Health and Care Bill

Baroness Penn Excerpts

Committee stage
Wednesday 9th February 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I thank the noble Baroness, Lady Walmsley, for presenting this amendment. I too take the view that ambulance services play a significant role in our National Health Service, particularly in the redesign of care pathways to reduce pressure on hospitals and provide better care to patients. If that can be at the right time, in the right place, that produces the greatest benefits.

The amendment in the name of the noble Baroness, Lady Walmsley, sets out the case for a more rigorous and accessible reporting system for ambulance services on response times. As your Lordships’ House debated just last week, and as the Minister acknowledged, at present performance is below what is acceptable. I am pleased that under the amendment, the method for introducing regulations would be subject to proper review by Parliament. On the specifics, it is welcome that there is a requirement of the use of data already captured by ambulance control and dispatch systems, specifically requiring analysis by integrated care system area and by postcode. This would provide a valuable source of further evidence about inequalities in care provisions which would mean that it was possible to identify and address them.

On the proposed requirement for the recording of explanations for all incidents where the relevant response time target was missed, it would of course be important to ensure that any extra recording of data in an emergency care environment did not add to existing pressures. I look forward to the Minister’s response.

[Baroness Penn (Con)]

I thank the noble Baroness, Lady Walmsley, for bringing this short but important debate before the Committee.

The Government fully recognise the importance of ambulance response times and of patients receiving the help they need when they need it. Like other emergency care services in the NHS during the pandemic, ambulance trusts have come under significant pressure, answering almost a million 999 calls in December alone —an increase of 22% on the year before. That is why we have put significant support in place to help ambulance trusts at this time. I will not go into the detail, which we covered in the debate last week. Instead, I will respond to the specifics of the amendment.

It is the Government’s view that it is right that reporting happens at the level of ambulance trust region. Trusts are commissioned to meet response time targets at a regional level, not at a more granular part of their operating area such as postcode or integrated care board area. It is inevitable that there will be variations in response times within regional footprints from month to month. However, the existing ambulance response time standards already include a mechanism to performance-manage significant variation or long waits for ambulances. All ambulance response time categories include a 90th centile response time standard to measure the “tail” of ambulance response times. This means that trusts are measured on the response to every call they receive and cannot favour some parts of their region over others to game response time targets. Reporting response times down to a postcode level would require a massive expansion to existing reporting that would not be reasonably deliverable.

I also reassure noble Lords that the service transparently provides clinical outcomes data. These indicators were introduced in 2011 and provide detailed information on clinical outcomes for cardiac arrest, heart attack, sepsis and stroke patients. While the Government acknowledge the challenges to ambulance response times and are working hard to address them, for the reasons I set out, I hope the noble Baroness feels able to withdraw her amendment.

[Baroness Walmsley (LD)]

I thank the noble Baroness, Lady Merron, and the Minister for their responses to this proposition. I still think that somewhat more granular collection of data would be really helpful, because a region is a very big area and there are all kinds of factors that affect how quickly ambulances get to people who need them. It is particularly important in the case of category 1 incidents, where life is at stake and interventions can have the most amazing results, if only they get to the patient within 40 minutes, say, in the case of stroke.

So, it is vital that we get that granular information. I accept what the Minister said about the additional money that has been provided, but as I and my noble friends have said, the problems are both sides of the ambulance: downstream and upstream. It is a systemic problem, and it needs to be looked at as a whole. Having said all that, I beg leave to withdraw the amendment.

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[Baroness Jones of Whitchurch (Lab)]

My Lords, I thank the noble Baroness, Lady Hollins, for this amendment. Like others, I pay tribute to her tremendous work on behalf of people with learning difficulties and autism, which we all acknowledge and respect.

The amendment would reinforce and hasten the implementation of and the legislative basis for the Government’s commitment to developing a mandatory training and professional development system for health and social care staff. It would also establish a statutory code of practice, to be updated every three years, setting out guidance on the content, accreditation, delivery, monitoring and evaluation of the training.

The NHS England pilots for the modules to support the development of the training are currently under way, as the noble Baroness said. They involve key stakeholders, including Mencap and the National Autistic Society. It would be helpful if the Minister could provide the Committee with an update on the progress and timescale for completing and assessing the pilots and for moving forward and implementing the new training system.

