Health and Care Bill

Martyn Day Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Fiona Bruce]

Yes; the organisation Right to Life, which is the secretariat to the all-party parliamentary pro-life group, has collated such data. Freedom of information data analysis also shows that one in 17 women taking abortion pills requires hospital treatment. That means that more than 14,000 women have been treated in hospital following the approval of pills-by-post abortion. A similar study of FOI data in February 2021 showed that every month, 495 women attended hospital with complications arising from abortion pills, and that 365 of them required hospital treatment. Thirty-six women every month are making 999 calls—that is more than one a day—seeking medical assistance because they are concerned about complications arising from taking abortion pills.

Women, especially vulnerable women, deserve the care and attention given in an in-person meeting with an experienced clinician before making such an important decision. Indeed, 74% of GPs have indicated concerns about women finding it distressing to terminate a pregnancy themselves at home. More than 600 medics signed an open letter to the Prime Minister in May 2021 calling for an end to pills-by-post abortion, and a clear majority—70%—of the respondents to the Government’s consultation on this subject said that the temporary measure of pills-by-post abortion should end.

However, whatever one’s views on abortion, the Government very recently made a decision to cease the authorisation of these pills from August this year, due to this being a temporary covid provision that was never intended to outlast the covid pandemic period. The Government—our Health Ministers—have made an informed, carefully considered, evidence-based decision. We should respect that, but once more, those pressing for an even more easily available abortion regime in this country are not willing to accept it. Instead, they are seeking to make a serious change to the law through an amendment, as is frequently their practice. That gives us far too little time to debate such fundamental issues. There is too little opportunity for us parliamentarians to scrutinise this serious issue, which is literally a matter of life and death. Whatever our views on abortion, that is simply wrong. I urge colleagues to vote against this proposal to make at-home abortion pills permanently available.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I come to this Bill rather late, so I pay tribute to my hon. Friend the Member for Central Ayrshire (Dr Whitford), who did most of the heavy lifting on it for the SNP. I have turned up for the fag end of the process. I hope the House will oblige me by listening to a few general comments before I address the Lords amendments.

Overall, this Bill is a missed opportunity for England to go back to a unified service, similar to the one we have in Scotland. Whatever system we have, I am sure each of us on these islands would wish to extend our gratitude and thanks to the staff who delivered such a focused patient care service in difficult times, throughout the pandemic. I also acknowledge the Government’s progress on recognising the need for consent from the devolved nations; that should have been included in the Bill from the get-go. Still, better late than never.

As we know, health is mainly a devolved matter. Following discussions with the UK Government, the Scottish Government were able to bring forward a legislative consent motion in December, further to which, in the light of securing acceptable amendments, the Scottish Government recommended consent to the Secretary of State’s power to transfer or delegate functions under clauses 88 to 94.

The UK Government made amendments to introduce two new clauses to the Bill—on hymenoplasty offences in Scotland, and on information about payments, et cetera, to persons in the healthcare sector—that also require legislative consent. The Scottish Government are content to recommend that the Scottish Parliament grants that consent.

In summary, the SNP supports Lords amendments 66 and 109 on the Health Services Safety Investigations Body to protect safe spaces and reduce any future harm to patients. These amendments largely rehash some of the amendments we tabled at previous stages, and I welcome the Government’s acceptance of the Lords amendment to remove coroners’ access in this regard.

A key health driver on which we can make a big difference is encouraging people to stop smoking, which is one of the best things people can do at any time of life. We support Lords amendments 85 to 88 on a tobacco products statutory scheme for the regulation of the prices and profits of tobacco manufacturers and importers, and they would require the Secretary of State to carry out a consultation on the scheme.

Although I understand that the Minister does not wish to prejudge the options for England’s tobacco control plan, we should remember that these would be UK-wide measures, and public health and smoking cessation are devolved to Scotland. The Scottish Government’s programme for government committed to a refreshed tobacco action plan built on the pillars of prevention, protection and cessation to achieve their target of lowering Scotland’s smoking rate to 5% or lower by 2034, which would put tobacco out of sight and out of mind for future generations. These Lords amendments, particularly on the “polluter pays” charge, would be beneficial in that regard, and Scotland’s progress should not be held back by decisions in this place.

In conclusion, I draw Members’ attention to the Cancer Research briefing:

“Implementing a ‘Smokefree Fund’ would require tobacco manufacturers to pay for the harm caused by tobacco but without letting them influence how the money is spent. It would provide much-needed investment in evidence-based measures such as public education campaigns and Stop Smoking Services, without further squeezing the public purse.”

Who could argue with that?

[Several hon. Members rose—]

Health and Care Bill

Martyn Day Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I will be brief, Madam Deputy Speaker.

Operational procurement is a devolved matter but, given our interest in trade policies, we welcome the progress on procurement to ensure that healthcare supply chains are not linked to modern slavery and human trafficking. We support UK Government amendment 48A in lieu of Lords amendment 48, and we also support Lords amendment 48B in lieu. It is perhaps worth reflecting on the fact that in Scotland half of all PPE is now produced locally and that the overall costs of pandemic procurement were a third less than those of the UK. Such measures can, then, be cost-effective and help to safeguard against global supply chain issues.

[Matt Hancock (West Suffolk) (Con)]

I rise to support the compromise measure on reconfigurations and to ask the Government to take forward the work on UK-wide statistics with vigour and gusto.

First, on reconfigurations, it is right and reasonable that the largest organisation in the country, which is funded by taxpayers through the taxes that every single citizen pays, should be accountable to Ministers who are in turn accountable to this House. Although that principle has been accepted in the Bill across the board and in general terms, the other place has decided that it should not apply in the specific circumstances of reconfigurations. It is vital that when a reconfiguration happens, not only the clinical voices but the voice of the local community should be heard. The two need to go together. The best way to make happen any reconfiguration that is needed on clinical grounds is to engage the local community and get it onside. If we are to save lives through a reconfiguration, we can win the argument, but only if we engage and make the argument. In my experience, too often a reconfiguration was put on the table, perhaps for good clinical reasons but without enough local engagement, and in practice the process just ran into the sand.

I welcome the six-month delay—I hope the Secretary of State will work quicker than six months most of the time, but it is a good backstop; I welcome the de minimis threshold, because relatively small reconfigurations happen all the time; and I welcome the removal of some of the bureaucracy in the amendment. To my hon. Friend the Minister, who has done a magnificent job on the Bill right from the start, before it even came to this House—I thank all his officials for their service—I say: let us take this compromise but say clearly to the other place, “Thus far and no further.” The principle of democratic responsibility for the NHS and for winning the argument with the public about its local design is at the heart of the Bill and it must stand.

In the final minute I have in which to speak, let me make a point about statistics. Those on the Treasury Bench have decided not to include in the Bill measures on the UK-wide measurement of health services and on the interoperability of data in the four nations of the UK, but I put on the record the importance—I hope the Minister reiterates this—of getting UK-wide measurements. In Wales, it was decided to discontinue the measurement of some aspects, especially in respect of A&E performance. A suspicion was raised—I am sure this could not possibly have been true—that those measurements were discontinued so that unfavourable comparisons with England could no longer be made. If that were true, it would be an outrage. I very much hope that it is not, but we should put it right anyway and measure NHS service delivery throughout the UK on the same basis, so that comparisons can be made, so that we can learn about and improve services across all four nations, and so that accountability can properly apply to the four different Governments who run the four parts of the one NHS, which operates across this United Kingdom.