Health and Care Bill

Debate between Baroness Eaton and Baroness Finlay of Llandaff

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

[Baroness Eaton (Con)]

My Lords, I speak to Amendment 92B in my name. It seeks to reinstate essential, in-person safeguarding checks for girls under 18 when seeking abortion. I have no doubt that the noble Baroness, Lady Sugg, had the best of intentions when she brought her abortion-at-home amendment to your Lordships’ House in support of women’s right to choose in respect of pregnancy. Unfortunately, Amendment 92A leaves a glaring gap: that of the interests of young and vulnerable females. My Amendment 92B is simply about requiring a face-to-face consultation with a qualified health professional for girls under the age of 18.

This is an amendment purely about child safeguarding: specifically, minimising the risk of harm to children through the use of abortion pills. It is not an amendment about the moral question of abortion. There would be no change to where the pills are taken or administered. The amendment is supported by the NHS body made up of doctors and nurses who are the leading experts in the field of children safeguarding, the National Network of Designated Healthcare Professionals for children, or NNDHP.

The NNDHP, which supports safe access to abortion for young people, has released a statement saying:

“All children and young people—those under 18 and in care under 25—must be seen face to face, and the age of the other applicants must be confirmed. The purpose of this position is to clinically assess the mid-trimester risk and prevent coercion and exploitation.”


The network expressed particular concern that phone and video consultations

“enable unseen and unheard coercive adults to influence the patient”

and

“enable pills to be obtained under false pretences.”

These NHS child-safeguarding experts have also raised concerns about the effects of trauma and neglected birth, pointing to evidence of the home use of abortion pills resulting in highly traumatic incidents. These are traumatic episodes, and they point out that children do not have the emotional resources and the brain maturity needed to access support in these cases. Even worse, they are aware that the policy has led to the births of very premature but potentially viable infants.

The Royal College of Paediatrics and Child Health, the UK’s leading professional body for paediatricians, which represents more than 20,000 child health professionals in the UK and abroad, has backed the amendment. It has voiced its support for the amendment due to concerns about the risks to girls under the age of 18 with the at-home abortion amendment that passed in the Commons. The RCPCH has warned of a “glaring gap” in the legislation—namely, children and young people. Moreover, it has asked for children’s vulnerabilities to be taken into greater account as the Health and Care Bill reaches its final stages. The college points out that

“telemedicine can present particular challenges”

for children and young people, and points to the need to

“assess any safeguarding issues as part of the pathway for early medical abortions.”

I have mentioned the views of the NHS safeguarding experts and the royal college that specialises in children’s health, but I would like to end by touching on the story of a 16 year-old girl in his country that demonstrates the need for this amendment. The BBC reported on a girl called Savannah, who took abortion pills at home after a telephone conversation with an abortion provider. The clinic she had spoken to had calculated that she was less than eight weeks pregnant, but she was neither examined nor scanned. She took the pills and, when she felt terrible pain, she was taken to hospital. It was discovered that she was actually between 20 and 21 weeks’ pregnant, and she gave birth to a baby with a heartbeat. Indeed, she said, “My boyfriend said he could see feet”. Savannah said she had been left traumatised and said, “If they scanned me and I knew that I was that far gone, then I would have had him.”

It is hard to comprehend the trauma of an experience such as this for such a young woman. The BBC report highlighted how her case was just one of dozens. Surely, we in this House owe it to our young women and girls, our daughters and granddaughters, to do more to protect their safety and well-being. This is not an amendment nor a debate about abortion or a woman’s right to choose; it is about children’s welfare and enshrining in law the essential protections for girls under the age of 18. This Government, and, indeed, previous Governments, have rightly prioritised children’s welfare, and all of us in Parliament who make laws should keep this in mind.

I am pleased that my noble friend the Minister has understood the very real concerns of many noble Lords and professional bodies in the medical profession. He has expressed a clear commitment to us today to ensure that the concerns are raised and addressed. It is vital that regulations and guidance deal with the safeguarding of young women. My noble friend has committed to working with the Royal College of Paediatrics and Child Health and the NNDHP, and I hope that they will be consulted and will work with the Government to make sure that these extremely challenging and difficult conditions for young women are given great concern and protection in any further work on the Bill. Because my noble friend has given such reassurances, I will not push this to a vote this evening.