The amendment is comprehensive in terms of both amending the 2014 regulations under the Health and Social Care Act 2008 and setting out issues that the code must address, including the relevant core education and training frameworks and strategies applying to learning disabilities and autistic people. It also contains the definitions of autism and learning disability on which the code should be based.

In this debate, we are all sadly reminded of the tragic death of Oliver McGowan, who died after those treating him medicated his autism incorrectly. His mother’s petition and determined campaign for mandatory training is thankfully coming to fruition, so that we can ensure that all staff receive proper training and can develop the skills and experience needed to provide the safest and most effective care and support for people with learning difficulties and autism. Including the mandatory training requirement on the face of the Bill would be a major step forward and I look forward to the Minister’s response.

[Baroness Penn (Con)]

My Lords, I too am grateful to the noble Baroness, Lady Hollins, for bringing the important matter of staff training on learning disability and autism for the health and social care workforce before the Committee today. Evidence tells us that there is a pressing need to improve understanding and awareness of learning disability and autism among health and social care staff and that the staff themselves want this training. Introducing mandatory training is an important way in which we can address persistent disparities in health and care outcomes for people with a learning ability and autistic people. As we set out in the Right to Be Heard publication of November 2019, the Government have committed to requiring all NHS and social care providers who carry out regulated activities to ensure that their staff have achieved the learning outcomes relevant to their role.

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[Baroness Merron (Lab)]

My Lords, this has been a very detailed debate and has explored what is at the heart of the subject before us. It has focused very much on what it is to have a safe space—something to which I will return briefly. I want to thank my noble friend Lord Hunt for leading this group of amendments and I will not repeat the points he made so ably in setting them out. As the noble Baroness, Lady Walmsley, said, I hope the Minister will take these amendments in the spirit they are intended. Clearly, they have been very carefully crafted and debated in order to improve this section of the Bill, and I believe that they are very worthy of merit.

We on these Benches also support the development of a culture where staff feel able to speak up about mistakes without a presumption of blame. Since its creation, the work of the HSIB has placed an important focus on learning and improvement when things have gone wrong. However, there must be a balance with the need for appropriate accountability and redress, for the public to be protected from unsafe practices and practitioners, and for public confidence in the system to be maintained.

This debate has been rightly supportive of the HSSIB, its mission and the concept of safe spaces—on that I think there is agreement. There is also agreement that it must be independent to be effective and trusted. However, following this debate, it seems that there is much work to be done by the Government on reviewing where, and to whom, disclosure of information can be made. Although the debate has expressed agreement that it is not appropriate for coroners, with their adversarial role, to have such access—and I share this view—there is a finely balanced debate about the issue of the ombudsman. As the noble Lord, Lord Kakkar, said, this is complex—which I think is something of an understatement. The debate reflects the reality of the world in which the HSSIB seeks to improve the delivery of service.

The noble Baroness, Lady Neuberger, and the noble and learned Lord, Lord Etherton, have put forward their view that the ombudsman needs to be able to investigate robustly. I am sure there is agreement on that. I am sure the difficulty that the Minister will want to unpick as she takes away the views of your Lordships’ Committee today is how it will be possible to allow the ombudsman to do its job and yet retain safe spaces. As the noble Lord, Lord Patel, said, it is so important to give confidence to professionals that they can contribute to the investigations into systems failure.

I say to the Minister that I hope there will be a close examination of all the points put forward in today’s debate. I feel that by further investigation into and thought about the points that noble Lords have made, this part of the Bill can certainly be strengthened.

[Baroness Penn (Con)]

My Lords, I thank all noble Lords for this debate and reassure them not only that I have listened carefully to it but that the Government will of course again look carefully at the arguments made. As the Committee has heard, HSSIB is no ordinary investigatory body. It will look at systemic risks and focus on learning lessons. It is not about blame; it is about improving patient safety incidents across the system and making a real difference to patient safety.

The Government agree that the integrity of the safe space is paramount. Safe space conditions will encourage patients, families, NHS staff and other investigation participants to speak freely and candidly. Without guarantees that this information will not be shared, except in very limited circumstances, we risk eroding the confidence of all those participating in an investigation, potentially leading to information being withheld and reducing the effectiveness of the investigation.

