Health and Care Bill

Lord Shinkwin Excerpts

Lords Hansard - Part 1 & Report stage
Thursday 3rd March 2022 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, I too thank my noble friend the Minister for Amendments 36 and 157. I shall also speak in support of Amendment 59 in the name of the noble Baroness, Lady Hollins. Before I do so, I hope your Lordships’ House will allow me to take this opportunity to thank the healthcare professionals at Guy’s and St Thomas’s, who recently looked after me so well following major surgery. Some noble Lords may have noticed my absence. I have had half my leg rebuilt and am now the proud, if involuntary, owner of a Meccano set inserted by my excellent surgeon, Marcus Bankes, and his registrar, Christian Smith. I apologise in advance if any noble Lord seeks to intervene and I dare not sit down to take their intervention as I am not sure I would be able to get back up again.

Although the pain was excruciating and the morphine, which I am weaning myself off, very welcome, it saddens me to say that that pain was compounded by the way in which I received no support from your Lordships’ House. I might as well have been dead. It reminded me that this wonderful institution remains a place whose rules and modus operandi were designed by and for rich, non-disabled men. I will say no more on the matter now, but it is clear to me that this needs to change if we are to become a stronger, more diverse, more representative House. If we do not want to be consigned to the past, we must stop living in the past. The appalling way we treat Members whose disability enforces temporary absence from your Lordships’ House is indefensible and cannot continue.

Returning to the substance of the amendments under discussion, I am hugely grateful that the Government have listened to concerns I raised at Second Reading and others raised, in my absence, in Committee. All credit goes to noble Lords for the strength and the passion with which they did this, and to the Minister for so obviously listening and taking their concerns on board. Taken together, Amendments 36 and 157 should make a real difference to the lives of all babies, children and young people in this country, particularly those with speech, language and communication needs. I should declare at this point my interest as a vice-president of the Royal College of Speech and Language Therapists. I know the Minister and his colleagues across government, not just in the Department of Health and Social Care but also in the Department for Education and the Ministry of Justice, share my ambition and the ambition of other noble Lords in wanting children and young people with communication needs and their families to have the best possible level of support so they can realise their potential.

To help deliver that ambition, I ask my noble friend to reflect on four things. First, I would be so grateful if he would look kindly on Amendment 59, so ably spoken to by the noble Baroness, Lady Hollins. This would help to close any potential accountability gap and considerably strengthen the provisions of Amendment 36.

Secondly, will the Minister pledge to ensure that all the guidance to the Bill specifically references children’s speech, language and communication needs? The statutory guidance and accountability lead for SEND is a very positive development, but it is not sufficient. The vast majority of children with communication needs do not have an education, health and care plan. This includes children with developmental language disorder—over 7% of all children—those who stammer, and those with speech-sound disorders. The guidance must, therefore, ensure that the needs of those children are supported. A model that the Government have already established for this is the statutory guidance to the Domestic Abuse Act, where speech, language and communication are listed as a specific intersectionality.

Thirdly, will the Minister agree to meet the chief executive of the Royal College of Speech and Language Therapists to discuss how the guidance on the Bill can best capture those issues? Fourthly, on Amendment 157, can the Minister reassure the House that the report will include commitments to act to improve information-sharing? Finally, may I reiterate my huge thanks to my noble friend the Minister, and say how pleased I am to be able to do so in person, in your Lordships’ House? It is good to be back.

[Baroness McIntosh of Pickering (Con)]

My Lords, I welcome my noble friend back and commend him for his bravery. We came into the House at the same time, and he is a source of constant inspiration to us all; I have endless admiration for him. I apologise to the House for having omitted to declare my interests when I spoke for the first time on Report on Tuesday. I refer to my entry in the register of interests, and in particular to the fact that I work with the board of the Dispensing Doctors’ Association. I am also a patron of the National Association of Child Contact Centres and a co-chair of the All-Party Group on Child Contact Centres and Services.

