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10:07
Debate: Report from the Preterm Birth Committee Preterm birth: 'reducing risks and improving lives'
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**** Possible New Speaker ****
Motion Motion for Motion for debate, Motion for debate, preterm Motion for debate, preterm birth committee debate.
**** Possible New Speaker ****
My Lords, I am pleased and honoured to lead the debate today on the preterm birth committee report. Before I do so, I would like to Before I do so, I would like to thank most sincerely all those who gave evidence to the committee, and in particular, the mothers and parents of children born preterm who parents of children born preterm who told us of their experiences as well as their prospective adults who were as their prospective adults who were born premature.
It is their powerful evidence that forms the backbone of evidence that forms the backbone of our report and the recommendation, and I will come back to that. I sincere thanks to specialist advisers. My thanks to the dedicated committee staff who supported us and did so brilliantly. The common committee clerk, policy analyst, Mark Gladwell, and Alec Brown, media and communications officer. A huge thank you to the more for their hard work and support.
Personal thanks to all the committee members. It was a privilege and was fun to be there chair because of their dedication and help in making sure we deliver evidence-based reports that helps improve the lives of mothers, parents, and the families of children born preterm. Thanks also to Baroness Burt in, and I am
Debate: Report from the Preterm Birth Committee Preterm birth: 'reducing risks and improving lives'
**** Possible New Speaker ****
Motion Motion for Motion for debate, Motion for debate, preterm Motion for debate, preterm birth committee debate.
**** Possible New Speaker ****
My Lords, I am pleased and honoured to lead the debate today on the preterm birth committee report. Before I do so, I would like to Before I do so, I would like to thank most sincerely all those who gave evidence to the committee, and in particular, the mothers and parents of children born preterm who parents of children born preterm who told us of their experiences as well as their prospective adults who were as their prospective adults who were born premature.
It is their powerful evidence that forms the backbone of evidence that forms the backbone of our report and the recommendation, and I will come back to that. I sincere thanks to specialist advisers. My thanks to the dedicated committee staff who supported us and did so brilliantly. The common committee clerk, policy analyst, Mark Gladwell, and Alec Brown, media and communications officer. A huge thank you to the more for their hard work and support.
Personal thanks to all the committee members. It was a privilege and was fun to be there chair because of their dedication and help in making sure we deliver evidence-based reports that helps improve the lives of mothers, parents, and the families of children born preterm. Thanks also to Baroness Burt in, and I am
10:10
Lord Patel (Crossbench)
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Lord Patel (Crossbench)
pleased that she will speak today, and I look forward to her speech. She was instrumental in persuading She was instrumental in persuading the Liaison Committee to set up the the Liaison Committee to set up the enquiry. I also look forward to speeches of all the noble Lords taking part today, including the taking part today, including the Minister. A committee was setup in Minister. A committee was setup in 2024 to consider prevention and consequences of preterm birth. The title of the report preterm birth title of the report preterm birth reduces risks and improving lives summarises it all.
I declare my summarises it all. I declare my interest of 39 years because I was interest of 39 years because I was not. By definition, preterm birth babies born for 37 weeks, and the current incidences 7.9% of all births. It is the main cause of neonatal deaths in the UK. 75% of babies burn preterm, very preterm. Most babies born preterm, the outcome is good. For many, it is not. 4.2% of those born preterm end up having severe disability.
At age 18. An 18.5% of mild disability. Children burn preterm have a need for special education, lower the gestation at birth, the higher the incidence. 82.6% of those born at near 24 weeks have a need for special education. Children born preterm also have low educational attendance. Whilst advances in neonatal care has led to improved survival, there has not been a corresponding improvement in neurodevelopment outcomes. Incidence of brain injury, for example, is 26 per thousand births in those born preterm compared to 3.5 per thousand births and those born to term.
It results in disability, cognitive impairment, memory loss, and other functions. Adults born preterm told us that issues they experience could be subtle but multiple. Added to which, a lack of awareness with the healthcare system of wrong term effects of prematurity means informed or specially support is difficult to access. It is not only the children born preterm for whom we can do better. But also, for the parents who are to care for these children. The survey showed that 24% of parents showed signs of post- traumatic shock.
As one mother said, and I quote, life before the neonatal unit is irrelevant. When you and yourself stood postpartum next to your baby in an incubator. Hoping and wishing that you make it out safely. The vulnerability is beyond quipping. The impact of prematurity does not end upon discharge from the neonatal unit. The experience stays with you for life. As these things demonstrate, it can be sudden and unexpected and have significant and sometimes lifelong impact on those born preterm torso on their families.
Many parents who spend weeks and months in hospital caring for their babies often in hospitals long way from home, incurring practical and financial difficulties. A mother with twins born very preterm was cared for in two different hospitals because of lack of capacity of neonatal base described vividly to us her daily difficulties and the stress it caused on her, travelling between two husbands visiting and caring for her to tiny babies. A survey showed that 24% of parents showed signs of post-traumatic shock.
75% of intensive neonatal care units do not have accommodation for parents. Most have poor facilities, even for mothers to express breastmilk or rest. It clearly shows the benefits of involving parents in the care of preterm babies, the so-called integrated that parents and all health professionals are enrolled in the care of the baby. It not only improves outcomes but importantly, it gives parents the consequence my confidence they need when it comes time to take their baby home.
There is a need to make integrated camel widespread. While we will not completely prevent preterm births, our enquiry clearly showed that we can reduce this impact by better policies of care and babies and support to parents. For example, saving babies lives developed by NHS England has guidelines that will improve outcomes if implemented in full. The evidence we got showed a wide variation in these guidelines, and important areas such as timing of clamping of the umbilical cord.
You might be surprised that they are factored in as the clamping of the cord had on the outcome for babies Timing of administration of steroids to the mother prior to birth. Non- use of ventilation and several other areas where the guidelines are not followed. The result is a poor outcome for babies. There is an urgent need to implement guidelines more widely and eliminate the variation in care. What role does the Minister think the Department of Health and Social Care can bring to bring about this change? We also heard of the challenges parents face after discharge from hospital.
Community services not only lack capacity, but often do not have the training required to be help to parents. Lord Darzi in his report highlighted the important role of health visitors in early years development of children. The shortage of not only health visitors but also midwives, specialist neonatal nurses, physiotherapists, and clinical psychologists. This will impact on the outcome for babies born preterm. And the recent report from the College of Midwives which reports that the newly qualified midwives are worried about not getting a job stop this cannot be right when you want to expand the midwifery workforce.
Can the minister give assurance that workforce issues will be addressed in the NHS 10 year plan? Personal guidelines stipulate the need for a series of assessment of children born preterm prior to starting school particularly age two and four. Delivery of this at best is inconsistent, and the majority of cases it does not happen at all. Figures show that at age two, 85% of babies born preterm are followed up but this drops to 6.7% of the crucial preschool age of four.
There is a need to urgently address this issue. I hope the government will take urgent action to do this. My Lords I now briefly come to the important issue of prevention and reducing incidents of preterm births. Prediction and prevention of preterm births is challenging. Because of the wide range of factors that contribute to a woman's individual risk, with many having no risk. The study showed a strong association of preterm birth linked to smoking, social economic status of parents, and an ethnicity.
These need urgent attention if we are to reduce incidents of preterm birth. I hope the Minister will comment on how the government intends to address each of these issues. We explored the role of screening to identify at-risk women from preterm births. We came to the conclusion of the need for a better design and more focused studies to see if it can be done. Despite this, there are opportunities to reduce the incidence of preterm birth. When will the government set out to revise the maternity safety guidelines and focus efforts to reduce rates of preterm births amongst all groups of women? Does the government have a target reduction? Providing women with information prior to pregnancy about their general health and lifestyle should be an important part of reducing incidents of preterm births.
Does the Minister agree that this should be part of the government's Women's Health Strategy as? There is currently under investment. The government's manifesto said Labour would prioritise women's, with a reformed NHS. The Minister in her evidence to the committee said, the government intends, " Health for women is optimised before they get to pregnancy. " The opportunity today for the Minister to say how this will be done. Being born preterm, weighing as little as 600 g, with body organs that sustain healthy life not fully developed, the consequence could be death or lifelong disability for many.
With provision of good care, the outcomes for not just the few but many would be better. Why would we not put policies in place to do this? I beg to move.
**** Possible New Speaker ****
I would like to thank Lord Patel and members of the committee for
**** Possible New Speaker ****
this very important... Oh sorry. I did beg to move. The question is that the motion be agreed.
**** Possible New Speaker ****
be agreed. My Lords, I would like to thank Lord Patel and the members of the committee for this really important report, and the time that it has come stop the situation in this come stop the situation in this country for pregnant women and for babies and preterm babies is a huge babies and preterm babies is a huge risk. This is the future of our country and the future of the world country and the future of the world and we do not take it in the way it should be taken.
If I could remind members of a few points. The report members of a few points. The report is titled reducing risks and improving lives. To do that we have to work much harder than we are at the moment. Women's health is in its worse position than it has ever been. I helped to launch the report from some members recently in the House of Lords and we have set out a manifesto for women is helpful the Minister was extreme helpful at that meeting and has helped us since.
The current landscape for preterm births in England in 2022, 7.9% of births in England were preterm. 45% of babies born before 37 weeks. Those babies will need a lot of help, a lot of support, not just in the very beginning but for the whole of their lives, certainly through secondary school and university. They will also need to be having proper checks as adults as well because of what happens when you are born in a way and it affects the lungs and the brain.
So it's important we have a way that people are checked regularly. A number of preterm babies are born with mothers who have pre-eclampsia. This has huge impact on the mother not only when she is pregnant but afterwards, including heart conditions. So all women who have had this should be being seen by their doctors every 12 months and having heart checks as well. They are the future and they are looked after children. So it is really important that we look at the state of others.
Preterm babies is that leading course of national morbidity in the UK was the outcomes of preterm infants remain uneven across the country. It is not registered when a child starts nursery or school in most places, and it should be so that teachers are understanding what is happening. are understanding what is happening. And there are disparities And there are disparities in And there are disparities in the figures. They are rooted in structural inequalities, poverty, and equal access to healthcare.
Unequal access to proper healthcare for pregnant women from the time that they are pregnant. They should be being seen regularly, they should know that they must keep these appointments, and if they don't, this must be followed through. We should have much more advertising and education for women and young girls about becoming pregnant, how you must be looked after and how you have to look after yourself. And if something is not right when you are pregnant, you know yourself it is not right so it shouldn't be for nurses to say go away and come back next week.
They should let you come in, let you be checked. I know some people will be more nervous than others but that will save lives and save awful things that happen. Poor maternal health outcomes, unconscious bias in healthcare settings, addressing preterm requires confronting underlying social issues with health. We need much more understanding by social workers and counsellors, and more understanding of what is needed for people not to be isolated because sometimes if somebody has a problem, loses a baby, or has taken a baby home that needs help, they are left on their own.
Sometimes in accommodation that is pretty terrible and they don't see anybody. Again we should be giving support and government can do that because the impact it has on families and other children. Parents of preterm babies experience high levels of trauma, anxiety, and uncertainty. Increased risk of postnatal depression, and that has a terrible effect on the marriage and on the other children, and on how babies may be looked after. Nearly 40% of mothers with preterm infants report clinical symptoms. Holding challenges due to separation and impacting developing outcomes was that the husband does not always come home or the partner they can't was understand what is wrong.
It is important that we try and get these clear messages over, everybody needs to support each other. The financial strain of travelling where babies are miles away from where the parents live and they are expected to come back and forth and there is no accommodation for them to be in hospital, they should be staying in hospital. This is really bad and we have all had people we have had to support. Loss of income, parents get exhausted. They have to apply for extra entitlements.
These take a long time to come, nobody is very helpful, they're having to do it online are not always capable. They are not always up to it because are not always up to it because emotionally they are worried about what is happening to the baby and themselves. It places additional emotional and administrative emotional and administrative pressure on families. Social isolation, as I have said earlier, is a real problem. I think we have is a real problem. I think we have to look on the whole question of pregnancy in a completely different pregnancy in a completely different way than must be looked at in the past.
It is something that goes past. It is something that goes away, you have a baby and you will be fine. Today we have to give much better care both to the babies and better care both to the babies and to the parents. Thank you.
I declare my summarises it all. I declare my interest of 39 years because I was interest of 39 years because I was not. By definition, preterm birth babies born for 37 weeks, and the current incidences 7.9% of all births. It is the main cause of neonatal deaths in the UK. 75% of babies burn preterm, very preterm. Most babies born preterm, the outcome is good. For many, it is not. 4.2% of those born preterm end up having severe disability.
At age 18. An 18.5% of mild disability. Children burn preterm have a need for special education, lower the gestation at birth, the higher the incidence. 82.6% of those born at near 24 weeks have a need for special education. Children born preterm also have low educational attendance. Whilst advances in neonatal care has led to improved survival, there has not been a corresponding improvement in neurodevelopment outcomes. Incidence of brain injury, for example, is 26 per thousand births in those born preterm compared to 3.5 per thousand births and those born to term.
It results in disability, cognitive impairment, memory loss, and other functions. Adults born preterm told us that issues they experience could be subtle but multiple. Added to which, a lack of awareness with the healthcare system of wrong term effects of prematurity means informed or specially support is difficult to access. It is not only the children born preterm for whom we can do better. But also, for the parents who are to care for these children. The survey showed that 24% of parents showed signs of post- traumatic shock.
As one mother said, and I quote, life before the neonatal unit is irrelevant. When you and yourself stood postpartum next to your baby in an incubator. Hoping and wishing that you make it out safely. The vulnerability is beyond quipping. The impact of prematurity does not end upon discharge from the neonatal unit. The experience stays with you for life. As these things demonstrate, it can be sudden and unexpected and have significant and sometimes lifelong impact on those born preterm torso on their families.
Many parents who spend weeks and months in hospital caring for their babies often in hospitals long way from home, incurring practical and financial difficulties. A mother with twins born very preterm was cared for in two different hospitals because of lack of capacity of neonatal base described vividly to us her daily difficulties and the stress it caused on her, travelling between two husbands visiting and caring for her to tiny babies. A survey showed that 24% of parents showed signs of post-traumatic shock.
75% of intensive neonatal care units do not have accommodation for parents. Most have poor facilities, even for mothers to express breastmilk or rest. It clearly shows the benefits of involving parents in the care of preterm babies, the so-called integrated that parents and all health professionals are enrolled in the care of the baby. It not only improves outcomes but importantly, it gives parents the consequence my confidence they need when it comes time to take their baby home.
There is a need to make integrated camel widespread. While we will not completely prevent preterm births, our enquiry clearly showed that we can reduce this impact by better policies of care and babies and support to parents. For example, saving babies lives developed by NHS England has guidelines that will improve outcomes if implemented in full. The evidence we got showed a wide variation in these guidelines, and important areas such as timing of clamping of the umbilical cord.
You might be surprised that they are factored in as the clamping of the cord had on the outcome for babies Timing of administration of steroids to the mother prior to birth. Non- use of ventilation and several other areas where the guidelines are not followed. The result is a poor outcome for babies. There is an urgent need to implement guidelines more widely and eliminate the variation in care. What role does the Minister think the Department of Health and Social Care can bring to bring about this change? We also heard of the challenges parents face after discharge from hospital.
Community services not only lack capacity, but often do not have the training required to be help to parents. Lord Darzi in his report highlighted the important role of health visitors in early years development of children. The shortage of not only health visitors but also midwives, specialist neonatal nurses, physiotherapists, and clinical psychologists. This will impact on the outcome for babies born preterm. And the recent report from the College of Midwives which reports that the newly qualified midwives are worried about not getting a job stop this cannot be right when you want to expand the midwifery workforce.
Can the minister give assurance that workforce issues will be addressed in the NHS 10 year plan? Personal guidelines stipulate the need for a series of assessment of children born preterm prior to starting school particularly age two and four. Delivery of this at best is inconsistent, and the majority of cases it does not happen at all. Figures show that at age two, 85% of babies born preterm are followed up but this drops to 6.7% of the crucial preschool age of four.
There is a need to urgently address this issue. I hope the government will take urgent action to do this. My Lords I now briefly come to the important issue of prevention and reducing incidents of preterm births. Prediction and prevention of preterm births is challenging. Because of the wide range of factors that contribute to a woman's individual risk, with many having no risk. The study showed a strong association of preterm birth linked to smoking, social economic status of parents, and an ethnicity.
These need urgent attention if we are to reduce incidents of preterm birth. I hope the Minister will comment on how the government intends to address each of these issues. We explored the role of screening to identify at-risk women from preterm births. We came to the conclusion of the need for a better design and more focused studies to see if it can be done. Despite this, there are opportunities to reduce the incidence of preterm birth. When will the government set out to revise the maternity safety guidelines and focus efforts to reduce rates of preterm births amongst all groups of women? Does the government have a target reduction? Providing women with information prior to pregnancy about their general health and lifestyle should be an important part of reducing incidents of preterm births.
Does the Minister agree that this should be part of the government's Women's Health Strategy as? There is currently under investment. The government's manifesto said Labour would prioritise women's, with a reformed NHS. The Minister in her evidence to the committee said, the government intends, " Health for women is optimised before they get to pregnancy. " The opportunity today for the Minister to say how this will be done. Being born preterm, weighing as little as 600 g, with body organs that sustain healthy life not fully developed, the consequence could be death or lifelong disability for many.
With provision of good care, the outcomes for not just the few but many would be better. Why would we not put policies in place to do this? I beg to move.
**** Possible New Speaker ****
I would like to thank Lord Patel and members of the committee for
**** Possible New Speaker ****
this very important... Oh sorry. I did beg to move. The question is that the motion be agreed.
**** Possible New Speaker ****
be agreed. My Lords, I would like to thank Lord Patel and the members of the committee for this really important report, and the time that it has come stop the situation in this come stop the situation in this country for pregnant women and for babies and preterm babies is a huge babies and preterm babies is a huge risk. This is the future of our country and the future of the world country and the future of the world and we do not take it in the way it should be taken.
If I could remind members of a few points. The report members of a few points. The report is titled reducing risks and improving lives. To do that we have to work much harder than we are at the moment. Women's health is in its worse position than it has ever been. I helped to launch the report from some members recently in the House of Lords and we have set out a manifesto for women is helpful the Minister was extreme helpful at that meeting and has helped us since.
The current landscape for preterm births in England in 2022, 7.9% of births in England were preterm. 45% of babies born before 37 weeks. Those babies will need a lot of help, a lot of support, not just in the very beginning but for the whole of their lives, certainly through secondary school and university. They will also need to be having proper checks as adults as well because of what happens when you are born in a way and it affects the lungs and the brain.
So it's important we have a way that people are checked regularly. A number of preterm babies are born with mothers who have pre-eclampsia. This has huge impact on the mother not only when she is pregnant but afterwards, including heart conditions. So all women who have had this should be being seen by their doctors every 12 months and having heart checks as well. They are the future and they are looked after children. So it is really important that we look at the state of others.
Preterm babies is that leading course of national morbidity in the UK was the outcomes of preterm infants remain uneven across the country. It is not registered when a child starts nursery or school in most places, and it should be so that teachers are understanding what is happening. are understanding what is happening. And there are disparities And there are disparities in And there are disparities in the figures. They are rooted in structural inequalities, poverty, and equal access to healthcare.
Unequal access to proper healthcare for pregnant women from the time that they are pregnant. They should be being seen regularly, they should know that they must keep these appointments, and if they don't, this must be followed through. We should have much more advertising and education for women and young girls about becoming pregnant, how you must be looked after and how you have to look after yourself. And if something is not right when you are pregnant, you know yourself it is not right so it shouldn't be for nurses to say go away and come back next week.
They should let you come in, let you be checked. I know some people will be more nervous than others but that will save lives and save awful things that happen. Poor maternal health outcomes, unconscious bias in healthcare settings, addressing preterm requires confronting underlying social issues with health. We need much more understanding by social workers and counsellors, and more understanding of what is needed for people not to be isolated because sometimes if somebody has a problem, loses a baby, or has taken a baby home that needs help, they are left on their own.
Sometimes in accommodation that is pretty terrible and they don't see anybody. Again we should be giving support and government can do that because the impact it has on families and other children. Parents of preterm babies experience high levels of trauma, anxiety, and uncertainty. Increased risk of postnatal depression, and that has a terrible effect on the marriage and on the other children, and on how babies may be looked after. Nearly 40% of mothers with preterm infants report clinical symptoms. Holding challenges due to separation and impacting developing outcomes was that the husband does not always come home or the partner they can't was understand what is wrong.
It is important that we try and get these clear messages over, everybody needs to support each other. The financial strain of travelling where babies are miles away from where the parents live and they are expected to come back and forth and there is no accommodation for them to be in hospital, they should be staying in hospital. This is really bad and we have all had people we have had to support. Loss of income, parents get exhausted. They have to apply for extra entitlements.
These take a long time to come, nobody is very helpful, they're having to do it online are not always capable. They are not always up to it because are not always up to it because emotionally they are worried about what is happening to the baby and themselves. It places additional emotional and administrative emotional and administrative pressure on families. Social isolation, as I have said earlier, is a real problem. I think we have is a real problem. I think we have to look on the whole question of pregnancy in a completely different pregnancy in a completely different way than must be looked at in the past.
It is something that goes past. It is something that goes away, you have a baby and you will be fine. Today we have to give much better care both to the babies and better care both to the babies and to the parents. Thank you.
10:26
Baroness Bertin (Conservative)
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Baroness Bertin (Conservative)
My Lords, I can't tell you how delighted I was when this issue was selected to be a special committee. I had witnessed friends of mine, I had witnessed families go through at a heartbreak. Many women can lose so many babies due to preterm. Of course the babies that do survive, there is huge toy that they have survived, there was not enough talked about but the general outcomes and the journey that those families have to go on.
So I want to give huge praise to the committee. What a credit to this House that there was a committee with such huge expertise. Lord Patel, I know you led this remarkably. I do want to also praise the people who worked on the committee as well, the staff. I was very disappointed not to be able to sit on the committee myself. Regrettably I have started work on, work the government on my harmful pornography review I felt I could not do both.
But I'm grateful to my noble Friend Baroness Wyld forgiving me very much updated on the progress of the report. I want to praise the report. It is so powerful. I welcome support many of the recommendations have been put forward by the committee to clearly those focused on improving long-term outcomes for babies and families. I think the noble Baroness raised so many bullet issues around the emotional toll that this takes. As the report rightly highlights, the devastating court acquitted of preterm birth do not end at the hospital doors.
For many families that is only the beginning. With one in 10 preterm babies going on to develop permanent disability, life often becomes far more complex. Both the child and for the parents. Many developmental delays and long-term health conditions only emerge over time and can only be identified, as has been mentioned in previous speeches, to regulate structured follow-up by clinicians and community health professionals particularly health visitors. Yet we are witnessing a troubling decline in the number of community health visitors, a workforce that is critical in identifying early signs of difficulty.
And providing the support in the home environment. I feel personally, not emotional, but this happens to me. I am lucky, I had had three children. Essentially I did not see a health visitor with my third baby at all. And I had to push and push and push. I commend thinking to myself, there are lots of problems with this, but luckily I knew what I was doing, I wasn't having any postnatal depression or issues. I baby I knew was roughly hitting his milestone.
Like a member thinking, my God, for new fragile mothers, particularly those have been through a difficult time, that would be unacceptable. I think it absolutely has to be raised. These checks are not optional extras, they are lifelines. Without them, early develop mental problems are missed. In the window for effective intervention begins to close. My Lords, we must ensure continuity of care not only for those children whose life chances depend on timely support and is critical years but also for the parents, who often bear the troubling impact of preterm birth in silence.
The noble Baroness also talked about relationship breakdowns. I don't know the figures but I can imagine it put an enormous strain on relationships, and that makes the whole situation even more difficult. Further to that, I'm very pleased that the committee has reiterated what many in the field have known, which is that despite remarkable advances in neonatal care, we must acknowledge that, but we are failing to make meaningful progress in mitigating the real risks of preterm birth. Without adequate and sustained funding, the field remains fragmented and underresearched.
Of course the underresearched. Of course the reality is that pregnant women quite rightly don't want to take drugs. There is not as much money going into the pharmaceutical research element of things because they can't perhaps sell as many drugs as they might like to. I'm not being cynical but that is a reality. When I first proposed the inquiry, only 2% of the health research but it went towards reproductive health per annum. I suspect this figure has not massively shifted in the last two is.
Clinicians and researchers are finding themselves competing for diminishing pots of money leading to vital projects faltering. This is not the only sector that has this issue. I would like to draw the attention of lordships to the work of a medical research charity, Born. I should declare an interest, the medical person then delivered my third baby. He has set up an amazing charity which focuses on preterm birth and I'm grateful for the work they do. They recently launched the Bourne collaborative, an initiative which has brought together leading experts from across the globe, not to compete to cooperate.
These experts have given their time and expertise to help set clear strategic priorities for research and investment, helping to limit evidence-based roadmaps to prevent This is the strategic direction that we lack at a national level. The current proposals don't yet go far enough, and I think the data speaks for itself. But this is why I am urging the government to consider more rigorous alternatives to both reduction, and amongst these should be the establishment of a national task force, a central body charged with oversight of research, prevention and intervention strategies, supported by experts.
strategies, supported by experts. This could reduce variation in care across the rate of regions. We always know there is a huge postcode lottery, and also, effective therapies and bundles. And with better coordination, real-time data collection and resource sharing, we can move from reactive care to proactive prevention, and that is what we need, and this sort of strategy applies across many issues in government, that I think we must act now, not with just words and symbolic gestures, but with meaningful and clear commitments because without it, women and families will continue to bear the burden of a system that often forgets them.
Thank you. forgets them. Thank you.
So I want to give huge praise to the committee. What a credit to this House that there was a committee with such huge expertise. Lord Patel, I know you led this remarkably. I do want to also praise the people who worked on the committee as well, the staff. I was very disappointed not to be able to sit on the committee myself. Regrettably I have started work on, work the government on my harmful pornography review I felt I could not do both.
But I'm grateful to my noble Friend Baroness Wyld forgiving me very much updated on the progress of the report. I want to praise the report. It is so powerful. I welcome support many of the recommendations have been put forward by the committee to clearly those focused on improving long-term outcomes for babies and families. I think the noble Baroness raised so many bullet issues around the emotional toll that this takes. As the report rightly highlights, the devastating court acquitted of preterm birth do not end at the hospital doors.
For many families that is only the beginning. With one in 10 preterm babies going on to develop permanent disability, life often becomes far more complex. Both the child and for the parents. Many developmental delays and long-term health conditions only emerge over time and can only be identified, as has been mentioned in previous speeches, to regulate structured follow-up by clinicians and community health professionals particularly health visitors. Yet we are witnessing a troubling decline in the number of community health visitors, a workforce that is critical in identifying early signs of difficulty.
And providing the support in the home environment. I feel personally, not emotional, but this happens to me. I am lucky, I had had three children. Essentially I did not see a health visitor with my third baby at all. And I had to push and push and push. I commend thinking to myself, there are lots of problems with this, but luckily I knew what I was doing, I wasn't having any postnatal depression or issues. I baby I knew was roughly hitting his milestone.
Like a member thinking, my God, for new fragile mothers, particularly those have been through a difficult time, that would be unacceptable. I think it absolutely has to be raised. These checks are not optional extras, they are lifelines. Without them, early develop mental problems are missed. In the window for effective intervention begins to close. My Lords, we must ensure continuity of care not only for those children whose life chances depend on timely support and is critical years but also for the parents, who often bear the troubling impact of preterm birth in silence.
The noble Baroness also talked about relationship breakdowns. I don't know the figures but I can imagine it put an enormous strain on relationships, and that makes the whole situation even more difficult. Further to that, I'm very pleased that the committee has reiterated what many in the field have known, which is that despite remarkable advances in neonatal care, we must acknowledge that, but we are failing to make meaningful progress in mitigating the real risks of preterm birth. Without adequate and sustained funding, the field remains fragmented and underresearched.
Of course the underresearched. Of course the reality is that pregnant women quite rightly don't want to take drugs. There is not as much money going into the pharmaceutical research element of things because they can't perhaps sell as many drugs as they might like to. I'm not being cynical but that is a reality. When I first proposed the inquiry, only 2% of the health research but it went towards reproductive health per annum. I suspect this figure has not massively shifted in the last two is.
Clinicians and researchers are finding themselves competing for diminishing pots of money leading to vital projects faltering. This is not the only sector that has this issue. I would like to draw the attention of lordships to the work of a medical research charity, Born. I should declare an interest, the medical person then delivered my third baby. He has set up an amazing charity which focuses on preterm birth and I'm grateful for the work they do. They recently launched the Bourne collaborative, an initiative which has brought together leading experts from across the globe, not to compete to cooperate.
These experts have given their time and expertise to help set clear strategic priorities for research and investment, helping to limit evidence-based roadmaps to prevent This is the strategic direction that we lack at a national level. The current proposals don't yet go far enough, and I think the data speaks for itself. But this is why I am urging the government to consider more rigorous alternatives to both reduction, and amongst these should be the establishment of a national task force, a central body charged with oversight of research, prevention and intervention strategies, supported by experts.
strategies, supported by experts. This could reduce variation in care across the rate of regions. We always know there is a huge postcode lottery, and also, effective therapies and bundles. And with better coordination, real-time data collection and resource sharing, we can move from reactive care to proactive prevention, and that is what we need, and this sort of strategy applies across many issues in government, that I think we must act now, not with just words and symbolic gestures, but with meaningful and clear commitments because without it, women and families will continue to bear the burden of a system that often forgets them.
Thank you. forgets them. Thank you.