I turn to Amendments 311, 311A and 312A. We have sought to strike a fine balance between protecting safe space and acknowledging the need for very limited exceptions. We have allowed senior coroners to have access to information from the HSSIB, but only when it is appropriate and necessary for them to fulfil their judicial functions, and not to disclose onwards without further protections in place. Where the HSSIB has information about a death which the coroner is investigating, we need to ensure that the coroner’s judicial role is not undermined and that they have accurate and clear information. It does not mean that the coroner will have complete access to safe space information—far from it—nor that they will be able to automatically share this information. We have drafted provisions so that this does not happen. It is an intentionally limited and contained exemption.

Regarding Amendment 311, the Bill’s provisions are likely to have a very limited impact on the Parliamentary and Health Service Ombudsman’s ability to fulfil its important independent role of investigating complaints, given that it will still be able to use its existing powers to obtain material directly from the same primary sources. It will often not be investigating the same incidents as the HSSIB, as we have heard in Committee. If the PHSO felt it needed to access protected material held by the HSSIB, it could apply to the High Court. We do not envisage this being a common occurrence, as the HSSIB’s purpose will be very different from that of the PHSO. However, it means that the PHSO does have a way to gain access to protected information in certain circumstances.

We are committed to monitoring the impact that the safe space provisions may have on the PHSO’s ability to carry out its functions. We shall report to the House of Commons Public Administration and Constitutional Affairs Committee on this issue within 12 months of the HSSIB being fully operational, which we expect to be 12 months after the Bill gains Royal Assent.

A number of amendments relate to the role of the Secretary of State in relation to the HSSIB. We believe it is appropriate that the Secretary of State can direct the HSSIB to investigate particular qualifying incidents. This is an important tool available to the Secretary of State, which enables him and the HSSIB to respond to emerging or ongoing patient safety issues, which may arise at any time. It would therefore not be appropriate or prudent to limit the Secretary of State’s ability to direct the HSSIB to the first 18 months of its operation.

More importantly, the Secretary of State would not be able to direct the HSSIB on how to conduct a particular investigation. Clause 115 rightly allows the Secretary of State to intervene if

“the HSSIB is failing or has failed to exercise any of its functions, and … the failure is significant.”

The Secretary of State is accountable to Parliament for the HSSIB’s performance, and it is in the public’s best interests that the HSSIB functions effectively.

I turn to Amendments 310A and 310B. Given the broad scope of the HSSIB’s investigation function, some flexibility is needed so that the Secretary of State can set out additional circumstances when the prohibition on disclosure—safe space—does not apply. It is vital that the HSSIB can adapt as clinical and record-keeping practices change on the front line and practice evolves. This power is about future-proofing and continuous improvement, not eroding safe space.

On Amendments 308A and 309, I understand the importance of the HSSIB having predictable budgets for planning, but requiring a three-year budget would cut across the established processes of spending reviews and put it out of step with the confirmation and allocation of budgets across government and other arm’s- length bodies.

Turning to Amendment 310, I reassure noble Lords that the HSSIB’s reports will be published. Organisations will generally be required to respond to the HSSIB’s recommendations and it may publish these responses. In some cases—for example, an investigation into a private provider—it would not be appropriate for the Secretary of State to publish an additional report.

I turn to Amendment 308. In line with the Cabinet Office’s Governance Code on Public Appointments, the chair of the HSSIB will undergo pre-appointment scrutiny by the Health and Social Care Committee. However, the appointment of the chief investigator, which is not a public appointment, will be undertaken directly by the non-executive members of the HSSIB, including the chair, with the consent of the Secretary of State. We believe that this strikes the right balance between scrutiny, accountability and operational independence, without compromising the effectiveness of the board.

Finally, I turn to Amendment 309A. Whistleblowing is a distinct legal concept, with an existing legislative framework to ensure that whistleblowers are protected. The purpose of the HSSIB’s investigations is to identify risks to the safety of patients and address them by facilitating the improvement of systems and practices in the provision of healthcare services in England. A disclosure to the HSSIB concerning patient safety is complementary to but distinct from whistleblowing, so it is right that it should sit outside that legal framework.

However, I reassure the noble Baroness, Lady Kramer, that information shared with the HSSIB to alert it to a patient safety issue will be protected by the safe space provisions if it fulfils the definition of protected material. If, as mentioned in the amendment, a concern is raised that conduct is illegal, we would expect it to be raised with an appropriate person. Similarly, concerns relating to unethical conduct would not be best dealt with solely by the HSSIB. This amendment would risk blurring the lines with other organisations which may be better placed to deal with such matters.

