Health and Care Bill

Edward Leigh Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Sajid Javid]

I am pleased that I gave way to the hon. Gentleman as he raises a very important issue. In this Bill, as I will come to, one of the central themes is integration. When I come to that, I hope he will see how that integration between NHS and social care will help to deliver a better service for those with dementia.

Everything I refer to—these challenges—are all in addition to the challenges of the pandemic that of course we still face and the elective backlog that we know is going to get worse before it gets better. Meeting the future with confidence relies on learning lessons from the pandemic—what worked and what did not work—and building on a decade of innovation in health and care.

Sometimes the best intentions of the past cannot stop what is right for the future. Bureaucracy can still make sensible decision making harder, silos can stifle work across boundaries and sometimes legislation can get in the way. We have seen how unnecessary rules have meant contracts have needed to be retendered even where high-quality services are being delivered, we have seen the complicated workarounds needed to help the NHS and local government to work together, and we have seen the uncertainty about how to share data across the health and care system. People working in health and social care want the very best for people in their care. That is what they have shown time and again, not least in the way they have embraced integration and innovation to save lives through this pandemic. They want to hold on to the remarkable spirit of integration and innovation, but they want to let go of everything that is holding them back and we want to help them to do it.

[Sir Edward Leigh (Gainsborough) (Con)]

On that point of bureaucracy, I recently saw the apotheosis of the NHS, where an Anglican church had draped an altar with a flag saying, “O Praise the NHS”. So when we have a new Secretary of State, can we have a really hard-hitting attitude to NHS bureaucracy? We all praise our doctors and nurses, but the fact is that, like any other bureaucracy, it is prone to underperformance, waste and incompetence. There is no harm, as long as we preserve the principle of being free at the point of delivery, in having innovative private sector solutions.

[Sajid Javid]

I hear what my right hon. Friend has said and I think that, as I progress through my opening remarks, he will like what I have to say about integration and cutting bureaucracy.

All these things that I refer to and all these changes we want to make are exactly what this Health and Care Bill will do. I want to thank the thousands of hard-working staff who, through two years of consultation and engagement, have come forward and told us what they think works and what they think needs to change. In the words of Lord Stevens, chief executive of the NHS, the overwhelming majority of these proposals are changes that the health service has asked for. The Bill supports improvements that are already under way in the NHS. It builds on the recommendations of the NHS’s own long-term plan. It is a product of the NHS, it is for the NHS, and it is supported by the NHS.

I am grateful to all the organisations that have helped to shape these important proposals—everyone from the NHS Confederation to the Local Government Association. I have spent many of my early days in this job talking to them, and they have all told me the same thing, which is that they are ready to take forward the reforms. I want to continue to work with them and to listen to their specific concerns, just as much as I want to listen to the concerns raised by hon. Members across the House and by Members in the other place.

Health and Care Bill

Edward Leigh Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

I would like to speak to new clause 31 in my name, which would reduce the upper gestational limit for abortion in most cases to 22 weeks gestation. This time limit amendment would replace the current 24-week time limit for abortions on the ground where there is a greater risk of injury to the physical or mental health of a pregnant woman or any of her children of proceeding with the pregnancy, under section 1(1)(a) of the Abortion Act 1967. The current 24-week limit law is based on an outdated understanding of the viability of premature babies, and it needs to be updated.

[Sir Edward Leigh (Gainsborough) (Con)]

Is it not absurd that in one ward of a hospital doctors can be fighting to save the life of a 22-week gestation baby while arguably, under the law, a 24-week baby can be aborted? That is ridiculous, and whatever anyone’s views on abortion, this is now the time to review this law, which is based on outdated technology and medical practices.

[Fiona Bruce]

My right hon. Friend makes exactly the right point.

Our law needs to be updated. The current 24-week limit was set over 30 years ago, in 1990. That legislation removed the previous time limit of 28 weeks. In 1990, 24 weeks was considered the point of viability outside the womb, but the scientific advances in those 31 years have been enormous. The latest guidance from the British Association of Perinatal Medicine establishes 22 weeks gestation to be the point of viability and enables doctors to intervene to save premature babies from 22 weeks. A study from a neonatal intensive care unit in London found that survival rates for babies born at 22 and 23 weeks gestation went from zero in the period from 1981 to 1985 to 19% in the period from 1986 to 1990, and then up to 54% in the years from 1996 to 2000. We would no doubt find that the figures had increased substantially since then, were those figures available. Just in the past few weeks, we have seen the incredible story from the American state of Alabama of the birth of a baby boy at just 21 weeks old. Weighing just 14.8 ounces, Curtis Means needs oxygen support and a feeding tube, but he is in good health. New clause 31 is a probing amendment, so I will not be pressing it to a vote on this occasion. However, I would welcome the Minister’s views and I look forward to a greater debate on this issue.