I again commend my noble friend the Minister for summing up and assessing the mood of the House and tabling the amendments today; I am grateful to him for that. I also support the noble Baroness, Lady Hollins, and her Amendment 59, which is very appropriate. I hope my noble friend will look favourably on it, and I pay tribute to the work of the noble Baroness. One of her remarks earlier on Report which struck a chord with me was about the shortage of psychiatrists and other mental health professionals, particularly for those in the age group affected by these amendments.

I endorse and support the amendments in the name of my noble friend Lord Farmer. He refers in particular to the family hubs, and I make a plea to the Minister to recognise, as part of a family hub, a child contact centre. Centres are usually manned by volunteers, and they do fantastic work—not necessarily in keeping families together, because, unfortunately, their role largely comes into play when families have broken, but they play a fantastic role in maintaining contact with the absent parent.

Obviously, in these constrained times, the budgets of all organisations come under increasing scrutiny and pressure, so I urge the Minister to use his good offices to speak to those in the Ministry of Justice and the Department for Education to ensure that the budget for child contact centres will be renewed not only for two years but for three years—the period promised earlier. Those centres do fantastic work, under great constraint, and I am proud to be associated with them. I wanted to use this opportunity to support the amendments and to urge my noble friend the Minister to use his good offices in this regard.

Health and Care Bill

Lord Shinkwin Excerpts

Lords Hansard - Part 1 & Committee stage
Tuesday 18th January 2022 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, it is a great pleasure to follow the right reverend Prelate the Bishop of Birmingham. I apologise to the Committee for not being able to be here at the start of the debate on this group, owing to a medical appointment.

I shall address my remarks to Amendments 141, 151 and 177. I do so because, like other noble Lords who have put their names to these amendments, and as I made clear at Second Reading, I believe that supporting speech, language and communication development and better outcomes for children and young people with speech, language and communication needs, which I shall refer to as communication needs for the remainder of my contribution, is incredibly important and a cost-effective investment.

I should at this point declare my interest as a proud vice-president of the Royal College of Speech and Language Therapists. I should also say that I have incorporated within my remarks those that would have been made by the right reverend Prelate the Bishop of Gloucester, who has a passionate interest in adequate support for people with communication needs as a former speech and language therapist.

My first point is that these amendments do not come with a significant price tag attached. Indeed, the price tag of not implementing what they propose would be considerably greater. These amendments would actually facilitate cost-efficiency because of the significant benefits over the medium to longer term of getting the system right at the outset—in other words, by ensuring that the system works to maximum effect when it matters most, as early as possible in children and young people’s lives.

We know that the impact of not supporting children and young people with communication needs in particular can be significant. For example, children and young people with long-term communication needs—10% of all children and young people—are at greater risk of worse educational attainment, mental health problems, unemployment and potential involvement in the criminal justice system if their needs are not identified and adequately supported. It seems common sense to require NHS England, as Amendment 141 proposes, to assess how well an integrated care board has identified and met children and young people’s needs in relation to the national accountability framework, which, of course, it has responsibility for publishing. It would help ensure transparent value for money—in other words, optimal bangs for bucks for the taxpayer. I have to ask: what’s not to like?

This amendment gives us the opportunity to ensure that children and young people are prioritised by decision-makers in the health system. Sadly, children and young people with communication needs are often even less of a priority. Indeed, this has been demonstrated by decisions taken during the pandemic, when speech and language therapy services to children were stopped and speech and language therapists were redeployed in many areas. As a result, according to a survey conducted by the Royal College of Speech and Language Therapists, 62% of children and young people received no speech and language therapy during the first lockdown. That is almost two-thirds whose life chances will have been adversely affected, and that will definitely come with a price tag attached over time.

It is therefore vital that integrated care boards are held to account to ensure that they give children and young people the priority they deserve, with a clear set of outcome metrics, including outcomes for children with communication needs. In fact, this would be in line with the Government’s very welcome acknowledgement—in a response to a Written Question tabled by the noble Lord, Lord Ramsbotham, in July 2019—that speech, language and communication skills are a primary indicator of a child’s well-being.

