, but we must start somewhere. The DHSC, with its scale of procurement, and the reports we have seen of the prevalence of Uighur forced labour in PPE and healthcare supply chains during the Covid-19 pandemic, seems to be the right place to start.

The issue of genocide has been subject to lengthy debate in your Lordships’ House, not least during the Trade Bill last year. While a form of compromise was reached, it is limited to countries with which we will be entering free trade agreements. That is not a solution for procurement for many of the countries with which the DHSC does business. Importantly, this amendment would create a process, a mechanism, through which the UK Government could be required to assess regions for “serious risk of genocide”, and indeed publish their assessment. That process is, so far, sadly lacking in this country.

The UK has a responsibility to do all it can to protect against human rights violations and genocide. We also have a responsibility to our NHS workers and those who use the health service to make sure that we give them ethically sourced products. As my noble friend Lord Blencathra said, UK taxpayers do not want to be part of genocide.

We need to see deeds, not words. This amendment will significantly reduce the likelihood that the Government will procure goods or services from regions where there is a serious risk of genocide. It will bring the UK a step closer to developing a comprehensive framework in responding to allegations of genocide, and will meaningfully engage its obligations to prohibit, prevent and punish perpetrators of genocide. It does so in a limited, proportionate, reasonable and modest way.

I hope the Government will properly consider this amendment, I look forward to hearing the Minister’s response, and I know that he will have heard support for it from all sides of your Lordships’ House.

[Lord Rooker (Lab)]

My Lords, the Government should embrace this amendment. I want to concentrate on the traceability argument of goods, and in particular cotton imports. Without good traceability, the genocide convention obligations cannot be met.

To date, I have had two very poor replies on cotton traceability from the noble Lord, Lord Grimstone of Boscobel, at Question Time on 21 October, and a Written Answer on 24 January. Of course, as has already been said, we are miles away from the policies of the United States Government, who have taken a proactive approach to imports from regions of China where we know human rights abuses take place. As has been said, on 23 December, President Biden signed the legislation into law.

It simply cannot be left to commercial companies to satisfy themselves. It is crucial to understand the geographic origins of products and conditions of production. The two things are intertwined and they both need to be dealt with. There has to be a robust methodology that is reliable even when working with partners that may be untrustworthy or unco-operative. The use of middlemen such as commodity traders and the practice of blending fibre from multiple sources create additional difficulty.

Traceability—both what is termed as upstream, starting at the farm, or downstream, to map products back to their origins—is currently used. However, full visibility of the supply chain using these methods is impossible, and especially so in restricted areas such as Xinjiang Uyghur Autonomous Region. It is just impossible to do in the normal way you would look at traceability. If the Minister is in doubt about this, his department should read the report from the Center for Strategic and International Studies of November last year entitled:

“New Approaches to Supply Chain Traceability (implications for Xinjiang and Beyond)”.


My conclusion from that is that paper-based traceability and supplier information is a non-starter for effective due diligence.

In addition, there is abundant evidence that the Chinese Communist Party, which owns China, actually launders Xinjiang cotton, either semi-finished or blended, into international supply chains. This is set out in considerable detail in the November 2021 paper by Laura T. Murphy of Sheffield Hallam University entitled:

“Laundering Cotton: How Xinjiang Cotton is Obscured in International Supply Chains”.


In 2019, it was established that 85% of Chinese cotton was from Xinjiang. That means that cotton from the Uyghur region of China accounts for 22%—a fifth—of cotton worldwide. What was once grown or reared retains details of its origins—in a way, this is the test. However, it takes more than a paper trail to identify as such. It requires forensic work; chemical, isotope and genetic tracing and other methods that I will not list here are all crucial.

I will give a good example. From 1,000 garment samples collected across the world in high-street fashion shops involving nearly 50 brands, Oritain Global Ltd detected that in Vietnam, Cambodia and Bangladesh, the cotton in the garments had a mixture from Xinjiang of between 6.5% and 25%. Chinese cotton was 41% consistent with Xinjiang. Some 10% of samples of products tested in the UK were consistent with Xinjiang cotton. The UK has a high rate of imports from Bangladesh, where 25% of the cotton was from Xinjiang. It is worth pointing out that India has zero consistency with Xinjiang; India has cleared out Chinese cotton fabrication.

As to the practicalities for the health service, in 2019, the UK imported furniture, bedding and mattresses from China to the tune of £2.3 billion and imported apparel and clothing accessories to the tune of £3.7 billion. Has the NHS used beds and mattresses containing cotton from China or from suppliers using connections with China or other countries known to have a mixture of Xinjiang cotton? Where did all the Nightingale equipment appear from so quickly? As I asked last week, without any warning, how much China cotton is involved in NHS uniforms and accessories? Others have mentioned face masks, but as I pointed out last Thursday, more nurses means more uniforms.

