Virginity Testing

Lord Kamall Excerpts

Tuesday 12th October 2021 Lords Chamber

[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.

[Baroness Brinton (LD) [V]]

My Lords, I also welcome the noble Lord, Lord Kamall, to the Dispatch Box. I want to pick up on points that the noble Baroness, Lady Sugg, raised. Some private clinics advertise these procedures to women, which perpetuate myths around virginity, falling way below the standards of honesty and integrity that are rightly expected of doctors. Indeed, the GMC ethical guidance on communicating information explicitly outlines that, when advertising your services, you must make sure that the information that you publish is factual, can be checked, and does not exploit patients. We have waited far too long for this to be made illegal. Can the Minister please press to make this happen sooner rather than later?

[Lord Kamall (Con)]

I thank the noble Baroness for her question, but also for having a meeting with me to discuss some of the issues that we will debate in future weeks and months. All preparation and revision are welcome.

I give a pledge that I will push back at my department and push to have both these practices banned as quickly as possible. However, as I said, some concerns have been raised from a legal perspective, given that hymenoplasty is a cosmetic procedure. All of us would agree that this is an awful thing and that it should be banned, but I want to make sure that in doing it we are very careful. A few years ago, I was a research director for a think tank, and one issue that I always considered with any change of law was unintended consequences. We have to be clear that we do this in a proper way, and I hope that we can introduce these bans as soon as possible.

[Baroness Hodgson of Abinger (Con)]

My Lords, I join others in welcoming my noble friend to the Dispatch Box. Virginity testing is such a demeaning process and, as has already been mentioned, an abuse against women. In October 2018, the UN human rights office, UN Women and the World Health Organization issued a joint statement calling for the end of this horrid practice, saying that it was a

“medically unnecessary, and oftentimes painful, humiliating and traumatic practice”.

What is the UK doing to support the World Health Organization, UN Women and the UN human rights office to ban this across the world and to mobilise other countries to outlaw this practice domestically?

[Lord Kamall (Con)]

I thank my noble friend for her warm welcome. In answer to her specific question, the Government absolutely agree with the World Health Organization’s view that virginity testing is a violation of the victim’s human rights and is associated with immediate and long-term consequences that are detrimental to physical, psychological and social well-being—as well as, in simple terms, being demeaning.

On my noble friend’s specific question about what we are doing with the World Health Organization, I shall write to her with more details.

[Baroness Bryan of Partick (Lab)]

My Lords, virginity testing is an abuse of women and a denial of their rights over their own body. The same private clinics can offer virginity testing and, once they have decided that a woman or a girl is not a virgin, they can then offer hymen repair procedure. Does the Minister agree that this should be illegal and that it is a total abuse of that clinic’s profession? Having listened, as I can hear he has, to campaigners and professionals, will he give a stronger assurance that something will be done in the Health and Care Bill?

[Lord Kamall (Con)]

The noble Baroness makes a valid point; I do not think anyone in this House would disagree with what she said. Virginity testing is demeaning and hymenoplasty is not only demeaning but damaging to women’s and girls’ health and we want it to be banned as soon as possible. I give a pledge that I will push for this to be introduced as soon as possible. Whenever noble Lords are told that the Government will find parliamentary time to do something, I understand why there might be some scepticism about that, but I will push to make sure that we can introduce it as soon as possible.

[Baroness Stuart of Edgbaston (CB)]

My Lords, virginity testing and hymenoplasty have to be made illegal at the same time, and rather than talking about it as a cosmetic procedure, it should be seen as a form of abuse. When I read the guidance from the Royal College of Obstetricians and Gynaecologists, it is rather limp. I encourage the Minister to ensure that the medical professions recognise that they will have an integral part in reporting and preventing any of this, just as they had when we started in the early days with FGM, because it is no good creating an offence without it being enforced and actually punished.

[Lord Kamall (Con)]

I give the noble Baroness the assurance that I agree—I do not think anyone disagrees—that we should try to ban both these practices as soon as possible. The issue is that although I do not personally consider it a cosmetic procedure, legally it is considered as such, and that is why we have to be a little more careful about how we address the issue in legal terms, and the exact drafting of the ban. Of course, any medical professional who carries out these procedures following a ban will be breaking the law, and that is absolutely right. The other issue we then have to consider is what penalty those who break the law in this way will face.

