Health and Care Bill

Baroness Laing of Elderslie Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this it will be convenient to discuss the following:

Government new clause 37—Offence of offering to carry out virginity testing: England and Wales.

Government new clause 38—Offence of aiding or abetting etc a person to carry out virginity testing: England and Wales.

Government new clause 39—Virginity testing offences in England and Wales: penalties.

Government new clause 40—Offence of virginity testing: Scotland.

Government new clause 41—Offence of offering to carry out virginity testing: Scotland.

Government new clause 42—Offence of aiding or abetting etc a person to carry out virginity testing: Scotland.

Government new clause 43—Virginity testing offences in Scotland: penalties and supplementary.

Government new clause 44—Offence of virginity testing: Northern Ireland.

Government new clause 45—Offence of offering to carry out virginity testing: Northern Ireland.

Government new clause 46—Offence of aiding or abetting etc a person to carry out virginity testing: Northern Ireland.

Government new clause 47—Virginity testing offences in Northern Ireland: penalties.

Government new clause 48—Virginity testing: consequential amendments.

New clause 1—Licensing of aesthetic non-surgical cosmetic procedures—

“(1) No person may carry on an activity to which this subsection applies—

(a) except under the authority of a licence for the purposes of this section, and

(b) other than in accordance with specified training.

(2) Subsection (1) applies to an activity relating to the provision of aesthetic non-surgical procedures which is specified for the purposes of the subsection by regulations made by the Secretary of State.

(3) A person commits an offence if that person contravenes subsection (1).

(4) The Secretary of State may by regulations make provision about licences and conditions for the purposes of this section.

(5) Before making regulations under this section, the Secretary of State must consult the representatives of any interests concerned which the Secretary of State considers appropriate.

(6) Regulations may, in particular—

(a) require a licensing authority not to grant a licence unless satisfied as to a matter specified in the regulations; and

(b) require a licensing authority to have regard, in deciding whether to grant a licence, to a matter specified in the regulations.”

This new clause gives the Secretary of State the power to introduce a licensing regime for aesthetic non-surgical cosmetic procedures and makes it an offence for someone to practise without a licence. The list of treatments, detailed conditions and training requirements would be set out in regulations after consultation with relevant stakeholders.

New clause 12—Protection of the title of “nurse”—

“(1) A person may not practise or carry on business under any name, style or title containing the word ‘nurse’ unless that person is registered with the Nursing and Midwifery Council and entered in sub part 1 or 2 of the register as a Registered Nurse or in the specialist community public health nursing part of the register.

(2) Subsection (1) does not prevent any use of the designation ‘veterinary nurse’, ‘dental nurse’ (for which see section 36K of the Dentists Act 1984) or ‘nursery nurse’.

(3) A person who contravenes subsection (1) is guilty of an offence and liable on summary conviction to a fine not exceeding level four on the standard scale.”

New clause 21—Prohibition of virginity testing—

“(1) A person is guilty of an offence if they attempt to establish that another person is a virgin by making physical contact with their genitalia.

(2) A person is guilty of an offence if they provide another person with a product intended for the purpose, or purported purpose, of establishing whether another person is a virgin.

(3) A person is guilty of an offence if they aid, abet, counsel or procure a person to establish that another person is a virgin by making physical contact with their genitalia.

(4) No offence is committed by an approved person who performs—

(a) a surgical operation on a person which is necessary for their physical or mental health; or

(b) a surgical operation on a female who is in any stage of labour, or has just given birth, for purposes connected with the labour or birth.

(5) The following are approved persons—

(a) in relation to an operation falling within subsection (4)(a), a registered medical practitioner; and

(b) in relation to an operation falling within subsection (5)(b), a registered medical practitioner, a registered midwife or a person undergoing a course of training with a view to becoming such a practitioner or midwife.

(6) There is also no offence committed by a person who—

(a) performs a surgical operation falling within subsection (4)(a) or (b) outside the United Kingdom; and

(b) in relation to such an operation exercises functions corresponding to those of an approved person.

