Foetal Sentience Committee Bill [HL]

Lord Jackson of Peterborough Excerpts

2nd reading
Friday 22nd March 2024 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, I commend my noble friend for tabling this Bill, which is on such an important issue. I had hoped that we would restrict our debate to empirical evidence on the merits of this modest Bill, rather than hear smears about right-wing dark money and conspiracies.

I will restrict my remarks to a few reflections on relevant studies on both sides of the debate and highlight the need for objectivity in this area, of a kind that could be provided by a suitably comprised committee.

[Baroness Kennedy of The Shaws (Lab)]

Why do noble Lords who are proposing and supporting this Bill assume that the Royal College of Obstetricians and Gynaecologists is not capable of researching in the way that the noble Lord describes? Why are they again attacking institutions that have expertise and do this constantly? It is like the attack on the Supreme Court. It is basically expressing contempt for the institutions that currently exist and doing precisely what they want, because they want to set up committees that I suggest would be weighted with people that they would choose.

[Lord Jackson of Peterborough (Con)]

I think that is a fatuous conspiracy theory again, but, if the noble Baroness satisfactorily answers my question about the involvement of Marie Stopes International and BPAS in the RCOG, I will gladly debate with her on the issues that she raises.

If I can continue—

[Baroness Thornton (Lab)]

I really must ask—

[Lord Jackson of Peterborough (Con)]

I will not give way.

[Baroness Thornton (Lab)]

I am not addressing the noble Lord. I am speaking to my colleagues on his Front Bench. I am very sorry, but shouting “you” and pointing is not the conduct that we expect in this House. It is in our guidance, so I ask the Government Whip to please remonstrate with his colleague not to behave like that.

[Lord Jackson of Peterborough (Con)]

I say to noble Lords that the noble Baroness, Lady Kennedy of The Shaws, had ample opportunity to make her points. She intervened on me and I put a very reasonable question back to her. Perhaps I can now continue.

Noble Lords may be aware of a fascinating peer-reviewed academic study published in 2010 of twins in the womb at 14 weeks of gestation. The study found that the twins’ self-directed hand movements were more calibrated than movements to the uterine wall, while movements towards the co-twin exhibited even greater care. The study determined that such deliberate actions could not be the result simply of spontaneous reflexes. The team behind the study concluded that these findings force us to predate the emergence of social behaviour. Another study published by a team of child psychologists and neuroscientists in 2006 found “surprisingly advanced motor planning” in foetuses at 22 weeks’ gestation, again pointing towards a sentience of the foetus during the second trimester of pregnancy.

These are precisely the kinds of studies that ought to be informing government policy, yet neither was cited in the RCOG reports on foetal sentience to which my noble friend alluded earlier. Some will no doubt argue that a committee is not required when we have the Royal College of Obstetricians and Gynaecologists to guide us, but, on the contrary, I would suggest that RCOG reports on foetal sentience highlight the need for objectivity in this area and there are a number of good reasons to be cautious about accepting the conclusions. The RCOG itself has now distanced itself from some of the conclusions in its 2010 report. For example, its updated 2022 report no longer asserts, as the earlier one did, that a foetus is in “continuous sleep-like unconsciousness or sedation”. The 2022 report also removed a section on responding to common questions that included answering the question, “Will the baby feel or suffer pain?” with “No, the foetus does not experience pain”. Seemingly, it is no longer sure.

Since the RCOG has rejected sections of its own report, it would seem wise not to assume that its 2022 update is wholly reliable either. In a letter published in the European Journal of Pain, Italian neonatologist and bioethicist Carlo Bellini, who has written extensively on foetal pain, has questioned the conclusions of the 2022 report, arguing that they were based on misrepresentations and incorrect extrapolations of research cited in their support. As a layman of course it is difficult for me to comment objectively on differing research, but what is clear is that government policy would be assisted by a committee that can provide objectivity in this debate and consider all relevant findings. In fact, this is something that ought to be supported by the RCOG.

Let me finish with a final reflection on why this matters beyond simply informing the abortion debate. A 2007 academic journal cited in Neurodevelopment Changes of Foetal Pain asserted:

“Exposure of the foetus and premature newborn to pain has been associated with long-term alterations in pain response thresholds as well as changes in behavioural responses relating to the painful stimuli”.


In other words, if a baby experiences pain before birth, it may impact its development and behaviour in later life. It is therefore imperative that we understand foetal sentience adequately so that any treatment of unborn babies is performed in a way that will not lead to long-term damage. I therefore strongly support my noble friend’s Bill.

Care of Critically Ill Children

Lord Jackson of Peterborough Excerpts

Monday 29th January 2024 Lords Chamber

[Lord Markham (Con)]

My understanding, now that the task force composition has been set up, is that this will be arranged shortly. I completely agree with the noble Baroness that these are important, as well as often heart-wrenching, matters, so urgency is required. As I have said, good progress has been made in a number of areas. Already, the MoJ is setting up a round table on this. The regional conflict managers have been established. We have training courses online so that communication can improve. A lot is being done, and the task force will push that forward further.