I suspect that I have not given noble Lords as much reassurance as they would like in order not to return to this issue, but I hope I have given them enough that they feel able withdraw or not move their amendments at this time.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to the Minister—she was succinct but we certainly got the drift of the Government’s arguments. We have had just over an hour’s debate. Ideally, we would have taken this as a separate Bill, as we did in 2019, because these are clearly very complex issues. The heart of it is the tension between the purity of the safe space concept and the statutory duties of a number of officeholders, including senior coroners and the ombudsman. We will not resolve that tonight. The pity of it is that we will move to Report and probably vote on this; I cannot help thinking that there is a need for a proper round-table discussion before that to see whether we can collectively tease out a way forward. Having said that, it has been an excellent debate and I beg leave to withdraw my amendment.

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[Lord Davies of Brixton (Lab)]

My Lords, I want to speak to this group of amendments—

[Baroness Penn (Con)]

My Lords, it might be appropriate for the mover of one of the amendments in the group to speak.

[Lord Clement-Jones (LD)]

I was not being discourteous, but I thank the Minister. We just go along the line of amendments.

It is a pleasure to follow the noble Lord, Lord Hunt, and my noble friend Lady Brinton. Of course, we all recognise the benefits of using health data which arises in the course of treating patients in the NHS for research that will lead to new and improved treatments for disease and for the purposes of public health and health service planning. It has been a great benefit in helping to improve the treatment of Covid during the pandemic.

However, the track record of the department and the NHS in protecting patient data has not been a glorious one. We have heard a few examples. Let us go back to December 2019 and the discovery by Privacy International that the Department of Health and Social Care had agreed to give free access to NHS England health data to Amazon, allowing it to develop advertising and sell new products, applications, cloud-based services and/or distributed software.

My noble friend Lady Brinton talked about the successful case brought by openDemocracy and Foxglove against the department over a Covid-19 datastore deal with big data firm Palantir Technologies for failing to consider the impact of the deal on patients and the public by a consultation and performing a fresh data protection impact assessment on a new deal.

Then, of course, we had the situation last year, mentioned by the noble Lord, Lord Hunt, which has been described as

“the biggest data grab in the history of the health service”

of GP patient data. I pay tribute to the campaigners, including a group of Tower Hamlets GPs who refused to hand over patient data. Ministers first announced that implementation would be delayed until 1 September, and then in a letter to GPs in July last year put the whole scheme on hold, including data collection.

After this bungled approach—the noble Lord, Lord Hunt, used the word “debacle”, which is perhaps more apposite—more than 1 million people have now opted out of NHS data sharing. There is a deep worry here that the Government have learned nothing from the fate of the care.data project. The Government have now had to revise their approach, devise a simpler opt-out system and commit to the publication of a data impact assessment before data collection starts again. They have had to commit that access to GP data will be only via a trusted research environment and to a properly thought-through engagement and communications strategy.

Wade-Gery does acknowledge some of these concerns but if we are going to retain and build trust in the use of health data, we really need a clear governance framework. The Government must gain public trust through honesty, transparency and rigorous safeguards, and the individual must have the right to choose whether or not to share their data and understand how it will be used. I hope that NHSE—and, indeed, NHSD—will take on board the ICO’s recommendations in its audit report of NHS Test and Trace regarding governance and accountability and processor and third-party supplier relationship management, which looks at the policies and procedures that were introduced to keep data secure. There are some valuable lessons to be learned there.

As the noble Lord, Lord Hunt, has described, all health data must be held anonymously and accessed through an accredited data-access environment, designed to cover not only the promised trusted research environment but where data is used for planning purposes.

As to the detail of the amendments in this group, the noble Lord, Lord Hunt, has described them and the patient-centred intent behind them admirably. I will simply lay out the rationale for Amendment 305, tabled by me and supported, I am glad to say, by the noble Lord, Lord Hunt.

The data held by the NHS must be considered as a unique source of value held for national benefit. My noble friend Lady Brinton reinforced that. As it is, NHSE has refused to publish the list of projects and organisations to which it releases data. Retaining control over our publicly generated data, particularly health data, for planning, research and innovation is vital if the UK is to maintain its position as a leading life science economy and innovator.