(7) For the purpose of determining whether an operation is necessary for the mental health of a girl it is immaterial whether she or any other person believes that the operation is required as a matter of custom or ritual.

(8) This section applies to any act done outside the United Kingdom by a United Kingdom national or resident.

(9) A person who is guilty of an offence under this section is liable, on summary conviction, to imprisonment for a term not exceeding 12 months, to a fine, or to both.

(10) The court must refer the case of any person guilty of an offence under this section who is subject to statutory professional regulation for investigation by the relevant regulator.”

New clause 22—Prohibition of hymenoplasty—

2(1) A person is guilty of an offence if they undertake a surgical procedure for the purpose of re-attaching membrane tissue, creating scar tissue or otherwise attempting to re-create the hymen in the vagina of a patient.

(2) A person is guilty of an offence if they advertise the service of hymenoplasty or any service that purports to ‘re-virginise’ or otherwise re-create or re-attach the hymen of a patient by way of surgical procedure.

(3) A person is guilty of an offence if they aid, abet, counsel or procure a person to undertake a surgical procedure for the purpose of re-attaching membrane tissue, creating scar tissue or otherwise attempting to or re-creating the hymen in the vagina of a patient.

(4) This section applies to any act done outside the United Kingdom by a United Kingdom national or resident.

(5) A person who is guilty of an offence under this section is liable, on conviction, to imprisonment for a term not exceeding 5 years.

(6) The court must refer the case of any person guilty of an offence under this section who is subject to statutory professional regulation for investigation by the relevant regulator.”

New clause 28—Secretary of State’s duty to report on long term workforce planning—

“(1) The Secretary of State must prepare and publish a report each year on projected workforce shortages and future staffing requirements for health, public health and social care sectors in the following five, ten and twenty years.

(2) The report must report projections of both headcount and full-time equivalent for the total health, public health and care workforce in England and for each region, covering all regulated professions and including those working for voluntary and private providers of health and social care as well as the NHS.

(3) The projections must be independently verified and based on projected health and care needs of the population for the following 5, 10 and 20 years, consistent with the Office for Budget Responsibility long-term fiscal projections.

(4) All relevant NHS bodies, arm’s-length bodies, expert bodies, trade unions and the Social Partnership forum must be consulted in the preparation of the report.

(5) The assumptions underpinning the projections must be published at the same time as the report and must meet the relevant standards set out in the National Statistics Authority’s Code of Practice for Statistics.

(6) The Secretary of State must update Parliament each year on the Government’s strategy to deliver and fund the long-term workforce projections.”

New clause 29—Duty on the Secretary of State to report on workforce planning and safe staffing—

“(1) At least every five years the Secretary of State must lay before Parliament a health and care workforce strategy for workforce planning and safe staffing supply.

(2) This strategy must include—

(a) actions to ensure the health and care workforce meets the numbers and skill-mix required to meet workforce requirements,

(b) equality impact assessments for planned action for both workforce and population,

(c) application of lessons learnt from formal reviews and commissions concerning safety incidents,

(d) measures to promote retention, recruitment, remuneration and supply of the workforce, and

(e) due regard for and the promotion of workplace health and safety, including provision of safety equipment and clear mechanisms for staff to raise concerns.”

Amendment 10, in clause 34, page 42, line 12, leave out from beginning to the end of line 17 and insert—

“(1) The Secretary of State must, at least once every two years, lay a report before Parliament describing the system in place for assessing and meeting the workforce needs of the health, social care and public health services in England.

(2) This report must include—

(a) an independently verified assessment of health, social care and public health workforce numbers, current at the time of publication, and the projected workforce supply for the following five, ten and 20 years; and

(b) an independently verified assessment of future health, social care and public health workforce numbers based on the projected health and care needs of the population for the following five, ten and 20 years, consistent with the Office for Budget Responsibility long-term fiscal projections.