Has the NHS supply chain used Oritain’s element analysis to check, or is it just relying on suppliers’ paperwork to check what would be only part of the supply chain? Companies and Governments need a degree of independence in assessing traceability and to not rely on companies doing it themselves. Some of the supply chains are five or six levels removed, so they cannot possibly have faith in each level and know the details from manufacturers, middlemen, traders, and agents. With the best will in the world and good corporate responsibility, checking the paper trail of five, six or seven levels will not work.

As I said earlier, the way to do it is to work on the basis that a product that was once grown or reared holds signs of its origins, and today’s advanced technology can do it. The technology of element analysis used by Oritain claims that it can tell the difference between two tea estates with a dirt road between them—it is so good and effective. For those who want more, I suggest the long read in the Guardian of 16 September 2021, which is where I came across the use of the technology. I have since met with senior reps of Oritain Global Ltd to better brief myself. Modern forensic technologies must be used, as is now required in the USA. The United States is using these technologies. Why are they not being used in the UK? The NHS, as the largest employer in Europe, should have a leading role.

It is not normal for the origin of cotton to be stated on labels. Of those 1,000 products which I mentioned were checked by Oritain last year, only 3% had the information on the label and, as a warning, the higher quality a product which attracts higher prices is more likely to be consistent with Xinjiang than cheaper items, so you must be really careful what you are looking at. Non-disclosure is almost the norm and of those who do disclose there is a high percentage of non-compliance, so labels and paperwork are not the answer.

Technology is the answer, and the ball is in the Government’s court. The old-fashioned gentlemen’s agreements and systems we are used to will not work. Modern technology is thought to be 95% accurate in identifying where an item was grown or reared. Only with that degree of information can the NHS satisfy the convention obligations. Otherwise, it will not work. The Government ought to embrace the amendment and then the new technology.

Virginity Testing

Baroness Sugg Excerpts

Tuesday 12th October 2021 Lords Chamber

Asked by

[Baroness Sugg]

To ask Her Majesty’s Government what plans they have to seek to use the Health and Care Bill to fulfil their commitment to make virginity testing illegal.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, they said today would be a baptism of fire, and I did expect this, I will be honest.

The Government are committed to safeguarding women and girls, which is why in the tackling violence against women and girls, or VAWG, strategy—as noble Lords know, DHSE loves acronyms—we announced our intention to ban virginity testing. It is widely acknowledged that such tests have no scientific merit or clinical indication, are a violation of human rights and have an adverse impact on girls’ and women’s well-being. Details of any offence are being carefully considered and the Government will make virginity testing illegal when parliamentary time allows.

[Baroness Sugg (Con)]

My Lords, I join others in welcoming my noble friend to his ministerial position and wish him all the best in his important brief. I am very encouraged by the clear indication in the violence against women and girls strategy that the Government intend to ban virginity testing when parliamentary time allows. The Health and Care Bill allows just that, and I hope that the Government will accept the amendments in the other place.

Virginity testing is inextricably linked with hymenoplasty, and any commitment to ban virginity testing will be undermined if we do not ban them both together. I am aware of an expert panel that has been convened on this, but I do not believe that it is necessary, as experts are aligned that there is no clinical or ethical reason for either invasive or harmful practice. Can the Minister tell me when that panel will report back so that action can be taken as quickly as possible, and we do not miss the opportunity to ban hymenoplasty in the Health and Care Bill at the same time as banning virginity testing?

[Lord Kamall (Con)]

We completely agree with my noble friend’s sentiments. It is really important that we ban virginity testing and hymenoplasty as soon as possible. The issue on hymenoplasty in particular is that, unfortunately, because it is classified as a cosmetic procedure, introducing legislation in this space might take away the right for women to make decisions about procedures that they wish to have and be counter to current regulation on cosmetic surgery. It is important that we work out how we can ban this practice, but those objections have been raised—and if those legal objections have been raised, we have to be careful that we work properly to make sure that we ban these procedures.

I give the commitment that I shall push as much as possible to make sure that we ban both virginity testing and hymenoplasty as soon as possible. My noble friend mentioned the amendments in the other place. The Member who submitted those amendments has been in consultation with the Department for Health and Social Care, and we hope to be able to introduce those changes, particularly those bans, as soon as possible.

Covid-19 Update

Baroness Sugg Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

I hear loud and clear the frustration of many noble Lords on the question of singing in churches; it is enormously frustrating to those who have a passion for singing. But I would be pretending to be other than I am if I did not level with the right reverend Prelate and say that this is an airborne, aerosol disease. It is breathed into buildings at huge risk to those inside, and there is a direct correlation between infection rates, that aerosol and that kind of singing. The decision has been made with huge regret and not without a huge amount of scientific analysis, and those who have made their case have been heard loud and clear—but we have to fight this virus and prevent people getting sick.