10:33
Lord Winston (Labour)
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Lord Winston (Labour)
May I first paid tribute of my noble friend Lord Patel who was an outstanding chairman as he has often been in the past with other enquiries which I have been associated, so I thank you very much indeed. I also want to suggest something which needs to be pointed out, and that is the fact that there was no point making a treatment unless you make a diagnosis, and the diagnosis must depend on the cause of the understanding, and the problem is various causes have been postulated for over 40 years in this area, and I will suggest that I will take a different line because many things will be said in this debate.
I want to suggest that we need to be linking much more closely the loss of babies in the uterus before term in the early stages of pregnancy, i.e. Miscarriage, with preterm birth because the causes almost certainly related and they are important, and that is what I want to discuss in the short speech. So many causes have been suggested. Changes in the DNA, genetic disposition which is different, abnormalities, metabolic problems, immune changes, molecules which perfect implantation of course, insufficiencies of placenta or afterbirth, anatomic abnormalities of the genital tract, failures of eggs to mature properly, vagina, uterine and gut bacteria and of course, infections using either viruses or parasitic infection.
The fact of the matter is that is very difficult to decipher where we are going, and I regret to say that much of the scientific evidence we will see was rather confusing, and I think that is something that we need to consider. It has not been well focused, and I think we need to consider why that is. There are associations which my noble friend has mentioned. The environmental factors include pesticides, pollution, smoking, poor diet, ingested toxins, weight like obesity, male and female age, and of course, obviously, the link there is with infertility which is the area I am particularly interested.
We don't understand why it is more common in some animals than others. We do know that it isn't particularly common to lose pregnancies in primates. That seems to be associated with stress in primates and may be related to changes in family circumstances, to Kelly with a dominant male which is quite interesting. Whether that is interesting, I'm not suggesting it is, but it is another example of why we are very much at loss. In 1987, I met a lady could Pamela who had three preterm babies, and they all died.
One boy who died a few weeks after birth, and the others in addition to the three that died before birth. She also had at least six miscarriages though she thought she had had more but she felt the doctors were not regarded. She had this constant problem, and it is one stage that her partner left her. She actually went on finally to deliver James. James was born premature and severely disabled at birth. It became much later on that there was a genetic disease, and finally, the diagnosis of a red disease which usually affects boys but not girls was in fact diagnosed.
And indeed, he was so disabled he live strapped in a wheelchair. He was not able to move his arms deliberately because if he did, he would mutilate himself. Eventually, his teeth were extracted because he was biting his lips off and his tongue. That is the nature of that disease which is causing miscarriage. After the diagnosis was made, we started to get very concerned about whether we could do some research to understand what was going on, and we took three years to identify this diagnosis of the syndrome in embryos.
Two embryos were transferred at different stages but she didn't get pregnant, and eventually, she had a normal baby some four years after we started the research. Her NHS treatments were pretty costly, and the cost of looking after that woman and her children were very considerable, and the research that we did was not funded. We got the funding by persuading women to cycle around the world to raise huge sums of money because these women felt very compassionate. There are 23 million miscarriages a year annually at least.
23 million, and that means about 44 pregnancies are lost every minute, something like that. And the pool is very high, over 15% of pregnancies lost in this way. It is a massive medical problem, and it is linked of course with premature birth because sometimes it is a marker of premature births, and therefore, we have to consider these things together which is why I make the speech as I do. If you add in premature births, you start to see the colossal consequences in handicap as we have seen, and the gravesite logical problems as well which affect people.
This is something that we need to consider because why is this happening? When you look at world figures, it is very puzzling. What we have seen is that, in the studies of miscarriage, that prevalence varies across the world. You would inspect it to be much more common with poverty and so on, but let's look at this in detail. Ethiopian is the country with most serious miscarriage rates that I could find. It is about eight times more common than it is in the UK.
True in Guyana and Bolivia as well. Eritrea and Zambia, the weight is quite prevalent, but in Malawi, the most poor African country of them all, it is not much to similar as it is in Britain, and that is very interesting. Quite unclear. It is not clearly related to what we think is the causes that we imagine associated with poverty, poor nutrition, smoking and so on. There are lots of other things going on. I think there are many things that we could do which have not been mentioned here.
One of the things is that we have to understand that what we need is much better recognition of people who are going through miscarriage and proper recording of what is going on. Much more investigation at the expense of the health service. I plead with the noble Lady that she might see how we can do that. These are not that expensive but pathology should be a part of it, and unfortunately, that is often missed out. Don't look at the products of conception when the miscarriage occurs.
They are just ignored, so women can out of hospital without any idea of what has happened, feeling absolutely desperate, bereaved, and it is worth bearing in mind that they remember the date of that miscarriages afterwards. They don't have a funeral. They don't have any recognition. They don't tell people at work because they can't and they have to suffer with their partners alone, and sometimes with the very serious problem of continuing infertility, bloodlust, and generally feeling really unwell as if they had had an anaesthetic and operation, having never been in hospital before any serious disease.
That is why I think we have to recognise why this is so important. We act have a great opportunity here because what we could do is do what we do so well in Britain. We are extremely good at cohort studies. We have, amongst other things, one of the best examples of biobank. It is making a massive difference at the moment. If you take the world of ophthalmology, we understand that buyback is giving us clues as to the causes of macular degeneration which has a whole range of causes, just like infertility.
We can see specific genetic predisposition is which I think going to lead to much better treatment of this lightness which prevents people being on work, for example, so I urge the government to think about this because, in fact, this scientific research is much needed. What is strange is the kind of paradox in the data bill we have discussed, and we have forgotten that science is actually due to serendipity. It is not related to careful recognition. Just looking at figures like this in the right sort of way is serendipitous and it is very likely that if we did this with proper data collection, we would end up with some very useful hypotheses.
If we did that, we would be able to focus research in the areas that are most relevant, and I think we would make real progress in treatment. This would be so much more than just a blanket funding of lots and lots of research. I don't think that is really needed because research councils show they have been funding for grant populations which is a very, very high number. It is much higher than other areas of medicine, but we need to do much better research, and we need to do it if we are going to change the heartache and suffering which is so often ignored, and which totally healthy women are ignored when going through this, and we need to do something about this, and we could do something which doesn't meet masses of expense, but it would mean looking at how we do things a bit better, which we can do, and trying to focus where we're going with to focus where we're going with better research which, at the moment, is not present.
I want to suggest that we need to be linking much more closely the loss of babies in the uterus before term in the early stages of pregnancy, i.e. Miscarriage, with preterm birth because the causes almost certainly related and they are important, and that is what I want to discuss in the short speech. So many causes have been suggested. Changes in the DNA, genetic disposition which is different, abnormalities, metabolic problems, immune changes, molecules which perfect implantation of course, insufficiencies of placenta or afterbirth, anatomic abnormalities of the genital tract, failures of eggs to mature properly, vagina, uterine and gut bacteria and of course, infections using either viruses or parasitic infection.
The fact of the matter is that is very difficult to decipher where we are going, and I regret to say that much of the scientific evidence we will see was rather confusing, and I think that is something that we need to consider. It has not been well focused, and I think we need to consider why that is. There are associations which my noble friend has mentioned. The environmental factors include pesticides, pollution, smoking, poor diet, ingested toxins, weight like obesity, male and female age, and of course, obviously, the link there is with infertility which is the area I am particularly interested.
We don't understand why it is more common in some animals than others. We do know that it isn't particularly common to lose pregnancies in primates. That seems to be associated with stress in primates and may be related to changes in family circumstances, to Kelly with a dominant male which is quite interesting. Whether that is interesting, I'm not suggesting it is, but it is another example of why we are very much at loss. In 1987, I met a lady could Pamela who had three preterm babies, and they all died.
One boy who died a few weeks after birth, and the others in addition to the three that died before birth. She also had at least six miscarriages though she thought she had had more but she felt the doctors were not regarded. She had this constant problem, and it is one stage that her partner left her. She actually went on finally to deliver James. James was born premature and severely disabled at birth. It became much later on that there was a genetic disease, and finally, the diagnosis of a red disease which usually affects boys but not girls was in fact diagnosed.
And indeed, he was so disabled he live strapped in a wheelchair. He was not able to move his arms deliberately because if he did, he would mutilate himself. Eventually, his teeth were extracted because he was biting his lips off and his tongue. That is the nature of that disease which is causing miscarriage. After the diagnosis was made, we started to get very concerned about whether we could do some research to understand what was going on, and we took three years to identify this diagnosis of the syndrome in embryos.
Two embryos were transferred at different stages but she didn't get pregnant, and eventually, she had a normal baby some four years after we started the research. Her NHS treatments were pretty costly, and the cost of looking after that woman and her children were very considerable, and the research that we did was not funded. We got the funding by persuading women to cycle around the world to raise huge sums of money because these women felt very compassionate. There are 23 million miscarriages a year annually at least.
23 million, and that means about 44 pregnancies are lost every minute, something like that. And the pool is very high, over 15% of pregnancies lost in this way. It is a massive medical problem, and it is linked of course with premature birth because sometimes it is a marker of premature births, and therefore, we have to consider these things together which is why I make the speech as I do. If you add in premature births, you start to see the colossal consequences in handicap as we have seen, and the gravesite logical problems as well which affect people.
This is something that we need to consider because why is this happening? When you look at world figures, it is very puzzling. What we have seen is that, in the studies of miscarriage, that prevalence varies across the world. You would inspect it to be much more common with poverty and so on, but let's look at this in detail. Ethiopian is the country with most serious miscarriage rates that I could find. It is about eight times more common than it is in the UK.
True in Guyana and Bolivia as well. Eritrea and Zambia, the weight is quite prevalent, but in Malawi, the most poor African country of them all, it is not much to similar as it is in Britain, and that is very interesting. Quite unclear. It is not clearly related to what we think is the causes that we imagine associated with poverty, poor nutrition, smoking and so on. There are lots of other things going on. I think there are many things that we could do which have not been mentioned here.
One of the things is that we have to understand that what we need is much better recognition of people who are going through miscarriage and proper recording of what is going on. Much more investigation at the expense of the health service. I plead with the noble Lady that she might see how we can do that. These are not that expensive but pathology should be a part of it, and unfortunately, that is often missed out. Don't look at the products of conception when the miscarriage occurs.
They are just ignored, so women can out of hospital without any idea of what has happened, feeling absolutely desperate, bereaved, and it is worth bearing in mind that they remember the date of that miscarriages afterwards. They don't have a funeral. They don't have any recognition. They don't tell people at work because they can't and they have to suffer with their partners alone, and sometimes with the very serious problem of continuing infertility, bloodlust, and generally feeling really unwell as if they had had an anaesthetic and operation, having never been in hospital before any serious disease.
That is why I think we have to recognise why this is so important. We act have a great opportunity here because what we could do is do what we do so well in Britain. We are extremely good at cohort studies. We have, amongst other things, one of the best examples of biobank. It is making a massive difference at the moment. If you take the world of ophthalmology, we understand that buyback is giving us clues as to the causes of macular degeneration which has a whole range of causes, just like infertility.
We can see specific genetic predisposition is which I think going to lead to much better treatment of this lightness which prevents people being on work, for example, so I urge the government to think about this because, in fact, this scientific research is much needed. What is strange is the kind of paradox in the data bill we have discussed, and we have forgotten that science is actually due to serendipity. It is not related to careful recognition. Just looking at figures like this in the right sort of way is serendipitous and it is very likely that if we did this with proper data collection, we would end up with some very useful hypotheses.
If we did that, we would be able to focus research in the areas that are most relevant, and I think we would make real progress in treatment. This would be so much more than just a blanket funding of lots and lots of research. I don't think that is really needed because research councils show they have been funding for grant populations which is a very, very high number. It is much higher than other areas of medicine, but we need to do much better research, and we need to do it if we are going to change the heartache and suffering which is so often ignored, and which totally healthy women are ignored when going through this, and we need to do something about this, and we could do something which doesn't meet masses of expense, but it would mean looking at how we do things a bit better, which we can do, and trying to focus where we're going with to focus where we're going with better research which, at the moment, is not present.
10:44
Baroness Wyld (Conservative)
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Baroness Wyld (Conservative)
Can I add my thanks to the noble Lord Lord Patel? We couldn't have wished for anyone better to be our chair. He did it with his unique blend of professional brilliance and deep compassion and were very lucky to have him. I also thank Baroness Burt and who proposed the committee. As we heard, she challenged your Lordships house to show ambition in its approach to this issue, and I know she made me even more determined to fight for better outcomes for women, their babies and families.
She kept on telling me to remember who we were doing this for. On that note, it has been a privilege for me to get to know some of the parents who gave evidence to us. I want to thank a moment to acknowledge the strength it took for those parents to come and tell their stories to a public hearing of the Select Committee, and to allow us to question them in order that we could find recommendations that would, we hope, improve the experience for others.
I have three general observations. Given as we still don't know enough about preterm labour, we await to women to do And second we do know a fair bit about ensuring the best possible quality care, women still cannot trust that this will be delivered consistently. Third, as a recommendations show, it should be possible to reduce risk and improve outcomes. But there is it seems to me a disappointing lack of pace and grip from the government, despite very warm words in its response to our report.
I do want to emphasise that I am very grateful to the noble Baroness the Minister for the time she has given me to discuss these issues. I've said in the national media that I was convinced that the will is there to tackle these issues. I'm happy to put that on the record. I also accept that the government is making progress on preventative healthcare, and I was very grateful for the smooth way in which they delivered the regulations to implement the neonatal care and pay bill which I took through this house in 2023.
It is in that spirit that I come to this debate. I will never play politics on this and I would be delighted if the Minister was able to contradict me in her summing up because I will now be more critical of the response to our recommendations. My Lords, our committee acknowledge the complexity of preterm birth. This is also expressed different views about the usefulness of just one overarching target of reduction to 6% by 2025. Which the Minister has acknowledged will be missed. None of this means from a policy perspective return births should be put in the "Too difficult" category.
The government has rightly accepted the principle that we need to address the focus on tackling the stark unacceptable inequalities, and clean the rate of preterm birth's that exist for black and Asian women and babies, and women and babies from the most deprived backgrounds. The government therefore needs to set out how it intends to get their, and given it is almost 7 months since publication is almost 7 months since publication of the report, I wouldn't be surprised if the noble Lady was not able to say whether government has landed on targets or where it is with the review.
I want to focus on several recommendations on chapters 4 and five in the report where we examined about improving outcomes for preterm babies and expenses of their families. As we have heard, many babies who are born early flourish. During our committee 's wounds stages we heard from those who have not been the case, including Francesca and Nadiya, both mothers preterm twins. I cannot do justice to that session in the time available today. Their campaigning called for all parents to be properly supported in the care of their babies born in hospital, and on their return home, must be acted on by the government.
First it seems to me astonishing that so many of us will stand in Parliament in 2025 today and have to argue the case that all parents must be able to stay overnight with their tiny and unwell babies in neonatal units. Including neonatal intensive care. They should be involved in their babies care as much as possible, and able to hold them. They must be listened to when their instinct tells them that something is wrong. The charity outlined evidence that this leads to a range of benefits including increased weight gain, increased breastfeeding and reduced rates of mortality and morbidity.
If the government and NHS agree with this, why have they not published a review of the NHS maternity and neonatal estate survey as requested by the committee, and promised early in 2025? In answer to a written question I'd tailored in April, the DHSC said NHS England will do it shortly, and we are now in June. If Can the minister give a definitive date for this? Given we await the NHS 10 year plan, can she say what consideration is given to extend and improve accommodation for neonatal babies? We also made clear that the impact of preterm birth does not end once families go home.
And yet, despite the fact that up to 40% of mothers experience symptoms of post-traumatic stress disorder six months after a preterm birth, witnesses told us that counselling after a preterm birth is either not in place or not offered as standard. I raised the wider issue of mental health in the house last month. Could the Minister expand on the answers she gave then to address the committee's recommendation that the government and NHS England should detail the steps they are taking to ensure equitable access to neonatal treatment and perinatal mental health services for all families that explains preterm birth.
This of course tied closely to recommendation eight, the need to develop specialist knowledge and the needs of preterm babies and their families and health visitor training, and continuous professional develop and with protected training time. As Baroness Bertin mentioned, it is people and relationships that can help others turn corners. I turned finally two of the most disappointing findings of the report, follow-up assessments for children born he term that are recommended by NICE and not be consistently delivered, in particular at age 4 is Lord Patel outline.
I think I speak for the whole committee in saying that we were highly dismayed that neither NHS England nor that DHSC able to explain why this was the case, or who was going to grip it. I know the government is in the process of NHS restructure, and I certainly don't want to open up that debate today. But to emphasise the committee's desire to see swift resolution of this. I would be most grateful for a precise answer from the noble Lady, the Minister.
In that summing up, while there is a huge amount of specialist knowledge and experience in this report, it is at its core very simple. We can and we must do better for babies, for mothers, and for families. The most powerful evidence comes from those parents who have campaigned the quiet dignity to try and spare others the pain they have experienced. I feel a huge response ability to keep up momentum to try and deliver change for them, and I reiterate my commitment to the Minister that I will work cross-party to try to do just that.
just that.
She kept on telling me to remember who we were doing this for. On that note, it has been a privilege for me to get to know some of the parents who gave evidence to us. I want to thank a moment to acknowledge the strength it took for those parents to come and tell their stories to a public hearing of the Select Committee, and to allow us to question them in order that we could find recommendations that would, we hope, improve the experience for others.
I have three general observations. Given as we still don't know enough about preterm labour, we await to women to do And second we do know a fair bit about ensuring the best possible quality care, women still cannot trust that this will be delivered consistently. Third, as a recommendations show, it should be possible to reduce risk and improve outcomes. But there is it seems to me a disappointing lack of pace and grip from the government, despite very warm words in its response to our report.
I do want to emphasise that I am very grateful to the noble Baroness the Minister for the time she has given me to discuss these issues. I've said in the national media that I was convinced that the will is there to tackle these issues. I'm happy to put that on the record. I also accept that the government is making progress on preventative healthcare, and I was very grateful for the smooth way in which they delivered the regulations to implement the neonatal care and pay bill which I took through this house in 2023.
It is in that spirit that I come to this debate. I will never play politics on this and I would be delighted if the Minister was able to contradict me in her summing up because I will now be more critical of the response to our recommendations. My Lords, our committee acknowledge the complexity of preterm birth. This is also expressed different views about the usefulness of just one overarching target of reduction to 6% by 2025. Which the Minister has acknowledged will be missed. None of this means from a policy perspective return births should be put in the "Too difficult" category.
The government has rightly accepted the principle that we need to address the focus on tackling the stark unacceptable inequalities, and clean the rate of preterm birth's that exist for black and Asian women and babies, and women and babies from the most deprived backgrounds. The government therefore needs to set out how it intends to get their, and given it is almost 7 months since publication is almost 7 months since publication of the report, I wouldn't be surprised if the noble Lady was not able to say whether government has landed on targets or where it is with the review.
I want to focus on several recommendations on chapters 4 and five in the report where we examined about improving outcomes for preterm babies and expenses of their families. As we have heard, many babies who are born early flourish. During our committee 's wounds stages we heard from those who have not been the case, including Francesca and Nadiya, both mothers preterm twins. I cannot do justice to that session in the time available today. Their campaigning called for all parents to be properly supported in the care of their babies born in hospital, and on their return home, must be acted on by the government.
First it seems to me astonishing that so many of us will stand in Parliament in 2025 today and have to argue the case that all parents must be able to stay overnight with their tiny and unwell babies in neonatal units. Including neonatal intensive care. They should be involved in their babies care as much as possible, and able to hold them. They must be listened to when their instinct tells them that something is wrong. The charity outlined evidence that this leads to a range of benefits including increased weight gain, increased breastfeeding and reduced rates of mortality and morbidity.
If the government and NHS agree with this, why have they not published a review of the NHS maternity and neonatal estate survey as requested by the committee, and promised early in 2025? In answer to a written question I'd tailored in April, the DHSC said NHS England will do it shortly, and we are now in June. If Can the minister give a definitive date for this? Given we await the NHS 10 year plan, can she say what consideration is given to extend and improve accommodation for neonatal babies? We also made clear that the impact of preterm birth does not end once families go home.
And yet, despite the fact that up to 40% of mothers experience symptoms of post-traumatic stress disorder six months after a preterm birth, witnesses told us that counselling after a preterm birth is either not in place or not offered as standard. I raised the wider issue of mental health in the house last month. Could the Minister expand on the answers she gave then to address the committee's recommendation that the government and NHS England should detail the steps they are taking to ensure equitable access to neonatal treatment and perinatal mental health services for all families that explains preterm birth.
This of course tied closely to recommendation eight, the need to develop specialist knowledge and the needs of preterm babies and their families and health visitor training, and continuous professional develop and with protected training time. As Baroness Bertin mentioned, it is people and relationships that can help others turn corners. I turned finally two of the most disappointing findings of the report, follow-up assessments for children born he term that are recommended by NICE and not be consistently delivered, in particular at age 4 is Lord Patel outline.
I think I speak for the whole committee in saying that we were highly dismayed that neither NHS England nor that DHSC able to explain why this was the case, or who was going to grip it. I know the government is in the process of NHS restructure, and I certainly don't want to open up that debate today. But to emphasise the committee's desire to see swift resolution of this. I would be most grateful for a precise answer from the noble Lady, the Minister.
In that summing up, while there is a huge amount of specialist knowledge and experience in this report, it is at its core very simple. We can and we must do better for babies, for mothers, and for families. The most powerful evidence comes from those parents who have campaigned the quiet dignity to try and spare others the pain they have experienced. I feel a huge response ability to keep up momentum to try and deliver change for them, and I reiterate my commitment to the Minister that I will work cross-party to try to do just that.
just that.
10:52
Baroness Owen of Alderley Edge (Conservative)
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Baroness Owen of Alderley Edge (Conservative)
My Lords, I want to begin by paying tribute to my noble friend Lord Patel for his excellent challenge with that Preterm Birth Committee and his huge compassion throughout. And to my noble friend Lady Bertin for proposing the subject of inquiry. My time on this committee was one of the most poignant moments in my time in your Lordships House. When the committee had a chance to visit a Neonatal Unit at a local hospital to gain an insight into the plight of babies born preterm, and the experience of their families.
Even one year on from my visit, the site of a tiny baby born at 23 weeks old in an incubator remained in my mind. And emphasises to me the importance of bringing about real positive change for those born too early. I hope that the work of the committee and the report does justice to those who gave evidence and bravely shared their experiences. I hope it can be used by government to improve for the better the lives of those born preterm. I will focus my remarks today on a few aspects of the committee's findings.
One of the things that struck me most during evidence sessions seems to be the simplicity of some of the interventions, and the frustration that great improvements could be made if these interventions were implemented in a consistent manner. The perinatal optimisation interventions, we heard specifically that delayed cord clamping can reduce mortality by up to half. For preterm babies. Yet it has not been implement it consistently. The charity Bliss in the recent briefing warned that variation in practice still remains rife.
Another example that formed part of the committee recommendations and has been highlighted by my noble friend Lady Wyld is the importance of family integrated care, when families play a key role in their babies care. Evidence from capless found it leads to better outcomes for babies, reducing mortality and morbidity as well as requiring fewer days in neonatal care. Despite the great benefits associated with family integrated care, it is sadly not always possible due to lack of facilities for parents and access to overnight accommodation.
The 2022 study from capless found that 75% of study from capless found that 75% of babies did -- from others did not have access to accommodation and the baby was critically ill. We were privileged to speak with parents and hear their expense. I'm pleased that given the committee recommendation, the government has said it will publish the findings on maternity and neonatal estate survey early next year. Detailing parental accommodation, but I would be grateful if the Minister could give a better idea of when this will be.
Finally, I wish to focus on the observation the committee made around research. During the evidence session, I was particularly surprised by the lack of both research and funding for research that took place into the causes of preterm birth. The committee has rightly highlighted the need to push for more research into pregnancy, and further our knowledge into mechanisms of preterm labour. Greater knowledge of this area is critical to not only improving the life outcomes of those who are born too early, but importantly, from a government perspective, the evidence suggests economic modelling for England and Wales that if we can delay preterm birth by one week across gestation or ages, it would lead to a cost saving of £1.41 billion a year.
The British Association of perinatal medicine is suggests that investment in simple low-cost interventions will engender longitudinal cost savings within healthcare and education many times over. I am pleased with the positive response from the government on the findings of the report. But it is vital that we continue a watching brief, and ensure commitments are followed through and recommendations implemented as quickly as possible. To improve the lives of babies born preterm in our society, so they cannot only survive but go on to flourish.
**** Possible New Speaker ****
My Lords, I join the very general
**** Possible New Speaker ****
My Lords, I join the very general and fervent thanks to the noble Lord Patel and his committee for this Patel and his committee for this terribly important report, and the noble Lord himself for the noble Lord himself for the introduction. The noble Lord picked an issue that I would like to start an issue that I would like to start with, which is the situation about current and final yet midwifery students. The Royal College of Midwives did a survey and found that Midwives did a survey and found that 84% of them said they were not confident they are going to find a job after graduating this year.
This job after graduating this year. This makes no sense at all, and we are makes no sense at all, and we are currently in the middle of tablet in the form either for how many midwives we need. Look at the figures from the Royal College of figures from the Royal College of Midwives, a survey of members recently found that midwives and maternity support workers were working and estimated 118,000 unpaid hours of overtime each week. To meet the needs of their patients.
We should be grabbing these graduating midwives with both hands and making sure they have a secure future because of course they now face the enormous weight of student debts, many of them being previous graduates were doing this as a second . There is a risk they were going do something else because they need to put food on the table and keep a roof over their head. Of course this is a situation that saw many resident doctors are facing. I have been putting written questions down on this.
Coming to the issue of preterm births, I will focus not on the care but on the public health issues here. We have heard a great deal from any expert figures in this debate, that we don't know in many cases what the cause of preterm delivery is. One of the things we do know is that poverty, inequality, discrimination increases the level of preterm births. It increases the suffering. The most recent figures show that neonatal mortality rate associated with preterm births from the most deprived areas have just increased for the third year in a
Even one year on from my visit, the site of a tiny baby born at 23 weeks old in an incubator remained in my mind. And emphasises to me the importance of bringing about real positive change for those born too early. I hope that the work of the committee and the report does justice to those who gave evidence and bravely shared their experiences. I hope it can be used by government to improve for the better the lives of those born preterm. I will focus my remarks today on a few aspects of the committee's findings.
One of the things that struck me most during evidence sessions seems to be the simplicity of some of the interventions, and the frustration that great improvements could be made if these interventions were implemented in a consistent manner. The perinatal optimisation interventions, we heard specifically that delayed cord clamping can reduce mortality by up to half. For preterm babies. Yet it has not been implement it consistently. The charity Bliss in the recent briefing warned that variation in practice still remains rife.
Another example that formed part of the committee recommendations and has been highlighted by my noble friend Lady Wyld is the importance of family integrated care, when families play a key role in their babies care. Evidence from capless found it leads to better outcomes for babies, reducing mortality and morbidity as well as requiring fewer days in neonatal care. Despite the great benefits associated with family integrated care, it is sadly not always possible due to lack of facilities for parents and access to overnight accommodation.
The 2022 study from capless found that 75% of study from capless found that 75% of babies did -- from others did not have access to accommodation and the baby was critically ill. We were privileged to speak with parents and hear their expense. I'm pleased that given the committee recommendation, the government has said it will publish the findings on maternity and neonatal estate survey early next year. Detailing parental accommodation, but I would be grateful if the Minister could give a better idea of when this will be.
Finally, I wish to focus on the observation the committee made around research. During the evidence session, I was particularly surprised by the lack of both research and funding for research that took place into the causes of preterm birth. The committee has rightly highlighted the need to push for more research into pregnancy, and further our knowledge into mechanisms of preterm labour. Greater knowledge of this area is critical to not only improving the life outcomes of those who are born too early, but importantly, from a government perspective, the evidence suggests economic modelling for England and Wales that if we can delay preterm birth by one week across gestation or ages, it would lead to a cost saving of £1.41 billion a year.
The British Association of perinatal medicine is suggests that investment in simple low-cost interventions will engender longitudinal cost savings within healthcare and education many times over. I am pleased with the positive response from the government on the findings of the report. But it is vital that we continue a watching brief, and ensure commitments are followed through and recommendations implemented as quickly as possible. To improve the lives of babies born preterm in our society, so they cannot only survive but go on to flourish.
**** Possible New Speaker ****
My Lords, I join the very general
**** Possible New Speaker ****
My Lords, I join the very general and fervent thanks to the noble Lord Patel and his committee for this Patel and his committee for this terribly important report, and the noble Lord himself for the noble Lord himself for the introduction. The noble Lord picked an issue that I would like to start an issue that I would like to start with, which is the situation about current and final yet midwifery students. The Royal College of Midwives did a survey and found that Midwives did a survey and found that 84% of them said they were not confident they are going to find a job after graduating this year.
This job after graduating this year. This makes no sense at all, and we are makes no sense at all, and we are currently in the middle of tablet in the form either for how many midwives we need. Look at the figures from the Royal College of figures from the Royal College of Midwives, a survey of members recently found that midwives and maternity support workers were working and estimated 118,000 unpaid hours of overtime each week. To meet the needs of their patients.
We should be grabbing these graduating midwives with both hands and making sure they have a secure future because of course they now face the enormous weight of student debts, many of them being previous graduates were doing this as a second . There is a risk they were going do something else because they need to put food on the table and keep a roof over their head. Of course this is a situation that saw many resident doctors are facing. I have been putting written questions down on this.