(3) NHS England and Health Education England must assist in the preparation of a report under this section.

(4) The organisations listed in subsection (3) must consult health and care employers, providers, trade unions, Royal Colleges, universities and any other persons deemed necessary for the preparation of this report, taking full account of workforce intelligence, evidence and plans provided by local organisations and partners of integrated care boards.”

This amendment would require the Government to publish independently verified assessments every two years of current and future workforce numbers required to deliver care to the population in England, based on the economic projections made by the Office for Budget Responsibility, projected demographic changes, the prevalence of different health conditions and the likely impact of technology.

Amendment 40, in clause 108, page 96, line 9, leave out subsection (2) and insert—

“(2) In this Part ‘protected material’ means—

(a) all statements taken from persons by the HSSIB during a safety investigation or in the course of deciding whether an incident is going to be subject to an HSSIB investigation,

(b) records revealing the identity of persons who have given evidence in the context of the safety investigation,

(c) information that has been collected by the HSSIB which is of a particularly sensitive and personal nature, such as (but not limited to) copies taken by the HSSIB of health records, care records, clinical notes, or personnel records,

(d) material subsequently produced during the course of an HSSIB investigation such as (but not limited to) notes, drafts and opinions written by the investigators, or opinions expressed in the analysis of information obtained through the investigation,

(e) drafts of preliminary or final reports or interim reports, and

(f) information that would be subject to legally enforceable commercial privileges.”

This amendment would define more closely the materials covered by the “safe space” protection provided for by the Bill.

Amendment 41, page 96, line 32, leave out

“information, document, equipment or other item held by that individual”

and insert “protected material”.

This amendment is consequential on Amendment 40.

Amendment 43, in clause 109, page 96, line 43, leave out from “Part” to end of line 24 on page 97.

This amendment would remove the ability of the Secretary of State to make regulations authorising disclosure of protected material beyond that provided for in the Bill.

Amendment 74, page 101, line 1, leave out clause 115.

Government amendments 24 and 127.

Amendment 57, page 110, line 11, leave out clause 127.

This amendment seeks to ensure that a profession currently regulated cannot be removed from statutory regulation and that regulatory bodies cannot be abolished.

Government amendments 86 and 87.

Government new schedule 1—Virginity testing: consequential amendments.

Government amendment 88.

Amendment 42, in schedule 14, page 218, line 30, leave out paragraph 6.

This amendment would remove the provision allowing coroners to require the disclosure of protected material.

[Edward Argar]

This broad group of amendments concern improving patient safety and the quality of health and care services, both of which are a priority for this Government. For that reason, this Bill will put the Health Services Safety Investigations Body on a statutory footing. The HSSIB will be one of the first independent healthcare bodies of its kind, leading the way in investigating for the purpose of learning, not blaming. For the HSSIB to be able to perform this “no-blame” role, the integrity of safe space is paramount. I look forward to contributions from right hon. and hon. Members from both sides of the House, recognising the depth of expertise, particularly that residing in the hon. Member for Central Ayrshire (Dr Whitford), on how best to make safe space work. As we discussed extensively in Committee, we recognise that ultimately this comes down to: what is the appropriate balance to be struck? Different views are likely to be aired again today.

Within this group, I will also address amendments brought forward by colleagues, including my right hon. Friend the Member for South West Surrey (Jeremy Hunt), on the health and social care workforce. Ensuring we have the workforce this country needs will, in the short-term, tackle the elective backlog. Crucially, in the long-term, as we build back better, it will help to reduce damaging health inequalities. For those reasons, I will later speak in more detail about this Government’s plans on the workforce, some of which of course are already in motion. I hope I can reassure the House that the provisions already made in this Bill, alongside the Government amendments I am about to discuss, do go sufficiently far to address these important issues.