Surely it makes complete sense that this accountability should be grounded in a national accountability framework so that we actually see equitable support across England and thereby reduce the risk of babies, children and young people and their families facing a postcode lottery of access to services. I assume that all noble Lords would agree that the service they receive should be based on need rather than where they live. I would be very grateful if the Minister could tell me whether the national accountability framework will include metrics on outcomes for children and young people with communication needs.

Amendments 151 and 177 are in a similar vein and would, I believe, also bring considerable cost benefits. Amendment 151 would require an integrated care partnership to specifically consider the needs of babies, children and young people when developing its strategy. As with Amendment 141, to ensure that the Government’s very welcome ambitions for babies, children and young people, including those with communication needs, are achieved, it is essential that an integrated care partnership’s strategy specifically considers the needs of babies, children and young people so that they can achieve the best possible outcomes, not least in terms of life chances. This would help to develop a holistic, local approach to supporting babies, children and young people and their families, including, of course, those with communication needs.

It is also crucial that the strategy includes plans to support speech, language and communication development at the population level. This would help not only to deliver better health outcomes for children but to tackle health inequalities, an issue that I appreciate noble Lords have already addressed in considerable detail in Committee.

Finally, on Amendment 177, this proposed new clause would require the Secretary of State to lay regulations and publish guidance on how integrated care systems should meet the needs of babies, children and young people. This would also require integrated care systems to act in accordance with guidance. The key point here is that bespoke guidance for integrated care systems on meeting the needs of babies, children and young people must be on a statutory footing if we are to ensure that the strongest possible support is provided, including for those with communication needs and their families. I suggest that only then can we be confident that meeting their needs will not be considered optional and that a potential postcode lottery in access to services and support can be pre-empted and prevented.

Health and Care Bill

Lord Shinkwin Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, I congratulate the noble Lord, Lord Stevens of Birmingham, on his excellent maiden speech. I also applaud the work of John Baron in the other place, as my noble friend Lord Sandhurst and others have done, on focusing the Government’s attention in the Bill on cancer outcomes, and of my old chief executive, Professor Alex Markham, with whom I was privileged to work at Cancer Research UK.

It is an absolute pleasure to follow my noble friend Lord Ramsbotham, who does so much for those of us with communication needs, and I count myself among them. It is also appropriate because I am going to focus my remarks on how the Bill represents a golden opportunity to breathe life into building back better so that for children and young people with communication needs, and their families, it is more than just another soundbite.

Of course, I appreciate that that is also what my noble friend the Minister wants, because we all have a common interest in countering the post-pandemic scepticism about politicians’ ability to deliver. I suggest that the best way of doing that is to make the Bill a vehicle for hope: hope for the 62% of children with communication needs, whom the Royal College of Speech and Language Therapists found did not receive any speech and language therapy during the first lockdown; hope for their families; in short, hope that the future will be better, because the prospects of these children and young people will be improved by the Bill.

Just to be clear, I am not talking about hanging more expensive baubles on the Christmas tree. Rather, I am talking about making sure that all the lights on the tree actually light up—in other words, ensuring that everything works, that the Bill does what it says on the tin, and that the systems are truly integrated. The question is: what does that look like for children and young people with speech, language and communication needs who, sadly, despite constituting 10% of children overall, are still so far down the priority list?

First, the Government could build on the welcome precedent they set recently in the domestic abuse legislation in ensuring that guidance refers specifically to people with communication needs. Can the Minister ensure that the integrated care systems guidance regarding babies, children and young people includes specific reference to those with speech, language and communication needs?

My noble friend the Minister will know better than I that the long-term cost of not supporting children and young people with communication needs can far outweigh any short-term savings. For example, children with communication needs are at greater risk of mental health problems, unemployment and potential involvement in the criminal justice system if their needs are not identified and adequately met from an early age. So it is in everyone’s interest that integrated care systems give due regard to meeting their needs.

