Complications from Abortions (Annual Report) Bill [HL]

Lord Scriven Excerpts

2nd reading
Friday 13th December 2024 Lords Chamber

[Lord Scriven (LD)]

My Lords, I thank the noble Lord, Lord Moylan, for this Bill. He may not realise that he has highlighted an important issue that needs to be addressed—not the limited and, I may say, misguided focus of this Bill, but the wider issue of robustness of health datasets and the reliability of statistics used to plan, improve and deliver safe services as part of our healthcare system. As a former health services manager, I have taken an interest in this for a long time.

The NHS is one of the most data-rich healthcare systems in the world, yet some of its datasets suffer from weaknesses that can impede its ability to deliver high-quality, data-driven care. These weaknesses can broadly be categorised into areas of data quality, interoperability, accessibility and governance. One of the fundamental challenges lies in the inconsistency and incompleteness of data. NHS datasets often include outdated, duplicated or incorrect information due to variations in how data is recorded across trusts and practices. For example, patient demographics, diagnosis or treatment codes and records might be inconsistently documented, making it difficult to draw accurate insights. This runs into thousands of conditions and treatments, not just this one, which I hazard an educated guess has not been randomly plucked for the attention of this Bill. When you add in the private sector, it becomes near impossible to provide a complete patient journey through statistics to help improve patient care.

If the noble Lord, Lord Moylan, and his supporters want to improve healthcare outcomes for not just women but everyone, and safety and policy built on better data, their Bill should focus on legislating to improve data quality in the NHS. It should be about adopting national standards for data quality, promoting interoperability, enhancing accessibility, strengthening governance and transparency and leveraging advanced analytics. So why pick out just one treatment among thousands with poor and conflicting data in our healthcare system and make the exception of trying to report it to this Parliament? The noble Lord’s reason for exceptionability does not stand up: 55% of ophthalmology cases are provided by the private sector and 30,000 hip replacements are provided by the healthcare sector.

This Bill is a back-door attempt to limit abortion in this country, using statistical jiggery-pokery as a smokescreen. I say sorry to the noble Lord and his supporters, but this just will not wash. The real motives need to be exposed. It is telling that the majority of those actively campaigning for this Bill are the very organisations that are prominent in attempts to restrict or, in some cases, ban abortion in this country.

These Benches will support genuine and effective measures to improve datasets in our healthcare system, to improve safety and outcomes for not just women but all patients, but we will not support the ideas of this Bill, which are not a foundation for effective improvement in healthcare and healthcare safety. We need to be clear: this Bill will not deal with the underlying weaknesses of healthcare datasets. It is the first step in an agenda to restrict women’s choice and, in some cases, restrict abortion altogether.

--- Later in debate ---

[Lord Moylan (Con)]

My Lords, I am very grateful to all noble Lords who have spoken in this short debate. My noble friends Lord Frost and Lady Lawlor made important points about patient empowerment, but also about the improvement in medical care that can only follow from a better understanding of what is actually going wrong.

I am also partly grateful to the noble Baroness, Lady Miller of Chilthorne Domer, because she supported the principle that the data should be collated—she thought perhaps not by means of an Act of Parliament. I conceded that point in my opening remarks—there are other means of doing it—but she said that she thought the data should be collated.

I find myself less able to express gratitude to the noble Baroness, Lady Barker, who lives in a world that I simply do not recognise. I have not read the American book she referred to. She came dangerously close to suggesting that I was either in receipt of or being influenced by money for this purpose. That would be a contemptible thing to say, and I will happily give way if she indicates that she wishes to distance herself from any such implication.

My noble friend Lady Sugg said that the Bill required abortion complications to be reported for the first time, and that this would be different. It does not. Abortion complications, as the Minister said, are already reported. The question is whether the data is robust and the sources from which it is drawn. My noble friend also said that collecting data could compromise the privacy of patients. Well, of course it could, but it does not, because you collect it without compromising the privacy of patients. Nobody has suggested that the report produced in November 2023 remotely compromised the privacy of patients. All that the Bill does is require that this report continue to be produced on an annual basis.

The noble Lord, Lord Scriven, was massively keen to improve the quality of NHS data, but the moment he sees a report from the Office for Health Improvement and Disparities, which clearly improves the quality of data, he retreats into a sort of conspiracy theory.