Having read speeches by Ministers trumpeting the UK’s

“new, bold approach to international data transfers”,

debated the UK approach to data sharing, particularly in the context of the passage of the Medicines and Medical Devices Bill and the Trade Bill, and seen the wording of new international trade agreements, such as that with Japan, I am not at all confident about the Government’s approach to this. Emphasis in coverage of the UK-Japan agreement was placed upon championing

“the free flow of data”.

Health data in particular amounts to a significant national asset or resource with the potential to function as a dynamo in relation to research, innovation and the continued growth of the life sciences, health and care sectors.

It seems that the Government recognise this, but by the same token, we need a guarantee that our health data will be used in an ethical manner, assigned its true value and used for the benefit of UK healthcare. Any proceeds from data collaborations that the Government agree to, integral to any “replacement” or “new” trade deals, should be ring-fenced for investment in the health and care system with a sovereign health fund. It should have governance mechanisms, such as those set out by the Ada Lovelace Institute in Exploring Legal Mechanisms for Data Stewardship last year. Those are the right foundations for health data governance and that is why I have tabled Amendment 305A.

I am not greatly reassured by the recent announcement by the DCMS of the creation of the International Data Transfer Expert Council; it looks rather as though data protection will be low on its list of priorities.

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Moved by

[Baroness Penn]

231H: After Clause 133, insert the following new Clause—
“CHAPTER 2HYMENOPLASTY OFFENCESHymenoplasty offences: England and WalesOffence of carrying out hymenoplasty: England and Wales
(1) It is an offence under the law of England and Wales for a person to carry out hymenoplasty.(2) “Hymenoplasty” means the reconstruction of the hymen (with or without consent).(3) An offence is committed under subsection (1) only if the person—(a) is in England and Wales, or(b) is outside the United Kingdom, and is a United Kingdom national or habitually resident in England and Wales.(4) “United Kingdom national” means an individual who is—(a) a British citizen, a British overseas territories citizen, a British National (Overseas) or a British Overseas citizen,(b) a person who under the British Nationality Act 1981 is a British subject, or(c) a British protected person within the meaning of that Act.”Member’s explanatory statement
This new Clause creates an offence under the law of England and Wales of carrying out hymenoplasty.

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[Baroness Penn]

My Lords, it is a pleasure to hopefully conclude this Committee stage of the Bill with some government amendments, which I hope will receive a welcome from the Committee. When we announced our intention to become one of the first countries in the world to fully ban virginity testing, in the Tackling Violence Against Women and Girls strategy, we also stated that we would establish an independent expert panel to review the ethical, legal and clinical aspects of hymenoplasty, a cosmetic procedure to reconstruct a hymen. This announcement followed concerns, highlighted in an internal review into virginity testing and hymenoplasty, that demand for hymenoplasty is driven by a repressive approach to female sexuality and is closely linked to virginity testing—an abhorrent practice that the Government brought forward an amendment to ban in the House of Commons.

However, as hymenoplasty is a cosmetic procedure, we recognised that a ban on it would mark a step change that could be counter to existing regulation on cosmetic procedures. Further concerns were raised that a ban would take away a woman’s right to choose what happens to her body. The panel’s task was to carefully consider these incredibly difficult and competing issues at length. The panel has now delivered its final report to the Government, which includes a robust set of recommendations. I take this opportunity to thank the co-chairs and all the panel members for the time and commitment they have dedicated, on a voluntary basis, to this incredibly important issue.

As we announced in Our Vision for the Women’s Health Strategy for England, the Government agree with the panel’s core recommendation that hymenoplasty should be banned. It is inextricably linked to virginity testing, and failure to prohibit hymenoplasty would not only undermine the Government’s commitment to address the violence against women and girls by criminalising virginity testing but also leave women and girls at risk of further harm and continue to perpetrate the harmful myths and attitudes towards virginity.

The package of amendments brought before the House today delivers on this promise. It would create three offences: carrying out hymenoplasty, offering hymenoplasty, and aiding or abetting another person to carry out hymenoplasty in the UK or on UK nationals overseas. Each of these offences carries a maximum penalty of five years’ imprisonment and/or an unlimited fine. This sentencing reflects the long-term physical and psychological damage that this repressive practice can cause. These offences, alongside the proposed virginity testing offences, begin to tackle the harmful misconceptions that surround a woman’s sexuality.