Coming to the issue of preterm births, I will focus not on the care but on the public health issues here. We have heard a great deal from any expert figures in this debate, that we don't know in many cases what the cause of preterm delivery is. One of the things we do know is that poverty, inequality, discrimination increases the level of preterm births. It increases the suffering. The most recent figures show that neonatal mortality rate associated with preterm births from the most deprived areas have just increased for the third year in a
11:00
Baroness Bennett of Manor Castle (Green Party)
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Baroness Bennett of Manor Castle (Green Party)
row. In terms of preterm births and neonatal mortality, the data is not neonatal mortality, the data is not nearly good enough, it is clear that minority ties communities are minority ties communities are suffering a double disadvantage and intersectional disadvantage. Let's make a statement of the obvious, reducing deprivation, reducing poverty would reduce preterm birth. poverty would reduce preterm birth. I don't believe there is anyone that would disagree with the statement. would disagree with the statement. And I ask the Minister in terms of the government response to recommendation one of the committee, recommendation one of the committee, what future metrics, what targets and what ambitions, is the government making progress in that government making progress in that area? Most of my speech will be addressing an issue that no no bloc addressing an issue that no no bloc has yet addressed.
I will focus on the one healthy environmental health aspects contributing undoubtedly to preterm birth even if we don't actually understand the precise details. We know that our environment is in a terrible state. Those who are pregnant are particularly vulnerable to that environment. We have a planet which has been choked in plastics, soaked in pesticide. We have seen drugs ending up out and the environment creating resistance, creating other medical effects. I will start with what I think I have to say is a deeply shocking study which came out after the committee reported.
It is only one study but seriously indicative. This was presented to the Society of maternity faecal earlier this year, the pregnancy meeting. It was investigators and the presenters were assessed, 100 were at term and 75 preterm. The level of microplastics and no plastics in the placenta was significantly higher with preterm births. They were much higher than previous levels of microplastics and nano plastics that had been measured The percent are is concentrating micro plastics that is in the microbial blood, but the preterm births have higher rates than do the full-term births, which is counterintuitive because if this was a gradual accumulation over a time that was an associate of the preterm birth, you would expect the longer term ones to have more plastic.
So, this is deeply concerning. I come now to chemicals, and there were two studies published in 2023 that showed an association between the level of PFASs in paternal blood and the rate of preterm birth. And one, the rate of preterm birth. And one, I will refer to the study that showed that it was particularly affecting male babies and the accumulation in male babies was higher than female babies. The noble Lords here will tell us that male babies are more fragile at birth, and PFASs concentrating more with those that are deeply concerning.
Another study found that mothers Another study found that mothers with higher levels in pregnancy are 1.5 times more likely to have a baby born three weeks before the due date or earlier, and the early term, 1 to 2 weeks before is also raised. We know also that we have pesticides. A recent study said that the chemical to which we are all very heavily exposed, the chemical to which noble Lords might have recently seen there was a study showing extraordinarily high levels in tampons, it is associated with blood levels with higher levels of predetermined birth.
More broadly, pesticide birth. More broadly, pesticide exposure, another study that showed that metre analysis, a lot of this is uncertain, but all of this is very complicated. It's just some of the ways in which pesticide might be having an impact on preterm birth and it might be triggering information and stress and disrupting functions. And finally, the microbiota. The noble Lord mentioned the issue we were starting to understand the microbiota is significant in terms of the preterm birth and many other aspects of health.
A study from 2023 showed, again this is one study, but there was a unique genetic profile in the microbiota of preterm births. There was a higher richness of diversity of microbes, and there was also a greater diversity of antimicrobial trends so we have a real problem with the microbiota's, and here, I cross-reference here the debate that the noble Lord and I had about regulating products because one of the issues that I was raising in the context of products is reusable products that have high level of silver and nano silver which demonstrably have negative effects on the microbiota.
Plus of course, the tampons I was talking about earlier, the pesticides, but also of heavy metals in the microbiota. So, all of these issues, and I apologies that this is been a rather depressing speech, but this situation is not inevitable. We have a situation where companies are making products that are threatening the health of all of us very broadly, but particularly threatening the health of the most vulnerable in our society, those who were pregnant and the young babies born into our society prematurely.
This is an area where we need urgent government action. I have cited recent studies, and the reaction from the government in all these issues tends to be that we have got to wait for more data. But actually, just look at the list of things that I have gone through, and each one of those were cases where one product, one factor in isolation, but no pregnant person is exposed to just one of these factors. Everyone has been exposed to all of these as a cocktail, and this cocktail is going up, the level of all of them is going up all of the time, and once we have put them out into the environment, we are unable to take them out.
Surely on preterm birth on the state of our health of our nation, we need to apply the precautionary principle and take urgent action to rein in the corporate's exposing us to all of these threats.
I will focus on the one healthy environmental health aspects contributing undoubtedly to preterm birth even if we don't actually understand the precise details. We know that our environment is in a terrible state. Those who are pregnant are particularly vulnerable to that environment. We have a planet which has been choked in plastics, soaked in pesticide. We have seen drugs ending up out and the environment creating resistance, creating other medical effects. I will start with what I think I have to say is a deeply shocking study which came out after the committee reported.
It is only one study but seriously indicative. This was presented to the Society of maternity faecal earlier this year, the pregnancy meeting. It was investigators and the presenters were assessed, 100 were at term and 75 preterm. The level of microplastics and no plastics in the placenta was significantly higher with preterm births. They were much higher than previous levels of microplastics and nano plastics that had been measured The percent are is concentrating micro plastics that is in the microbial blood, but the preterm births have higher rates than do the full-term births, which is counterintuitive because if this was a gradual accumulation over a time that was an associate of the preterm birth, you would expect the longer term ones to have more plastic.
So, this is deeply concerning. I come now to chemicals, and there were two studies published in 2023 that showed an association between the level of PFASs in paternal blood and the rate of preterm birth. And one, the rate of preterm birth. And one, I will refer to the study that showed that it was particularly affecting male babies and the accumulation in male babies was higher than female babies. The noble Lords here will tell us that male babies are more fragile at birth, and PFASs concentrating more with those that are deeply concerning.
Another study found that mothers Another study found that mothers with higher levels in pregnancy are 1.5 times more likely to have a baby born three weeks before the due date or earlier, and the early term, 1 to 2 weeks before is also raised. We know also that we have pesticides. A recent study said that the chemical to which we are all very heavily exposed, the chemical to which noble Lords might have recently seen there was a study showing extraordinarily high levels in tampons, it is associated with blood levels with higher levels of predetermined birth.
More broadly, pesticide birth. More broadly, pesticide exposure, another study that showed that metre analysis, a lot of this is uncertain, but all of this is very complicated. It's just some of the ways in which pesticide might be having an impact on preterm birth and it might be triggering information and stress and disrupting functions. And finally, the microbiota. The noble Lord mentioned the issue we were starting to understand the microbiota is significant in terms of the preterm birth and many other aspects of health.
A study from 2023 showed, again this is one study, but there was a unique genetic profile in the microbiota of preterm births. There was a higher richness of diversity of microbes, and there was also a greater diversity of antimicrobial trends so we have a real problem with the microbiota's, and here, I cross-reference here the debate that the noble Lord and I had about regulating products because one of the issues that I was raising in the context of products is reusable products that have high level of silver and nano silver which demonstrably have negative effects on the microbiota.
Plus of course, the tampons I was talking about earlier, the pesticides, but also of heavy metals in the microbiota. So, all of these issues, and I apologies that this is been a rather depressing speech, but this situation is not inevitable. We have a situation where companies are making products that are threatening the health of all of us very broadly, but particularly threatening the health of the most vulnerable in our society, those who were pregnant and the young babies born into our society prematurely.
This is an area where we need urgent government action. I have cited recent studies, and the reaction from the government in all these issues tends to be that we have got to wait for more data. But actually, just look at the list of things that I have gone through, and each one of those were cases where one product, one factor in isolation, but no pregnant person is exposed to just one of these factors. Everyone has been exposed to all of these as a cocktail, and this cocktail is going up, the level of all of them is going up all of the time, and once we have put them out into the environment, we are unable to take them out.
Surely on preterm birth on the state of our health of our nation, we need to apply the precautionary principle and take urgent action to rein in the corporate's exposing us to all of these threats.
11:07
Baroness Penn (Conservative)
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Baroness Penn (Conservative)
This is been an excellent debate so far based on excellent report. It has taken place under the chairmanship of the noble Lord Lord Patel. Our focus is on the support that we give to parents who have had preterm babies, but before I do, I want to touch on just one other aspect of the report, and that is staffing levels. We have had chronic shortages of maternity and neonatal staff for years, and that affects so much of the delivery of what is in this report, and I think the noble Lord hotel in Lady Bennett have raised the concerns from the Royal midwives that the current cohort of midwifery graduates are not confident of getting roles in the NHS when they graduate, and I know that the government's currently refreshing their long-term workforce plan, but can I ask the noble Baroness the Minister when we can expect to see an updated plan, and when it specifically addressed midwifery, and can I also ask her how abolishing NHS England will affect the delivery of that plan? Who will be responsible and accountable for delivery, and how will that transition take place? Turning now to my main focus which is the support we give to parents at this very difficult time.
As the report makes clear, following preterm birth, many parents will spend weeks or months caring for their baby in a neonatal care unit. And not only do they have to deal with the alien environment of a neonatal care unit, and a feeling of daily amputation in being separated from their babies, witnesses also emphasise the practical and financial challenges that parents can face in the circumstances. Babies might be being cared for at various hospitals, sometimes a long way from home, and the charity Bliss found that one in four families with a baby on a neonatal unit have to borrow money or increase their debts to manage.
The introduction of neonatal care, leave and pay which became rate in April this year was a really important step forward in supporting parents had a difficult time, and I pay tribute to all of those, particularly my noble friend who work to make that reality. But of course, as with any scheme like these, there are some limitations. If your baby spends six days or fewer, you do not qualify for any additional leave, despite the fact that mum and baby might have significant health concerns that need proper support.
And the leave is only paid at the statutory rate that we have all parental leave which is currently at around £187 a week. But because we have such a poor fund of paternity leave, this has a particular impact on dads and second parents ability to support mothers and their new babies at such a crucial time. Let me give an example from the charity Bliss. A baby is born struggling to maintain the temperature and spend three days receiving transitional care in hospital before being discharged.
A few days later, they are readmitted as they struggle to feed and have jaundice. They receive six days before being discharged. Neither episode of care lasted for more time, so no leave is accrued. It is perfectly possible that this point, dads maternity leave has run out any has to return to work, despite a premature and vulnerable baby who has had repeat hospitalisations at home, and despite a mum who may have had a traumatic birth, or even if not, if she has had a C-section and will still be in recovery from surgery being left alone for herself and her vulnerable baby.
This is not to criticise neonatal care or leave or pay in anyway, but it is to say that parents of preterm babies, and all babies will be far better supported if they had a proper system of paternity leave and pay in this country which neonatal care leave and pay came on top of. We have the worst paternity pay and leave system in Europe. And the biggest barrier to dads taking proper time is often babies are born our affordability. And as my noble friends have highlighted, family integrated can make a huge difference for babies who are born preterm, but the report notes the potential disparity and access to that family integrated for those on lower incomes.
As a group highlighted, fathers are non- birthing parents often have to return to work while their baby is still in neonatal care. Even mothers who are self-employed face this dilemma. This has a detrimental impact to implement in family care and parent-child bonding. If we increase paternity leave to 60% with a cap for higher earnings, this would resolve that dilemma for so many families who experience preterm birth. The employment rights bill currently being debated at the moment gives us the opportunity to make that change.
I asked the noble Lady the Minister what have you is on the impact that would have for parents, particularly fathers of preterm babies. I think we have an opportunity to ease the burden for thousands of parents who struggle with the practical as well as emotional impact of having a baby preterm, whether on not they are in neonatal care, and I hope she will join me in seizing it.
**** Possible New Speaker ****
It was a privilege and a pleasure to sit on the committee under the chairmanship of the noble Lord Lord chairmanship of the noble Lord Lord Patel. He is an absolute master of
As the report makes clear, following preterm birth, many parents will spend weeks or months caring for their baby in a neonatal care unit. And not only do they have to deal with the alien environment of a neonatal care unit, and a feeling of daily amputation in being separated from their babies, witnesses also emphasise the practical and financial challenges that parents can face in the circumstances. Babies might be being cared for at various hospitals, sometimes a long way from home, and the charity Bliss found that one in four families with a baby on a neonatal unit have to borrow money or increase their debts to manage.
The introduction of neonatal care, leave and pay which became rate in April this year was a really important step forward in supporting parents had a difficult time, and I pay tribute to all of those, particularly my noble friend who work to make that reality. But of course, as with any scheme like these, there are some limitations. If your baby spends six days or fewer, you do not qualify for any additional leave, despite the fact that mum and baby might have significant health concerns that need proper support.
And the leave is only paid at the statutory rate that we have all parental leave which is currently at around £187 a week. But because we have such a poor fund of paternity leave, this has a particular impact on dads and second parents ability to support mothers and their new babies at such a crucial time. Let me give an example from the charity Bliss. A baby is born struggling to maintain the temperature and spend three days receiving transitional care in hospital before being discharged.
A few days later, they are readmitted as they struggle to feed and have jaundice. They receive six days before being discharged. Neither episode of care lasted for more time, so no leave is accrued. It is perfectly possible that this point, dads maternity leave has run out any has to return to work, despite a premature and vulnerable baby who has had repeat hospitalisations at home, and despite a mum who may have had a traumatic birth, or even if not, if she has had a C-section and will still be in recovery from surgery being left alone for herself and her vulnerable baby.
This is not to criticise neonatal care or leave or pay in anyway, but it is to say that parents of preterm babies, and all babies will be far better supported if they had a proper system of paternity leave and pay in this country which neonatal care leave and pay came on top of. We have the worst paternity pay and leave system in Europe. And the biggest barrier to dads taking proper time is often babies are born our affordability. And as my noble friends have highlighted, family integrated can make a huge difference for babies who are born preterm, but the report notes the potential disparity and access to that family integrated for those on lower incomes.
As a group highlighted, fathers are non- birthing parents often have to return to work while their baby is still in neonatal care. Even mothers who are self-employed face this dilemma. This has a detrimental impact to implement in family care and parent-child bonding. If we increase paternity leave to 60% with a cap for higher earnings, this would resolve that dilemma for so many families who experience preterm birth. The employment rights bill currently being debated at the moment gives us the opportunity to make that change.
I asked the noble Lady the Minister what have you is on the impact that would have for parents, particularly fathers of preterm babies. I think we have an opportunity to ease the burden for thousands of parents who struggle with the practical as well as emotional impact of having a baby preterm, whether on not they are in neonatal care, and I hope she will join me in seizing it.
**** Possible New Speaker ****
It was a privilege and a pleasure to sit on the committee under the chairmanship of the noble Lord Lord chairmanship of the noble Lord Lord Patel. He is an absolute master of
11:13
Baroness Seccombe (Conservative)
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Baroness Seccombe (Conservative)
Patel. He is an absolute master of this, and with his deep knowledge of former medical matters, he was able to procure witnesses who shared their expertise and experience with us. Research into this harrowing us. Research into this harrowing issue is crucial. We need to understand why that occurs in order to prevent as many tragedies as possible. I refer to previous comments from members of this House on expanding and supporting the search, which I fully support. My small contribution concentrates on midwives, those dedicated professionals on the branch, and the fundamental roles they should play in any birth.
I was shocked to find that we currently have a shortage of 2 1/2 thousand midwifes. This is extremely worrying, and I would encourage government to act fast to address this. For instance, I would like to see that assistance can be given to those nurses wishing to enhance their career by becoming fully qualified midwifes. This should be a priority for all of us. Midwifes are essential to the care of expectant mothers and mothers of newborn babies. As well as providing the link to increased medical care.
As with all medical care, it is their manner which is just as important as their professional skills. However proficient parents may be, actually holding your baby for the first time makes you realise the responsibility you have taken on, and how dependent this tiny, fragile person is on you. I think it is essential that parents have someone to help cope with this miracle that has taken place in their lives. This is where a midwife can either be that person or the link to a local person assigned to This is even more important in preterm babies, who often have special needs.
Midwives give much needed help and confident to parents who return home with a baby needing exceptional care. Many of these parents might not have known that their baby would have special needs, and will be in a state of shock. As they comprehend the impact this will have on their family's life for many years to come. Is it not our duty to help these parents as they navigate a difficult time, by ensuring we have trained and dedicated midwives available for all? Things were very different when I was having children in the early 1950s.
I was in a nursing home for two weeks, and help from my mother with my first baby. With my second, I had a dedicated midwife who lived at home with us for a month. She soon got to be organised and was a brilliant cook so we all thrived. Of course family life has changed since then. Nowadays grandparents are often still working, and parents live far away from them. So whilst I would like to encourage full family involvement where possible, we should, as a society, give extra help where the parents needed.
My second ask is around improving hospital accommodation for new parents. Preterm babies often spend a long time in hospital, so that their development continues as they strive to meet the correct weight. Some hospitals do have stained facilities for mothers, but often not for fathers. I would like to see more facilities available so that parents can be near and bond with their baby. Spending time away from your baby in those first days is, I think, harmful for the baby and parents.
This has been a fascinating debate, and my Lords I hope that it has become obvious that I'm fully behind midwives and their roles before and after the births of all babies. I do hope the government will do all it can to encourage more of these pillars of society to sign up for this vital help.
**** Possible New Speaker ****
My Lords, I am only the third male member of this House to speak on this debate. Following on from on this debate. Following on from Lord Patel and Lord Winston which, in addition to the other excellent contribution that have been made in contribution that have been made in this House, I say it gives me a slight feeling of being woefully inadequate to be able to comment on inadequate to be able to comment on this subject. Can I start by commending what I think is an commending what I think is an excellent report.
One that, whilst the scope of the report deals with the scope of the report deals with England and Wales, I think that the lessons are drawn from it are applicable in all parts of the United Kingdom. It focuses in I think on the two critical points think on the two critical points which are the incidents of preterm births, and how we can optimise care births, and how we can optimise care for both the babies and their families in the days after birth.
It is critical because I think it goes to the heart of one of the two great nightmares that any parent can face, the second worst situation for any parent is to be left in a situation in which your child is faced with a life-threatening condition, or you are left with weeks or months of trauma, not knowing whether your child will survive. Not even being able to give that child comfort. And often faced with a situation in which that baby is faced with lifelong conditions.
That is the second worst situation for any parent. The worst situation, which sadly also pertains to a number of parents in return births, is the death of their child. There is no greater trauma that any parent can
I was shocked to find that we currently have a shortage of 2 1/2 thousand midwifes. This is extremely worrying, and I would encourage government to act fast to address this. For instance, I would like to see that assistance can be given to those nurses wishing to enhance their career by becoming fully qualified midwifes. This should be a priority for all of us. Midwifes are essential to the care of expectant mothers and mothers of newborn babies. As well as providing the link to increased medical care.
As with all medical care, it is their manner which is just as important as their professional skills. However proficient parents may be, actually holding your baby for the first time makes you realise the responsibility you have taken on, and how dependent this tiny, fragile person is on you. I think it is essential that parents have someone to help cope with this miracle that has taken place in their lives. This is where a midwife can either be that person or the link to a local person assigned to This is even more important in preterm babies, who often have special needs.
Midwives give much needed help and confident to parents who return home with a baby needing exceptional care. Many of these parents might not have known that their baby would have special needs, and will be in a state of shock. As they comprehend the impact this will have on their family's life for many years to come. Is it not our duty to help these parents as they navigate a difficult time, by ensuring we have trained and dedicated midwives available for all? Things were very different when I was having children in the early 1950s.
I was in a nursing home for two weeks, and help from my mother with my first baby. With my second, I had a dedicated midwife who lived at home with us for a month. She soon got to be organised and was a brilliant cook so we all thrived. Of course family life has changed since then. Nowadays grandparents are often still working, and parents live far away from them. So whilst I would like to encourage full family involvement where possible, we should, as a society, give extra help where the parents needed.
My second ask is around improving hospital accommodation for new parents. Preterm babies often spend a long time in hospital, so that their development continues as they strive to meet the correct weight. Some hospitals do have stained facilities for mothers, but often not for fathers. I would like to see more facilities available so that parents can be near and bond with their baby. Spending time away from your baby in those first days is, I think, harmful for the baby and parents.
This has been a fascinating debate, and my Lords I hope that it has become obvious that I'm fully behind midwives and their roles before and after the births of all babies. I do hope the government will do all it can to encourage more of these pillars of society to sign up for this vital help.
**** Possible New Speaker ****
My Lords, I am only the third male member of this House to speak on this debate. Following on from on this debate. Following on from Lord Patel and Lord Winston which, in addition to the other excellent contribution that have been made in contribution that have been made in this House, I say it gives me a slight feeling of being woefully inadequate to be able to comment on inadequate to be able to comment on this subject. Can I start by commending what I think is an commending what I think is an excellent report.
One that, whilst the scope of the report deals with the scope of the report deals with England and Wales, I think that the lessons are drawn from it are applicable in all parts of the United Kingdom. It focuses in I think on the two critical points think on the two critical points which are the incidents of preterm births, and how we can optimise care births, and how we can optimise care for both the babies and their families in the days after birth.
It is critical because I think it goes to the heart of one of the two great nightmares that any parent can face, the second worst situation for any parent is to be left in a situation in which your child is faced with a life-threatening condition, or you are left with weeks or months of trauma, not knowing whether your child will survive. Not even being able to give that child comfort. And often faced with a situation in which that baby is faced with lifelong conditions.
That is the second worst situation for any parent. The worst situation, which sadly also pertains to a number of parents in return births, is the death of their child. There is no greater trauma that any parent can
11:20
Lord Weir of Ballyholme (Democratic Unionist Party)
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Lord Weir of Ballyholme (Democratic Unionist Party)
face. That is why this issue is so vital. In the time available to me, I want to look at three aspects of the report. First of all, looking at the report. First of all, looking at the issue of incidents of preterm births. We are thankfully living in an era which we have seen, on a wide an era which we have seen, on a wide range of medical issues, a consistent period of improvement. No more so is that the case than for the decades and centuries than the issues around birth and maternity.
issues around birth and maternity. It was, in human history, it was not that long ago that the levels of mortality rates for babies and mortality rates for babies and mothers was extremely high. Apply not simply to those with socio- economic problems, but equally quite often to the most privileged and richest in the land. Thankfully we have seen considerable improvement in that which is why I think the statistics produced within this report are quite worrying. As indicated earlier, the target was set 10 years ago of reducing the number of preterm births from around 8% to 6%.
Yet in that 10 year period, the figures have remained stubbornly high. Currently the position is, England I think the figure is 7.9%. In Wales it is 8.1%. As indicated in the report, those figures mask underlying further problems. Both in terms of the higher level of incidents that are there for mothers from lower socio economic backgrounds, and for those from ethnic minorities. There is a stark statistic that, for black mothers, for very preterm births, it is twice as likely to occur than to a white mother.
Similarly, the figures have not shifted in terms of neurodevelopment issues. As indicated, the reasons for this, the risk factors are multitudes, mention is made of smoking, drinking, mental health issues, diabetes, a wide range. One of the key aspects that we do have to look at, to something under the government is focused on, is that wider public health message because a lot of these problems can be eased prior to even pregnancy taking place, but I think one of the areas as highlighted in the report, we know the risk factors.
There is still a job of work to be done with good levels of research to work out the levels of causality between risk factors and the end results. Secondly, there is a wide range of screening, treatment, of scanning that takes place, but there is also the case that, while new technologies can make improvements to those, again I think this is an area that we do need to drill down to much greater levels of research. To try to make sure that what we are providing prior to birth is the best possible situation we try to avoid preterm births.
The second area is a welcome recognition that, while there is an important surround birth in the weeks after birth, the issues of preterm birth go well beyond that. We know and I think it is important, we are looking at targets, that we do acknowledge that there are a number of cases where preterm births medically induced, where it is both necessary and virtuous, where it produces a better result for the Mother and Baby Homes double but we also know that around 75%, and other statistics are 79%, of neonatal deaths are to preterm babies.
Beyond that, the figures also suggest that, for deaths of children under 10, 46% will be preterm babies. For preterm babies we know there are greater incidence of both severe and mild disabilities, of ADHD, of cerebral palsy, and indeed the figures would suggest that, in terms of the number of children with severe brain injuries, the incidences is around about seven times higher than for those babies that have gone full- those babies that have gone full- term.
So there is an important repercussions, simply beyond the initial period in Neonatal Unit. The report is also good at establishing some of the problems that also created, not simply for the babies themselves were for the families. We know this can be very traumatic experience. It is rarely anticipated by parents. For many mothers and fathers, they are left with a high level of anxiety, a separation where they are not able in that traumatic period to be able to bring comfort to their children, to hold their newborn babies.
That can create a feeling of separation, alienation. The report indicates the number of parents that have PTSD as a result of that. Again, the point that is made very well within the report is, this is not simply something in the first few weeks of birth. It can quite often, as sometimes happens with trauma, kicking much later, may be months or even one or two mac years afterwards. It is clear that perhaps the levels of support are not necessarily there for that.
It is also the case that, in terms of follow-up support for parents, there is not always the level of counselling that is given. On the third and final point, I suppose it is written large through the report, the level of variations that are there. We have seen that while there has been considerable improvement in has been considerable improvement in terms of the number of trusts embracing a bundle of interventions, there are still gaps that are there. We need to work with best case models, best practice, such as perhaps a model that is used.
We can see where we can roll these out. There are a range of other issues that link to that. The extent to which training is able to be given sometimes dependent upon the variation within trusts of how much they are able to release staff. We have seen that, in terms of family integrated care, it is not always universal within that. Some trusts according to the report watered down at national level guidance. Beyond that, they have been highlighted examples of staff shortages, from examples of staff shortages, from gynaecology department to midwifery.
Indeed, the gaps that are there in terms of midwives also means that there isn't a consistency of care. Finally, beyond that, as is highlighted in the report, we have seen there can be a very sporadic element of follow-up in terms of for example the level of knowledge that is there from health visitors. The position that is the follow-up over the two years and the four years. And the lack of counselling for parents. So there is a lot to be done. We need to see a greater level of consistency and as is highlighted in the report, one of the startling statistics which shows the need to further prioritise this issue is that, for every pound that is spent on pregnancy care, there is less than one penny in this country spent on pregnancy research.
This report gives a very good roadmap. I welcome the commitments that have been made by the government. If this is not simply to be an excellent report which gathers dust on the shelf, we need to see those commitments turned into a reality by the government preventing the report. preventing the report.
issues around birth and maternity. It was, in human history, it was not that long ago that the levels of mortality rates for babies and mortality rates for babies and mothers was extremely high. Apply not simply to those with socio- economic problems, but equally quite often to the most privileged and richest in the land. Thankfully we have seen considerable improvement in that which is why I think the statistics produced within this report are quite worrying. As indicated earlier, the target was set 10 years ago of reducing the number of preterm births from around 8% to 6%.
Yet in that 10 year period, the figures have remained stubbornly high. Currently the position is, England I think the figure is 7.9%. In Wales it is 8.1%. As indicated in the report, those figures mask underlying further problems. Both in terms of the higher level of incidents that are there for mothers from lower socio economic backgrounds, and for those from ethnic minorities. There is a stark statistic that, for black mothers, for very preterm births, it is twice as likely to occur than to a white mother.
Similarly, the figures have not shifted in terms of neurodevelopment issues. As indicated, the reasons for this, the risk factors are multitudes, mention is made of smoking, drinking, mental health issues, diabetes, a wide range. One of the key aspects that we do have to look at, to something under the government is focused on, is that wider public health message because a lot of these problems can be eased prior to even pregnancy taking place, but I think one of the areas as highlighted in the report, we know the risk factors.
There is still a job of work to be done with good levels of research to work out the levels of causality between risk factors and the end results. Secondly, there is a wide range of screening, treatment, of scanning that takes place, but there is also the case that, while new technologies can make improvements to those, again I think this is an area that we do need to drill down to much greater levels of research. To try to make sure that what we are providing prior to birth is the best possible situation we try to avoid preterm births.
The second area is a welcome recognition that, while there is an important surround birth in the weeks after birth, the issues of preterm birth go well beyond that. We know and I think it is important, we are looking at targets, that we do acknowledge that there are a number of cases where preterm births medically induced, where it is both necessary and virtuous, where it produces a better result for the Mother and Baby Homes double but we also know that around 75%, and other statistics are 79%, of neonatal deaths are to preterm babies.
Beyond that, the figures also suggest that, for deaths of children under 10, 46% will be preterm babies. For preterm babies we know there are greater incidence of both severe and mild disabilities, of ADHD, of cerebral palsy, and indeed the figures would suggest that, in terms of the number of children with severe brain injuries, the incidences is around about seven times higher than for those babies that have gone full- those babies that have gone full- term.
So there is an important repercussions, simply beyond the initial period in Neonatal Unit. The report is also good at establishing some of the problems that also created, not simply for the babies themselves were for the families. We know this can be very traumatic experience. It is rarely anticipated by parents. For many mothers and fathers, they are left with a high level of anxiety, a separation where they are not able in that traumatic period to be able to bring comfort to their children, to hold their newborn babies.
That can create a feeling of separation, alienation. The report indicates the number of parents that have PTSD as a result of that. Again, the point that is made very well within the report is, this is not simply something in the first few weeks of birth. It can quite often, as sometimes happens with trauma, kicking much later, may be months or even one or two mac years afterwards. It is clear that perhaps the levels of support are not necessarily there for that.