[Lord Scriven (LD)]

If you are going to have end-to-end patient data, it needs to include A&E, GP, private, in-patient and out-patient. The statistical analysis that the Bill puts in place is a complete gap and does not give end-to-end patient data. Therefore, it becomes a totally ineffective use of statistics.

[Lord Moylan (Con)]

With respect, it is true that the report, which the noble Lord has obviously read carefully, does not include data from GPs or from 111. That would have been an onerous task and, as the Government have said, this was a first and experimental effort. This is an argument for going further and improving the collection of that data, not for giving up the attempt altogether and seeing it as a conspiracy, which is what the noble Lord appeared to do.

We are really all on one page about this—or at least he and I seem to be. What is so strange about the advocates of choice in this debate is that they are so defensive; they speak as if they are surrounded by conspiracy. I do not actually think they are. If I thought I was surrounded by conspiracy, I would want to live in a world of facts and not hide myself from them, which is what they seem to be doing. The proposal is that data produced by an arm of the NHS should continue to be produced, whether by statutory or administrative means. That is all it is.

I know that there are other things happening today, so I turn finally to the remarks of the Minister. I am grateful to her for being one of the few people to treat the Bill seriously and to look at what the words in it say. She wandered slightly from that into the worlds of strange contexts, but in fact a great deal of her speech was an echo of my speech. On the history and the factual and contextual issues here, we are largely agreed. I agree that the Bill exceptionalises abortion to some extent because, as I said, abortion is exceptional, in that its statistics are generated from different data sources, which is very different from the majority of NHS procedures that take place inside a hospital. I grant that the noble Lord, Lord Scriven, has a point that there are other exceptional cases. I did not say that abortion was unique; I said it was exceptional. There are differences between the two words, and he is right about some hip operations and so forth taking place in the private sector, where similar issues might arise as well.

The Minister says that there are different and other ways of collecting these statistics: non-statutory means. I conceded that point, too, in my opening remarks. What she did not say is that she would use a different, non-statutory means of collecting these statistics. I remind her that when she signs her letters, underneath her name it says: “Minister for Patient Safety and Women’s Health”.

We need better statistics on complications arising from abortions. I am disappointed that the Minister has not committed herself to that and agreed that, even if a Bill is not necessary for this purpose, she will set herself to do so. Sadly, she has not.

Public Procurement: Data Offshoring

Lord Scriven Excerpts

Tuesday 8th October 2024 Lords Chamber

[Baroness Twycross (Lab)]

I think the security piece and the development piece can and should go in tandem, otherwise neither is sustainable. Three in every four people in England have already downloaded the app. This Government want to establish adoption through improved patient experience and system benefits, and to expand the services offer. This is part of making sure that more people can access the services they require.

[Lord Scriven (LD)]

My Lords, Microsoft gave a view to the Scottish Government in June this year that it could not guarantee that data held by public services on its Microsoft 365 and Azure hyperscale cloud infrastructure will remain in the UK. What mitigations are the Government looking at in the light of this statement by Microsoft?

[Baroness Twycross (Lab)]

I refer back to my initial Answer, which is that each contracting authority should carefully consider, and make risk-based decisions on, whether and where data can be offshored. We can get really hung up on offshoring, onshoring or where the data is stored, but we have to make sure that all data and cybersecurity are central to how we move forward with this type of procurement. This is why the Government are introducing a cybersecurity and resilience Bill, which will help ensure our cybersecurity for the future.

Global IT Outage

Lord Scriven Excerpts

Thursday 25th July 2024 Lords Chamber

[Baroness Twycross (Lab)]

I thank the noble Lord for his question, which packed a lot in. I agree that the dominance of any particular software company or IT system is a risk to resilience, as government has known for some time. But we need to look at this as a whole and—I do not want to sound like a broken record—this will be covered by the cybersecurity and resilience Bill as it proceeds through the House.

[Lord Scriven (LD)]

My Lords, one of the public services specifically hit was the NHS, so why are systematic back-up systems not in place in the NHS for primary care and pharmacy? Who has been asked to take this forward to ensure that such systems are in place as a matter of urgency for those who are ill?

[Baroness Twycross (Lab)]

All relevant departments will take part in the review, and I will feed back the specific points made to the Cabinet Office and colleagues in the Department of Health. Going back to the previous point about the widespread use of specific software systems, this needs to be taken seriously as we move forward with the proposed legislation.