In response to concerns that vulnerable women and girls will be taken abroad and subjected to hymenoplasty once the offence is banned in the UK, these offences also carry extraterritorial jurisdiction. These proposals have been discussed by Health Ministers across the UK, and my noble friend is working with them to ensure the whole of the UK, together, tackles this harmful practice.

These amendments are an important milestone in this Government’s ongoing mission to safeguard women and girls but our work will not stop here. The Government recognise that banning virginity testing and hymenoplasty alone will not tackle the harmful misconceptions and misbeliefs surrounding virginity. That is why we will also put in place a programme of education in community, education and clinical settings.

Finally, I give thanks to my noble friend Lady Sugg for bringing the practice of hymenoplasty to the attention of this House, and for the wider work she is doing on this issue to improve the lives of women and girls. I hope the House will pass the Government’s amendments today and allow our important work on safeguarding and improving the lives of women and girls across the UK to continue. I beg to move.

[The Principal Deputy Chairman of Committees (The Earl of Kinnoull) (CB)]

My Lords, the noble Baroness, Lady Brinton, is participating remotely and I call her to speak.

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[Baroness Merron (Lab)]

My Lords, I am very glad that the Government have heeded the calls of victims and experts alike to make hymenoplasty a criminal offence, along with virginity testing. As we have heard repeatedly both this evening and in the course of campaigning for this, the two practices are inextricably linked. It is right that those who carry out or facilitate these practices should face justice and that no woman or girl should have to suffer these abusive, intrusive and medically unsound practices. This legislation will send the strongest of messages and I am very glad that education will underpin it.

Of course, the fight to end violence against women and girls is not over, but it has taken a step forward in this measure. I add my thanks to all those who have campaigned tirelessly on this, as outlined by the noble Baroness, Lady Sugg. I thank the noble Baroness, the noble Lord, Lord Patel, and others for all they have done in your Lordships’ House to bring this forward. This is a positive point on which to bring our deliberations in Committee to a close. I very much welcome this move.

[Baroness Penn (Con)]

My Lords, I thank noble Lords for the short but constructive debate on these amendments. I add my thanks to the noble Lord, Lord Patel, for his support on this issue.

My noble friend Lady Sugg asked about the other recommendations in the panel’s report. Of course, the amendments brought forward today satisfy many of the recommendations made in the final report, including: prohibiting the advertising of hymenoplasty; the inclusion of extraterritorial jurisdiction; ensuring that women will not be criminalised for undergoing hymenoplasty; and that there should be no defence or exemption for a healthcare professional or anyone to carry out hymenoplasty. The Government are carefully considering the panel’s remaining recommendations and will provide an update on this in due course.

There were also a number of questions about implementation. Guidance will be produced alongside these offences coming into force. It will make clear that hymenoplasty is a form of violence against women and girls and lay the framework for how it can be prevented and, when it has taken place, reported. While the details of the guidance are being carefully considered, I can say that it will focus on how the Government, local authorities, social services, the police, education providers and third-sector organisations and community groups can work together to effectively safeguard women and girls.

A number of other specific points were raised, such as whether the FCDO can learn from legislation relating to forced marriage and measures to spot girls who are at risk, the religious element which may feature within this, and UK-registered practitioners conducting these practices abroad. I suggest I write to noble Lords with further detail in response to those questions.

Amendment 231H agreed.

Moved by

[Baroness Penn]

231J: After Clause 133, insert the following new Clause—
“Offence of offering to carry out hymenoplasty: England and Wales
(1) It is an offence under the law of England and Wales—(a) for a person in England and Wales to offer to carry out hymenoplasty in the United Kingdom or hymenoplasty that has a sufficient jurisdictional connection, or(b) for a person anywhere to offer to carry out hymenoplasty if the person is a United Kingdom national or habitually resident in England and Wales. (2) Hymenoplasty has a sufficient jurisdictional connection for the purposes of subsection (1)(a) if it is carried out in relation to a person who is—(a) a United Kingdom national, or(b) habitually resident in the United Kingdom.(3) In this section—“United Kingdom national” has the meaning given by section (Offence of carrying out hymenoplasty: England and Wales)(4);“hymenoplasty” has the meaning given by section (Offence of carrying out hymenoplasty: England and Wales)(2).”Member’s explanatory statement
This new Clause creates an offence under the law of England and Wales of offering to carry out hymenoplasty.