I would therefore value my noble friend’s reassurance that integrated care systems will not be allowed to consider children’s and young people’s communication needs as optional, given how this could exacerbate postcode lotteries, with all the longer-term false economies that I have already alluded to. Would my noble friend consider putting the guidance on to a statutory footing?

In conclusion, I ask my noble friend if he would be prepared to meet with me and the chief executives of I CAN and the Royal College of Speech and Language Therapists to consider how we can ensure that the Bill improves data and information sharing for children as well as adults and that, in the same vein, the barriers currently preventing local authorities and the NHS from planning and delivering services in a joined-up way for children with communication needs are removed?

NHS: Hospital Visiting

Lord Shinkwin Excerpts

Wednesday 15th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we brought in harsh guidance at the early stage of the pandemic. That was lifted quickly, for exactly the reasons the noble Lord gave, and we keep the current restrictions under review all the time. But it is up to local trusts to put the right infection control measures in place. Although we have some guidance in place, it encourages visiting, for the reasons the noble Lord points out, and we leave it to trusts to make the ultimate decisions.

[Lord Shinkwin (Con)]

My Lords, I will always remember how my spirits rose the moment my mother appeared at the entrance to the children’s ward when, as a child, I was confined to bed with yet another fracture. Given that the isolation of lockdown has highlighted the importance of human contact to good mental health, I ask my noble friend how the Government are advising hospital trusts on taking the mental health of visitors and those they are visiting into account.

[Lord Bethell (Con)]

What a touching piece of testimony from my noble friend. The feelings he had as a child are felt by a great number of people, not only those in hospital and social care but their loved ones. We are mindful of the impact of visiting on the mental health and the good feeling of those in hospital. Visiting was suspended on 4 April last year, but that suspension was lifted on 5 June. Since then, we have sought wherever possible to put careful visiting policies in place. In October last year, the number of visitors was limited to one family contact or somebody important to the patient; since then, we have made huge strides in trying to lift those restrictions wherever we can. It is left to trusts to implement exactly those restrictions that are suitable to maintain infection control in their area.

Commonwealth Fund Report: NHS Ranking

Lord Shinkwin Excerpts

Tuesday 14th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness half answers her own question. When it comes to universal coverage, I am extremely proud of the NHS and the service that we provide to the British public. There is no other health system like it anywhere in the world. The report makes cogent points on equality, and we have put that at the centre of our agenda, and in the NHS long-term plan, the prevention Green Paper and the newly implemented Office for Health Improvement and Disparities. We are doing that work through the obesity plan, the NHS health checks, the tobacco control plan and the vaccination plan. We are highly committed to this agenda, and we are making an impact.

[Lord Shinkwin (Con)]

My Lords, of course we must protect the NHS and support social care but, given the proposed tax increase, can my noble friend the Minister explain to taxpayers on low incomes how they will know whether their money is well spent?

[Lord Bethell (Con)]

My Lords, we raise taxes with huge hesitation. My noble friend is entirely right to hold the system to account for delivering value for money and to question productivity, but I reassure him that we have one of the most efficient health systems in the world. The money spent by the department on behalf of taxpayers is very wisely invested, and we are extremely grateful to those in social care and the NHS for the incredibly effective way in which they go about their business.

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

Lord Shinkwin Excerpts

Wednesday 30th December 2020 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, it is ironic, is it not, that on the very day that we are considering the European Union (Future Relationship) Bill, which should, in theory, make government far more accountable to Parliament, we are also considering yet more restrictions, retrospectively, which suggest that, in practice, we are moving in the opposite direction. If I were speaking in the Bill debate later today, I would applaud the achievement of the Prime Minister and the noble Lord, Lord Frost. It is immense, not least because it was secured in the face of sustained “scrutiny” by your Lordships’ House and the other place at every single step of the way.