It is also the case that, in terms of follow-up support for parents, there is not always the level of counselling that is given. On the third and final point, I suppose it is written large through the report, the level of variations that are there. We have seen that while there has been considerable improvement in has been considerable improvement in terms of the number of trusts embracing a bundle of interventions, there are still gaps that are there. We need to work with best case models, best practice, such as perhaps a model that is used.
We can see where we can roll these out. There are a range of other issues that link to that. The extent to which training is able to be given sometimes dependent upon the variation within trusts of how much they are able to release staff. We have seen that, in terms of family integrated care, it is not always universal within that. Some trusts according to the report watered down at national level guidance. Beyond that, they have been highlighted examples of staff shortages, from examples of staff shortages, from gynaecology department to midwifery.
Indeed, the gaps that are there in terms of midwives also means that there isn't a consistency of care. Finally, beyond that, as is highlighted in the report, we have seen there can be a very sporadic element of follow-up in terms of for example the level of knowledge that is there from health visitors. The position that is the follow-up over the two years and the four years. And the lack of counselling for parents. So there is a lot to be done. We need to see a greater level of consistency and as is highlighted in the report, one of the startling statistics which shows the need to further prioritise this issue is that, for every pound that is spent on pregnancy care, there is less than one penny in this country spent on pregnancy research.
This report gives a very good roadmap. I welcome the commitments that have been made by the government. If this is not simply to be an excellent report which gathers dust on the shelf, we need to see those commitments turned into a reality by the government preventing the report. preventing the report.
11:28
Baroness Sugg (Conservative)
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Baroness Sugg (Conservative)
My Lords, when the House of Lords preterm birth committee released its report in November last year, it was an important contribute to our national conversation about preterm birth. It brought overdue attention to complex but urgent challenge that affects over 45,000 babies born prematurely in England each year. As the report highlighted, many premature babies go on to thrive, realities that preterm babies remain the leading cause of neonatal mortality in the UK. It is a contribute to long-term disability and childhood illness, an immense emotional and financial strain on families.
The report really highlights the importance of action across this area. In 2015, the then government set ambition to reduce the preterm birth rate to 6% by 2025. As we have heard, most recent figures show that this is still hovering around 7.9% in England. The target is not going to be met. I don't think this is the failure of will but the failure of access and resources and infrastructure, and of consistency. We now look to the government upcoming 10-Year Health Plan is a real chance to change course.
The Royal College of Obstetricians and Gynaecologists has joined others including the charity Bliss calling for clear detailed unfunded targets that also address the inequalities that shape this. As we have heard from other noble Lords, rates are highest amongst black and Asian babies and amongst families from deprived communities. These disparities are not inevitable. They are really the result of systemic inequalities that we must confront directly. Like others, I'm very interested to hear from the Minister on where the government has got to their consideration of future ambition.
The preterm birth committee was right to stress that reducing the preterm birth rate is only part of the story. You must also improve the outcomes for families experience in it. Too often, preterm birth happens very suddenly without warning or identifiable risk factors. And Lord Patel in his comrades introduction to this debate highlighted that parents spend weeks or months in Neonatal Unit often in hospitals far from home with limited accommodation, scarce emotional support, and inconsistent follow-up The committee's call to invest in accommodation is a powerful ask.
The government's commitment no response to the report to review funding in the next spending review is very welcome but timelines and delivery are key here. And that is also true about our maternity workforce, and without adequate staffing and support, even the best intentioned policy wilful short. As highlighted in this debate, we need planning to be much more joined up, and my noble friend highlighted the crucial role played, and we need more advice, and we need to train more midwives as well as retaining the existing ones, we need to make sure they are employed when they qualify.
The workforce should support midwifery, and can I asked the noble Lady the Minister in her response to confirm the midwifery will be explicitly addressed? We must also recognise that safety doesn't begin and end in the labour ward. A life course approach, one that doesn't include support for mental health, smoking cessation and access to reproductive services is really essential. Nearly one in five preterm births can be linked to socio-economic inequality, and if we are serious about their prevention, we need a strategy that really tackles the root causes of maternal health.
I welcome the government's commitment to revise the maternity safety ambition and to include birthrates and priorities, but as the president said earlier this year, what we need are timelines, funding and accountability. Looking outside the NHS to how employers can help on preterm birth, I welcome the implementation of the neonatal care and payout and acknowledge Lady Wyld's important role in taking us through this place, we should be looking at doing more to support employees, and they can do so more effectively by adopting compassionate flexible and proactive HR and workplace policies.
They can do this through enhanced leave, do this through enhanced leave, offering pay maternity in the cases of preterm birth, started from the birthdate rather than the expected due date, and to improve flexibility with remote working and compassionate leave foot of their many excellent examples, and I hope the lady will discuss this further. I thank the Baroness Fall proposing this support, and I help Lord Patel who has been an excellent chair, and all the members of the preterm birth committee, many of whom have made powerful speeches today.
If we act on the recommendations, then we can make meaningful progress, not just in reducing preterm births but in transforming how we care for women and families at every stage of their
**** Possible New Speaker ****
life. I declare an interest as the chair of the trust of the Royal of chair of the trust of the Royal of obstetricians and gynaecologists. I also have another interest in that I am the grandmother of preterm twins am the grandmother of preterm twins born at 29 weeks. They are an example of the success of the NHS in example of the success of the NHS in providing excellent care. They now professional women with professional women with qualifications. I want to thank the excellent chair of the committee.
I am also very grateful to the government for many of the positive replies that have been provided for replies that have been provided for the committee in its response to the recommendations. There are several recommendations. There are several issues with an update would be valuable, and one or two were more valuable, and one or two were more detail would be helpful to build on promises. The two important issues I want to raise concerns staffing and research. I will begin with the first of these.
Good outcomes in terms of reducing the percentage of births which are preterm and improving the care of infants and small children who were born prematurely, depends on better staffing. They are complex and require first-class coordination between different professionals to be truly effective. So can I asked the minister to answer specific questions in selling the need for adequate numbers of doctors, whether there are serious pressures on existing staff, and these pressures
The report really highlights the importance of action across this area. In 2015, the then government set ambition to reduce the preterm birth rate to 6% by 2025. As we have heard, most recent figures show that this is still hovering around 7.9% in England. The target is not going to be met. I don't think this is the failure of will but the failure of access and resources and infrastructure, and of consistency. We now look to the government upcoming 10-Year Health Plan is a real chance to change course.
The Royal College of Obstetricians and Gynaecologists has joined others including the charity Bliss calling for clear detailed unfunded targets that also address the inequalities that shape this. As we have heard from other noble Lords, rates are highest amongst black and Asian babies and amongst families from deprived communities. These disparities are not inevitable. They are really the result of systemic inequalities that we must confront directly. Like others, I'm very interested to hear from the Minister on where the government has got to their consideration of future ambition.
The preterm birth committee was right to stress that reducing the preterm birth rate is only part of the story. You must also improve the outcomes for families experience in it. Too often, preterm birth happens very suddenly without warning or identifiable risk factors. And Lord Patel in his comrades introduction to this debate highlighted that parents spend weeks or months in Neonatal Unit often in hospitals far from home with limited accommodation, scarce emotional support, and inconsistent follow-up The committee's call to invest in accommodation is a powerful ask.
The government's commitment no response to the report to review funding in the next spending review is very welcome but timelines and delivery are key here. And that is also true about our maternity workforce, and without adequate staffing and support, even the best intentioned policy wilful short. As highlighted in this debate, we need planning to be much more joined up, and my noble friend highlighted the crucial role played, and we need more advice, and we need to train more midwives as well as retaining the existing ones, we need to make sure they are employed when they qualify.
The workforce should support midwifery, and can I asked the noble Lady the Minister in her response to confirm the midwifery will be explicitly addressed? We must also recognise that safety doesn't begin and end in the labour ward. A life course approach, one that doesn't include support for mental health, smoking cessation and access to reproductive services is really essential. Nearly one in five preterm births can be linked to socio-economic inequality, and if we are serious about their prevention, we need a strategy that really tackles the root causes of maternal health.
I welcome the government's commitment to revise the maternity safety ambition and to include birthrates and priorities, but as the president said earlier this year, what we need are timelines, funding and accountability. Looking outside the NHS to how employers can help on preterm birth, I welcome the implementation of the neonatal care and payout and acknowledge Lady Wyld's important role in taking us through this place, we should be looking at doing more to support employees, and they can do so more effectively by adopting compassionate flexible and proactive HR and workplace policies.
They can do this through enhanced leave, do this through enhanced leave, offering pay maternity in the cases of preterm birth, started from the birthdate rather than the expected due date, and to improve flexibility with remote working and compassionate leave foot of their many excellent examples, and I hope the lady will discuss this further. I thank the Baroness Fall proposing this support, and I help Lord Patel who has been an excellent chair, and all the members of the preterm birth committee, many of whom have made powerful speeches today.
If we act on the recommendations, then we can make meaningful progress, not just in reducing preterm births but in transforming how we care for women and families at every stage of their
**** Possible New Speaker ****
life. I declare an interest as the chair of the trust of the Royal of chair of the trust of the Royal of obstetricians and gynaecologists. I also have another interest in that I am the grandmother of preterm twins am the grandmother of preterm twins born at 29 weeks. They are an example of the success of the NHS in example of the success of the NHS in providing excellent care. They now professional women with professional women with qualifications. I want to thank the excellent chair of the committee.
I am also very grateful to the government for many of the positive replies that have been provided for replies that have been provided for the committee in its response to the recommendations. There are several recommendations. There are several issues with an update would be valuable, and one or two were more valuable, and one or two were more detail would be helpful to build on promises. The two important issues I want to raise concerns staffing and research. I will begin with the first of these.
Good outcomes in terms of reducing the percentage of births which are preterm and improving the care of infants and small children who were born prematurely, depends on better staffing. They are complex and require first-class coordination between different professionals to be truly effective. So can I asked the minister to answer specific questions in selling the need for adequate numbers of doctors, whether there are serious pressures on existing staff, and these pressures
11:36
Baroness Blackstone (Labour)
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Baroness Blackstone (Labour)
reduce the quality of care. As part of the workforce planning exercise, the DHS commissioned the RCOG to the DHS commissioned the RCOG to accurately quantify the number of obstetricians needed in maternity units in England. The tool was units in England. The tool was developed to compare staffing levels with national averages, taking into account the local context, including account the local context, including the complexity of their caseload. The Department received findings, including an estimate for the number of obstetricians needed in 2023.
Continuation of this work is now Continuation of this work is now urgent that so far, the DHS has failed to confirm the next stage of failed to confirm the next stage of the project. Can it do so now? For the saving babies lives care bubble, properly staffed preterm birth properly staffed preterm birth prevention clinics are needed with access to regional centres, where this is impossible. Further training is needed with a special staff required in developing cross specialty leadership which includes people, medicine, as well as neonatal care and anaesthetics.
Employers need to be resourced to get in-service training and to build a supportive learning touch. There is also a crucial shortage of perinatal pathologists who need to examine preterm birth referred to Burma noble friend Lord Winston. We need parental pathology of women undertaken, those who have given earth less than 32%. Even when the service is provided, there is a lack of specialist postnatal clinics to follow-up on the results, but can this be rectified? So far, I focus on doctors but nurses and midwives are also crucial, so I welcome the three-year delivery plan to boost the midwifery workforce.
Perhaps the DHS could start considering what it will do when three years is up next year? I also welcome greater attention being given to the retention of nurses through more flexible working arrangements. I first became aware of the shortage of neonatal nurses when I chaired the Great Ormond Street Hospital board, and that was several years ago, yet they continue. Perhaps a minister could explain what the governor could mean in practical terms when it said that it will refer to the workforce plan.
Could I also prefer the minister to the Royal midwife survey findings that final year midwifery students lack confidence that they will find work as a midwife. It is puzzling with the large amount of overtime that they currently work, so can workforce planning in this area be improved? Turning now to research, it is recognised that causes of preterm birth and prevention are not as widely understood as the noble Lord Winston has set out so well earlier.
Without funding for more research, this will continue. I recognise more research is going on in many areas of medicine. It is widespread, but the costs of prematurity, especially when it is extreme are enormous. Better research can have funding and benefit families. The high quality research, more attention is required to developing digital systems to improve data collections. The variation in digital systems across the country prevents creating a comprehensive national database of birth outcomes and characteristics.
Without this, we cannot do good research that is now needed. Lastly, I want to touch on socio-economic and ethnic questions. It is well- known that higher rates of preterm birth are linked to socio-economic deprivation. Policies way beyond healthcare are needed to address inequality. Yet there are specific steps needed to support women who are poor when they become pregnant. The promotion of unhealthy food and tobacco. Prenatal and postnatal monitoring is especially important for women coming from deprived communities.
To reduce the incidence and mitigate the effect of preterm births. Measures such as parental accommodation on neonatal units, whilst valuable for all parents, are particularly important for the socio- deprived. This was mentioned earlier by the noble Baroness Lady Wyld. Can the Minister confirm that there is the necessary government investment in its plans for this purpose? This is just one way to help families who are suffering acute stress as a result of preterm birth. I will end with a little anecdote.
No one so far in this debate has mentioned siblings. After my premature twin granddaughters were born, I looked after their older sister who is 2 1/2 years old. I took her to visit my brother and his family. One no one was looking, she bit the baby in the pram. I think she was giving us a little message. I'm distressed to. I've been displaced and I don't like babies. We need to end story such as
**** Possible New Speaker ****
this. Thank you. It is a pleasure to follow Lady Blackstone and I congratulate Lord Blackstone and I congratulate Lord Patel and his committee for this excellent report. The report takes excellent report. The report takes the recommendations of better births the recommendations of better births onto a new level. More detailed, more expert level including very importantly expert by experience, importantly expert by experience, assessing our hospitals preterm in the light of the decade that has the light of the decade that has followed.
I talked to Lady Cumberlege late in 2016 about the Cumberlege late in 2016 about the better births report because in May 2016, my first two identical 2016, my first two identical granddaughters were born in May at 29 weeks. Just like Lady
Continuation of this work is now Continuation of this work is now urgent that so far, the DHS has failed to confirm the next stage of failed to confirm the next stage of the project. Can it do so now? For the saving babies lives care bubble, properly staffed preterm birth properly staffed preterm birth prevention clinics are needed with access to regional centres, where this is impossible. Further training is needed with a special staff required in developing cross specialty leadership which includes people, medicine, as well as neonatal care and anaesthetics.
Employers need to be resourced to get in-service training and to build a supportive learning touch. There is also a crucial shortage of perinatal pathologists who need to examine preterm birth referred to Burma noble friend Lord Winston. We need parental pathology of women undertaken, those who have given earth less than 32%. Even when the service is provided, there is a lack of specialist postnatal clinics to follow-up on the results, but can this be rectified? So far, I focus on doctors but nurses and midwives are also crucial, so I welcome the three-year delivery plan to boost the midwifery workforce.
Perhaps the DHS could start considering what it will do when three years is up next year? I also welcome greater attention being given to the retention of nurses through more flexible working arrangements. I first became aware of the shortage of neonatal nurses when I chaired the Great Ormond Street Hospital board, and that was several years ago, yet they continue. Perhaps a minister could explain what the governor could mean in practical terms when it said that it will refer to the workforce plan.
Could I also prefer the minister to the Royal midwife survey findings that final year midwifery students lack confidence that they will find work as a midwife. It is puzzling with the large amount of overtime that they currently work, so can workforce planning in this area be improved? Turning now to research, it is recognised that causes of preterm birth and prevention are not as widely understood as the noble Lord Winston has set out so well earlier.
Without funding for more research, this will continue. I recognise more research is going on in many areas of medicine. It is widespread, but the costs of prematurity, especially when it is extreme are enormous. Better research can have funding and benefit families. The high quality research, more attention is required to developing digital systems to improve data collections. The variation in digital systems across the country prevents creating a comprehensive national database of birth outcomes and characteristics.
Without this, we cannot do good research that is now needed. Lastly, I want to touch on socio-economic and ethnic questions. It is well- known that higher rates of preterm birth are linked to socio-economic deprivation. Policies way beyond healthcare are needed to address inequality. Yet there are specific steps needed to support women who are poor when they become pregnant. The promotion of unhealthy food and tobacco. Prenatal and postnatal monitoring is especially important for women coming from deprived communities.
To reduce the incidence and mitigate the effect of preterm births. Measures such as parental accommodation on neonatal units, whilst valuable for all parents, are particularly important for the socio- deprived. This was mentioned earlier by the noble Baroness Lady Wyld. Can the Minister confirm that there is the necessary government investment in its plans for this purpose? This is just one way to help families who are suffering acute stress as a result of preterm birth. I will end with a little anecdote.
No one so far in this debate has mentioned siblings. After my premature twin granddaughters were born, I looked after their older sister who is 2 1/2 years old. I took her to visit my brother and his family. One no one was looking, she bit the baby in the pram. I think she was giving us a little message. I'm distressed to. I've been displaced and I don't like babies. We need to end story such as
**** Possible New Speaker ****
this. Thank you. It is a pleasure to follow Lady Blackstone and I congratulate Lord Blackstone and I congratulate Lord Patel and his committee for this excellent report. The report takes excellent report. The report takes the recommendations of better births the recommendations of better births onto a new level. More detailed, more expert level including very importantly expert by experience, importantly expert by experience, assessing our hospitals preterm in the light of the decade that has the light of the decade that has followed.
I talked to Lady Cumberlege late in 2016 about the Cumberlege late in 2016 about the better births report because in May 2016, my first two identical 2016, my first two identical granddaughters were born in May at 29 weeks. Just like Lady
11:42
Baroness Brinton (Liberal Democrat)
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Baroness Brinton (Liberal Democrat)
29 weeks. Just like Lady Blackstone's. But they were at heightened risk because they had 2020 transfusion across the placenta which is dangerous to both twins and the status of one of them was already serious prior even to that point. My son and his daughter-in- law looked the full experience of preterm birth and its after-effects for four years, so what I want to focus on the recommendations and the governments response, it is in the context of the most intense period of our family's lives.
And I need to say at the start that now, these 29-year-old twins are healthy, active and intelligent. Only possible because Kingston Hospital and the local community services, as well as organisations such as the Twins and multiple birth Association and Bliss, delivered everything that they need to survive and grow. Lady Seccombe talked about the importance of health visitors. They are as pressurised as MPs and we need to do more of them. Committee report in front of us today is excellent and the expertise of its members especially the chair Lord Patel is evident in the recommendations, but as I have said, I want to look at the governance responses to the report from these benches.
And it is good that it has in principle accepted the recommendations of the report, but it is the implementations of those that I want to ask questions about, and I echo Lady Bennett's questions about staffing levels and working practices for midwives which other noble Lords of spoken on. Government response begins by assessing the challenges ahead maternity services, reporting frankly on the broken NHS as well as the very specific problems in a number of maternity services. Only yesterday, the health service Journal said that an analysis of the extra money for the NHS this year as effectively all spent already.
Can the Minister stay if there is sufficient resource this year in future years to effect the changes that it aspires to, not just during this parliament but this year during this parliament but this year and next year as well. At the start, their response speaks about the excellence of the NHS savings babies lives bundle but note that its application is inconsistent. So can I ask the Minister if there are specific funding to ensure that bundle can be delivered consistently across the country by April 2026.
The same is also true of the key targets to reduce preterm births given the previous targets as others have said of reducing the rate of 6% which will not be met. The government response is silent on new targets to replace this, citing only the challenges. Can the Minister tell us when new charges will be announced? The government cites the 50 million challenge fund created a year ago by the previous government to provide researchers and policymakers with resources to assess new way to tackle maternal disparities and poor pregnancy outcomes.
I agree that this is vital but when will their reports be Lord Winston spoke of the importance of more research on miscarriage. He is right. This should be considered too. The noble Lady said how important early advice and guidance is to reduce preterm births. Recommendation two sets out information that future parents need long before the pregnancy. I welcome the government endorsement of this. Much of this is funded through the public health budgets which is notoriously under pressure. Lady Bennett highlighted this and Lady Sugg also talked about the real problems of financial inequalities.
There is also reference to the GP follow-up, being carried out in full. The proposals are excellent, but you are currently hard-pressed GPs have the capacity at the moment to deliver this vital checkup in the detail that is actually needed? Recommendation three focuses on clinical guidance for preterm birth care. My daughter-in-law's experience of a complex pregnancy underwent transfusion and put not just one but both girls lives at risk. This is textbook. The delicacy with which the risks were explained to her and my son, care before, during, and after the operation in utero at 16 weeks on her girls was breathtaking.
Things just seemed to happen so fast. All the staff that we as a family encountered were caring and careful. When the girls arrived at 29 weeks we were ready. A couple of days for had they were warned they might not be two incubators at Kingston and one might have to go to Southampton, the nearest place with a space. Yes, Southampton. Can you imagine two new parents, one of whom has had a cesarean, trying to manage two babies 60 miles apart? Lady Penn was right to point out this issue.
On the day they had two incubators at Kingston, I suspect another family was sent to Southampton. Can I ask the Minister, is there a review of the number of incubators to prevent this happening in future? We were warned that one of them might have severe problems and not survive. She did, or 700 g of her. Lady Bertin spoke of the tiny size of these babies. Her son, she could hold the entire body in the palm of hand. The other baby, 1.5 kg, came home.
The issues which were not unusual for a baby of her size continued. After a few weeks she moved to a different hospital and remains there until she was 10 months old. Care was extraordinary. And yet we watched our children manage, while in hospital in Waterloo, as well as my son holding down a job and the stress it puts on both of them. I thank Lady Wyld for her bill on the neonatal pay, care, and support. That will undoubtedly help families in the future.
Lady Penn said we needed better parental leave and she is right. The legislation that Joe Swinson led in coalition was a start, but we all knew it was just the first step. Recommendations five and six on parental accommodation for neonatal support is just the tip of the iceberg. We, the grandparents, aunts and uncles and friends, all had the privilege of supporting our children. In my case, I was able to be at the hospital most mornings. But this was a first for us too.
As Lady Bertin pointed out, the impact of prematurity does not end upon discharge from the Neonatal Unit. So true. A Had a ventilating and nasal gastric tube until she was nearly 4. We were trained to manage these so we could babysit both girls and stay overnight to give their parents a break. Without it, they would have had no respite. Care was not available from the local community. Recommendation nine suggests that NHS England should take action to deal with follow-up assessments particularly up to age 4.
Our family had the benefit of a series of follow-up assessments even though by that stage, A had a clear dislike people in white coats, who can blame her? Her final assessment when she walked firmly and bravely through the door, but thrilled you do not have to return again. By then the speech and language therapists had supported her. The hole in the heart had healed, and she no longer needed that ventilator. Although she still finds running difficult. The baby used to wave at Granny's office, every night, over the river.
From her ward, and she now has a passion for wildcats. She has no memory of what happened but she would not be with us that every single one of the professionals who were there for her and her twin. From the moment of that first scan at Kingston Hospital. My hope is that Lord Patel's report and government action will ensure this is the case for all families facing this extraordinary time in their lives. A consistently delivered service will not just save lives of preterm babies but also improve the quality of their lives.
**** Possible New Speaker ****
My Lords, it is always an honour
**** Possible New Speaker ****
My Lords, it is always an honour and a privilege to participate in any debate on your Lordships House will stop but today is particularly will stop but today is particularly so for me, as my children were born preterm. Please allow me to thank the noble Baroness Lady Blackstone, the noble Baroness Lady Blackstone, noble Baroness Lady Owen, the noble Baroness Lady Seccombe, the noble Baroness Lady Seccombe, the noble Baroness Lady Wyld, the noble Lord Lord Winston, and the noble Lord Lord Winston, and the noble Lord Lord Patel, all in their place.
As well as other noble Lords on the well as other noble Lords on the committee, for this compelling and measured report, as well as all noble Lords who have made valuable contributions today. The evidence it presents is sobering. There are clear challenges ahead. With the help of this report, those challenges can be overcome. Preterm birth remains among the most pressing issues in perinatal health care. 2022, nearly one in 12 babies were born preterm in England. These early births account for a disproportionate share of neonatal mortality and long-term health complications.
They place considerable strain on families and the NHS. Despite repeated odyssey commitments to reduce this figure to 6% by 2025, the committee makes it clear this target will not be met. Preterm birth is not only a clinical
And I need to say at the start that now, these 29-year-old twins are healthy, active and intelligent. Only possible because Kingston Hospital and the local community services, as well as organisations such as the Twins and multiple birth Association and Bliss, delivered everything that they need to survive and grow. Lady Seccombe talked about the importance of health visitors. They are as pressurised as MPs and we need to do more of them. Committee report in front of us today is excellent and the expertise of its members especially the chair Lord Patel is evident in the recommendations, but as I have said, I want to look at the governance responses to the report from these benches.
And it is good that it has in principle accepted the recommendations of the report, but it is the implementations of those that I want to ask questions about, and I echo Lady Bennett's questions about staffing levels and working practices for midwives which other noble Lords of spoken on. Government response begins by assessing the challenges ahead maternity services, reporting frankly on the broken NHS as well as the very specific problems in a number of maternity services. Only yesterday, the health service Journal said that an analysis of the extra money for the NHS this year as effectively all spent already.
Can the Minister stay if there is sufficient resource this year in future years to effect the changes that it aspires to, not just during this parliament but this year during this parliament but this year and next year as well. At the start, their response speaks about the excellence of the NHS savings babies lives bundle but note that its application is inconsistent. So can I ask the Minister if there are specific funding to ensure that bundle can be delivered consistently across the country by April 2026.
The same is also true of the key targets to reduce preterm births given the previous targets as others have said of reducing the rate of 6% which will not be met. The government response is silent on new targets to replace this, citing only the challenges. Can the Minister tell us when new charges will be announced? The government cites the 50 million challenge fund created a year ago by the previous government to provide researchers and policymakers with resources to assess new way to tackle maternal disparities and poor pregnancy outcomes.
I agree that this is vital but when will their reports be Lord Winston spoke of the importance of more research on miscarriage. He is right. This should be considered too. The noble Lady said how important early advice and guidance is to reduce preterm births. Recommendation two sets out information that future parents need long before the pregnancy. I welcome the government endorsement of this. Much of this is funded through the public health budgets which is notoriously under pressure. Lady Bennett highlighted this and Lady Sugg also talked about the real problems of financial inequalities.
There is also reference to the GP follow-up, being carried out in full. The proposals are excellent, but you are currently hard-pressed GPs have the capacity at the moment to deliver this vital checkup in the detail that is actually needed? Recommendation three focuses on clinical guidance for preterm birth care. My daughter-in-law's experience of a complex pregnancy underwent transfusion and put not just one but both girls lives at risk. This is textbook. The delicacy with which the risks were explained to her and my son, care before, during, and after the operation in utero at 16 weeks on her girls was breathtaking.
Things just seemed to happen so fast. All the staff that we as a family encountered were caring and careful. When the girls arrived at 29 weeks we were ready. A couple of days for had they were warned they might not be two incubators at Kingston and one might have to go to Southampton, the nearest place with a space. Yes, Southampton. Can you imagine two new parents, one of whom has had a cesarean, trying to manage two babies 60 miles apart? Lady Penn was right to point out this issue.
On the day they had two incubators at Kingston, I suspect another family was sent to Southampton. Can I ask the Minister, is there a review of the number of incubators to prevent this happening in future? We were warned that one of them might have severe problems and not survive. She did, or 700 g of her. Lady Bertin spoke of the tiny size of these babies. Her son, she could hold the entire body in the palm of hand. The other baby, 1.5 kg, came home.
The issues which were not unusual for a baby of her size continued. After a few weeks she moved to a different hospital and remains there until she was 10 months old. Care was extraordinary. And yet we watched our children manage, while in hospital in Waterloo, as well as my son holding down a job and the stress it puts on both of them. I thank Lady Wyld for her bill on the neonatal pay, care, and support. That will undoubtedly help families in the future.
Lady Penn said we needed better parental leave and she is right. The legislation that Joe Swinson led in coalition was a start, but we all knew it was just the first step. Recommendations five and six on parental accommodation for neonatal support is just the tip of the iceberg. We, the grandparents, aunts and uncles and friends, all had the privilege of supporting our children. In my case, I was able to be at the hospital most mornings. But this was a first for us too.
As Lady Bertin pointed out, the impact of prematurity does not end upon discharge from the Neonatal Unit. So true. A Had a ventilating and nasal gastric tube until she was nearly 4. We were trained to manage these so we could babysit both girls and stay overnight to give their parents a break. Without it, they would have had no respite. Care was not available from the local community. Recommendation nine suggests that NHS England should take action to deal with follow-up assessments particularly up to age 4.
Our family had the benefit of a series of follow-up assessments even though by that stage, A had a clear dislike people in white coats, who can blame her? Her final assessment when she walked firmly and bravely through the door, but thrilled you do not have to return again. By then the speech and language therapists had supported her. The hole in the heart had healed, and she no longer needed that ventilator. Although she still finds running difficult. The baby used to wave at Granny's office, every night, over the river.
From her ward, and she now has a passion for wildcats. She has no memory of what happened but she would not be with us that every single one of the professionals who were there for her and her twin. From the moment of that first scan at Kingston Hospital. My hope is that Lord Patel's report and government action will ensure this is the case for all families facing this extraordinary time in their lives. A consistently delivered service will not just save lives of preterm babies but also improve the quality of their lives.
**** Possible New Speaker ****
My Lords, it is always an honour
**** Possible New Speaker ****
My Lords, it is always an honour and a privilege to participate in any debate on your Lordships House will stop but today is particularly will stop but today is particularly so for me, as my children were born preterm. Please allow me to thank the noble Baroness Lady Blackstone, the noble Baroness Lady Blackstone, noble Baroness Lady Owen, the noble Baroness Lady Seccombe, the noble Baroness Lady Seccombe, the noble Baroness Lady Wyld, the noble Lord Lord Winston, and the noble Lord Lord Winston, and the noble Lord Lord Patel, all in their place.