[Lord Jackson of Peterborough (Con)]

My Lords, the Minister will know that there is currently an imbalance between the resources available to the parents and guardians of children involved in end-of-life care—particularly time, money and legal advice—and that of public bodies such as NHS trusts. Compounding that issue is the routine use of secret transparency orders, which prevent scrutiny and oversight of court proceedings, particularly in the family court. Does the Minister agree with me in that respect: that secret justice is no justice at all?

[Lord Markham (Con)]

Clearly, the processes on these terrible cases have got to be as transparent as possible. As noble Lords probably know, legal aid is automatically available in all these types of cases to make sure that there is a level playing field. I also think we all believe that there is a case for seeing whether we can use mediation more as, obviously, courts should only ever be a last resort.

National Health Service: Key Targets

Lord Jackson of Peterborough Excerpts

Tuesday 16th January 2024 Lords Chamber

[Lord Markham (Con)]

One of the key learnings from last year, which goes back to the whole question about planning, was actually that if you put social care moneys in too late, you do not get nearly as effective spend. That is why we brought forward the £600 million discharge fund much earlier—actually, into the summer—so that local authorities and care providers could plan on that money. It is starting to make a difference. A key thing that noble Lords have heard me talk about is bed-blocking. Actually, we have seen a 10% reduction in bed-blocking since these measures have come into effect in the last few weeks. It is early days, but we are actually making progress.

[Lord Jackson of Peterborough (Con)]

My Lords, the number of over-85s is due to double over the next 30 years. Would my noble friend the Minister give some consideration to government funding for extra care facilities and at-home treatment, such as physiotherapy, in order that pressure be taken off acute district hospital beds in respect of older people?

[Lord Markham (Con)]

Funnily enough, I had this conversation in terms of productivity just today. The virtual wards—the 11,000 extra beds we have put in—are actually making a real impact on that, because of course it is much better that people can be treated in their own home, knowing they have the comfort of these virtual displays and treatment to look after them. We have 11,000 extra beds, with 72% utilisation, and, yes, it is really working.

NHS Long-term Workforce Plan

Lord Jackson of Peterborough Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord is correct that it is essential. I emphasise that this is an NHS document, and the whole point is that it does not look to go “zoom” on recruitment. There is absolutely the understanding that this is a pipeline that has to be built brick by brick. There is no point front-loading the number of university places if, as the noble Lord mentions, there is no follow-up behind it in clinicians. The plan has been developed from the bottom up, including with clinicians and the trusts. There is an understanding that they need to build their own part of the pipeline towards this as well.

[Lord Jackson of Peterborough (Con)]

I welcome this ambitious and comprehensive workforce plan and I concur with other noble Lords on the issue of social care. On the specific issue of medical school places, while I strongly welcome and commend the Government for responding to the campaign of many people—including Policy Exchange and its excellent Double Vision report, published earlier this year—my concern is the waste of resources and the talents of those thousands of A-level students who do not get university places to study medicine. While I welcome the focus on degree apprenticeships and the regionalisation of medical education, is there any chance that we could speed up the process? Another eight years to double the number of medical places is an awfully long time—it is almost the equivalent of two Parliaments.

[Lord Markham (Con)]

As for the A-level point and those people not being able to go on to universities, that is what the different routes are about. The different pathways that we are talking about include nursing associate training places, which we want to see increased to 10,000, and similarly with physician associates. While we all understand that having a university education is a fantastic medical grounding, there are many other ways to get there. I am sure we all have very good examples of fantastic clinicians who did not have a degree.

Pharmacies: Medicines at Home

Lord Jackson of Peterborough Excerpts

Wednesday 17th May 2023 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, on the subject of support services, is my noble friend the Minister aware of, and does he deprecate, the widespread practice of catheterising very elderly people who are only temporarily immobile or infirm? In the long term, that reduces their independence and adds to the cumulative costs to the state of their care, particularly to primary care, the NHS and local authorities.

[Lord Markham (Con)]

Yes.

Bread and Flour Regulations 1988

Lord Jackson of Peterborough Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is correct. Key to all these things is awareness that the best advice is to take folic acid supplements, as suggested. I am happy to provide precise figures of how that has moved in recent years. I completely agree that, as ever, education and awareness are key to this.

[Lord Jackson of Peterborough (Con)]

My Lords, I welcome my noble friend the Minister’s very positive tone. I first campaigned on this issue as a constituency MP 18 years ago, but it is 32 years since the Medical Research Council established the causal link between the ingestion of folic acid and the reduction of neural tube defects such as spina bifida and hydrocephalus. Scores of countries have pursued this policy and it has had a significant impact on reducing the tragedy of lifetime disability that has affected many families. Can the Minister ensure that the review is concluded expeditiously so that we can erode these terrible medical conditions as soon as possible?

[Lord Markham (Con)]

Yes, I am very happy to do so. It has been quite a process, as my noble friend says, but we are getting there. As I said, the good news is that the industry is seeing the direction of travel and is responding as well. That is always better when done voluntarily. We are seeing more foods with levels of fortification. We will get there in terms of it being mandated as well.