Online Safety Bill

Lord Bethell Excerpts

Committee stage
Thursday 11th May 2023 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I shall speak to this group which includes Amendments 52, 99 and 222 in my name. These are complemented by Amendments 223 and 224 in the name of my noble friend Lord Knight. I am grateful to the noble Lords, Lord Clement-Jones and Lord Bethell, and to the noble Baroness, Lady Bennett, for putting their names to the amendments in this group. I am also grateful to the noble Lord, Lord Moylan, for tabling Amendments 59, 107 and 264. I appreciate also the work done by the APPG on Digital Regulation and Responsibility and by Full Fact on this group, as well as on many others in our deliberations.

These amendments would ensure that platforms were required to undertake a health misinformation and disinformation risk assessment. They would also require that they have a clear policy in their terms of service on dealing with harmful, false and misleading health information, and that there are mechanisms to support and monitor this, including through the effective operation of an advisory committee which Ofcom would be required to consult. I appreciate that the Minister may wish to refer to the false communication offence in Clause 160 as a reason why these amendments are not required. In order to pre-empt this suggestion, I put it to him that the provision does not do the job, as it covers only a user sending a knowingly false communication with the intention of causing harm, which does not cover most of the online health misinformation and disinformation about which these amendments are concerned.

Why does all this matter? The stakes are high. False claims about miracle cures, unproven treatments and dangerous remedies can and do spread rapidly, leading people to make the poorest of health decisions, with dire consequences. We do not have to go far back in time to draw on the lessons of our experience. It is therefore disappointing that the Government have not demonstrated, through this Bill, that they have learned the lessons of the Covid-19 pandemic. This is of concern to many health practitioners and representatives, as well as to Members of your Lordships’ House. We all remember the absolute horror of seeing false theories being spread quickly online, threatening to undermine the life-saving vaccine rollout. In recent years, the rising anti-vaccine sentiment has certainly contributed to outbreaks of preventable diseases that had previously been eradicated. This is a step backwards.

In 2020, an estimated 5,800 people globally were admitted to hospital because of false information online relating to Covid-19, with at least 800 people believed to have died because they followed this misinformation or disinformation. In 2021, the Royal College of Obstetricians and Gynaecologists found that only 40% of women offered the vaccine against Covid-19 had accepted it, with many waiting for more evidence that it would be safe. It is shocking to recall that, in October 2021, one in five of the most critically ill Covid patients was an unvaccinated, pregnant woman.

If we look beyond Covid-19, we see misinformation and disinformation affecting many other aspects of health. I will give a few examples. There are false claims about cancer treatment—for example, lemons treat cancer better than chemotherapy; tumours are there to save your life; cannabis oil cures cancer; rubbing hydrogen peroxide on your skin will treat cancer. Just last year, the lack of publicly available information about Mpox fuelled misinformation online. There is an issue about the Government’s responsibility for ensuring that there is publicly available information about health risks. In this respect, the lack of it—the void—led to a varied interpretation and acceptance of the public health information that was available, limited though it was. UNAIDS also expressed concern that public messaging on Mpox used language and imagery that reinforced homophobic and racist stereotypes.

For children, harmful misinformation has linked the nasal flu vaccine to an increase in Strep A infections. In late 2022, nearly half of all parents falsely believed these claims, such that the uptake of the flu vaccine among two and three year-olds dropped by around 11%. It is not just that misinformation and disinformation may bombard us online and affect us; there are also opportunities for large, language-model AIs such as ChatGPT to spread misinformation.

The Government had originally promised to include protections from harmful false health content in their indicative list of harmful content that companies would have been required to address under the now removed adult safety duties, yet we find that the Bill maintains the status quo, whereby platforms are left to their own devices as to how they tackle health misinformation and disinformation, without the appropriate regulatory oversight. It is currently up to them, so they can remove it at scale or leave it completely unchecked, as we recently saw when Twitter stopped enforcing its Covid-19 misinformation policy. This threatens not just people’s health but their freedom of expression and ability to make proper informed decisions. With that in mind, I look forward to amendments relating to media literacy in the next group that the Committee will consider.

I turn to the specific amendments. The new clause proposed in Amendment 52 would place a duty on category 1 platforms to undertake a health misinformation risk assessment and set out a policy on their treatment of health misinformation content. It would also require that the policy and related terms of service are consistently applied and clear and accessible—something that we have previously debated in this Committee. It also defines what is meant by

“harmful health disinformation and misinformation”—

and, again, on that we have discussed the need for clarity and definition.

Amendment 99 would require Ofcom to consult an advisory committee on disinformation and misinformation when preparing draft codes of practice or amendments to such codes. Amendment 222 is a probing amendment and relates to the steps, if any, that Ofcom will be expected to take to avoid the advisory committee being dominated by representatives of regulated services. It is important to look at how the advisory committee is constructed, as that will be key not just to the confidence that it commands but to its effectiveness.

Amendment 223, in the name of my noble friend Lord Knight, addresses the matter of timeliness in respect of the establishment of the advisory committee, which should be within six months of the Bill being passed. Amendment 224, also in the name of my noble friend Lord Knight, would require the advisory committee to consider as part of its first report whether a dedicated Ofcom code of practice in this area would be effective in the public interest. This would check that we have the right building blocks in place. With that in mind, I beg to move.

[Lord Bethell (Con)]

My Lords, it is a great honour to rise after the noble Baroness, Lady Merron, who spoke so clearly about Amendment 52 and the group of amendments connected with health misinformation, some of which stand also in my name.