As well as other noble Lords on the well as other noble Lords on the committee, for this compelling and measured report, as well as all noble Lords who have made valuable contributions today. The evidence it presents is sobering. There are clear challenges ahead. With the help of this report, those challenges can be overcome. Preterm birth remains among the most pressing issues in perinatal health care. 2022, nearly one in 12 babies were born preterm in England. These early births account for a disproportionate share of neonatal mortality and long-term health complications.
They place considerable strain on families and the NHS. Despite repeated odyssey commitments to reduce this figure to 6% by 2025, the committee makes it clear this target will not be met. Preterm birth is not only a clinical
11:54
The Earl of Effingham (Conservative)
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The Earl of Effingham (Conservative)
issue but one with profound implications for families and wider implications for families and wider society. It is the leading cause of neonatal death, and a major contributor to childhood mortality contributor to childhood mortality and long-term disability. Babies born too early face significant higher risks of cerebral palsy, learning difficulties, and learning difficulties, and developmental delay. They are more likely to struggle at school, and more likely to require support through their life. The impact does not end with a child.
The report details evidence from parents whose lives were overturned in a matter of hours. Whose babies were whisked hours. Whose babies were whisked into critical care, often hospitals far from their home. Families are far from their home. Families are routinely separated with little or no access to overnight accommodation. Many parents have highlighted they were unable to stay near their critically ill child. This has been flagged by the noble Baroness Lady Sugg, the noble Baroness Lady Penn, the noble Baroness Lady Wyld, noble Baroness Lady Owen, and the noble Baroness Lady Seccombe.
My Lords, I believe it would be fair to say that childbirth itself is challenging for all concerned. To add preterm birth into that mix, and further to not be able to stay with your just born child would be incredibly distressing. And then further to the emotional havoc that this reeks, there is also the financial strain where one in four families have to borrow money or take on additional debt to get through this period. I think the founder of the charity of the Smallest Things, sums up everywhere she said, " We know how hard it is to sit beside an intimate full of fear.
We know how hard it is to bond with a baby full of tubes and wires in intensive care, and the parents still hear the hospital alarms when they close their eyes after coming home. " There are also disparities amongst those affected. The term birth rate amongst black women is 8.5%, and among Asian women 8.3%. It compares with 7.7% for white women. The committee rightly describes these inequalities is complex and interconnected. But we must be clear, they are unacceptable in a modern equitable healthcare system.
The government has signalled its intention to refresh the maternity ambition that this must be part of a coordinated intervention on all fronts. Alone it will not suffice. The report has given us a robust and compassionate roadmap. His Majesty's Official Opposition commends the report's central message. Whilst it is impossible to prevent all preterm births, it appears far more can be done to reduce the number and mitigate the consequences. Key among the report's recommendations is the call to revise national targets.
Not merely to lower the overall rate but to tackle the specific inequalities that persist across ethnic and socio economic lines. This is not a partisan issue. It concerns the fundamental matter of equity and clinical necessity. The report also highlights the inconsistent implementation of existing guidance. The saving babies life care bundle contains interventions proven to improve outcomes for preterm babies. Access to these measures remains worryingly dependent on geography. The noble Baroness flagged postcode lottery, the noble Lord talked about a national rollout for best practice.
We must ensure that provisions for such essential care are equitably distributed and maintained. Staffing shortages in maternity and neonatal care continue to undermine even the best clinical intentions. Both the government and the previous government acknowledge this, and the long-term workforce plan aiming to address these shortfalls, but training must include a specific focus on the care needs of preterm babies and their families. Health visitors in particular require dedicated support and protected time to deliver a follow-up care effectively.
Too often, follow-up assessment, especially at ages two and for simply do not take place. This represents a clear breach of national guidance, and a serious failure in our early years provision. The result is lost opportunities for intervention, and avoidable suffering for families already under strain. As highlighted by the noble Baroness Lady Wyld, investment is also required in neonatal estates. The government must publish the results of its maternity and neonatal estates survey without delay.
And ensure that phase two of the Spending Review includes funding to expand rental accommodation across the NHS. Data collection and research was referenced by the noble Lord Lord Winston, the noble Baroness Lady Owen, the noble Baroness Lady Seccombe, the noble Lord Lord Weir, and the noble Baroness Lady Blackstone. We have to continue to strengthen our research effort. Many preterm births occur without any known risk factors. Understanding the biological processes of early labour, the social determinants that compound risk, is vital for prevention.
Optimising women's prior to pregnancy was highlighted by the noble Lord Lord Winston, the noble Lord Lord Weir, the noble Baroness Lady Sugg, and the noble Baroness Lady Blackstone. The Secretary of State for Health has quite rightly said that holistically speaking, revenge and is better than cure. One of the key conclusions of the report is that optimising women's health prior to pregnancy is an important part of the term birth prevention. In order to address risk factors such as obesity and mental health issues, we have to ask, is the government going to make a healthy diet and exercise a major priority in their program of prevention? Both in schools, and the adult population at large, because currently, the statistics paint a frightening The committee's findings have been welcomed by clinicians, researchers and advocates alike.
In recent weeks, we have heard constructive challenges to the government, in your Lordships' House, regarding reviews and time delays. In the same light, we must challenge on any further reviews, regarding preterm birth. We now have some of the answers. And as the charity Bliss has rightly stated, this is a moment of action, not aspiration. We urge the noble Baroness the Minister to provide clarity, on how the government will act upon each of the reports recommendations.
So the families affected by preterm birth receive the care, compassion and the clarity which they deserve.
**** Possible New Speaker ****
My Lords, it is, I am sure I
**** Possible New Speaker ****
My Lords, it is, I am sure I When I say it feels somewhat overwhelming at the end of the overwhelming at the end of the debate, such as this. Not least of all because noble Lords have been very generous and open about their personal experiences, not just of their own, but of their friends and their own, but of their friends and their families. I am grateful to all noble Lords for being willing to do noble Lords for being willing to do that.
And of course, I join up with that. And of course, I join up with all of the thanks to the noble Lord, Lord Patel, not just for his expert Lord Patel, not just for his expert chairing of the committee, which is given as the quality of report that we've got, but also for his we've got, but also for his introduction today. And my thanks are also due to all members of the committee, I am sure that members of the committee are very proud of the report and I did hear that this is a report that should not sit on the shelf and I quite agree.
It has shone a light on many of the challenges and as the noble Lord, Earl of Effingham said, no one actually, on its own will make a difference. I do feel, having given evidence as to the committee and having read the report and overseeing the response of the government, that the more we go to look into this there is great complexity. We have sought to take each item as best we can. Is there more to do? Completely. Do we start in a difficult place, yes we do.
And in a difficult place, yes we do. And so I am very grateful for this report. And I would also associate myself with the thanks that were given to all those who provided evidence. It will have been an extremely affecting, I am sure, experience to hear from parents and others, who have been affected, in
The report details evidence from parents whose lives were overturned in a matter of hours. Whose babies were whisked hours. Whose babies were whisked into critical care, often hospitals far from their home. Families are far from their home. Families are routinely separated with little or no access to overnight accommodation. Many parents have highlighted they were unable to stay near their critically ill child. This has been flagged by the noble Baroness Lady Sugg, the noble Baroness Lady Penn, the noble Baroness Lady Wyld, noble Baroness Lady Owen, and the noble Baroness Lady Seccombe.
My Lords, I believe it would be fair to say that childbirth itself is challenging for all concerned. To add preterm birth into that mix, and further to not be able to stay with your just born child would be incredibly distressing. And then further to the emotional havoc that this reeks, there is also the financial strain where one in four families have to borrow money or take on additional debt to get through this period. I think the founder of the charity of the Smallest Things, sums up everywhere she said, " We know how hard it is to sit beside an intimate full of fear.
We know how hard it is to bond with a baby full of tubes and wires in intensive care, and the parents still hear the hospital alarms when they close their eyes after coming home. " There are also disparities amongst those affected. The term birth rate amongst black women is 8.5%, and among Asian women 8.3%. It compares with 7.7% for white women. The committee rightly describes these inequalities is complex and interconnected. But we must be clear, they are unacceptable in a modern equitable healthcare system.
The government has signalled its intention to refresh the maternity ambition that this must be part of a coordinated intervention on all fronts. Alone it will not suffice. The report has given us a robust and compassionate roadmap. His Majesty's Official Opposition commends the report's central message. Whilst it is impossible to prevent all preterm births, it appears far more can be done to reduce the number and mitigate the consequences. Key among the report's recommendations is the call to revise national targets.
Not merely to lower the overall rate but to tackle the specific inequalities that persist across ethnic and socio economic lines. This is not a partisan issue. It concerns the fundamental matter of equity and clinical necessity. The report also highlights the inconsistent implementation of existing guidance. The saving babies life care bundle contains interventions proven to improve outcomes for preterm babies. Access to these measures remains worryingly dependent on geography. The noble Baroness flagged postcode lottery, the noble Lord talked about a national rollout for best practice.
We must ensure that provisions for such essential care are equitably distributed and maintained. Staffing shortages in maternity and neonatal care continue to undermine even the best clinical intentions. Both the government and the previous government acknowledge this, and the long-term workforce plan aiming to address these shortfalls, but training must include a specific focus on the care needs of preterm babies and their families. Health visitors in particular require dedicated support and protected time to deliver a follow-up care effectively.
Too often, follow-up assessment, especially at ages two and for simply do not take place. This represents a clear breach of national guidance, and a serious failure in our early years provision. The result is lost opportunities for intervention, and avoidable suffering for families already under strain. As highlighted by the noble Baroness Lady Wyld, investment is also required in neonatal estates. The government must publish the results of its maternity and neonatal estates survey without delay.
And ensure that phase two of the Spending Review includes funding to expand rental accommodation across the NHS. Data collection and research was referenced by the noble Lord Lord Winston, the noble Baroness Lady Owen, the noble Baroness Lady Seccombe, the noble Lord Lord Weir, and the noble Baroness Lady Blackstone. We have to continue to strengthen our research effort. Many preterm births occur without any known risk factors. Understanding the biological processes of early labour, the social determinants that compound risk, is vital for prevention.
Optimising women's prior to pregnancy was highlighted by the noble Lord Lord Winston, the noble Lord Lord Weir, the noble Baroness Lady Sugg, and the noble Baroness Lady Blackstone. The Secretary of State for Health has quite rightly said that holistically speaking, revenge and is better than cure. One of the key conclusions of the report is that optimising women's health prior to pregnancy is an important part of the term birth prevention. In order to address risk factors such as obesity and mental health issues, we have to ask, is the government going to make a healthy diet and exercise a major priority in their program of prevention? Both in schools, and the adult population at large, because currently, the statistics paint a frightening The committee's findings have been welcomed by clinicians, researchers and advocates alike.
In recent weeks, we have heard constructive challenges to the government, in your Lordships' House, regarding reviews and time delays. In the same light, we must challenge on any further reviews, regarding preterm birth. We now have some of the answers. And as the charity Bliss has rightly stated, this is a moment of action, not aspiration. We urge the noble Baroness the Minister to provide clarity, on how the government will act upon each of the reports recommendations.
So the families affected by preterm birth receive the care, compassion and the clarity which they deserve.
**** Possible New Speaker ****
My Lords, it is, I am sure I
**** Possible New Speaker ****
My Lords, it is, I am sure I When I say it feels somewhat overwhelming at the end of the overwhelming at the end of the debate, such as this. Not least of all because noble Lords have been very generous and open about their personal experiences, not just of their own, but of their friends and their own, but of their friends and their families. I am grateful to all noble Lords for being willing to do noble Lords for being willing to do that.
And of course, I join up with that. And of course, I join up with all of the thanks to the noble Lord, Lord Patel, not just for his expert Lord Patel, not just for his expert chairing of the committee, which is given as the quality of report that we've got, but also for his we've got, but also for his introduction today. And my thanks are also due to all members of the committee, I am sure that members of the committee are very proud of the report and I did hear that this is a report that should not sit on the shelf and I quite agree.
It has shone a light on many of the challenges and as the noble Lord, Earl of Effingham said, no one actually, on its own will make a difference. I do feel, having given evidence as to the committee and having read the report and overseeing the response of the government, that the more we go to look into this there is great complexity. We have sought to take each item as best we can. Is there more to do? Completely. Do we start in a difficult place, yes we do.
And in a difficult place, yes we do. And so I am very grateful for this report. And I would also associate myself with the thanks that were given to all those who provided evidence. It will have been an extremely affecting, I am sure, experience to hear from parents and others, who have been affected, in
12:04
Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
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Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
this way. But what the report is this way. But what the report is about and what I wish to be about is about protecting the most vulnerable, the babies, the women and their families. And I know that everybody has come from that place everybody has come from that place today. Let me say to the noble Lady, Baroness Wyld, she knows, I welcome the challenge that she and the the challenge that she and the committee make to the Government. I will seek to be as helpful as will seek to be as helpful as possible, as I can be, today.
I know that I will not be able to provide every answer, but it is right that every answer, but it is right that the questions answered. Aware there are considerable areas if I do not get to address, I will pick them up get to address, I will pick them up afterwards. My Lords, I also want to say to the noble Lady, Baroness Brinton, who I know is deeply affected by the words she shared, well she affected us all.
Ha that was, I'm sure. The noble Lady brought into the room exactly why we are here. What is the scale of the problem before risk? In 2023, the year from which we have the most recent figures, there were almost 4,600 preterm births stop that is just over 8% of births. A very considerable amount. I do share the view that rapid improvements are needed to improve outcomes and also the experience of women and their babies. We have heard today about the many risks that contribute to preterm birth, which include pre- existing health conditions, such as high blood pressure and diabetes.
Multiple pregnancy factors, such as smoking and obesity, maternal age and assisted reproductive technologies, such as IVF. We also know that preterm birth is more prevalent for women, from a black and Asian groups and for those women living in the most deprived areas. And this is not a situation that can be allowed to continue. My Lords, of course at the impact of it being born preterm is significant, as we have heard. Not least and not only, but preterm babies are more likely but preterm babies are more likely to die in the first 28 days, or their first year of life.
And in fact the number of child deaths, from pre-maturity rose from 2019 and 2023, we know the scale of the challenge before us. And preterm birth does increase the risk of chronic conditions. Babies are born preterm require more hospital-based care, in infancy, childhood. I was very interested to hear, put on record, by noble Lords, including my noble friend Baroness Goudie, that preterm birth can indeed place a significant emotional, financial and logistical stress on families. I very much welcomes and was glad to support the launch of the create health report, which shone a light It is an important point to make and it was made in some part, in the debate.
In some cases preterm birth is a medically appropriate and it is something I can recall discussing, with the committee. Because, in that instance it is safest for mother and babies. One of the difficulties with the target, from the previous government, I felt, is that it did not make that distinction and so it is very important we do get any further targets right. What actions are under way? My department works with NHS England and across the sector, including the charities referred to, by the noble Earl Effingham.
To whom I also add my thanks to those charities and third sector organisations. We are working on a range of actions, for now and also into the future. To tackle some of what are the most deeply entrenched issues. The noble Lord, Lord Patel and other noble Lords made a very positive reference, which I will share, to the save the babies alive care bundle. This has been codeveloped, with clinical experts and professional societies and it very much draws on frontline learning and experience.
It does provide a package of interventions, to reduce variations in care, which we know are out there. And to improve neonatal care quality and outcomes. Let me say to your Lordships' House macro that the implementation of the care bundle is one of the conditions required to ensure compliance, with safety requirements. The other point I would wish to refer to, which at the noble Lady, Baroness Brinton did raise. As of May, of this year, some 97% of maternity services were fully compliant with the bundle, which is increased from 10% since last year.
I can assure the noble Lady that the remaining small percentage is nevertheless significant and we are following up with those, to ensure that they will become fully compliant. The elements of the care bundle due address of the committee's recommendation, but we also to go further. Earl Effingham raised the two four-year assessment checks for children who are born preterm. They are extremely important. We are looking at what further actions are needed, to ensure that children actually do receive these follow-up assessments, because of the importance of them.
I can tell your Lordships' House that all 150 maternity and neonatal units, in England are taking part in the NHSE perinatal culture leadership program. A number of noble Lords, including the noble Lord, Lord Patel and the noble Lady, Baroness Wyld, were absolutely right to highlight the importance of the maternity and neonatal estate, when it comes to supporting parents to be fully involved in their babies care. I am glad that just last week, the allocation was announced of the sub- £750 million, through the estate safety fund, to start tackling and it can only be a first step.
Because of the amount of maintenance backlog. The 750 million support will support many sites. Let me say, very specifically it includes over £100 million, for maternity units, to enable better care, for mother's and their newborns. I know the noble Lady, Baroness Seccombe is also rightly exercised about this point. Let's say to the noble Lady, Baroness Wyld and other noble Lords, I do understand the frustration about the time hat that has been taken, about NHS England publishing the findings of the maternity and neonatal estates survey.
I can say, to noble Lords, that they won't be having to wait much longer. I too want to see it. A number of interventions are rightly centred around the workforce. There are still shortages across the workforce and if I can say, overall, the refreshed workforce plan, which will be published in the next few months, in answer to the questions, will seek to transform the services over the next decade, to ensure better care for patients.
And my noble friend, Baroness Blackstone asked about what is happening to understand obstetric staffing and managing the workforce more broadly. As I say, that will be covered by the workforce plan. However, I would also say it is the responsibility of trusts to ensure that they do have the right staff in place. To the point about the workforce, the noble Baroness, Baroness Wyld also asked about professional development and other noble Lords asked about the inclusion of midwifery, including the noble Baroness, Baroness Ullock and it is -- Baroness saga.
It is crucial that they have the training they need to make the right knowledge and the right care. The new workforce plan, will follow the 10-Year Health Plan and Spending Review, whilst I know noble Lords will understand that I cannot pre- empt exactly what it will save. I can say it will look at the issues, the wide range of issues that face of the workforce and that will of course include midwives. And colleagues across NHSE and the Department do remain committed to delivering on this in respect of workforce.
And our, I will very much be having the midwifery service that we need. I do understand the concerns of that were raised about the survey, about training midwives are being very concerned about their future prospects, in terms of employment. And this was raised by a number of noble Lords, including the noble Baroness, Baroness Bennett, the noble Baroness, Baroness Caine. Honourable friend, Baroness Blackstone, noble Lady, Baroness Sugg. What I can share with your Lordships' House is that there is, in some way, a positive position.
This isn't a way of glossing over the difficulties. And that is that there are fewer vacancies currently, because of improved retention. And in fact the NHS nursing and midwifery workforce has grown in recent years. And so we do have branches of nursing and midwifery where supply is greater than the number of posts available, this number of posts available, this year. I do appreciate the tension. I can assure the noble Lords of the NHS England are working with educators, employers and regional teams, in order to support newly qualified nurses, midwives, to secure, to secure employment.
And that does include developing resources to support learners through the recruitment process and identify suitable opportunities and support. The noble Lady Baroness support. The noble Lady Baroness Penn specifically asked me about N H Because of its abolition and where responsibility will lie. I can say to the noble Lady, specifics are being worked through a central team leading the change and they will ensure nothing is lost in terms of what we need to do.
The service we are concerned about here in terms of provision will remain a priority. I would say to the noble Lady, the abolition of NHSE will remove duplication and therefore I expect to see improvements in this area. The noble Lady, Baroness raised an important point about nurses training to be midwives. I am grateful the noble Lady spoke to me about this separately. I agree, nurses who trained to become midwives bring a whole wealth of experience.
So NHSE does offer funding to support this shift. However what I do recognise is we may need to go further to support nurses to remain on the relevant courses and take up posts in maternity units. So the funding offer for this will be reviewed later this year. The noble Lord, Lord Patel spoke about the importance of community services and health visiting services. I can say throughout -- through our plan to change we will ensure children and their families are cared for by the right professional.
We will be strengthening health visitor services. The noble Lady Baroness Bertin spoke to the point very sensitively about mental health issues. As well as a number of other issues. As well as a number of other points. Specialist Perry mental -- specialist perinatal mental health services are now available in all 42 Integrated care systems and very important they are indeed. I agree with noble Lords, including the noble Lord, Lord Weir and the noble Lord, Lord Patel and the importance of a woman's health before pregnancy.
More work is required to improve awareness of preconception health and pregnancy. Taking into account, this is another key point of course, that many pregnancies are not planned. That is why the point about early education and support is so crucial. The 10-Year Plan which we will see shortly will set out how we are going to tackle the inequities that lead to poorer health. In terms of research which my noble friend, Lord Winston raised as well as the noble Lady, Baroness Owen, the noble Lord, Lord Weir and the noble Lady, Baroness Bertin, can I say since the committee hearing in September 2024, the NIHR has commissioned three new research awards.
Including research to investigate prevention of Preterm Birth. As well as interventions to improve health outcomes of preterm babies. Over the last five financial years research programs invested in 77 research awards, focusing on Preterm Birth. Again across the full duration that was a total of £93 million of funding. And yes I totally agree about the importance of research. I will write my noble friend, Lord Winston following upon his point urging the government to use opportunities of biobank, that it presents.
On the matter of, the important matter of miscarriage I do share the noble view of my noble friend, Lord Winston and others set out. We are taking steps to improve data on miscarriage and fill what are the very considerable current gaps. There is a new digital standard which will record new information. Previous miscarriage and also baby loss and I am looking at how effective that is being applied. I am also looking forward to the review of the Tommy's graded model of care.
In respect of miscarriage. I very much take the points on board. There are a whole number of further action is being taken to improve maternity safety. The maternity outcomes signalling system, the maternity safety support program, avoiding brain injury in childbirth and I am pleased to say all local areas have published equity and equality action plans. Which particularly set out tailored interventions for those from ethnic minority backgrounds and those in -- living in the most deprived areas.
This will be an important focus for the 10-Year Plan too. There are 14 maternal medicine networks that have been set up across England, made up of 70 specialist mental care centres and high quality neonatal care is being networked together across England. We are investing 45 million in increasing neonatal cut capacity and assign in care coordinators -- assigning care coordinators. We are taking further actions in terms of tackling obesity and tackling smoking and again that will be referred to in the 10-Year Plan.
Let me say in closing to noble Lords there has been much richness not just in the committee report but in today's debate. For which I am entirely grateful and I look forward to using what has been written and what has been said and further discussions so that we can provide the service we all want to see.
I know that I will not be able to provide every answer, but it is right that every answer, but it is right that the questions answered. Aware there are considerable areas if I do not get to address, I will pick them up get to address, I will pick them up afterwards. My Lords, I also want to say to the noble Lady, Baroness Brinton, who I know is deeply affected by the words she shared, well she affected us all.
Ha that was, I'm sure. The noble Lady brought into the room exactly why we are here. What is the scale of the problem before risk? In 2023, the year from which we have the most recent figures, there were almost 4,600 preterm births stop that is just over 8% of births. A very considerable amount. I do share the view that rapid improvements are needed to improve outcomes and also the experience of women and their babies. We have heard today about the many risks that contribute to preterm birth, which include pre- existing health conditions, such as high blood pressure and diabetes.
Multiple pregnancy factors, such as smoking and obesity, maternal age and assisted reproductive technologies, such as IVF. We also know that preterm birth is more prevalent for women, from a black and Asian groups and for those women living in the most deprived areas. And this is not a situation that can be allowed to continue. My Lords, of course at the impact of it being born preterm is significant, as we have heard. Not least and not only, but preterm babies are more likely but preterm babies are more likely to die in the first 28 days, or their first year of life.
And in fact the number of child deaths, from pre-maturity rose from 2019 and 2023, we know the scale of the challenge before us. And preterm birth does increase the risk of chronic conditions. Babies are born preterm require more hospital-based care, in infancy, childhood. I was very interested to hear, put on record, by noble Lords, including my noble friend Baroness Goudie, that preterm birth can indeed place a significant emotional, financial and logistical stress on families. I very much welcomes and was glad to support the launch of the create health report, which shone a light It is an important point to make and it was made in some part, in the debate.
In some cases preterm birth is a medically appropriate and it is something I can recall discussing, with the committee. Because, in that instance it is safest for mother and babies. One of the difficulties with the target, from the previous government, I felt, is that it did not make that distinction and so it is very important we do get any further targets right. What actions are under way? My department works with NHS England and across the sector, including the charities referred to, by the noble Earl Effingham.
To whom I also add my thanks to those charities and third sector organisations. We are working on a range of actions, for now and also into the future. To tackle some of what are the most deeply entrenched issues. The noble Lord, Lord Patel and other noble Lords made a very positive reference, which I will share, to the save the babies alive care bundle. This has been codeveloped, with clinical experts and professional societies and it very much draws on frontline learning and experience.
It does provide a package of interventions, to reduce variations in care, which we know are out there. And to improve neonatal care quality and outcomes. Let me say to your Lordships' House macro that the implementation of the care bundle is one of the conditions required to ensure compliance, with safety requirements. The other point I would wish to refer to, which at the noble Lady, Baroness Brinton did raise. As of May, of this year, some 97% of maternity services were fully compliant with the bundle, which is increased from 10% since last year.
I can assure the noble Lady that the remaining small percentage is nevertheless significant and we are following up with those, to ensure that they will become fully compliant. The elements of the care bundle due address of the committee's recommendation, but we also to go further. Earl Effingham raised the two four-year assessment checks for children who are born preterm. They are extremely important. We are looking at what further actions are needed, to ensure that children actually do receive these follow-up assessments, because of the importance of them.
I can tell your Lordships' House that all 150 maternity and neonatal units, in England are taking part in the NHSE perinatal culture leadership program. A number of noble Lords, including the noble Lord, Lord Patel and the noble Lady, Baroness Wyld, were absolutely right to highlight the importance of the maternity and neonatal estate, when it comes to supporting parents to be fully involved in their babies care. I am glad that just last week, the allocation was announced of the sub- £750 million, through the estate safety fund, to start tackling and it can only be a first step.
Because of the amount of maintenance backlog. The 750 million support will support many sites. Let me say, very specifically it includes over £100 million, for maternity units, to enable better care, for mother's and their newborns. I know the noble Lady, Baroness Seccombe is also rightly exercised about this point. Let's say to the noble Lady, Baroness Wyld and other noble Lords, I do understand the frustration about the time hat that has been taken, about NHS England publishing the findings of the maternity and neonatal estates survey.
I can say, to noble Lords, that they won't be having to wait much longer. I too want to see it. A number of interventions are rightly centred around the workforce. There are still shortages across the workforce and if I can say, overall, the refreshed workforce plan, which will be published in the next few months, in answer to the questions, will seek to transform the services over the next decade, to ensure better care for patients.
And my noble friend, Baroness Blackstone asked about what is happening to understand obstetric staffing and managing the workforce more broadly. As I say, that will be covered by the workforce plan. However, I would also say it is the responsibility of trusts to ensure that they do have the right staff in place. To the point about the workforce, the noble Baroness, Baroness Wyld also asked about professional development and other noble Lords asked about the inclusion of midwifery, including the noble Baroness, Baroness Ullock and it is -- Baroness saga.
It is crucial that they have the training they need to make the right knowledge and the right care. The new workforce plan, will follow the 10-Year Health Plan and Spending Review, whilst I know noble Lords will understand that I cannot pre- empt exactly what it will save. I can say it will look at the issues, the wide range of issues that face of the workforce and that will of course include midwives. And colleagues across NHSE and the Department do remain committed to delivering on this in respect of workforce.
And our, I will very much be having the midwifery service that we need. I do understand the concerns of that were raised about the survey, about training midwives are being very concerned about their future prospects, in terms of employment. And this was raised by a number of noble Lords, including the noble Baroness, Baroness Bennett, the noble Baroness, Baroness Caine. Honourable friend, Baroness Blackstone, noble Lady, Baroness Sugg. What I can share with your Lordships' House is that there is, in some way, a positive position.
This isn't a way of glossing over the difficulties. And that is that there are fewer vacancies currently, because of improved retention. And in fact the NHS nursing and midwifery workforce has grown in recent years. And so we do have branches of nursing and midwifery where supply is greater than the number of posts available, this number of posts available, this year. I do appreciate the tension. I can assure the noble Lords of the NHS England are working with educators, employers and regional teams, in order to support newly qualified nurses, midwives, to secure, to secure employment.
And that does include developing resources to support learners through the recruitment process and identify suitable opportunities and support. The noble Lady Baroness support. The noble Lady Baroness Penn specifically asked me about N H Because of its abolition and where responsibility will lie. I can say to the noble Lady, specifics are being worked through a central team leading the change and they will ensure nothing is lost in terms of what we need to do.
The service we are concerned about here in terms of provision will remain a priority. I would say to the noble Lady, the abolition of NHSE will remove duplication and therefore I expect to see improvements in this area. The noble Lady, Baroness raised an important point about nurses training to be midwives. I am grateful the noble Lady spoke to me about this separately. I agree, nurses who trained to become midwives bring a whole wealth of experience.
So NHSE does offer funding to support this shift. However what I do recognise is we may need to go further to support nurses to remain on the relevant courses and take up posts in maternity units. So the funding offer for this will be reviewed later this year. The noble Lord, Lord Patel spoke about the importance of community services and health visiting services. I can say throughout -- through our plan to change we will ensure children and their families are cared for by the right professional.
We will be strengthening health visitor services. The noble Lady Baroness Bertin spoke to the point very sensitively about mental health issues. As well as a number of other issues. As well as a number of other points. Specialist Perry mental -- specialist perinatal mental health services are now available in all 42 Integrated care systems and very important they are indeed. I agree with noble Lords, including the noble Lord, Lord Weir and the noble Lord, Lord Patel and the importance of a woman's health before pregnancy.