[Lord Black of Brentwood (Con)]

My Lords, I welcome the Government’s renewed commitment to making virginity testing illegal, but I hope the fate of similar commitments in the health and care sector does not befall it. It is now four years since the Government made a similar pledge to end another degrading and cruel practice, that of so-called gay conversion therapy, and we are no nearer action to making it illegal than we were in 2017. Does my noble friend understand the frustration of those who want to see this repulsive practice banned but are having to wait for endless consultations and a failure to find parliamentary time? Is not the Health and Care Bill the perfect vehicle to fulfil this long-standing government commitment?

[Lord Kamall (Con)]

I thank my noble friend for that question. I think we all agree, as he said, that conversion therapy is an awful practice and should be outlawed. The Government have made a commitment to outlaw it. There is an interesting thing, when we talk about the history of various commitments from the Front Bench and whether they were implemented: around Christmas time, we often see advertisements saying, “A dog—or a puppy—is for life, not just for Christmas”. As we know, with ministerial life, it is the opposite: a ministerial portfolio is for Christmas, not for life. However, when I look back at my time, I would ask people to judge me on my actions.

[Baroness Merron (Lab)]

My Lords, I welcome the Minister to his place and wish him well. In addition to private examinations performed by gynaecologists and other medical professionals, campaigners report that victims are often subject to extremely crude examinations performed at home by family members, involving such means as inserting fingers into the vagina to check if the hymen is intact. What steps are the Government taking to tackle such hidden forms of abuse?

[Lord Kamall (Con)]

One issue we have to think about whenever we bring in any new law or ban is the unintended consequences. One unintended consequence that has been raised is that doing so might drive this practice not only into the home but underground. If we make it illegal, it is illegal; we must make sure that, when someone subjects a woman or girl to that awful experience, everyone knows it is illegal and that they will face the full force of the law.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the time allowed for this Question has elapsed.

Health: Type 2 Diabetes

Lord Kamall Excerpts

Tuesday 12th October 2021 Lords Chamber

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what assessment they have made of the data analysis by Diabetes UK, published on 6 October, which suggests that one in three adults in the United Kingdom could be at increased risk of developing type 2 diabetes by 2030.

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

I thank noble Lords for giving me a pause for breath; I appreciate the patience they have shown me today. The Government welcome Diabetes UK’s research in increasing our understanding of diabetes and are committed to reducing and preventing type 2 diabetes, particularly in those groups who are more at risk of developing it and face poorer outcomes. This is why the Government launched the NHS diabetes prevention programme and the healthy weight strategy to look at ways to tackle weight gain and reduce children’s exposure to high-fat and high-sugar foods, including using digital tools to reach key groups.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for that reply and welcome him to his new post. He has had a baptism of fire today and has come through reasonably well—so far. We wish him well and good health too. Does he agree that one of the major and most successful initiatives of recent years was Mrs May’s move in 2018 to introduce a sugar tax on fizzy drinks? Employers have been persuaded to reformulate their product. Will the Government now extend that taxation over a wider front on food and drinks? Can they start giving some thought to possibly following the substance of that approach on fat and see whether we can move towards taxing it?

[Lord Kamall (Con)]

I first thank the noble Lord very much for his warm welcome and his modest appraisal of my performance thus far. I am told that, coming from him, that is high praise indeed; he may disagree afterwards. As he knows, the Government are committed to this, but one thing we always have to look at in introducing new laws, bans or taxes is unintended consequences. Before I came to this role, I read some research which said that there were unintended consequences of some of the sugar taxes; for example, did they force people from poorer families or poorer communities to buy alternative, cheaper brands of the same drinks with the same sugar content, or did they just take the hit to their pockets and pay more? Were the outcomes any better? When looking at some of the programmes being put in place to tackle type 2 diabetes and the taxes proposed, it is important that we make sure it is all evidence-based and work out whether there are unintended consequences. If there are, we must find other ways to make sure we tackle obesity and some of the other issues that lead to type 2 diabetes.

[Lord Davies of Brixton (Lab)]

My Lords, the figures in the report are shocking, so I hope the Minister understands that with diabetes, as much as or more than other conditions, there is a need for close and consistent monitoring, not just for the patient’s sake but to avoid greater subsequent demand on the NHS. Is he therefore concerned by reports that in too many areas the essential regular reviews of patients’ conditions are simply not happening because of pressure on clinics or even a shortage of the equipment required to undertake the necessary tests?