I do not mean to detract at all from the fantastic progress made in finding a vaccine. I welcome today’s announcement that the AstraZeneca vaccine has been approved. It is, of course, wonderful news, but equally welcome would be a new approach by the Government of engaging with parliamentarians, such as Mark Harper in the other place, on cost impact assessments, for example —an issue so ably addressed by my noble friend Lady Neville-Rolfe in the debate on her regret Motion earlier this month.

Difficult decisions have had to be made; doubtless, more lie ahead of us. That is why I would urge the Government to make this new year’s resolution: to trust Parliament more and to treat it with the respect it deserves. That is the best way, indeed the only way, we are going to emerge from such a testing time as a renewed and reinvigorated parliamentary democracy, able to embrace the exciting opportunities afforded to us by our future relationship with the EU.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Lord Shinkwin Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, I shall speak to the amendment to the Motion in my name. As far as I know, I have not had coronavirus. What I do know is that whether I live or die is neither here nor there. In the grand scheme of things, though, whether parliamentary democracy survives and thrives is an entirely different question. That does matter, not just to all of us privileged to serve in the mother of Parliaments. It also matters to a totalitarian regime whose evident aspirations for domination depend on democracy’s demise. The totalitarian regime to which I refer is, of course, that of the Chinese Communist Party, or CCP. For that regime’s value system to succeed, ours must fail.

As Lord Sumption and others have made clear, coronavirus has caused democracy to be placed under threat. The threat stems not just from the CCP’s military expansion and its aggression in, for example, Nepal and the South China Sea, nor in the corrosive cynicism of the retrospective application of new laws of repression in Hong Kong, but also from the growing popular disenchantment with the ability of democratic Governments to strike the right balance, to which my noble friend Lord Forsyth of Drumlean referred in his excellent speech, between saving lives and saving livelihoods during a pandemic which originated in Wuhan.

I do not intend to rehearse the points made so eloquently by my noble friends Lord Robathan, Lady Noakes and Lord Forsyth of Drumlean, with which I agree. Naturally, most people are focused on the impact on their families and friends, but we can be sure that Big Brother is watching us. I do not mean our own state, although it is increasingly intruding on and controlling every aspect of our lives. I refer of course to Xi Jinping, the head of the CCP and of the world’s most repressive, surveillance-obsessed and threatening totalitarian regime. He may not be watching today’s debate in your Lordships’ House, but we can be sure that he will be watching and analysing the signals that we and the other place send. It is therefore worth reflecting on whether the messages that we are conveying highlight the strength of parliamentary democracy in the face of crisis or show panic, disarray and weakness.

I wish this were simply about tackling a dreadful, devastating and deadly virus. Unfortunately, what is at stake is so much more significant than any of our lives: it is the future of western democracy itself. That is why we cannot afford to signal that we are panicking or weak. Consider this: if one wanted cynically to expose the fault lines of western democracy, there could scarcely be a better way to do so than to allow a vicious virus to engulf the globe and plunge it into poverty. That is what we are facing.

We cannot afford to be in this situation again. We cannot afford, as Theresa May said in the other place only a few hours ago, for it to look as if the figures are chosen to support the policy rather than the policy being based on figures. That is the path to mistrust and cynicism. If we really want to save Christmas, we need to save people’s livelihoods. If we want to save the NHS, we need to ensure that we safeguard the tax revenues that are so crucial to funding it.

I am not saying this is necessarily the case, but I am saying it is essential that we entertain the awful possibility that a totalitarian regime capable of incarcerating in concentration camps millions of its Muslim Uighur population and harvesting their organs, capable of turning disputed rocky outcrops in the South China Sea into fortified islands and capable of turning the bastion of freedom that was Hong Kong into a police state is surely capable of allowing perhaps the most potent threat that western democracies have faced in the last 30 years to spread until it was too late.

The Government do not know best and noble Lords should resist any suggestion that they do, especially at a time of crisis.

--- Later in debate ---

Tabled by

[Lord Shinkwin]

At end insert “but that this House regrets that a further national lockdown to address the COVID-19 pandemic signals to totalitarian regimes that Her Majesty’s Government have failed to address the pandemic effectively, and that the United Kingdom’s parliamentary democracy is weak.”