More work is required to improve awareness of preconception health and pregnancy. Taking into account, this is another key point of course, that many pregnancies are not planned. That is why the point about early education and support is so crucial. The 10-Year Plan which we will see shortly will set out how we are going to tackle the inequities that lead to poorer health. In terms of research which my noble friend, Lord Winston raised as well as the noble Lady, Baroness Owen, the noble Lord, Lord Weir and the noble Lady, Baroness Bertin, can I say since the committee hearing in September 2024, the NIHR has commissioned three new research awards.
Including research to investigate prevention of Preterm Birth. As well as interventions to improve health outcomes of preterm babies. Over the last five financial years research programs invested in 77 research awards, focusing on Preterm Birth. Again across the full duration that was a total of £93 million of funding. And yes I totally agree about the importance of research. I will write my noble friend, Lord Winston following upon his point urging the government to use opportunities of biobank, that it presents.
On the matter of, the important matter of miscarriage I do share the noble view of my noble friend, Lord Winston and others set out. We are taking steps to improve data on miscarriage and fill what are the very considerable current gaps. There is a new digital standard which will record new information. Previous miscarriage and also baby loss and I am looking at how effective that is being applied. I am also looking forward to the review of the Tommy's graded model of care.
In respect of miscarriage. I very much take the points on board. There are a whole number of further action is being taken to improve maternity safety. The maternity outcomes signalling system, the maternity safety support program, avoiding brain injury in childbirth and I am pleased to say all local areas have published equity and equality action plans. Which particularly set out tailored interventions for those from ethnic minority backgrounds and those in -- living in the most deprived areas.
This will be an important focus for the 10-Year Plan too. There are 14 maternal medicine networks that have been set up across England, made up of 70 specialist mental care centres and high quality neonatal care is being networked together across England. We are investing 45 million in increasing neonatal cut capacity and assign in care coordinators -- assigning care coordinators. We are taking further actions in terms of tackling obesity and tackling smoking and again that will be referred to in the 10-Year Plan.
Let me say in closing to noble Lords there has been much richness not just in the committee report but in today's debate. For which I am entirely grateful and I look forward to using what has been written and what has been said and further discussions so that we can provide the service we all want to see.
12:23
Lord Patel (Crossbench)
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Lord Patel (Crossbench)
My Lords, I thank the Minister for her response. It has been often said this has been a good debate. It has not been a good debate, it has been a brilliant debate! The passion, all of the speakers who have shown this passion related to making the service for mothers and babies better, there are no political issues in all of the speeches that were made. There was only one thing and that was to support future mothers and future preterm born babies in their lives so they are made better.
We have the same passion we heard from the noble Baroness Brinton and thank you very much for the courage to do so Baroness Brinton. We heard this from many many witnesses and I said at the beginning, the report was underpinned by the evidence we heard from others and lived experience of adults who themselves were born preterm. And how the services were preterm. And how the services were failing them. Services were failing them and not much resources are required.
It is the dedication shown by the professional that is not supported that is required. I hope we will do something. I have to say I think the Minister probably had a difficult task answering all of the questions that were raised. But they were all good questions. It will require careful reading of a response to know how far she show the same compassion where the government can show the same compassion. Not her personally, I know she is compassionate about it.
But that will deliver to these future mothers and babies born preterm because babies will be born preterm. I sadly have to say that I delivered my godson at 26 weeks. He is 54 years old. It is severely handicapped. Like he is severely handicapped. I also deliver 10 years later a young preterm baby who later a young preterm baby who weighed exactly 600 grams. Who I also heard twice as the Chancellor has graduated law. There have been many stories about young premature babies who survive.
I hope we will not forget this debate because the mothers and their babies out there who are born need our support. I agree with the noble Baroness we must not let this be the only occasion we discussed this again. The same debate another time every
**** Possible New Speaker ****
year may help. I beg to withdraw. Does the noble Lord wish to
**** Possible New Speaker ****
Does the noble Lord wish to withdraw? The question is this motion be agreed to. As many as are of that opinion, say, "Content". Of the contrary, "Not content". The contents have it. Cabinet Chief
**** Possible New Speaker ****
Whip. My Lords, the time is now 1225. I
**** Possible New Speaker ****
My Lords, the time is now 1225. I am conscious we have two more, to PSBs before us. I am also conscious that has been a long week for that has been a long week for everybody. I want the House to rise if we can around 3 o'clock. Can I ask colleagues intend to speak in the first PMB I hope we can be able to bring that in a close by around 2 PM if not earlier to leave at least an hour for the second PMB.
I do want to get them both down today. I
**** Possible New Speaker ****
do not want to keep the House after 3 o'clock if I do not have to. The House to be in committee on the complicated -- on the
We have the same passion we heard from the noble Baroness Brinton and thank you very much for the courage to do so Baroness Brinton. We heard this from many many witnesses and I said at the beginning, the report was underpinned by the evidence we heard from others and lived experience of adults who themselves were born preterm. And how the services were preterm. And how the services were failing them. Services were failing them and not much resources are required.
It is the dedication shown by the professional that is not supported that is required. I hope we will do something. I have to say I think the Minister probably had a difficult task answering all of the questions that were raised. But they were all good questions. It will require careful reading of a response to know how far she show the same compassion where the government can show the same compassion. Not her personally, I know she is compassionate about it.
But that will deliver to these future mothers and babies born preterm because babies will be born preterm. I sadly have to say that I delivered my godson at 26 weeks. He is 54 years old. It is severely handicapped. Like he is severely handicapped. I also deliver 10 years later a young preterm baby who later a young preterm baby who weighed exactly 600 grams. Who I also heard twice as the Chancellor has graduated law. There have been many stories about young premature babies who survive.
I hope we will not forget this debate because the mothers and their babies out there who are born need our support. I agree with the noble Baroness we must not let this be the only occasion we discussed this again. The same debate another time every
**** Possible New Speaker ****
year may help. I beg to withdraw. Does the noble Lord wish to
**** Possible New Speaker ****
Does the noble Lord wish to withdraw? The question is this motion be agreed to. As many as are of that opinion, say, "Content". Of the contrary, "Not content". The contents have it. Cabinet Chief
**** Possible New Speaker ****
Whip. My Lords, the time is now 1225. I
**** Possible New Speaker ****
My Lords, the time is now 1225. I am conscious we have two more, to PSBs before us. I am also conscious that has been a long week for that has been a long week for everybody. I want the House to rise if we can around 3 o'clock. Can I ask colleagues intend to speak in the first PMB I hope we can be able to bring that in a close by around 2 PM if not earlier to leave at least an hour for the second PMB.
I do want to get them both down today. I
**** Possible New Speaker ****
do not want to keep the House after 3 o'clock if I do not have to. The House to be in committee on the complicated -- on the
12:27
Legislation: Complications from Abortions (Annual Report) Bill – committee stage
-
**** Possible New Speaker ****
the complicated -- on the Complications from Abortions (Annual Report) Bill. I beg to move the Houston resolve itself into a committee upon the itself into a committee upon the bill. The question is the House do now adjourn itself into a committee on the bill. As many as are of that opinion, say, "Aye". -- As many as are of that opinion, say, "Content". Of the contrary, "Not content". The contents have it. The question is clause 1 stand part of the bill.
**** Possible New Speaker ****
Baroness Thornton. I Lords, it was a great honour to
Legislation: Complications from Abortions (Annual Report) Bill – committee stage
**** Possible New Speaker ****
the complicated -- on the Complications from Abortions (Annual Report) Bill. I beg to move the Houston resolve itself into a committee upon the itself into a committee upon the bill. The question is the House do now adjourn itself into a committee on the bill. As many as are of that opinion, say, "Aye". -- As many as are of that opinion, say, "Content". Of the contrary, "Not content". The contents have it. The question is clause 1 stand part of the bill.
**** Possible New Speaker ****
Baroness Thornton. I Lords, it was a great honour to
12:28
Clause 1 Stand part.
Baroness Thornton (Labour)
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**** Possible New Speaker ****
I Lords, it was a great honour to listen to the last debate. I commend my noble friend. Lord Patel forward my noble friend. Lord Patel forward for debate. However, we move on. In for debate. However, we move on. In moving clause stand part I would like to explain to the House why I like to explain to the House why I am doing so. First I have a was understood a Private Members Bill in understood a Private Members Bill in the House should seek to remedy one problem or issue which needs Prime problem or issue which needs Prime legislation to do so.
I do not think I might respectfully say, the noble Lord, Lord Moylan's bill fulfils this criteria. It is not a necessary this criteria. It is not a necessary solution to a problem or lack of something. Because my Lords, there is nothing -- there is not a problem to be solved that requires Prime legislation. And that is why I have not sought to amend this bill. The reason there is not a problem to be answered is the information about complications from all medical procedures including abortions are already collected.
We might question the efficacy of data collection and the fact the systems do not talk to each other across the NHS but all of those things, there needs to be definite improvements but they do not need primary legislation to do so. In the case of abortions my Lords, it is the only kind of healthcare in the UK which is governed by specific criminal law. Regulations issued under the Abortion Act 1967 require the woman's name, date of birth and personal identifier is submitted on every abortion provider to the medical, the Chief Medical Officer.
Via the abortion notification system. NHS numbers are not required. This data includes complications which are identified before patients are discarded -- discharged from clinics and the information is managed by the Department of Health & Social Care. My second reason for my amendment here is why would abortion be singled out as a medical procedure in the way this particular singular primary legislation would require? The UK covenant to publish an annual report on the complications from abortions in England. Why not knee replacements? Appendicitis? Operations to remove tumours? Cataracts? Hernias? And the many other everyday complex procedures, all of which carry both humours and risks which are explained to patients.
And whose outcomes are recorded. The Secretary of State will be required in this case to improve -- to approve the abortion rate by method of abortion, age of gestation and abortion type. The Royal College sent obstetricians like the Royal College of Obstetricians & Gynaecologists are very clear that this bill is neither clear nor practical. If passed this bill would therefore be required by the Secretary of State to reduce an annual report -- produce an annual report with data collections that are inadequate.
But also an important aspect of providing abortion care to women is confidentiality. A woman may not wish to have the abortion on her personal medical record. This could be due to fear of abusive partner or relative who may work in the NHS being able to access a file. And cause them harm. It is essential when seeking to improve data collectionss it is right for confidentiality that is retained. Particularly as a matter for women's safety. Where I suspect the noble Lord, Lord Moylan and I would agree and all of us in the House would agree including my noble friend the Minister, in the 10-Year Plan and the updating of the Women's Health Strategy the government needs to improve data collection in women's health and ensure women's confidential it is prioritised at I am sure we are all supportive of improving data collection which will benefit patient safety, clinicians, NHSE, abortion providers and researchers to have a fully informed conversations about how to reduce complications and improve women's health.
So whilst it may not be the health. So whilst it may not be the noble Lords intention, the effect of his Private Members' Bill would be to exceptional lies and stigmatise abortion care, for both women and the medical professionals who provide that care. It would also contribute to the false narrative, that there are significant levels of complications in abortive care, to require political intervention, to reduce women's access. This is in the face of all the evidence which tells us that abortion is a safe and effective medical intervention.
However, those opposed to abortion, who seek to paint it as a dangerous thing for women, groups and the USA, without any clinical evidence. I suggest that that is not a path we would want to follow in the UK. As at the Royal College of obstetricians and gynaecologists say, "The obligation on the Secretary of State to publish a yearly report, including details of complications and abortion care, to whom former policy and safe practice, regarding the termination of pregnancy, suggest that politicisation of what is and should remain an area of healthcare, by medical experts stop it could also hold back modernisation of abortion law and innovation in care, by adding a further layer of legislation.
This would not be tolerated in other areas of healthcare, we would encourage the Department to recognise this and speak against the bill. " I agree with this and that is why this Private Members' Bill is not needed. I have cause will not divide the House on this occasion, it is committee stage. I think to say that I will return to this at report stage. Lord Moylan is not convinced by my argument that this is not a necessary bill. A big move.
**** Possible New Speaker ****
It might be helpful, excuse me. It might be helpful if I spoke and It might be helpful if I spoke and On various developments that have taken place in second reading. I'm grateful to the noble Baroness, Lady Thornton for her remarks about the importance of improving data and the importance of that data for what women's health will stop nearly all of the other points she made were in of the other points she made were in of the other points she made were in fact dealt with and debated at second reading, which the noble Baroness was not able to attend, but the fact is that there is nothing in this bill which exceptional lies
Clause 1 Stand part.
Baroness Thornton (Labour)
**** Possible New Speaker ****
I Lords, it was a great honour to listen to the last debate. I commend my noble friend. Lord Patel forward my noble friend. Lord Patel forward for debate. However, we move on. In for debate. However, we move on. In moving clause stand part I would like to explain to the House why I like to explain to the House why I am doing so. First I have a was understood a Private Members Bill in understood a Private Members Bill in the House should seek to remedy one problem or issue which needs Prime problem or issue which needs Prime legislation to do so.
I do not think I might respectfully say, the noble Lord, Lord Moylan's bill fulfils this criteria. It is not a necessary this criteria. It is not a necessary solution to a problem or lack of something. Because my Lords, there is nothing -- there is not a problem to be solved that requires Prime legislation. And that is why I have not sought to amend this bill. The reason there is not a problem to be answered is the information about complications from all medical procedures including abortions are already collected.
We might question the efficacy of data collection and the fact the systems do not talk to each other across the NHS but all of those things, there needs to be definite improvements but they do not need primary legislation to do so. In the case of abortions my Lords, it is the only kind of healthcare in the UK which is governed by specific criminal law. Regulations issued under the Abortion Act 1967 require the woman's name, date of birth and personal identifier is submitted on every abortion provider to the medical, the Chief Medical Officer.
Via the abortion notification system. NHS numbers are not required. This data includes complications which are identified before patients are discarded -- discharged from clinics and the information is managed by the Department of Health & Social Care. My second reason for my amendment here is why would abortion be singled out as a medical procedure in the way this particular singular primary legislation would require? The UK covenant to publish an annual report on the complications from abortions in England. Why not knee replacements? Appendicitis? Operations to remove tumours? Cataracts? Hernias? And the many other everyday complex procedures, all of which carry both humours and risks which are explained to patients.
And whose outcomes are recorded. The Secretary of State will be required in this case to improve -- to approve the abortion rate by method of abortion, age of gestation and abortion type. The Royal College sent obstetricians like the Royal College of Obstetricians & Gynaecologists are very clear that this bill is neither clear nor practical. If passed this bill would therefore be required by the Secretary of State to reduce an annual report -- produce an annual report with data collections that are inadequate.
But also an important aspect of providing abortion care to women is confidentiality. A woman may not wish to have the abortion on her personal medical record. This could be due to fear of abusive partner or relative who may work in the NHS being able to access a file. And cause them harm. It is essential when seeking to improve data collectionss it is right for confidentiality that is retained. Particularly as a matter for women's safety. Where I suspect the noble Lord, Lord Moylan and I would agree and all of us in the House would agree including my noble friend the Minister, in the 10-Year Plan and the updating of the Women's Health Strategy the government needs to improve data collection in women's health and ensure women's confidential it is prioritised at I am sure we are all supportive of improving data collection which will benefit patient safety, clinicians, NHSE, abortion providers and researchers to have a fully informed conversations about how to reduce complications and improve women's health.
So whilst it may not be the health. So whilst it may not be the noble Lords intention, the effect of his Private Members' Bill would be to exceptional lies and stigmatise abortion care, for both women and the medical professionals who provide that care. It would also contribute to the false narrative, that there are significant levels of complications in abortive care, to require political intervention, to reduce women's access. This is in the face of all the evidence which tells us that abortion is a safe and effective medical intervention.
However, those opposed to abortion, who seek to paint it as a dangerous thing for women, groups and the USA, without any clinical evidence. I suggest that that is not a path we would want to follow in the UK. As at the Royal College of obstetricians and gynaecologists say, "The obligation on the Secretary of State to publish a yearly report, including details of complications and abortion care, to whom former policy and safe practice, regarding the termination of pregnancy, suggest that politicisation of what is and should remain an area of healthcare, by medical experts stop it could also hold back modernisation of abortion law and innovation in care, by adding a further layer of legislation.
This would not be tolerated in other areas of healthcare, we would encourage the Department to recognise this and speak against the bill. " I agree with this and that is why this Private Members' Bill is not needed. I have cause will not divide the House on this occasion, it is committee stage. I think to say that I will return to this at report stage. Lord Moylan is not convinced by my argument that this is not a necessary bill. A big move.
**** Possible New Speaker ****
It might be helpful, excuse me. It might be helpful if I spoke and It might be helpful if I spoke and On various developments that have taken place in second reading. I'm grateful to the noble Baroness, Lady Thornton for her remarks about the importance of improving data and the importance of that data for what women's health will stop nearly all of the other points she made were in of the other points she made were in of the other points she made were in fact dealt with and debated at second reading, which the noble Baroness was not able to attend, but the fact is that there is nothing in this bill which exceptional lies
12:34
Lord Moylan (Conservative)
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Lord Moylan (Conservative)
this bill which exceptional lies abortion. Because of the statistics on abortion complications have to be collected. There is a requirement already. That may be collected under the existing abortion regulations, but they are collected, using a system, which relies on data, provided by the abortion provider. And that might have been sensible that the regulations were put in place. Currently, what has happened since then, the majority of abortions take place, by pills, very often a home for supper thing are complications that they are presented, in most cases, at hospitals, at A&E.
And they are not part of the national statistics collection system for stop those complications, the majority of them are no longer captured by the current system. The Royal College says it is impossible to capture them. It seems to be completely unaware of the fact that in November 2023, the office of health improvements and is to reduce the report, which, with some labour, did actually capture them and showed it could be done. And all that is in this bill, is a requirement that that report, which has been treated by the Department as a one-off, not to be repeated.
That report should be repeated. It is completely wrong to suggest that this cannot be done. It has been done. And it can be done again. I would like, if I may, I am conscious of the words of the Chief Whip, before we started. I would like to move on to some developments that have occurred since second reading. At the end of second reading, thinking that perhaps of the bill wouldn't be committee stage, I tabled some questions on this matter and I had A1 reply, from noble Baroness, Lady Twycross, on behalf the Cabinet Office.
Which effectively introduced it to the director-general for the office of statistics regulation, Mr Ed conference, with whom I have had correspondence since then. I only wish to quote briefly from his letter to me of 20 February. In which he says, perhaps before I say that, I should just remark, as was mentioned at second reading, that these statistics are what are referred to as a national statistics. They are required to comply with the statistics code. So in that light, the last compliance check was carried out in 2012.
And because of he says we have agreed, with DHSC, the complies check of the statistics would be beneficial. So a great deal of what the bill is seeking to achieve is likely an hour to be pursued, by the Office for Statistics Regulation's in consultation with DSH see, since I think it is very unlikely that any compliance check would consider that the current system was successfully capturing complications arising from abortions -- DHSC. I'm very pleased abortions -- DHSC. I'm very pleased with what has been said.
I will go on, in his letter, a little bit. My pleasure at his agreement to carry out a compliance check is a slightly modified by his timetable and approach. Because he goes on to say, we plan to carry out this review in the first quarter of 2026 /27. Giving DH and this is the important point, giving DHSC time to undertake its planned developments. These include supporting data providers, to move to DHSC's digital submission system. And working with the digital experts and a system that uses, to improve the design of the abortion and notification system.
I am certain that the noble Baroness, Lady Thornton and I would be in agreement, that that work would be very welcome. My only quibble with Mr Hunt for certain and I have written to him to say this is that I would have thought that the sensible thing would be to have the compliance check first agreed between the DHSC and the regulator what the efficiencies are and for the Department to invest in the digitisation of the collection of statistics, in such a way that they will comply with the regulator's requirements.
And I would hope, very much, that when the Minister comes to reply, she will be able to say that, sure that of course she was so she will cooperate fully with the Office for Statistics Regulation and the work, I fully expect the Department to do that. It is the responsible thing to do. I wonder if she would consider whether this has been done in quite the right order. Whether it wouldn't be sensible to bring the compliance check forward, so that, as I say, the developments then carried out, which will I'm sure involve investment and time are not wasted, but actually achieve what the regulator will be satisfied
**** Possible New Speaker ****
with, at the end of the day. I would like to apologise for not
And they are not part of the national statistics collection system for stop those complications, the majority of them are no longer captured by the current system. The Royal College says it is impossible to capture them. It seems to be completely unaware of the fact that in November 2023, the office of health improvements and is to reduce the report, which, with some labour, did actually capture them and showed it could be done. And all that is in this bill, is a requirement that that report, which has been treated by the Department as a one-off, not to be repeated.
That report should be repeated. It is completely wrong to suggest that this cannot be done. It has been done. And it can be done again. I would like, if I may, I am conscious of the words of the Chief Whip, before we started. I would like to move on to some developments that have occurred since second reading. At the end of second reading, thinking that perhaps of the bill wouldn't be committee stage, I tabled some questions on this matter and I had A1 reply, from noble Baroness, Lady Twycross, on behalf the Cabinet Office.
Which effectively introduced it to the director-general for the office of statistics regulation, Mr Ed conference, with whom I have had correspondence since then. I only wish to quote briefly from his letter to me of 20 February. In which he says, perhaps before I say that, I should just remark, as was mentioned at second reading, that these statistics are what are referred to as a national statistics. They are required to comply with the statistics code. So in that light, the last compliance check was carried out in 2012.
And because of he says we have agreed, with DHSC, the complies check of the statistics would be beneficial. So a great deal of what the bill is seeking to achieve is likely an hour to be pursued, by the Office for Statistics Regulation's in consultation with DSH see, since I think it is very unlikely that any compliance check would consider that the current system was successfully capturing complications arising from abortions -- DHSC. I'm very pleased abortions -- DHSC. I'm very pleased with what has been said.
I will go on, in his letter, a little bit. My pleasure at his agreement to carry out a compliance check is a slightly modified by his timetable and approach. Because he goes on to say, we plan to carry out this review in the first quarter of 2026 /27. Giving DH and this is the important point, giving DHSC time to undertake its planned developments. These include supporting data providers, to move to DHSC's digital submission system. And working with the digital experts and a system that uses, to improve the design of the abortion and notification system.
I am certain that the noble Baroness, Lady Thornton and I would be in agreement, that that work would be very welcome. My only quibble with Mr Hunt for certain and I have written to him to say this is that I would have thought that the sensible thing would be to have the compliance check first agreed between the DHSC and the regulator what the efficiencies are and for the Department to invest in the digitisation of the collection of statistics, in such a way that they will comply with the regulator's requirements.
And I would hope, very much, that when the Minister comes to reply, she will be able to say that, sure that of course she was so she will cooperate fully with the Office for Statistics Regulation and the work, I fully expect the Department to do that. It is the responsible thing to do. I wonder if she would consider whether this has been done in quite the right order. Whether it wouldn't be sensible to bring the compliance check forward, so that, as I say, the developments then carried out, which will I'm sure involve investment and time are not wasted, but actually achieve what the regulator will be satisfied
**** Possible New Speaker ****
with, at the end of the day. I would like to apologise for not
12:40
Baroness Finn (Conservative)
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**** Possible New Speaker ****
I would like to apologise for not being able to attend a second being able to attend a second reading. I would like to begin with the observation that, as a healthcare service, abortion is highly regulated and are subject to the same oversight as any other care. As a result of the abortion act 1967 it is also subject to additional oversight, which predates many of the regulatory systems in place, across the health service today. Its context is relevant to the bill before us, which seeks to build on this 58-year-old framework.
I am wholly in favour of the monitoring of all forms of healthcare provision and entirely agree that further work needs to be done on the collection and analysis of large datasets, relating to women's reproductive health. However, I have concerns that this bill and primary legislation is not the best way to approach this important work. I am aware that both the Royal College of Obstetricians and Gynaecologists, the RCOG and the British Pregnancy Advisory Service a shed with noble Lords at their concerns that, as the noble Baroness, Lady Thornton has said, that singling out abortion for new legislation, in this way exceptional ices abortion and fails to treated other forms of healthcare.
This would potentially stigmatise abortion care, for both winning and the edible professionals who provide the care. It would also indicate that abortion is considered to be It is in need of particular oversight. The RCOG point out that abortion is a safe and effective procedure. One in three women in the UK will have had an abortion, before the age of 45 and International studies have reportedly found that abortion is of less risk to women than complications that can arise from continuing a pregnancy to term and giving birth.
As a result, I am concerned by any indication that this House considers abortion to require increased monitoring over and above comparative healthcare and the message you send to the nearly 300,000 women who access abortion services, across the UK, every year. I do agree with my noble friend, Lord Moylan and that we need to approve a collection of data. This must be done across women's healthcare, more broadly. I would be interested to hear from the Minister, but what plans the Government has to achieve this.
We know that in many areas, women Wayne disproportionately long time for diagnosis of devastating conditions, such as endometriosis and in that time, often suffer complications that come from lack of treatment. It was for this reason that the previous government published the widely welcomed first ever women's health strategy, for England, to take a holistic approach to women's healthcare. I pay particular tribute to MoD for her tireless and excellent work, to make this work. We also highlighted the Dane is the first Women's Health Ambassador to support the implementation of the support the implementation of the strategy.
I was pleased to note that the Minister for secondary care confirmed in the other place that the government's commitment to the women's health strategy and commitment to the women's health strategy, though I'm concerned about the lack of progress against the strategies wildly wildly wildly working commitments, the government targets for ICBs about the creation of women's health ups. The RCOG has said that the hubs have produced referrals and enabled women to access support quickly. The NHS are 10-Year Plan and monitoring of women's health strategy would, I hope, offer an opportunity to address the challenge of good monitoring, without adding unnecessary legal burdens to the healthcare system.
I would hope that we can all agree that the purpose of this monitoring has to be to improve information and care for women. And that singling out abortion is unfortunately likely to do more unfortunately likely to do more I would like to touch on the practicality and operability of this legislation. I understand that the information currently used by the department, to produce abortion statistics, such as the type of abortion, gestational age and information about women accessing care, is a separate in the majority of cases, from a woman's broader healthcare record.
It seems to me incredibly important to protect this right to privacy, for women accessing abortion care, for particularly women at risk of domestic abuse, honour-based abuse or reproductive caution. I know my noble friend, would not want to place women at risk as a result of this legislation. So I wonder if the Minister can confirm that the department is able to make abortion records, with wider healthcare records come in the way this legislation would require. And if so, whether that would be in portion care on a woman's route medical record whether or not she had given consent.
Given my concerns about the impact of the proposals, in this bill, and women in the wider healthcare system. I am not able to support it in its current form and would support the noble Baroness, Lady Thornton, with her amendment.
**** Possible New Speaker ****
I join, I think with others, perhaps initially adding my apologies do not being here at
Baroness Finn (Conservative)
**** Possible New Speaker ****
I would like to apologise for not being able to attend a second being able to attend a second reading. I would like to begin with the observation that, as a healthcare service, abortion is highly regulated and are subject to the same oversight as any other care. As a result of the abortion act 1967 it is also subject to additional oversight, which predates many of the regulatory systems in place, across the health service today. Its context is relevant to the bill before us, which seeks to build on this 58-year-old framework.
I am wholly in favour of the monitoring of all forms of healthcare provision and entirely agree that further work needs to be done on the collection and analysis of large datasets, relating to women's reproductive health. However, I have concerns that this bill and primary legislation is not the best way to approach this important work. I am aware that both the Royal College of Obstetricians and Gynaecologists, the RCOG and the British Pregnancy Advisory Service a shed with noble Lords at their concerns that, as the noble Baroness, Lady Thornton has said, that singling out abortion for new legislation, in this way exceptional ices abortion and fails to treated other forms of healthcare.
This would potentially stigmatise abortion care, for both winning and the edible professionals who provide the care. It would also indicate that abortion is considered to be It is in need of particular oversight. The RCOG point out that abortion is a safe and effective procedure. One in three women in the UK will have had an abortion, before the age of 45 and International studies have reportedly found that abortion is of less risk to women than complications that can arise from continuing a pregnancy to term and giving birth.
As a result, I am concerned by any indication that this House considers abortion to require increased monitoring over and above comparative healthcare and the message you send to the nearly 300,000 women who access abortion services, across the UK, every year. I do agree with my noble friend, Lord Moylan and that we need to approve a collection of data. This must be done across women's healthcare, more broadly. I would be interested to hear from the Minister, but what plans the Government has to achieve this.
We know that in many areas, women Wayne disproportionately long time for diagnosis of devastating conditions, such as endometriosis and in that time, often suffer complications that come from lack of treatment. It was for this reason that the previous government published the widely welcomed first ever women's health strategy, for England, to take a holistic approach to women's healthcare. I pay particular tribute to MoD for her tireless and excellent work, to make this work. We also highlighted the Dane is the first Women's Health Ambassador to support the implementation of the support the implementation of the strategy.
I was pleased to note that the Minister for secondary care confirmed in the other place that the government's commitment to the women's health strategy and commitment to the women's health strategy, though I'm concerned about the lack of progress against the strategies wildly wildly wildly working commitments, the government targets for ICBs about the creation of women's health ups. The RCOG has said that the hubs have produced referrals and enabled women to access support quickly. The NHS are 10-Year Plan and monitoring of women's health strategy would, I hope, offer an opportunity to address the challenge of good monitoring, without adding unnecessary legal burdens to the healthcare system.
I would hope that we can all agree that the purpose of this monitoring has to be to improve information and care for women. And that singling out abortion is unfortunately likely to do more unfortunately likely to do more I would like to touch on the practicality and operability of this legislation. I understand that the information currently used by the department, to produce abortion statistics, such as the type of abortion, gestational age and information about women accessing care, is a separate in the majority of cases, from a woman's broader healthcare record.