[Lord Kamall (Con)]

I take a personal interest in diabetes; I have two very close family members with diabetes, one type 1 and one type 2. I noticed during the Covid lockdown the different approaches in meeting their clinicians—telephone calls rather than meeting in person, and reviewing their charts and sugar graphs over time, which is regularly done at these reviews. I agree completely that it is really important that we now try to address this backlog as much as possible. I know that the Secretary of State is committed to making sure that, with the uplift, we try to tackle as much of the backlog as possible, including for patients with type 2 and type 1 diabetes.

[Baroness Jenkin of Kennington (Con)]

My Lords, I associate myself with the remarks of the noble Lord, Lord Brooke. I think everybody in the Chamber will appreciate the challenges that my noble friend has faced today with all these questions. My noble friend will probably know that 10% of NHS spending is currently on type 2 diabetes. That is £25,000 a minute, £1.5 million an hour, and rising. He will be aware that diabetes is reversible by diet. I am not sure whether he is also aware that, under the leadership of Jonathan Valabhji, the NHS has now endorsed a 12-week programme which has put many patients into remission rather than having to go on to medication.

[Lord Kamall (Con)]

I thank my noble friend. I have done my homework and I have read a little about what has been happening up to now, especially about the NHS diabetes prevention programme, which identifies those most at high risk of developing diabetes and refers them on to behavioural change programmes and personalised education to reduce their risk of developing diabetes, including things such as bespoke exercise programmes and learning about healthy eating and lifestyle. The programme achieved full national rollout in 2018 and 2019, with services available to patients in every system in England.

As we know, tackling diabetes is multifactorial. Nevertheless, the NHS long-term plan sets out plans for increased action on diabetes and related issues. I shall mention just a few, including the healthy weight strategy launched in July 2020 to help adults and children maintain a healthy weight, and the restrictions on the promotion and advertising of foods high in fat, sugar and salt, as was mentioned earlier. It is really important with programmes such as this that we look at these studies on a longitudinal basis and look at the evidence. Some of these programmes will work, and some will not. That is just the way the world is. We have to make sure that we tackle unintended consequences first of all, and that any future policy is very heavily based on evidence rather than a wish. That will be the most effective way of tackling diabetes.

[Baroness Merron (Lab)]

My Lords, the rise in diabetes means that millions of people are at risk of devastating complications, including heart attacks. In 2009, to improve heart health, checks were introduced for the over-40s. However, by 2019, only half of those invited actually received those checks, and the checks were paused during the pandemic. Does the Minister agree that it is vital that these preventive checks are relaunched, and will he commit to putting in place a plan to ensure that people are able and willing to attend them?

[Lord Kamall (Con)]

I do not think anyone will disagree on the importance of making sure that these checks are reinitiated, or on what is being put in place to make sure either that patients are able to continue with or that new patients can start some of these programmes. Also, as noble Lords can imagine, there has been better use of technology in all fields during the Covid lockdown. For example, the NHS used Facebook to reach millions of men aged 40 or over who were at risk of developing type 2 diabetes. We also know that, in some cases, there are online consultations between patients and medical experts. Of course, with better tools, such as remote monitoring and flash blood readers, it is important that information can reach clinicians and be reviewed remotely. But there is no substitute for face-to-face meetings, and we hope very much that many of these can be resumed as soon as possible.

[Lord Dubs (Lab)]

My Lords, given the clear links between obesity and type 2 diabetes, does the Minister agree that more can be done to tackle obesity among children and young people? May I commend to him some of the practices being followed in Amsterdam, where this has really been tackled in a holistic manner? Could we not do likewise?

[Lord Kamall (Con)]

I hope the noble Lord will forgive me, but I am not yet aware of the practices in Amsterdam. I would very much like to look into those and learn more. We can learn. It is really important that we learn from best practice around the world, and I would very much welcome it if he could write to me with some details.

[Baroness McDonagh (Lab)]

There are not many questions left for the Minister now—it will soon be over. Can I ask again the question that some of my noble friends have asked, as I have not specifically understood the answer? What impact assessment have the Government done to understand the implications of the reduction of face-to-face GP and nurse appointments and the reduction in eye appointments, footcare appointments and nutrition appointments for the diagnosis and management of diabetes? We know that this is a progressive illness, and failure to act makes people much sicker and makes it very hard for the NHS to reverse the problems that diabetes causes. What assessment has been made of this impact?

[Lord Kamall (Con)]

I thank the noble Baroness. I do not have the detailed assessments of that but I commit to writing to her with more details.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, that concludes Oral Questions for today.