Lord Shinkwin’s amendment to the Motion not moved.

Queen’s Speech

Lord Shinkwin Excerpts

Thursday 9th January 2020 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, I was really pleased to see in the gracious Speech a focus on enabling individuals to develop their skills and realise their potential. This reminded me of a powerful point made by the Prime Minister during the election campaign that talent is distributed equally but opportunity is not. As he said, and as many other noble Lords have said, we need to level up. To do that, I believe that this one-nation Conservative Government must prioritise promoting equality of opportunity.

The year 2020 is one of momentous legislative anniversaries for equality. I think of parliamentary giants like the late noble Lords, Lord Ashley of Stoke and Lord Morris of Manchester. Incredibly, the latter’s Chronically Sick and Disabled Persons Act is 50 this year. My noble friend Lord Hague of Richmond’s ground-breaking Disability Discrimination Act—the DDA—is 25 years old and, of course, the Equality Act turns 10 this year.

How different the world would be for me, for the UK’s 14 million disabled people and, indeed, for those with other protected characteristics—including women and members of the BAME and LGBT communities—had noble Lords not worked together to pass those and related pieces of legislation. What a cause for celebration it is that your Lordships’ House did so.

Yet I am also acutely aware of two things that are not a cause for celebration. First, so much remains to be done to realise the empowering vision of the DDA and the Equality Act so that equality of opportunity becomes a reality for everyone, regardless of their protected characteristic. Secondly, there is a real danger that essential change will not happen unless there is political will on all sides to make it happen.

The need is now. As my noble friend Lord Forsyth of Drumlean indicated in his powerful speech, the demographic pressure on social care is growing exponentially. We need to release resources to fund it. We can do this if we help more people to enter and flourish in employment, reducing reliance on benefits and increasing tax revenues. In short, there is no alternative if we are to make any investment sustainable.

Sadly, the current reality is that, as we enter the third decade of the 21st century, some are still denied the equality of opportunity to make the most of their potential. Take, for example, ethnic minorities, with an employment gap of almost 13%, or disabled people, with a gap of almost 30%. Stonewall has found that 18% of LGBT people were discriminated against while looking for work.

As we have already heard said today, it is time for some radical, fresh thinking to build on the success of big business giants like Paul Polman, the former chief executive of Unilever, who has voiced support for pay gap reporting and led the way in promoting diversity that enriches and rewards employers and employees alike. My workforce information Bill would help to do this. It already has the support of big businesses like EY and Enterprise Holdings, and of people such as my noble friend Lady McGregor-Smith, Andy Street, and Matthew Cameron from LGBT Great. My Bill would harness the energy of enterprise to drive equality of opportunity as a competitive advantage for big businesses looking to attract, retain and develop the best from the most diverse talent pool and, most importantly, to grow their turnover.

Big businesses deserve a level playing field to maximise the incentive to make best practice common practice. That means extending mandatory pay gap reporting for big business to other protected characteristics as well. So I close with a plea to the Minister and to your Lordships’ House as a whole: a quarter of a century after the DDA became law, let us make 2020 the year that is remembered for how, together, we struck another powerful blow for equality of opportunity. Supporting the measures contained in my Bill would be a step in the right direction.

Queen’s Speech

Lord Shinkwin Excerpts

Thursday 29th June 2017 Lords Chamber

[Lord Shinkwin (Con)]

My Lords, I intend to focus my remarks on an important subject that transcends the policy areas covered by today’s debate: disability equality. Some noble Lords may have heard that I have a new status since last we met: I have been abolished. For noble Lords who missed the piece in last weekend’s Sunday Times, I am referring to the fact that having applied in response to an advert specifically for the position of disability commissioner at the Equality and Human Rights Commission, I was told by its chair, 36 hours before my first board meeting, that the board had decided to abolish the role. In his words, the role was “redundant”. I was then pressured by the chair to accept that the disability commissioner was no more and that I would therefore not chair the commission’s important Disability Advisory Committee. In other words, as the Sunday Times put it, my role as champion of the nation’s 11 million disabled people had been abolished.