It seems to me incredibly important to protect this right to privacy, for women accessing abortion care, for particularly women at risk of domestic abuse, honour-based abuse or reproductive caution. I know my noble friend, would not want to place women at risk as a result of this legislation. So I wonder if the Minister can confirm that the department is able to make abortion records, with wider healthcare records come in the way this legislation would require. And if so, whether that would be in portion care on a woman's route medical record whether or not she had given consent.
Given my concerns about the impact of the proposals, in this bill, and women in the wider healthcare system. I am not able to support it in its current form and would support the noble Baroness, Lady Thornton, with her amendment.
**** Possible New Speaker ****
I join, I think with others, perhaps initially adding my apologies do not being here at
12:45
Lord Weir of Ballyholme (Democratic Unionist Party)
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Lord Weir of Ballyholme (Democratic Unionist Party)
apologies do not being here at second reading, my case on medical grounds. A consistent theme that is occurring, in this debate. Can I say that when looking at the amendment today, the legislation today, it is important we actually look at what is there, rather than debating and indeed, I appreciate the Baroness is not going to push this to a division today, rather than ultimately dividing on something which is not there. Abortion, I think, down the years, is clearly and I think whatever anybody is a view on the subject can be, I think is clearly a significant issue.
It is something which has been controversial, it is something which I think sensitivity is needed when dealing with. And indeed, I am sure at some point in the future there will be some piece of legislation, when there will be a range of arguments, from those who support the status quo, as regards to the current abortion regulations, those who would seek a more permissive law, as regards to abortion. Those who would seek a more restrictive law as regards to abortion. That is not the subject that is before us today.
That is a The divisive social issues within the United States are not relevant. Lord Moylan's bill are trying to ensure we have the most accurate data on convocations with regards to abortions. I.e. The issue that has been raised while it is specifically about abortion. I think Lord Moylan has clearly indicated one of the very major problems we have at present is that on the abortion, the ANS figures they are clearly out of date. They are not fit for purpose because they do not operate to collect all the data.
There is a, an enormous gap or A-level of At least which was highlighted by the OHID report in 2023. Because of the changing situation that has taken place with regards to how abortions are carried out. And that means the data we have at present we do not know quite frankly how reliable it is. On any aspect of public life if we are looking at whoever is taking a decision, we need data which is accurate, we need data that is reliable and focused on the issue at hand.
And we need data that is timely. And that is true whether you are a policymaker or an individual citizen making a decision. As a policymaker I was in the Northern Ireland Executive during COVID. While we had a reasonable amount of information and data which came our way, looking back for years from those, four or five years from those events had were more real-time data, had we had data which drilled down more into the detail. Had we had data which was most appropriate what we were thinking -- seeking, there will be either in Northern Ireland or indeed throughout the UK, could better decisions have been made? Obviously that is a question for the inquiry.
As a public policymaker, the better the data we have, the better potentially are our decisions. It is particularly relevant if we are looking at data and evidence for the individual citizen and particularly the individual patient in a medical situation. It is the case I think for most of us that if we have had any form of medical issue we do not really think about that much until it directly affects us. Taking myself as an example, approximately one year-and-a-half ago I was diagnosed with a condition in one of my feet called charcoal.
It is something I had never heard of before. Some of you if you are very fortunate might have avoided the -- avoided me as I zoom around an electric wheelchair. I hope I have not managed to injure anyone in the process. But in doing so I came to that from a position of complete level of ignorance. It had a major impact on me. I was facing at some stage surgery. I was faced at one stage with an option being put for me of the amputation of part of my leg.
And in moving forward I had to take a number of decisions. At different junctures. And in reaching those decisions I wanted to make sure and I sought out the data and the evidence. And it was critical that was the most expert and it was the most accurate data. I met for example with the board to see what the longer-term implications would be. That is just one example. That would have been something that would have never crossed my mind until I was faced with that position.
It is critical for any individual patient, they have that data. They have the strongest and most reliable data. That is what this bill I think seeks to change -- to achieve. We get that data it may or may not produce inconvenient results. For some of us. It may well be that some of us would argue for a different regime with regards to abortion for example. We might find the figures very inconvenient for us. But in a tolerant and open society the mark of that is having, tolerating a wide range of opinions.
Sometimes dealing with inconvenient opinions. If we can deal with inconvenient opinions, how much more important is it to deal in facts and evidence? It seems to me at times we may be faced with inconvenient facts and inconvenient evidence. But stronger and more reliable those facts are, the stronger and more reliable that evidence is, the better. Which is why I believe this is a productive way forward and why I am not minded towards the amendment but supportive of the original wording of this
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bill. My Lords, it is part of my work at Cambridge -- in Cambridge which at Cambridge -- in Cambridge which is in Register of Interests. I was involved in the making of decision involved in the making of decision AIDS to help NHS patients make decisions about their health care treatments. Part of my work was to treatments. Part of my work was to find the evidence that risks -- about risks and benefits of different treatment options. I am very familiar with let us say, the lack of data in many respects in both the efficacy and in more cases the side-effects of different treatment options.
I would treatment options. I would absolutely stand by any bill that aimed to improve this data for individuals to make decisions. But I do not see why abortion is being singled out in this way for this particular bill. Bearing in mind the Chief Whip's notes and I can speak for some time on the lack of data for side-effects in many treatments but just two examples, hip replacements. I was involved in the decision aid for osteoarthritis in hips. This is an example where again we have large numbers of treatments being done outside of the NHS clinics.
And we are really lacking in long-term follow-up and in
It is something which has been controversial, it is something which I think sensitivity is needed when dealing with. And indeed, I am sure at some point in the future there will be some piece of legislation, when there will be a range of arguments, from those who support the status quo, as regards to the current abortion regulations, those who would seek a more permissive law, as regards to abortion. Those who would seek a more restrictive law as regards to abortion. That is not the subject that is before us today.
That is a The divisive social issues within the United States are not relevant. Lord Moylan's bill are trying to ensure we have the most accurate data on convocations with regards to abortions. I.e. The issue that has been raised while it is specifically about abortion. I think Lord Moylan has clearly indicated one of the very major problems we have at present is that on the abortion, the ANS figures they are clearly out of date. They are not fit for purpose because they do not operate to collect all the data.
There is a, an enormous gap or A-level of At least which was highlighted by the OHID report in 2023. Because of the changing situation that has taken place with regards to how abortions are carried out. And that means the data we have at present we do not know quite frankly how reliable it is. On any aspect of public life if we are looking at whoever is taking a decision, we need data which is accurate, we need data that is reliable and focused on the issue at hand.
And we need data that is timely. And that is true whether you are a policymaker or an individual citizen making a decision. As a policymaker I was in the Northern Ireland Executive during COVID. While we had a reasonable amount of information and data which came our way, looking back for years from those, four or five years from those events had were more real-time data, had we had data which drilled down more into the detail. Had we had data which was most appropriate what we were thinking -- seeking, there will be either in Northern Ireland or indeed throughout the UK, could better decisions have been made? Obviously that is a question for the inquiry.
As a public policymaker, the better the data we have, the better potentially are our decisions. It is particularly relevant if we are looking at data and evidence for the individual citizen and particularly the individual patient in a medical situation. It is the case I think for most of us that if we have had any form of medical issue we do not really think about that much until it directly affects us. Taking myself as an example, approximately one year-and-a-half ago I was diagnosed with a condition in one of my feet called charcoal.
It is something I had never heard of before. Some of you if you are very fortunate might have avoided the -- avoided me as I zoom around an electric wheelchair. I hope I have not managed to injure anyone in the process. But in doing so I came to that from a position of complete level of ignorance. It had a major impact on me. I was facing at some stage surgery. I was faced at one stage with an option being put for me of the amputation of part of my leg.
And in moving forward I had to take a number of decisions. At different junctures. And in reaching those decisions I wanted to make sure and I sought out the data and the evidence. And it was critical that was the most expert and it was the most accurate data. I met for example with the board to see what the longer-term implications would be. That is just one example. That would have been something that would have never crossed my mind until I was faced with that position.
It is critical for any individual patient, they have that data. They have the strongest and most reliable data. That is what this bill I think seeks to change -- to achieve. We get that data it may or may not produce inconvenient results. For some of us. It may well be that some of us would argue for a different regime with regards to abortion for example. We might find the figures very inconvenient for us. But in a tolerant and open society the mark of that is having, tolerating a wide range of opinions.
Sometimes dealing with inconvenient opinions. If we can deal with inconvenient opinions, how much more important is it to deal in facts and evidence? It seems to me at times we may be faced with inconvenient facts and inconvenient evidence. But stronger and more reliable those facts are, the stronger and more reliable that evidence is, the better. Which is why I believe this is a productive way forward and why I am not minded towards the amendment but supportive of the original wording of this
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bill. My Lords, it is part of my work at Cambridge -- in Cambridge which at Cambridge -- in Cambridge which is in Register of Interests. I was involved in the making of decision involved in the making of decision AIDS to help NHS patients make decisions about their health care treatments. Part of my work was to treatments. Part of my work was to find the evidence that risks -- about risks and benefits of different treatment options. I am very familiar with let us say, the lack of data in many respects in both the efficacy and in more cases the side-effects of different treatment options.
I would treatment options. I would absolutely stand by any bill that aimed to improve this data for individuals to make decisions. But I do not see why abortion is being singled out in this way for this particular bill. Bearing in mind the Chief Whip's notes and I can speak for some time on the lack of data for side-effects in many treatments but just two examples, hip replacements. I was involved in the decision aid for osteoarthritis in hips. This is an example where again we have large numbers of treatments being done outside of the NHS clinics.
And we are really lacking in long-term follow-up and in
12:53
Baroness Freeman of Steventon (Crossbench)
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Baroness Freeman of Steventon (Crossbench)
particular asking patients the really important patient reported really important patient reported outcome measures. The things that are important to them. Cataracts is another one. It is one of our biggest operations, most numerous operations. More than half of the operations. More than half of the modern outside of NHS clinics. Again the data of actually asking people the data of actually asking people how many would say after Woods -- afterwards their vision has afterwards their vision has improved, you would think this is a very basic thing but we are lacking it.
I would absolutely love to have it. I would absolutely love to have more data on side-effects and on efficacies of these things. Side- effects that are not expected, effects that are not expected, things that are not on the official lists to be collected. I did a decision aid on gallbladder surgery decision aid on gallbladder surgery and diarrhoea is a very common, more than 10% outcome of this surgery. Yet it is not on -- often recorded. Sexual dysfunction is side-effects in many treatments, it is not something patients want to bring up.
It is really important, there are so many issues about data. If you look at this data on abortion statistics and complications, the 2023 report is very good. It is highlighting the numbers of patients who need to make decisions. The rates are not changing every year. We do not opt -- update our decision AIDS every year. The data remains stable unless there is a very dramatic change in clinical practice. So I would absolutely support better collection of data. And I am hoping there are opportunities to do that in future.
But in this particular occasion -- on this particular occasion I very much support the noble Baronesses
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amendment. My Lords, I rise to oppose the
I would absolutely love to have it. I would absolutely love to have more data on side-effects and on efficacies of these things. Side- effects that are not expected, effects that are not expected, things that are not on the official lists to be collected. I did a decision aid on gallbladder surgery decision aid on gallbladder surgery and diarrhoea is a very common, more than 10% outcome of this surgery. Yet it is not on -- often recorded. Sexual dysfunction is side-effects in many treatments, it is not something patients want to bring up.
It is really important, there are so many issues about data. If you look at this data on abortion statistics and complications, the 2023 report is very good. It is highlighting the numbers of patients who need to make decisions. The rates are not changing every year. We do not opt -- update our decision AIDS every year. The data remains stable unless there is a very dramatic change in clinical practice. So I would absolutely support better collection of data. And I am hoping there are opportunities to do that in future.
But in this particular occasion -- on this particular occasion I very much support the noble Baronesses
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amendment. My Lords, I rise to oppose the
12:55
Baroness Lawlor (Conservative)
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My Lords, I rise to oppose the noble Baroness motion and stand part of the bill. My noble friend, Lloyd Moylan has mentioned the 2023 Moylan has mentioned the 2023 analysis by the office for health and and analysis. -- Offers analysis. It made its evidence solely on NHS England statistics, the database of admissions, A&E attendance and outpatients appointments. Using this data different outcomes will recorded. -- Were recorded. It only is the data Were recorded.
It only is the data contained in records for patient admissions and for abortion -related complications as the primary or secondary diagnosis. Not those who complete abortion who did not have a further complete. We see therefore the complication rate varies depending on the evidence which is before the statistician. For these reasons I think there is little reasons I think there is little disagreement amongst groups concerned, where we Parliamentary or non-Parliamentary, we all want good data collection.
Yes some of us are more concerned with data collection on one kind of procedure, others on another. But now that we are updating and digitising the NHS system it seems an opportunity to improve data right around the system. But this should not be excluded and I do not think noble Lords should suggest an exception, it is an exceptional thing to require accurate data where possible and where it can be obtained. So that we can use the digitisation of the system in order to encourage the best statistics.
My noble friend has referred to some of the changes we have seen, the position has changed since statistics were checked for the last compliance code, with the Code of Practice full statistics in 2012. With the increase of medically 2012. With the increase of medically induced abortions from 48% to 85%. Also in England and Wales, 75% of abortions are completed at home. As a result complications me not be -- may not be recorded on the NHSE for forms. The forms which are the basis for the present statistics.
Under the abortion notification service. With women administering medication at home, if there is a complication they go to the GP surgeries or they may dial 111. Although may go to A&E. If there is a comp. This data or complications are not necessarily recorded on forms which we used to come higher -- which were used to compile the data we have on the forms. This is why I find this an interesting debate statistically. It has been used by 2023 analysis which I mentioned.
And it can be used. For these reasons I would say I welcome the fact the statistics regulator is going to check on the compliance and the Department of Health & Social Care has agreed and of course I implore that. I think the timing is quite important. As the NHS systems digitised, they can prepare thing so the records can be read digitally, accurately and cheaply. And the data entered into the system on publications from abortion. -- Complications from abortions.
I think the compliance should be instituted in advance of digitisation as my noble friend, Lord Moylan composers. So the Statistics Authority can then report and the Department of Health may or can be aware as a result of where and what digitisation is needed. So the records can be used in digital form. Cheaply and with the transparency we need full statistics. This will save money later on any further necessary updates. I do not take the point some noble Lords have made about confidentiality.
Confidentiality is extremely important. I agree with all confidentiality requirements. This is a vital subject if one is to have trust in one's health service. And provider. But these things are done by codes. Every operation as far as I know, but the Minister please correct me if I am wrong. They have codes and there are people who are not named but there are codes for referring to whatever procedures are taking place. This is very useful for digitisation. So if we have, if things are done earlier it saves money later on and when or if any further updates are needed as a result of compliance checks.
Accurate national statistics on abortion complete are obligatory under the abortion regulations 1991. Regulation for and schedule two. Which specify the locations to be reported. It is therefore not exceptional rising this procedure, it is a matter for law. More generally it is vital that where statistics are prepared to perform policy and operations these are based on the best available evidence. This is important not only for transparency and accuracy but it is important the health service statistics should prompt confidence.
Especially amongst users and the For these reasons I do hope that we will move rapidly to the compliance checks, so the NHS can take advantage of whatever suggestions, or proposals are made by the statistics regulator. If public confidence in the statistics systems drain, because they are based on merely partial evidence. I therefore feel for these reasons, I hope that we will proceed to report stage and we will be able to consider some of the questions again.
I propose, for the moment, Baroness Thornton's
**** Possible New Speaker ****
motion. I rise to offer support for
**** Possible New Speaker ****
I rise to offer support for Baroness Thornton's amendment. I almost feel like I do not need to give Baroness Freeman of Steventon, give Baroness Freeman of Steventon, a very powerful and argument in a very powerful and argument in terms of the way in which this bill unnecessarily in sexualise is abortion, when there are very comparable procedures conducted in a similar procedural ways, hit placements and cataract operations
Baroness Lawlor (Conservative)
**** Possible New Speaker ****
My Lords, I rise to oppose the noble Baroness motion and stand part of the bill. My noble friend, Lloyd Moylan has mentioned the 2023 Moylan has mentioned the 2023 analysis by the office for health and and analysis. -- Offers analysis. It made its evidence solely on NHS England statistics, the database of admissions, A&E attendance and outpatients appointments. Using this data different outcomes will recorded. -- Were recorded. It only is the data Were recorded.
It only is the data contained in records for patient admissions and for abortion -related complications as the primary or secondary diagnosis. Not those who complete abortion who did not have a further complete. We see therefore the complication rate varies depending on the evidence which is before the statistician. For these reasons I think there is little reasons I think there is little disagreement amongst groups concerned, where we Parliamentary or non-Parliamentary, we all want good data collection.
Yes some of us are more concerned with data collection on one kind of procedure, others on another. But now that we are updating and digitising the NHS system it seems an opportunity to improve data right around the system. But this should not be excluded and I do not think noble Lords should suggest an exception, it is an exceptional thing to require accurate data where possible and where it can be obtained. So that we can use the digitisation of the system in order to encourage the best statistics.
My noble friend has referred to some of the changes we have seen, the position has changed since statistics were checked for the last compliance code, with the Code of Practice full statistics in 2012. With the increase of medically 2012. With the increase of medically induced abortions from 48% to 85%. Also in England and Wales, 75% of abortions are completed at home. As a result complications me not be -- may not be recorded on the NHSE for forms. The forms which are the basis for the present statistics.
Under the abortion notification service. With women administering medication at home, if there is a complication they go to the GP surgeries or they may dial 111. Although may go to A&E. If there is a comp. This data or complications are not necessarily recorded on forms which we used to come higher -- which were used to compile the data we have on the forms. This is why I find this an interesting debate statistically. It has been used by 2023 analysis which I mentioned.
And it can be used. For these reasons I would say I welcome the fact the statistics regulator is going to check on the compliance and the Department of Health & Social Care has agreed and of course I implore that. I think the timing is quite important. As the NHS systems digitised, they can prepare thing so the records can be read digitally, accurately and cheaply. And the data entered into the system on publications from abortion. -- Complications from abortions.
I think the compliance should be instituted in advance of digitisation as my noble friend, Lord Moylan composers. So the Statistics Authority can then report and the Department of Health may or can be aware as a result of where and what digitisation is needed. So the records can be used in digital form. Cheaply and with the transparency we need full statistics. This will save money later on any further necessary updates. I do not take the point some noble Lords have made about confidentiality.
Confidentiality is extremely important. I agree with all confidentiality requirements. This is a vital subject if one is to have trust in one's health service. And provider. But these things are done by codes. Every operation as far as I know, but the Minister please correct me if I am wrong. They have codes and there are people who are not named but there are codes for referring to whatever procedures are taking place. This is very useful for digitisation. So if we have, if things are done earlier it saves money later on and when or if any further updates are needed as a result of compliance checks.
Accurate national statistics on abortion complete are obligatory under the abortion regulations 1991. Regulation for and schedule two. Which specify the locations to be reported. It is therefore not exceptional rising this procedure, it is a matter for law. More generally it is vital that where statistics are prepared to perform policy and operations these are based on the best available evidence. This is important not only for transparency and accuracy but it is important the health service statistics should prompt confidence.
Especially amongst users and the For these reasons I do hope that we will move rapidly to the compliance checks, so the NHS can take advantage of whatever suggestions, or proposals are made by the statistics regulator. If public confidence in the statistics systems drain, because they are based on merely partial evidence. I therefore feel for these reasons, I hope that we will proceed to report stage and we will be able to consider some of the questions again.
I propose, for the moment, Baroness Thornton's
**** Possible New Speaker ****
motion. I rise to offer support for
**** Possible New Speaker ****
I rise to offer support for Baroness Thornton's amendment. I almost feel like I do not need to give Baroness Freeman of Steventon, give Baroness Freeman of Steventon, a very powerful and argument in a very powerful and argument in terms of the way in which this bill unnecessarily in sexualise is abortion, when there are very comparable procedures conducted in a similar procedural ways, hit placements and cataract operations
13:03
Baroness Bennett of Manor Castle (Green Party)
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Baroness Bennett of Manor Castle (Green Party)
placements and cataract operations that yes we need to improve the collection of statistics, but we do not have a bill before us to do that. The exceptional icing. I want to pick up to comments made by the Lord said what happening in the US is not relevant here. When I spoke at second reading, I spoke about the influence, the money flowing from the US, into the UK. And I can update your Lordship's House on what I said then and I was referring then and going as far back to a book addressing these issues in 2014.
This is something that has been highlighted and for sale emails, among others. The so-called alliance for defending freedom, from the US is massively funded, in 2020 £324,000, into the similarly named organisation in the UK. By 2024 that had risen to £1.1 million of the organisation's total income of £1.3 million. So we are debating this bill, in the context of that flood of US money seeking to influence what is happening in the UK. I will note that I put a question to the government about this, Britain questioned six 540 and I am afraid I do not think the government is taking this with the seriousness it deserves, in terms of defending our democracy.
The answer I got referred to lobbying of the government and what measures the government has in place. We need to think about the measures we need across all of our society, to deal with the inequality of financial arms that is occurring in these debates, because of the money flooding in from certain forces, within the US. The second point, also picking up the noble Lord Weir's comments. He said, the noble Lord said that the context didn't really matter. But of course this bill appears before us in the context of more than 60 MPs in the other place backing amendment, one amendment.
Another one as well, to decriminalise abortion, to actually end the exceptionalism, the exceptional isolation of abortion, right across our law. And that would make this bill, particularly strange and ill fitting. So, for those reasons, I support the noble Lady, Baroness Thornton's amendment.
**** Possible New Speaker ****
Unfortunately I too was unable to be at second reading and I am speaking today, in order to support Lady Thornton's amendment and also
This is something that has been highlighted and for sale emails, among others. The so-called alliance for defending freedom, from the US is massively funded, in 2020 £324,000, into the similarly named organisation in the UK. By 2024 that had risen to £1.1 million of the organisation's total income of £1.3 million. So we are debating this bill, in the context of that flood of US money seeking to influence what is happening in the UK. I will note that I put a question to the government about this, Britain questioned six 540 and I am afraid I do not think the government is taking this with the seriousness it deserves, in terms of defending our democracy.
The answer I got referred to lobbying of the government and what measures the government has in place. We need to think about the measures we need across all of our society, to deal with the inequality of financial arms that is occurring in these debates, because of the money flooding in from certain forces, within the US. The second point, also picking up the noble Lord Weir's comments. He said, the noble Lord said that the context didn't really matter. But of course this bill appears before us in the context of more than 60 MPs in the other place backing amendment, one amendment.
Another one as well, to decriminalise abortion, to actually end the exceptionalism, the exceptional isolation of abortion, right across our law. And that would make this bill, particularly strange and ill fitting. So, for those reasons, I support the noble Lady, Baroness Thornton's amendment.
**** Possible New Speaker ****
Unfortunately I too was unable to be at second reading and I am speaking today, in order to support Lady Thornton's amendment and also
13:05
Baroness Brinton (Liberal Democrat)
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Baroness Brinton (Liberal Democrat)
Lady Thornton's amendment and also taught Lady Finn has said, including an important review of data collection. Actually, across the health sector, as I will explain on data and particularly on the data relating to abortions. Lady Thornton has spoken to some of the elements of this short bill being inconsistent, which makes it unable to deliver. I think what Lord Moylan hopes and I will go on to explain why, even if it were the right thing to do. I do agree with the points that Lady Thornton has made.
The one issue at the heart of this inconsistency is the issue of use of patient confidential health and personal data. There is an absolute presumption, by patients that the health and personal data will always be kept confidential, between them and their medical practitioners. Indeed noble Lord may remember, a few years ago, when the then government, proposed care. Data plans, when it became clear that we were likely to move to a US type system of allowing researchers, insurers etc. Access to anonymized, skewed and eyes data.
During that debate became absolutely important to note that it is possible to reverse most anonymized and pseudo- lies and data. Particularly if you're dealing with the usual circumstance, because when she got one or two identifiers, you can get it to a very small geographic position, very quickly. Frankly sometimes to a postcode and therein lies problem, confidentiality is lies problem, confidentiality is lost. The work initially proposed in the core crime said it Senior Courts Act 2022 which give the police and the Home Secretary, Mr Patel the power to demand data from any relevant personal authority, to be able to see data that might be of interest to an investigation.
I was working on that bill and when I queried this in your Lordship's House, it transpired this wasn't just for suspects of crime, but anyone connected with the incident, who might or might not be a witness. That went completely against everything, in the doctor's secret code of confidentiality, regarding the patient. I am pleased to say that following my amendments on that bill and pressure from. These, the new clause 16. Four 4 a was modified to prevent access to health data compared unafraid to other bodies where it is in place.
That was followed by the Health and Care Bill were use of personal health data for research. Lord Clement-Jones, myself and others made it very clear that assuming that anonymized pseudo- noise and data was acceptable and out of that, a new system of black or, where the anonymity of patients is guaranteed, was introduced. However, abortion data is different, because it is not within the safeguards. The abortion act 1967 requires a woman's name, date of birth, personal identifier must be submitted on every abortion.
And provided to the Chief Medical Officer, via the abortion education system. And whilst as others have said, this data includes complications prior to discharge, hospital episode statistics quoted in clause 3 B, Lord Moylan's bill or only based on abortion data from trust. It is an linked to data from two different sources and collected different data. As of the tells us, it neither captures all cases. Nor can the statistics be analysed by methods of gestation, or abortion. So get again, another difference.
I do not think Lord Moylan cover that particular point. This disparity when he spoke earlier. I worry is that the annual report would not actually reflect the wider picture. Second issue that I want to raise is that of those other delicate areas that of those other delicate areas that might inadvertently draw into the type of reporting on complications and abortion. The previous debate we have had in your Lordship's House today, we discussed miscarriages and preterm births. Nearly 50 years ago, I had an early miscarriage and when I went to the hospital, I was told that I was having a spontaneous abortion.
Lastly phrase. I still had reminiscences of my body that needed to be removed, to ensure a complete abortion. Even more ghastly phrase. In the middle of my grief at losing my first baby the medics were talking about abortion. In the very helpful briefing from the obstetricians and gynaecologists, they point out the differing terms that can be entered into hospital coding is induced miscarriage and spontaneous abortion. They say, "This can result in a code being applied for an abortion complication that should have been for a miscarriage complication and vice versa.
" This isn't just about words, like spontaneous abortion. Following on from Lady Bennett speech, in the USA, since the jobs case, miscarriages increasingly have been brought into the debate about abortion. In West Virginia, which has one of the toughest set of abortion laws, ectopic or incest, total non-viable pregnancy. It gets worse. Last week accounting West Virginia, the prosecutor attorney advised to get in touch with police, law enforcement or a doctor, if they were worried that they might be charged with mishandling the feature remains.
The example quoted was the arrest of a woman for disposing of feed tool remains in her bins. This said, a number of charges under state code including felonies could be levied against anyone who flushes feature remains, flushes or deals with remains following an abortion or miscarriage. In this situation I talked about earlier she could be well be prosecuted. The miscarriage I refer to is not unusual, I lost a tiny foetus down the toilet. I was distressed beyond measure. In West Virginia you would now have to retrieve the feature remains, or be at risk of prosecution.
I am sure there is absolutely no intention in the UK for this to happen, but the debate that is happening in the US is beginning to colour the debate that we are having here. And I am very clear that the problem is that there are some people who do want miscarriage to be treated as suspicious. They clearly aren't medics. 15 to 20% of pregnancies end in miscarriage. It is surprisingly uncommon and good luck to the prosecutor in West Virginia.
He is going to spend his entire time on people reporting miscarriage. I would bubble my Lords, the issue of miscarriage of spontaneous abortion is yet another issue of mothers data that is proposed in this annual report. It demonstrates sadly that I was here for second reading and I was here to hear Lord Moylan tell us about how the abortion landscape is shifting quite rapidly. But, between the second reading and today we saw a very vivid example of just how a very vivid example of just how that landscape is and why it needs to shift very rapidly, because we saw the conclusion of the trial of Nicola Packham, who thankfully the jurors have recently cleared.
The 45-year-old the legally terminating her pregnancy. She suffered more than four years the police and criminal proceedings. And in fact the number of women being prosecuted on suspicion of breaking abortion laws has increased, over recent years. So the landscape is actually getting worse. That is partly why very pleased to secure this Amendment four Baroness Thornton. This bill does nothing to improve the abortion landscape. Personally I'm quite surprised that Lord Moylan has brought it back today to committee stage, because it was made quite evident, to assert second reading, by the Minister and other speakers, including my noble friend, Lord Scriven that it was absolutely unnecessary and very unhelpful.
And indeed we have heard from Baroness Freeman of Steventon, today, exactly why that is. I hope this House was to soon have the opportunity to debate real change along the lines of the two amendments Baroness Bennett referred to, which have been tabled in the other place. I want to check with Lord Moylan, when he said, second reading and a respect What is strange about the advocates of choice in this debate as they are so defensive.
They speak as if they are surrounded by conspiracy. If I thought I was surrounded by conspiracy I would want to live in a
The one issue at the heart of this inconsistency is the issue of use of patient confidential health and personal data. There is an absolute presumption, by patients that the health and personal data will always be kept confidential, between them and their medical practitioners. Indeed noble Lord may remember, a few years ago, when the then government, proposed care. Data plans, when it became clear that we were likely to move to a US type system of allowing researchers, insurers etc. Access to anonymized, skewed and eyes data.