I do not accept the right reverend Prelate’s view that discipline has broken down. Quite the opposite: I am astounded by the British public and their adherence to voluntary guidelines and arrangements. I pay tribute to the British public, and I do not think that the right reverend Prelate does any favours when he suggests that discipline has broken down.

Lastly, I really do not accept the concept of an acceptable death rate. That is not how we play the health system in this country. We are here to save lives; that is our priority. There is a balance between the economy, freedom and lives, but as a Health Minister my starting point is to save lives.

[Baroness Sugg (Con)]

My Lords, it is great to see the data on the efficacy of vaccines against the delta variant, but we know that that might not always be the case in the future. The announcement from the Prime Minister that we will share 100 million of our excess vaccines is a welcome first step, but the G7 failed to achieve its 1 billion target, let alone the 11 billion that the WHO says is needed. Does my noble friend the Minister agree that variants present one of the greatest threats to the unlockdown here in the UK and that the pandemic is not over here unless it is over everywhere? What are the next steps to ensure that low-income countries are vaccinated as soon as possible? Given the success of our vaccine programme, will the UK take a leadership role in this, as we continue our G7 presidency?

[Lord Bethell (Con)]

Yes, I entirely agree with my noble friend on this matter: we are of course only safe when we are all safe. As chair of the G7, we have done an enormous amount to try to show leadership in this area. The G7 committed to share at least 870 million doses directly over the next year and to make these doses available as soon as possible. But the numbers involved are absolutely enormous: 870 million is an astonishing figure, but it is not near to the 8 billion that we ultimately need. At the end of the day, we need manufacturing in all the regions of the world. That is why, as the supporter of the AstraZeneca vaccine, which is made on a profit-free basis and on extremely generous terms to manufacturers of the world, Britain has given an enormous benefit to the world. I very much hope that the manufacturing can ramp up to meet that need.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Baroness Sugg Excerpts

2nd reading
Friday 16th April 2021 Lords Chamber

[Baroness Sugg (Con) [V]]

My Lords, I speak in full support of this Bill. I congratulate my noble friend Lady Wyld for sponsoring it and thank Laura Trott MP for her work on it in the other place.

The non-surgical cosmetic treatment industry is worth over £2.75 billion and accounts for over 75% of all cosmetic enhancements carried out each year. However, it remains almost entirely unregulated, meaning that legally, cosmetic injections can be administered by pretty much anyone.

A number of reports over the years have highlighted and flagged this problem. The review by Sir Bruce Keogh, commissioned by my noble friend Lord Lansley, found that, among other things, non-surgical cosmetic procedures were almost entirely unregulated. In 2017, a report by the Nuffield Council on Bioethics highlighted several concerns, including “inadequate” controls on the safety of some of the products and the absence of any statutory requirements for practitioners who perform such procedures to have particular qualifications or experience.

I am pleased that the Government have been considering ways that training and qualifications could strengthen sector standards and that they have been exploring the regulation of premises, practitioners, products and consumer safeguards. I welcome moves from practitioners to make these procedures safer, and I commend the work of bodies such as Save Face, an organisation that provides a national register of accredited practitioners.

This Bill is needed, and needed now. We know this is a problem that needs resolving. There are clear complications that can occur through such treatments, which other noble Lords have highlighted. The number of cases of botched jobs has at least doubled in the last year and, given the unregulated nature of the industry, that is probably just the tip of the iceberg.

As the demand for treatment has continued to increase, so have the number of unscrupulous treatment providers. We know that tens of thousands of under-18s undergo cosmetic enhancements every year, with cosmetic fillers being the most common procedure. Children should not be able to access these procedures from unregulated and unqualified providers, let alone with no prior medical or psychological assessment required.

It has been nearly a decade since Sir Bruce Keogh’s original and concerning report. In the intervening years, as my noble friend Lady Wyld highlighted in her opening speech, there has been a growing prevalence and normalisation of non-surgical cosmetic procedures. These services are more accessible and more affordable. For young people, as the noble Baronesses, Lady Massey and Lady Bull, highlighted, there are huge pressures to conform to the unrealistic and unattainable ideals that young people, particularly girls, see on social media.

This Bill will stop the dangerous and unnecessary non-medical procedures that can ruin children’s lives. It is narrowly focused and includes exceptions and protections where appropriate. It has been widely welcomed as a positive step forward by the industry and patient safety campaigners and across the political spectrum, and I hope that it moves forward unamended. My particular questions to the Minister have already been asked by other noble Lords today. I am pleased that the Government fully supported the Bill in the other place, and I look forward to hearing the Minister’s response.