I will begin by addressing new clauses 36 to 48, new schedule 1 and amendments 86 and 87, which comprise the package of Government amendments to prohibit virginity testing in the UK. I offer my deepest thanks to my hon. Friend the Member for North West Durham (Mr Holden) for his tireless efforts in proposing these amendments originally and in supporting the Government in proposing our variations on them, which we believe achieve the right balance—I will turn to that in a moment—as we bring forward this ban.

I should also put on the record my gratitude to the Opposition Front-Bench team for their constructive engagement on this issue, which does not divide us on party political lines but is about doing the right thing. I am grateful to the shadow Ministers on the Opposition Front Bench: the hon. Members for Ellesmere Port and Neston (Justin Madders) and for Nottingham North (Alex Norris).

In July, the Government promised in our violence against women and girls strategy that virginity testing will not be tolerated in the UK and will be banned at the earliest opportunity, so I am delighted that we are introducing amendments that demonstrate the strength of our commitment to the removal of all forms of abuse against women and girls. Our amendments will create three offences: conducting a virginity test; offering virginity testing; and aiding or abetting another person to conduct a virginity test in the UK or on UK nationals overseas. Each offence will carry 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.

The offences begin to tackle the harmful misconceptions that surround a woman’s sexuality. This House’s commitment to legislate is a profoundly important step forward in helping to tackle the damaging myths concerning the so-called purity of women’s sexuality. In response to concerns that, once the offence is banned in the UK, vulnerable women and girls will be taken abroad and subjected to virginity testing there, the offences will carry extraterritorial jurisdiction.

The proposals have been discussed by Health Ministers throughout the UK, including in the devolved Administrations, and I am working with them to ensure that the whole of the UK together tackles this abhorrent practice. I put on record my gratitude to the devolved Administrations for the constructive manner in which they have engaged on the issue. I hope that the House will pass the amendments today and allow us to take another step forward in our shared endeavour and important work on safeguarding and improving the lives of women and girls throughout the United Kingdom.

Let me turn briefly to new clause 21, tabled by my hon. Friend the Member for North West Durham—I thank him again for doing so. I hope that what I have said will reassure him and the rest of the House that the package of Government amendments that I have just discussed go further to protect women and girls from this form of abuse and are the most effective vehicle by which we can achieve what we seek to do. Our package of amendments set out that the conducting, offering or aiding of a virginity test is simply indefensible. The amendments ensure that victims are protected on our shores and abroad and that the sentencing of those convicted reflects the detrimental physical and psychological impacts of the practice. I therefore hope that my hon. Friend will feel able not to press his new clause to a vote and instead to support our amendments. I am incredibly grateful to him—as, I am sure, is the House—for his campaigning vigour on this issue.

My hon. Friend also tabled new clause 22, which seeks to ban the practice of hymenoplasty. The Government remain concerned that hymenoplasty is also driven by a repressive approach to female sexuality and is closely related to virginity testing, which we have made clear today is not an acceptable practice in the United Kingdom or elsewhere. We announced in the violence against women and girls strategy that we would set up an independent expert panel to explore the complex clinical, legal and ethical aspects of the procedure in more detail. The panel, which includes key stakeholders with ethical and clinical expertise, has already met and will shortly make its recommendations to Ministers, before Christmas. It is crucial that, having asked the panel to contribute, we carefully consider its views before we make a firm decision to ban hymenoplasty. However, I assure the House that although we cannot accept the new clause today because we await the recommendations of the review panel, we will of course fully reassess our position as soon as the panel makes its recommendations.

If we are to ensure patient safety and quality of care, it is vital that we have the workforce in place to deliver it. That is a priority for the Government and I reassure the House that we are taking the necessary steps to secure the workforce of the health and social care sector. Members throughout the House would all agree that although investment in technology, in new hospitals and buildings, in therapeutics and in kit are all phenomenally important, the golden thread that makes that investment valuable is the workforce—the people who always go above and beyond, particularly in the past 18 months, to make that equipment more than just a shiny piece of kit but something that actually saves lives. They are absolutely the heart of what we are doing.