I reject what I regard as a retrograde and deeply regrettable decision. Perhaps I can share with the House why I am so concerned. The excellent report produced recently by the ad hoc Select Committee on the Equality Act 2010 and Disability states that there had been,

“a loss of focus on disability discrimination”,

and furthermore that,

“combining disability with the other protected characteristics in one Act”—

the Equality Act—

“did not in practice benefit disabled people”.

Nowhere in the report is there the slightest suggestion that one way to reassure disabled people would be to reduce the focus further, which is exactly what the abolition of the disability commissioner post does.

I am also concerned about the commission’s interpretation of equality. As noble Lords may recall, I argued in the last Session that disability equality before birth is fundamental, because unless a disabled human being’s equal right to exist is respected, all other rights are academic. One needs to be born to exercise them. Otherwise, the situation whereby after birth I am somehow good enough to be in your Lordships’ House, but before birth I am only good enough for the incinerator because of my disability, means that discrimination on the grounds of disability is perpetuated.

I have been told by the commission’s chair in effect to shut up on the issue of disability equality before birth. His exact, rather sinister, words were, “I appreciate this approach”—the commission’s approach—“would be a departure from your previous engagement in this field”. What is the commission’s approach? He states that the commission would have to agree its position on disability equality before birth based on an analysis of all relevant rights affected and consider whether and how to act on the issue through a prioritisation process based on strategic objectives.

Since when was equality, and especially a disabled human being’s equal right to exist, based on a prioritisation process and weighed against the rights of other groups? Does this apply to other protected characteristics covered by the Equality Act? Is it okay to deny their equal right to life specifically because of their protected characteristic? I think not. This is inequality. This is disability discrimination perpetuated by the very equality body that I, and every other human diagnosed before birth with a disability, should be able to rely on to defend our intrinsic equality. Yet I have sadly discovered that I cannot do so.

Within the last few hours, the commission chair has rushed out a letter to stakeholders highlighting the commission’s work on equality, presumably in anticipation of my speaking in this debate. That sadly confirms to me that the commission is missing the point: that the volume of activity is no substitute for a nominated disability champion in the form of a disability commissioner. It does nothing to lessen my fear that some non-disabled people see themselves as passionate advocates of equality but equality on non-disabled people’s terms. That has to change, and as disability commissioner I would have ensured that it does change.

Perhaps the most chilling aspect of all this is that no one was meant to know about the situation in which I find myself, because I was meant to acquiesce. Indeed, at one point I was asked not to mention it to other disabled people for fear that it would leak. I am not requesting that the Government get involved. This is a struggle for equality between the commission and me as a disabled person. However, in conclusion, I thank all noble Lords who have encouraged me to stand my ground and to refuse to accept that this is a done deal, and who have asked how they can help. I ask noble Lords to make their support for my position known, because the fact remains that we need a strong disability commissioner, and a genuine Equality and Human Rights Commission, now more than ever.

Abortion (Disability Equality) Bill [HL]

Lord Shinkwin Excerpts

Report stage (Hansard): House of Lords
Friday 24th February 2017 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, I start by joining other noble Lords in congratulating my noble friend Lord Shinkwin on steering the Bill through its Lords stages so far and on his engagement with noble Lords on the Bill. It raises important and sensitive issues about disability rights and abortion and it is quite right and proper that these are discussed and scrutinised at length by your Lordships. I am also grateful to the noble Lord, Lord Winston, for his amendment and for the scientific authority which he brings to the issues. I commend all noble Lords for the quality of the debate we have had on this amendment.

As I set out in Committee, the issue of abortion is a matter of conscience for noble Lords, as the noble Lord, Lord Alton, and the noble Baroness, Lady Massey, reminded us. The decisions that we take on this transcend the normal political or partisan divides and it is for that reason that the Government have taken and continue to take a neutral position on this issue and on the Bill. The Government do not, therefore, have a position on the amendment of the noble Lord, Lord Winston, or on those that will follow in the House today. I do not intend to comment on subsequent amendments unless there are specific points that noble Lords wish to put directly to me and to which I can respond.