As the noble Baroness rightly pointed out, we have known for a long time the negative impact of social media, with all its death scrolls, algorithms and rabbit holes on vaccine uptake. In 2018, the University of Southampton did a study of pregnant women and found that those who reported using social media to research antenatal vaccinations were 58% less likely to accept the whooping cough vaccine. Since then, things have only got worse.

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[Baroness Bennett of Manor Castle (GP)]

My Lords, I have attached my name to Amendments 52 and 99 in the name of the noble Baroness, Lady Merron, respectively signed by the noble Lords, Lord Bethell and Lord Clement-Jones, and Amendment 222 in her name. I entirely agree with what both the noble Baroness, Lady Merron, and the noble Lord, Lord Bethell, said. The noble Lord in particular gave us a huge amount of very well-evidenced information on the damage done during the Covid pandemic—and continuing to be done—by disinformation and misinformation. I will not repeat what they said about the damage done by the spread of conspiracy theories and anti-vaccination falsehoods and the kind of malicious bots, often driven by state actors, that have caused such damage.

I want to come from a different angle. I think we were—until time prevented it, unfortunately—going to hear from the noble Baroness, Lady Finlay of Llandaff, which would have been a valuable contribution to this debate. Her expert medical perspective would have been very useful. I think that she and I were the only two Members in the Committee who took part in the passage of the Medicines and Medical Devices Act. I think it was before the time of the noble Lord, Lord Bethell—he is shaking his head; I apologise. He took part in that as well. I also want to make reference to discussions and debates I had with him over changes to regulations on medical testing.

The additional point I want to make about disinformation and misinformation—this applies in particular to Amendment 222 about the independence of the advisory committee on disinformation and misinformation—is that we are now seeing in our medical system a huge rise in the number of private actors. These are companies seeking to encourage consumers or patients to take tests outside the NHS system and to get involved in a whole set of private provision. We are seeing a huge amount of advertising of foreign medical provision, given the pressures that our NHS is under. In the UK we have had traditionally, and still have, rules that place severe restrictions on the direct advertising of medicines and medical devices to patients— unlike, for example, the United States, where it is very much open slather, with some disastrous and very visible impacts.

We need to think about the fact that the internet, for better or for worse, is now a part of our medical system. If people feel ill, the first place they go—before they call the NHS, visit their pharmacist or whatever—is very often the internet, through these providers. We need to think about this in the round and as part of the medical system. We need to think about how our entire medical ecology is working, and that is why I believe we need amendments like these.

[Lord Bethell (Con)]

The noble Baroness makes two incredibly important points. We are seeking to give people greater agency on their own health and the internet has been an enormous bonus in doing that, but of course that environment needs to be curated extremely well. We are also seeking to make use of health tech—non-traditional clinical interventions, some of which do not pierce the skin and therefore fall outside the normal conversation with GPs—and giving people the power to make decisions about the use of these new technologies for themselves. That is why curation of the health information environment is so important. Does the noble Baroness have any reflections on that.

[Baroness Bennett of Manor Castle (GP)]

I thank the noble Lord for his intervention. He has made me think of the fact that a particular area where this may be of grave concern is cosmetic procedures, which I think we debated during the passage of the Health and Care Act. These things are all interrelated, and it is important that we see them in an interrelated way as part of what is now the health system.

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[Baroness Merron (Lab)]

My Lords, I am most grateful to noble Lords across the Committee for their consideration and for their contributions in this important area. As the noble Baroness, Lady Kidron, and the noble Lord, Lord Clement-Jones, both said, this was an area of struggle for the Joint Committee. The debate today shows exactly why that is so, but it is a struggle worth having.

The noble Lord, Lord Bethell, talked about there being a gap in the Bill as it stands. The amendments include the introduction of risk assessments and transparency and, fundamentally, explaining things in a way that people can actually understand. These are all tried and tested methods and can serve only to improve the Bill.

I am grateful to the Minister for his response and consideration of the amendments. I want to take us back to the words of the noble Baroness, Lady Kidron. She explained it beautifully—partly in response to the comments from the noble Baroness, Lady Fox. This is about tackling a system of amplification of misinformation and disinformation that moves the most marginal of views into the mainstream. It deals with restricting the damage that, as I said earlier, can produce the most dire circumstances. Amplification is the consideration that these amendments seek to tackle.

I am grateful to the noble Lord, Lord Moylan, for his comments, as well as for his amendments. I am sure the noble Lord has reflected that some of the previous amendments he brought before the House somewhat put the proverbial cat among the Committee pigeons. On this occasion, I think the noble Lord has nicely aligned the cats and the pigeons. He has managed to rally us all—with the exception of the Minister—behind these amendments.

[Lord Bethell (Con)]

The noble Baroness is entirely right to emphasise amplification. May I put into the mix the very important role of the commercialisation of health misinformation? The more you look at the issue of health misinformation, the more you realise that its adverse element is to do with making money out of people’s fears. I agree with the noble Baroness, Lady Fox, that there should be a really healthy discussion about the efficacy, safety and value for money of modern medicines. That debate is worth having. The Minister rightly pointed out some recent health scandals that should have been chased down much more. The commercialisation of people’s fears bears further scrutiny and is currently a gap in the Bill.

[Baroness Merron (Lab)]

I certainly agree with the noble Lord, Lord Bethell, on that point. It is absolutely right to talk about the danger of commercialisation and how it is such a driver of misinformation and disinformation; I thank him for drawing that to the Committee’s attention. I also thank my noble friend Lady Healy for her remarks, and her reflection that these amendments are not a question of restricting free speech and debate; they are actually about supporting free speech and debate but in a safe and managed way.