I also want to take a few moments to give my support to new clause 51, in the name of the hon. Member for Upper Bann (Carla Lockhart), which would clarify that abortion on the ground of the sex of the foetus is illegal. This relates to the truly awful exploitative practice whereby women can be pressurised into abortions based on the sex of their unborn child. I also support new clause 52, also in the name of the hon. Member for Upper Bann, which seeks to bring parity to the law in equalising time limits on abortions that take place on the ground of disability, so that they would be equal to the limits on most other abortions. The current law permits abortions up to birth if the baby is deemed likely to be born seriously handicapped. This is interpreted to include entirely non-fatal disabilities such as Down’s syndrome and easily surgically rectifiable conditions such as cleft palate and club foot. One of my sons was born with club foot, and I know how rectifiable it is. The law is plainly inconsistent with the disability discrimination legislation that applies after birth, and it sends a dreadful message to people who are living and thriving with disabilities about how little their lives are valued under abortion law. Again, I look forward to hearing the Minister’s views.

Health and Care Bill

Edward Leigh Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Three Members are standing and I want to get you all in, so we will have a four-minute time limit.

[Sir Edward Leigh (Gainsborough) (Con)]

Obviously, abortion is a deeply emotional issue and we probably all know where we stand, but this is not a debate about abortion. At-home abortions were brought in as a purely temporary measure to defend women’s health. It was always the understanding that the measure would continue just as long as the pandemic continued.

There are many different arguments about this issue. I could go through the statistics that have been given to me that some people might deny, but it is undoubtedly the case that more than 10,000 women who took at least one abortion pill at home provided by the NHS in 2020 needed hospital treatment. There is therefore an issue around safety and women’s health and we need a proper debate. This amendment was brought in in the House of Lords at night-time. Barely a seventh of the Members of the House of Lords actually took part in the Division. We need a proper, evidenced debate on this issue. There is nothing more important when a human life is at risk.

Of course, we all support telemedicine; I chaired a meeting yesterday on atopic eczema and we are making wonderful steps, but as important as curing atopic eczema is, it is nowhere near as important as a situation where a life is at stake. I know that there are different views about coercion, but surely the whole point of the Abortion Act, for those who supported it, was to get abortions into a safe medical location and to get them away from the backstreets. People surely did not want them to be done at home, where there is risk. The hon. Member for Upper Bann (Carla Lockhart) spoke about the case of the 16-year-old girl who delivered a foetus who, apparently, was 20 weeks old. That is why, as my hon. Friend the Member for Congleton (Fiona Bruce) said, the National Network of Designated Healthcare Professionals for Children welcomes the Government’s stance, and why children and young people will be provided with protections.

I urge hon. Members, whatever their view, to think, to consider the evidence and not to rush in. The amendment goes completely against the whole spirit of the Abortion Act. Whatever we think of that Act, the amendment would be a huge new step that I believe would put more women’s health at risk and possibly lead to coercion—we need more evidence on that. I therefore support what the Government are doing today.

[Matt Warman (Boston and Skegness) (Con)]

I rather think that men should enter the debate on abortion with a degree of trepidation and humility. In that spirit, I will make three simple points.

First, it strikes me as absolutely right that parliamentarians in this place and in the other place should seek to use every vehicle before them to enact the improvements in our constituents’ lives that we all want. It is right and fair to say that the measures were temporary and were brought in only for a certain purpose, but it cannot be right to say that now that we have done that extraordinary experiment, seen how many women have benefited from the change in telemedicine and got the data, we cannot let the vehicle of the Bill pass us by without trying to make this improvement.

Secondly, the reason that all the expert bodies—including the Royal College of Obstetricians and Gynaecologists, Women’s Aid and the Academy of Medical Royal Colleges, where I have to declare that my wife works—support this approach is that they have seen the evidence. They look at that evidence as organisations that have the safeguarding of their patients absolutely at the heart of every single thing they do. They have looked at what we have done and the evidence we have gathered, and they say it is right to continue with the measures brought in for the pandemic. That is why Wales and Scotland have continued them.

We have to trust the evidence; we have to trust the science. We have to understand that we are in the position that we are in as a result of the covid vaccine programme because we trusted the science. Today, we have an opportunity to trust the science yet again. That seems to me an incredibly powerful argument.

We are not making telemedicine compulsory; we are making it a choice. Yes, we are putting a huge burden on doctors to say that the person on the other side of the screen is not someone who should have pills by post, so to speak. We are saying that they should make that calculated judgment. We ask the professionals, be they in charities or in hospitals, to make those judgments every day. We do so because they are the experts.

I say simply to hon. Members that there are issues on which we profoundly disagree—of course there are; these are fundamentally ethical issues—but if we are in favour of abortion, we should be in favour of the choice that is provided by the very safest options. We can see today from the evidence of the past couple of years that it is safer for women who are at their most vulnerable to have the option that we are talking about today. It is not compulsory; it is an option. For me, supporting that today is the definition of being pro-choice.