I do, however, wish to make one point that I believe is germane to the issues under discussion in this amendment and, indeed, in the Bill in general, and that is that it is vital that we have accurate statistics on and evidence for the reasons for termination of pregnancy. Officials are working directly with hospital staff to improve reporting on abortions. We have also reminded all doctors involved in abortion care of their legal responsibility under the Abortion Act 1967 and the Abortion Regulations 1991 to submit form HSA4, the abortion notification form, within 14 days of a termination.

Overall, between 2013 and 2015, there was an 18% increase in the number of reported ground E abortions. While we obviously cannot claim that this increase is solely the result of increased reporting of these abortions, as opposed to increased instances, we do know that this is the case in some of the units that officials have been working directly with. The department will continue to monitor carefully levels of underreporting of abortions for foetal abnormality.

The noble Baroness, Lady Stroud, asked about palliative care for babies. I fear that I do not have that information to hand but I will be happy to write to her on the issue.

[Lord Shinkwin]

My Lords, I thank all noble Lords who have expressed support for my Bill and I thank the noble Lord, Lord Winston, for his medical lecture on so-called serious foetal anomalies. I address the noble Lord, Lord Winston, with respect but I also address him and all other noble Lords as an equal. I should say at the outset that I totally reject the very premise of this amendment. Other noble Lords have already explained why the amendment is totally inappropriate and, indeed, crassly insensitive, from a Northern Ireland perspective in particular, when it is linked to Amendment 8. I offer a disabled person’s perspective on why it is unacceptable. I have been consistently clear that the purpose of my Bill—a disability rights Bill—is to bring the law as it applies to disability discrimination before birth into line with the laws that your Lordships’ House has already passed to counter disability discrimination after birth.

Noble Lords will know that I accepted an amendment in Committee for an impact review as a logical amendment to a logical Bill. However, in the context of a Bill which promotes disability equality where discrimination begins before birth, this cynical amendment is not remotely logical. Indeed, it runs counter to the very essence of my Bill. The amendment reinforces discrimination because it singles out even more acutely a particular group for destruction on grounds of disability. It seeks to legitimise their destruction after 24 weeks with terminology that commands no clinical consensus and despite the fact that cell-free foetal DNA can first be detected in maternal blood as early as seven weeks’ gestation, which means that genetic or chromosomal abnormalities are being detected well in advance of 24 weeks. So what justification is there for abortion after 24 weeks on the grounds of so-called serious foetal anomaly?

Some noble Lords have seen that I recently asked the Department of Health about the number of fatal foetal abnormalities diagnosed in each of the past five years. The answer was that the information is not collected centrally. I followed up and asked about the number of fatal foetal abnormalities diagnosed after 24 weeks in each of the past five years. The answer was the same: the information is not collected centrally. I find that revealing, not because information is being concealed but because it reflects the reality—the truth of the situation.

Those noble Lords who were invited to attend a meeting on this issue, which I understand was held somewhere in the House on Wednesday, could be forgiven for thinking that there is some medical authority—some clear medical consensus—behind the definition of “fatal foetal abnormality”. There is not because there is not an agreed definition. Indeed, the consensus is that what is considered fatal or life-limiting involves a degree of subjective judgment which is influenced by understandings and by the availability of technology, both of which can change with time. The noble Lords who received the invitation to that meeting might also have got the impression, as was intended by the wording of the invitation, that those 230 disabled babies aborted after 24 weeks in 2015 had all been diagnosed with severe or fatal foetal abnormalities. They were not. Of the 659 babies aborted for the crime of having Down’s syndrome, for example, two were aborted at 25 weeks, one at 26 weeks, one at 28, one at 30, another at 31, three at 32 weeks, two at 33, two at 34—and one at 39 weeks.