[Baroness Finlay of Llandaff (CB)]

I am grateful to the noble Baroness, Lady Eaton, for raising this issue. I should declare that some years ago when I was a GP, I was responsible for looking after three care homes with children with really quite profound psychological disturbance because of what they had gone through prior to being taken into care. I carefully read the briefing from the Royal College of Paediatrics and Child Health. It is very important to listen to that college in particular, which has put out a remarkably strong briefing that also takes account of children up to the age of 25 when they are care leavers.

The last time we debated this I was concerned about contraceptive advice. I therefore contacted an abortion provider to ask about the contraceptive advice provided and was assured that really sound contraceptive advice is part of the telemedicine procedure. Does the Minister have any data on the number of second-time and third-time abortions that are being requested through telemedicine, as compared with those from face-to-face consultation? Certainly, in my time in practice, when one provided contraceptive services, one always felt that when somebody was presenting for an abortion, somewhere along the line one’s contraceptive advice had failed—often because of coercion by the male partner, one way or another. But for those who are emotionally vulnerable it can be very important.

I will address in just one sentence the excellent speech by my noble friend Lord Crisp in relation to his Motion J1. I hope the Government will listen to it, because we cannot carry on allowing the tobacco industry to exploit public health in the way that we have.

Domestic Abuse Bill

Debate between Baroness Eaton and Baroness Finlay of Llandaff

Committee stage & Committee: 3rd sitting (Hansard) & Committee: 3rd sitting (Hansard): House of Lords
Monday 1st February 2021 Lords Chamber

[Baroness Eaton (Con) [V]]

My Lords, I declare my interest as a vice-president of the Local Government Association. I am pleased to speak in support of Amendment 176 in the name of my noble friend Lord Polak.

Extending the current statutory duty to police and crime commissioners and clinical commissioning groups is a welcome step that the Local Government Association has previously called for. There needs to be a mutual duty on a range of organisations to ensure that there is provision of emergency accommodation and community support service, and not just a duty placed on tier 1 local authorities. However, it remains my view that imposing a statutory duty on local authorities that is overly prescriptive and does not allow for local flexibility is not the best way of improving services. An improvement-led approach is the best way to provide local domestic abuse services.

The £40 million for specialist services has already been referred to, and is most welcome. However, it is not clear whether the funding made available in the government spending review will be adequate to meet the needs of all domestic abuse victims, as the allocation of funding per area is still to be announced. A statutory duty to deliver community-based services and specialist services will not be effective without a clear commitment from government to provide adequate and sufficient funding, as many speakers have said today. There is a need, long called for, for wider investment in prevention and early intervention services, community-based support and perpetrator interventions. Additional investment in these preventive services is vital.

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, many important points have been made in this debate. In particular, I hope my remarks on Amendment 177 will supplement the points made by my noble and learned friend Lord Thomas of Cwmgiedd.

I was glad to hear from Jane Hutt, Deputy Minister and chief whip in the Senedd, in her letter to me of 29 January that the designate domestic abuse commissioner for England and Wales, Nicole Jacobs, has agreed to hold regular meetings with the Welsh Government to discuss how to further improve the prevention of domestic abuse and support victims in a devolved context. The Welsh Government are a strong advocate in eradicating all forms of domestic abuse.

Sadly, calls to Wales’s national helpline, Live Fear Free, rose by nearly 50% in the first wave of the pandemic, call time trebled and callers often reported more frequent abuse with shorter escalation periods. Visits to the Live Fear Free website increased markedly too. I am glad to know that Her Majesty’s Government are working closely with the Welsh Government, because it is crucial that the Domestic Abuse Bill and the Violence Against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 are complementary and enable all victims of domestic abuse across England and Wales to have access to the specialist services that they need, wherever they live.

We must leave no gaps in the legislation for victims of domestic abuse to fall through. I hope the Minister can assure me that both non-devolved and devolved public sector actors can work together to ensure that our service models are aligned and that equivalent funding is allocated to support domestic abuse services in Wales.

According to Welsh Women’s Aid, even before the pandemic over 500 survivors were unable to access refuges due to lack of space, capacity and resources. Now, when many do not have access to their usual support networks, it is more important than ever that we leave no one behind. Domestic abuse survivors in Wales must be able to easily understand how the devolved and non-devolved competency areas interact and have confidence that they will have access to the services they need, when they need them.