Health and Care Bill

Baroness Bennett of Manor Castle Excerpts

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I support Motion B1 in the name of the noble Baroness, Lady Cumberlege. I will be brief and not repeat what others have said. However, it is worth noting that in the Statement on the Ockenden report, the Secretary of State for Health said:

“I am also taking forward the specific recommendations that Donna Ockenden has asked me to. The first is on the need to further expand the maternity workforce.”—[Official Report, Commons, 30/3/22; col. 819.]


That phrase could be repeated for every part of the NHS and social care workforce, so I believe that has changed the situation since the other House debated this issue.

The public are asking what the national insurance levy is for if not to increase the number of professional staff in training. We are turning away people who want to be paramedics and nurses, as my noble friend has just said, who want to train locally. Of course we should undertake ethical overseas recruitment as well, but we need both. I firmly believe that this amendment needs the full support of this House.

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Watkins, and to ensure that full support for Motion B1 has been presented from all round your Lordships’ House, including the Government Benches. The Green group also supports Motion C1 particularly strongly, and Motions D1, F1, G1 and L1, but I will speak briefly only to Motion B1 because it is so crucial.

In introducing this group the Minister spoke, as the Government often do, about the record numbers of staff in the NHS. I do not think anyone has yet mentioned the NHS staff survey conducted between September and November. Just 21% of nurses and midwives thought that there were enough staff in their unit to do their job properly and provide an adequate standard of care; almost 80% thought there were not enough. The noble Baroness, Lady Tyler, referred to the Ockenden report: that helped to highlight that, despite the fact that the Government have been trying to recruit more midwives, in the last year the number of midwives has actually gone down.

We really have to ask ourselves why the Government are so opposed to this amendment when there is such strong support for it around this House and among all the key bodies around the country. It may be that the Government have an ideological objection to the word “planning”, or that the Minister does, but this is about the future of our NHS and all the evidence says that this is an essential amendment. Surely the Government are not going to let ideology stand in the way of the future of our NHS.

I finish by commenting on the typically wonderful introduction to this group from the noble Baroness, Lady Cumberlege, who referred to the strong civil society campaign. The hashtag for it on Twitter is #StrengthInNumbers, and that says so much. We need the numbers and the facts so that we can get the numbers of staff in the NHS.

--- Later in debate ---

[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.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise very briefly, having contributed quite significantly to the debate on Report. I support the Government’s amendment, which is not a position I find myself in very often. I respectfully disagree with the noble Lord, Lord Alton of Liverpool, who said this was not settled. As the noble Baroness, Lady Sugg—who has been such a leader, working on this issue in the House with great tenacity and determination to defend the well-being of patients—said, it has been settled in both Houses of Parliament and has been debated extensively.

The point the noble Lord, Lord Alton, just made about the sex-selection question was comprehensively answered. The dates do not work; we are talking about early medical abortion and you do not know by that stage. We have to come back to the evidence. We had an unintended experiment as a result of Covid, which showed us that telemedicine not only reduced the rate of abortion complication but increased the level of safeguarding disclosures. It is really important that we think about an equalities issue here. Access to telemedicine is medically preferable and results in more safeguarding disclosures. We do not want to deny that to young women where it is judged that it is medically appropriate.

I note that the National Network of Designated Healthcare Professionals for Safeguarding Children is working with the Royal College of Obstetricians and Gynaecologists to develop standards. It says that this should not be subject to discrimination in the law, as the safeguarding standards and guidelines are adequate. If we think about this as an access issue, this minimises the risks of young people going to provision outside the healthcare system. This is a crucial equalities issue.