During that debate became absolutely important to note that it is possible to reverse most anonymized and pseudo- lies and data. Particularly if you're dealing with the usual circumstance, because when she got one or two identifiers, you can get it to a very small geographic position, very quickly. Frankly sometimes to a postcode and therein lies problem, confidentiality is lies problem, confidentiality is lost. The work initially proposed in the core crime said it Senior Courts Act 2022 which give the police and the Home Secretary, Mr Patel the power to demand data from any relevant personal authority, to be able to see data that might be of interest to an investigation.
I was working on that bill and when I queried this in your Lordship's House, it transpired this wasn't just for suspects of crime, but anyone connected with the incident, who might or might not be a witness. That went completely against everything, in the doctor's secret code of confidentiality, regarding the patient. I am pleased to say that following my amendments on that bill and pressure from. These, the new clause 16. Four 4 a was modified to prevent access to health data compared unafraid to other bodies where it is in place.
That was followed by the Health and Care Bill were use of personal health data for research. Lord Clement-Jones, myself and others made it very clear that assuming that anonymized pseudo- noise and data was acceptable and out of that, a new system of black or, where the anonymity of patients is guaranteed, was introduced. However, abortion data is different, because it is not within the safeguards. The abortion act 1967 requires a woman's name, date of birth, personal identifier must be submitted on every abortion.
And provided to the Chief Medical Officer, via the abortion education system. And whilst as others have said, this data includes complications prior to discharge, hospital episode statistics quoted in clause 3 B, Lord Moylan's bill or only based on abortion data from trust. It is an linked to data from two different sources and collected different data. As of the tells us, it neither captures all cases. Nor can the statistics be analysed by methods of gestation, or abortion. So get again, another difference.
I do not think Lord Moylan cover that particular point. This disparity when he spoke earlier. I worry is that the annual report would not actually reflect the wider picture. Second issue that I want to raise is that of those other delicate areas that of those other delicate areas that might inadvertently draw into the type of reporting on complications and abortion. The previous debate we have had in your Lordship's House today, we discussed miscarriages and preterm births. Nearly 50 years ago, I had an early miscarriage and when I went to the hospital, I was told that I was having a spontaneous abortion.
Lastly phrase. I still had reminiscences of my body that needed to be removed, to ensure a complete abortion. Even more ghastly phrase. In the middle of my grief at losing my first baby the medics were talking about abortion. In the very helpful briefing from the obstetricians and gynaecologists, they point out the differing terms that can be entered into hospital coding is induced miscarriage and spontaneous abortion. They say, "This can result in a code being applied for an abortion complication that should have been for a miscarriage complication and vice versa.
" This isn't just about words, like spontaneous abortion. Following on from Lady Bennett speech, in the USA, since the jobs case, miscarriages increasingly have been brought into the debate about abortion. In West Virginia, which has one of the toughest set of abortion laws, ectopic or incest, total non-viable pregnancy. It gets worse. Last week accounting West Virginia, the prosecutor attorney advised to get in touch with police, law enforcement or a doctor, if they were worried that they might be charged with mishandling the feature remains.
The example quoted was the arrest of a woman for disposing of feed tool remains in her bins. This said, a number of charges under state code including felonies could be levied against anyone who flushes feature remains, flushes or deals with remains following an abortion or miscarriage. In this situation I talked about earlier she could be well be prosecuted. The miscarriage I refer to is not unusual, I lost a tiny foetus down the toilet. I was distressed beyond measure. In West Virginia you would now have to retrieve the feature remains, or be at risk of prosecution.
I am sure there is absolutely no intention in the UK for this to happen, but the debate that is happening in the US is beginning to colour the debate that we are having here. And I am very clear that the problem is that there are some people who do want miscarriage to be treated as suspicious. They clearly aren't medics. 15 to 20% of pregnancies end in miscarriage. It is surprisingly uncommon and good luck to the prosecutor in West Virginia.
He is going to spend his entire time on people reporting miscarriage. I would bubble my Lords, the issue of miscarriage of spontaneous abortion is yet another issue of mothers data that is proposed in this annual report. It demonstrates sadly that I was here for second reading and I was here to hear Lord Moylan tell us about how the abortion landscape is shifting quite rapidly. But, between the second reading and today we saw a very vivid example of just how a very vivid example of just how that landscape is and why it needs to shift very rapidly, because we saw the conclusion of the trial of Nicola Packham, who thankfully the jurors have recently cleared.
The 45-year-old the legally terminating her pregnancy. She suffered more than four years the police and criminal proceedings. And in fact the number of women being prosecuted on suspicion of breaking abortion laws has increased, over recent years. So the landscape is actually getting worse. That is partly why very pleased to secure this Amendment four Baroness Thornton. This bill does nothing to improve the abortion landscape. Personally I'm quite surprised that Lord Moylan has brought it back today to committee stage, because it was made quite evident, to assert second reading, by the Minister and other speakers, including my noble friend, Lord Scriven that it was absolutely unnecessary and very unhelpful.
And indeed we have heard from Baroness Freeman of Steventon, today, exactly why that is. I hope this House was to soon have the opportunity to debate real change along the lines of the two amendments Baroness Bennett referred to, which have been tabled in the other place. I want to check with Lord Moylan, when he said, second reading and a respect What is strange about the advocates of choice in this debate as they are so defensive.
They speak as if they are surrounded by conspiracy. If I thought I was surrounded by conspiracy I would want to live in a
13:16
Baroness Miller of Chilthorne Domer (Liberal Democrat)
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Baroness Miller of Chilthorne Domer (Liberal Democrat)
world with facts and not hide myself from them. While the facts are, in this case, that all medical opinion is behind the decriminalisation of is behind the decriminalisation of abortion. From the BMA and the Royal colleges of midwives or obstetricians and gynaecologists, obstetricians and gynaecologists, obstetricians and gynaecologists, None of them seem the data issue -- none of them see the data issue as critical. Whereas the decriminalisation is critical. That decriminalisation is critical. That is a healthcare matter that is really affecting women very adversely.
My Lords, the general adversely. My Lords, the general population agree there have been population agree there have been numerous bowls -- polls now since 2020 which show whether it is 76% or 2020 which show whether it is 76% or 82%, the vast majority of people 82%, the vast majority of people agree abortion is a women's right to choose. By debating this in your Lordships' House even further I fear we are getting more and more out of touch when we talk about data and not about the fundamental issues the other place has been debating.
I am very pleased to support the amendment today. I hope Lord Moylan may on reflection decide not to continue with this bill.
**** Possible New Speaker ****
My Lords, I too spoke at Second Reading and I welcome the Reading and I welcome the opportunity to speak again. To set in context what this bill is in context what this bill is actually part of and is all about. I
My Lords, the general adversely. My Lords, the general population agree there have been population agree there have been numerous bowls -- polls now since 2020 which show whether it is 76% or 2020 which show whether it is 76% or 82%, the vast majority of people 82%, the vast majority of people agree abortion is a women's right to choose. By debating this in your Lordships' House even further I fear we are getting more and more out of touch when we talk about data and not about the fundamental issues the other place has been debating.
I am very pleased to support the amendment today. I hope Lord Moylan may on reflection decide not to continue with this bill.
**** Possible New Speaker ****
My Lords, I too spoke at Second Reading and I welcome the Reading and I welcome the opportunity to speak again. To set in context what this bill is in context what this bill is actually part of and is all about. I
13:17
Baroness Barker (Liberal Democrat)
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Baroness Barker (Liberal Democrat)
too have to disagree quite fundamentally with Lord Weir. Not on the necessity for accurate data and statistics. But you cannot separate this bill from the wider context of what is going on in the politics of reproduction and reproductive association with gender identity. I spoke last time about the international campaign, being organised largely by nationalists across the USA and Europe and Russia. Which have a specific aim. It is to destroy human rights and reproductive rights in the International Organisations which are responsible for upholding those.
If people wish to doubt me I suggest you go and read any amount of reports. The one that sets out on the mental basis of the campaign as a report by the European Parliament form 218 called restoring the natural order. It sets out how a small group of people have set out to overturn the human rights framework that were developed following the horrors of World War II. And have developed over the last years in order to quote restore the national order.
They have specific objectives within that. Key amongst them is making sure the definition of marriage and family pertains only to heterosexual people. Definitely overturning abortion and access to abortion and contraception. Overturning divorce laws actually is part of what they want to do. Rejecting compulsory sex and reproductive and health education. And perhaps most interestingly of all, making sure the first and primary educators are children -- of children must always be family. Even if that is to the exclusion of public education.
Baroness Bennett was absolutely right. If you want to see how it is unfolding just look at what is happening in states in America and Hungary and Poland. Because what is happening in the USA is not just happening, it is funded by billions and billions and billions of dollars here in Europe, mostly emanating from America and Russia and in Africa. This is part of that. Why is it important and relevant we look at that today? It is because the data you get relies upon and relies entirely upon the questions you ask.
The question that you ask -- questions that you ask are determined by the outcomes you want to achieve. One of the things we have noticed because some of us sit and watch this campaign unfolding in its different areas and manifestations, it is moving on. People behind it, the alliance defending freedom, the Heritage foundation, all of those massive Christian national organisations and catholic and religious institutions in Europe. They have realised in order to make their campaign more widely palatable, they have moved away from them being a bunch of male, because they are largely male led organisations, they have moved away and through a number of different funding organisations and changed the language they used to talk about rights and so on.
And what they have now chosen to do, they have learned from those of us who fought for human rights over the years. They have learned the importance of not only having your messages framed in terms of rights, the rights of people to resist a liberal elite which is arguing for these things like equality. Things like equality laws are inevitably disproportionately affecting some people, particularly some poorer people. What they have gone to do is say Brightwell what -- right well what we can do other than relying on what we have done so far is we will go further and create the information that will backup our campaign.
Now interestingly in some cases they have gone to setting up private universities. Private universities which produce research which appears like the academic research but it is in fact grey research. Always leading inevitably to the current solutions back to the conclusions that support their causes. This is not new, noble Lords know this has happened for years and have seen the dodgy dossiers which come from the Christian Institute. All that kind of stuff. That is why it is important that what we do is we make sure the statistics that we get on abortion and incidentally access to contraception are timely and are accurate.
Noble Lords have mentioned this, they are absolutely right. Politicised of data in this area is really -- politicisation of data in this area is really important. Known as being prosecuted. The increasing number of women being prosecuted because they have had a miscarriage is coming as a direct result of this campaign. I do not think those of us on our side have anything to fear. We kept statistics will be introduced telemedicine and medical abortion. The advance of it, people who are listening on the other side of the argument full of dire warnings of all sorts of crimes being committed.
They were not. And the statistics and the data have shown that. So what my plea to Baroness Barran is, when government does look at this issue and I agree we should. I have nothing against the improvement of the collection of data in the health service. What I would ask her to ensure is that statisticians are able to resist the political pressure which is being exercised across all different parts of government and different parts of organisations. Because of this campaign which is being waged on a number of different fronts.
Ultimately it is a campaign that is a vicious campaign and it will damage all sorts of people, minorities but particularly will be harmful to women and girls.
**** Possible New Speaker ****
I am grateful to be joining this
If people wish to doubt me I suggest you go and read any amount of reports. The one that sets out on the mental basis of the campaign as a report by the European Parliament form 218 called restoring the natural order. It sets out how a small group of people have set out to overturn the human rights framework that were developed following the horrors of World War II. And have developed over the last years in order to quote restore the national order.
They have specific objectives within that. Key amongst them is making sure the definition of marriage and family pertains only to heterosexual people. Definitely overturning abortion and access to abortion and contraception. Overturning divorce laws actually is part of what they want to do. Rejecting compulsory sex and reproductive and health education. And perhaps most interestingly of all, making sure the first and primary educators are children -- of children must always be family. Even if that is to the exclusion of public education.
Baroness Bennett was absolutely right. If you want to see how it is unfolding just look at what is happening in states in America and Hungary and Poland. Because what is happening in the USA is not just happening, it is funded by billions and billions and billions of dollars here in Europe, mostly emanating from America and Russia and in Africa. This is part of that. Why is it important and relevant we look at that today? It is because the data you get relies upon and relies entirely upon the questions you ask.
The question that you ask -- questions that you ask are determined by the outcomes you want to achieve. One of the things we have noticed because some of us sit and watch this campaign unfolding in its different areas and manifestations, it is moving on. People behind it, the alliance defending freedom, the Heritage foundation, all of those massive Christian national organisations and catholic and religious institutions in Europe. They have realised in order to make their campaign more widely palatable, they have moved away from them being a bunch of male, because they are largely male led organisations, they have moved away and through a number of different funding organisations and changed the language they used to talk about rights and so on.
And what they have now chosen to do, they have learned from those of us who fought for human rights over the years. They have learned the importance of not only having your messages framed in terms of rights, the rights of people to resist a liberal elite which is arguing for these things like equality. Things like equality laws are inevitably disproportionately affecting some people, particularly some poorer people. What they have gone to do is say Brightwell what -- right well what we can do other than relying on what we have done so far is we will go further and create the information that will backup our campaign.
Now interestingly in some cases they have gone to setting up private universities. Private universities which produce research which appears like the academic research but it is in fact grey research. Always leading inevitably to the current solutions back to the conclusions that support their causes. This is not new, noble Lords know this has happened for years and have seen the dodgy dossiers which come from the Christian Institute. All that kind of stuff. That is why it is important that what we do is we make sure the statistics that we get on abortion and incidentally access to contraception are timely and are accurate.
Noble Lords have mentioned this, they are absolutely right. Politicised of data in this area is really -- politicisation of data in this area is really important. Known as being prosecuted. The increasing number of women being prosecuted because they have had a miscarriage is coming as a direct result of this campaign. I do not think those of us on our side have anything to fear. We kept statistics will be introduced telemedicine and medical abortion. The advance of it, people who are listening on the other side of the argument full of dire warnings of all sorts of crimes being committed.
They were not. And the statistics and the data have shown that. So what my plea to Baroness Barran is, when government does look at this issue and I agree we should. I have nothing against the improvement of the collection of data in the health service. What I would ask her to ensure is that statisticians are able to resist the political pressure which is being exercised across all different parts of government and different parts of organisations. Because of this campaign which is being waged on a number of different fronts.
Ultimately it is a campaign that is a vicious campaign and it will damage all sorts of people, minorities but particularly will be harmful to women and girls.
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I am grateful to be joining this
13:24
Baroness Boycott (Crossbench)
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I am grateful to be joining this debate to follow the powerful speech of the noble Baroness to say I have been involved in women's rights for been involved in women's rights for a very long time. I started in 1972, we campaigned all of our lives for things like abortions and now today I can honestly say I think the life facing a young woman is more frightening than it was facing me as a young woman. I look at what is happening online, you can download very simple apps and I had lunch with Laura Bates the other day which the Lords came to.
She was explaining you can download an app and I could take a photograph of the noble Baroness right beside me and press a button and I have a photo of them naked. Not Kate Moss's body but the noble Baronesses body. You can do this at 11 or 12. It is really threatening being a young woman today. There are many things that I feel out of our control. We as women who are older and have had successful lives, we have to fight fantastically hard to protect this next-generation for a lot of the stuff that is coming out of the pipes.
I very much listened to and know about what the conspiracies are and power is happening in America to try and alter fundamental rights like abortion. I find it externally distressing measures like this should be coming into the House of Lords and even debated seriously, that there should be a politicisation of women who face abortions. Frankly no-one wants an abortion. I cannot think why anybody thought that. Nobody says what I want to do in my life, several things you do not say, you say you do not want to be an alcoholic, you do not see want an abortion.
You do not put them on your wish list. They happen. We should protect women and happen. We should protect women and support them all the way through it. The noble Lord Patel talked in his fantastic debate earlier. These people need our protection and love. I feel we as women, I really support Baroness Thornton for bringing this forward. Any further debate I will take part in. Because this is vital and we are vital to this and other voices really really matter here.
Baroness Boycott (Crossbench)
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I am grateful to be joining this debate to follow the powerful speech of the noble Baroness to say I have been involved in women's rights for been involved in women's rights for a very long time. I started in 1972, we campaigned all of our lives for things like abortions and now today I can honestly say I think the life facing a young woman is more frightening than it was facing me as a young woman. I look at what is happening online, you can download very simple apps and I had lunch with Laura Bates the other day which the Lords came to.
She was explaining you can download an app and I could take a photograph of the noble Baroness right beside me and press a button and I have a photo of them naked. Not Kate Moss's body but the noble Baronesses body. You can do this at 11 or 12. It is really threatening being a young woman today. There are many things that I feel out of our control. We as women who are older and have had successful lives, we have to fight fantastically hard to protect this next-generation for a lot of the stuff that is coming out of the pipes.
I very much listened to and know about what the conspiracies are and power is happening in America to try and alter fundamental rights like abortion. I find it externally distressing measures like this should be coming into the House of Lords and even debated seriously, that there should be a politicisation of women who face abortions. Frankly no-one wants an abortion. I cannot think why anybody thought that. Nobody says what I want to do in my life, several things you do not say, you say you do not want to be an alcoholic, you do not see want an abortion.
You do not put them on your wish list. They happen. We should protect women and happen. We should protect women and support them all the way through it. The noble Lord Patel talked in his fantastic debate earlier. These people need our protection and love. I feel we as women, I really support Baroness Thornton for bringing this forward. Any further debate I will take part in. Because this is vital and we are vital to this and other voices really really matter here.
13:26
Lord Sandhurst (Conservative)
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Lord Sandhurst (Conservative)
My Lords, I thank my noble friend Lord Moylan again for bringing to the House attention the issue of the reliability of statistics on the complications of abortion. It is absolutely right in all healthcare we have correct and accurate data. Which health service providers can use to understand the safety of procedures. It is the usual practice for Committee stage to include the discussion of the amendments that have been tabled to the bill. But here of course there is only the one amendment and it seeks to stand apart in a substantive clause of the bill.
This therefore has necessitated a general discussion of the underlying principles behind the bill. In a restatement for our part on this side of the House of our positions. At Second Reading I said our view is this bill performs an important service by highlighting the absence of accurate statistics in respect of abortions. I explained in the same speech improved data collection and reporting has not -- does not require legislation for it to be delivered. In short I do not depart from that view today.
But what this bill has allowed is an informed debate to emerge about data in this field. It resents an opportunity to urge the government to do more to rationalise data recording and collection. So proper evidence-based medicine can be implicated. In this respect I endorse what my noble friend Baroness Finn has said today. About data collection and statistics more generally. In answer to a written question asked by my noble friend, the director-general for the Office of National Statistics regulation like the office of statistics regulation stated that office, the OSR have not completed a compliance check on the abortion statistics collected by the Office for Health Improvements and Disparities since as long ago since 2012.
-- Since as long ago as 2012. That raises important issues of data quality. I am glad to note it has now been agreed the OSR will carry out a compliance check, a long overdue compliance check on the statistics. Only after the Department for Health and Social Care has been able to update the design of the abortion notification system. This does seem to me and to others on this side the wrong way round. Surely it would make more sense to complete these compliance checks before making alterations to the ANS.
That way the department will be able to better understand any deficiencies in the system. We know there are some. I hope the noble Baroness the Minister will be able to comment on this and address it. Overall my Lords, my noble friend has raised an important concern and I suggest now the government must take steps to ensure the data are gathered on a more reliable and consistent basis.
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My Lords, I would like to thank
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My Lords, I would like to thank the noble Lord, Lord Moylan for tabling this Private Members Bill. tabling this Private Members Bill. And also to thank my noble friend, And also to thank my noble friend, Baroness Thornton for tabling an amendment. I would also like to say how much I appreciate the how much I appreciate the cultivations -- contributions that have been made by a number of noble Lords. With regards to the Private Lords. With regards to the Private Members Bill, the stated make Members Bill, the stated make permanence of it is to impose a legal duty on the Secretary of State to publish and lay before Parliament
This therefore has necessitated a general discussion of the underlying principles behind the bill. In a restatement for our part on this side of the House of our positions. At Second Reading I said our view is this bill performs an important service by highlighting the absence of accurate statistics in respect of abortions. I explained in the same speech improved data collection and reporting has not -- does not require legislation for it to be delivered. In short I do not depart from that view today.
But what this bill has allowed is an informed debate to emerge about data in this field. It resents an opportunity to urge the government to do more to rationalise data recording and collection. So proper evidence-based medicine can be implicated. In this respect I endorse what my noble friend Baroness Finn has said today. About data collection and statistics more generally. In answer to a written question asked by my noble friend, the director-general for the Office of National Statistics regulation like the office of statistics regulation stated that office, the OSR have not completed a compliance check on the abortion statistics collected by the Office for Health Improvements and Disparities since as long ago since 2012.
-- Since as long ago as 2012. That raises important issues of data quality. I am glad to note it has now been agreed the OSR will carry out a compliance check, a long overdue compliance check on the statistics. Only after the Department for Health and Social Care has been able to update the design of the abortion notification system. This does seem to me and to others on this side the wrong way round. Surely it would make more sense to complete these compliance checks before making alterations to the ANS.
That way the department will be able to better understand any deficiencies in the system. We know there are some. I hope the noble Baroness the Minister will be able to comment on this and address it. Overall my Lords, my noble friend has raised an important concern and I suggest now the government must take steps to ensure the data are gathered on a more reliable and consistent basis.
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My Lords, I would like to thank
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My Lords, I would like to thank the noble Lord, Lord Moylan for tabling this Private Members Bill. tabling this Private Members Bill. And also to thank my noble friend, And also to thank my noble friend, Baroness Thornton for tabling an amendment. I would also like to say how much I appreciate the how much I appreciate the cultivations -- contributions that have been made by a number of noble Lords. With regards to the Private Lords. With regards to the Private Members Bill, the stated make Members Bill, the stated make permanence of it is to impose a legal duty on the Secretary of State to publish and lay before Parliament
13:30
Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
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Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
an annual report of complications from the termination of pregnancy in England under the Abortion Act 1967. The purpose of such an annual report as I understand would be to inform policy and practice regarding the termination of pregnancy. I know noble Lords will appreciate this government is entirely committed to the priority of patients safety. -- Patient safety. To the points that have been directed to the government which other ones I am able to refer to, the noble Lord, Lord Moylan and Lord Sandhurst and the noble Lady, Baroness Lawlor all asked about the improvement of the design of the abortion notification system.
And also whether it would be sensible to change the order. To ensure review of office the statistics regulation of office the statistics regulation That I can say the department is reviewing digital experts and we are also conducting research amongst system users in order to redesign the system. It was also mentioned about the ordering of work as I said. I can confirm the department said. I can confirm the department is developing work with the ORS. And improvements to the system that are required irrespective of the statistical impact and the reason for that.
The reason for that is to improve user experience for clinicians. However I would say the bill is not required to make such an
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improvement. Yes. Am I right in understanding the
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Am I right in understanding the Minister to say the work of digitising and adapting the abortion digitising and adapting the abortion notification system which her department plans to carry out is department plans to carry out is going to be done on the basis of working with and collaboration with working with and collaboration with the office of statistics recollection? Or is the intention they do the work in their own box so they do the work in their own box so to speak and then the office for statistics regulation comes in and statistics regulation comes in and checks it? Because she seemed to be hinting for the first time it might hinting for the first time it might be the former which would be quite encouraging.
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encouraging. I think the noble Lord is giving me the opportunity to correct myself. I should have said OSR not ORS. I should have said OSR, not ORS on the point of data. I'm grateful to the noble Lord for giving me that chance. As I said we are developing work with the OSR. As with all ways of developing work that does mean working in a way that will get to the place we wish to get. I do not quite recognise, I think it was the latter way forward the noble Lord said.
I would be very pleased to write to him further on this matter. To the noble Lady, Baroness Finlay -- Baroness Finn, I can assure the noble Lady our focus in terms of the women's health strategy and turning those commitments into action. I can straight away draw the noble Lady's attention to the provision of emergency hormonal contraception, free of charge at pharmacies from October of this year. Secondly setting out how we will eliminate cervical cancer by 20 cervical cancer by 2040.
-- Eliminate cervical cancer by 2040 by the new cervical cancer plan and taking urgent action to tackle gynaecology waiting list through the reform plan. I would say they are all very tangible improvements to women's health. I can assure the noble Lady the women's health strategy is very much kept under review to see how and when and where it can be improved. The noble Lady Baroness Finn also asked about linking of records. It is not currently possible to link abortion, the abortion notification system with wider health records data.
The reason for that is due to the unique identifiers on the abortion notification system. On the data. However as I said earlier we are reviewing the wording of the form that is used so it will be easier for clinicians to complete. Hopefully that will bring about some improvements. To the noble Lady, Baroness Freeman, the government is focused on moving the NHS from analogue to digital. To improve the improved data collection many noble Lords have referred to. That is across all areas of healthcare.
At that point I think -- it is a point that I think has been called for a number of times in this debate. To the noble Lady, Baroness Bennett who called on the government to seriously consider the implications of money flowing in from the USA with a view to influence a point also referred to by the noble Ladies Baroness Brinton and Baroness Barker, I can confirm this matter is indeed being considered more widely across government. Returning to the bill in hand, as noble Lords may remember the government has expressed reservations to this bill.
As legislation is not required to produce an annual report. We believe the aims of this bill can be achieved through existing routes. Thereby rendering further legislation unnecessary. In 2023 the department published a report on abortion complications. And could choose to do so again. However the department has no plans to publish ongoing separate additional annual reports on abortion complications as there is no operational need to do so. I hope noble Lords will understand and some noble Lords have made this point, we have to uphold the duty of care not to legislate when there are other reasonable
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processes available as there are in The question is that clause 1 stand part of the bill? As many as are of that opinion, say, "Content". are of that opinion, say, "Content". Nobody is content. Of the contrary, "Not content". I think the content "Not content". I think the content do have it. I'm sorry about that. The question is that they speak the The question is that they speak the title of the bill? As many as are of that opinion, say, "Content". Of the contrary, "Not content".
The contents have it. That can clause at contents have it. That can clause at the committee's proceedings, the the committee's proceedings, the And the House is now to be in committee on the Crown Estate
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(Wales) Bill, Lord Wigley. I beg to move to move the House did now resolve itself into a
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did now resolve itself into a committee upon the bill. As many as are of that opinion, say, "Content". Of the contrary, say, "Content". Of the contrary, say, "Content". Of the contrary, Before we start on that, Baroness Harris of Richmond will be taking Harris of Richmond will be taking part remotely and I remind the committee that unless their leading group remote speakers speak first, group remote speakers speak first, after the mover of the lead after the mover of the lead amendment and may therefore speak to other amendments in the group, ahead of members who have tabled them.
We of members who have tabled them. We now come, in clause 1, amendment one, Lord Hollick.
And also whether it would be sensible to change the order. To ensure review of office the statistics regulation of office the statistics regulation That I can say the department is reviewing digital experts and we are also conducting research amongst system users in order to redesign the system. It was also mentioned about the ordering of work as I said. I can confirm the department said. I can confirm the department is developing work with the ORS. And improvements to the system that are required irrespective of the statistical impact and the reason for that.
The reason for that is to improve user experience for clinicians. However I would say the bill is not required to make such an
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improvement. Yes. Am I right in understanding the
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Am I right in understanding the Minister to say the work of digitising and adapting the abortion digitising and adapting the abortion notification system which her department plans to carry out is department plans to carry out is going to be done on the basis of working with and collaboration with working with and collaboration with the office of statistics recollection? Or is the intention they do the work in their own box so they do the work in their own box so to speak and then the office for statistics regulation comes in and statistics regulation comes in and checks it? Because she seemed to be hinting for the first time it might hinting for the first time it might be the former which would be quite encouraging.
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encouraging. I think the noble Lord is giving me the opportunity to correct myself. I should have said OSR not ORS. I should have said OSR, not ORS on the point of data. I'm grateful to the noble Lord for giving me that chance. As I said we are developing work with the OSR. As with all ways of developing work that does mean working in a way that will get to the place we wish to get. I do not quite recognise, I think it was the latter way forward the noble Lord said.
I would be very pleased to write to him further on this matter. To the noble Lady, Baroness Finlay -- Baroness Finn, I can assure the noble Lady our focus in terms of the women's health strategy and turning those commitments into action. I can straight away draw the noble Lady's attention to the provision of emergency hormonal contraception, free of charge at pharmacies from October of this year. Secondly setting out how we will eliminate cervical cancer by 20 cervical cancer by 2040.
-- Eliminate cervical cancer by 2040 by the new cervical cancer plan and taking urgent action to tackle gynaecology waiting list through the reform plan. I would say they are all very tangible improvements to women's health. I can assure the noble Lady the women's health strategy is very much kept under review to see how and when and where it can be improved. The noble Lady Baroness Finn also asked about linking of records. It is not currently possible to link abortion, the abortion notification system with wider health records data.
The reason for that is due to the unique identifiers on the abortion notification system. On the data. However as I said earlier we are reviewing the wording of the form that is used so it will be easier for clinicians to complete. Hopefully that will bring about some improvements. To the noble Lady, Baroness Freeman, the government is focused on moving the NHS from analogue to digital. To improve the improved data collection many noble Lords have referred to. That is across all areas of healthcare.
At that point I think -- it is a point that I think has been called for a number of times in this debate. To the noble Lady, Baroness Bennett who called on the government to seriously consider the implications of money flowing in from the USA with a view to influence a point also referred to by the noble Ladies Baroness Brinton and Baroness Barker, I can confirm this matter is indeed being considered more widely across government. Returning to the bill in hand, as noble Lords may remember the government has expressed reservations to this bill.
As legislation is not required to produce an annual report. We believe the aims of this bill can be achieved through existing routes. Thereby rendering further legislation unnecessary. In 2023 the department published a report on abortion complications. And could choose to do so again. However the department has no plans to publish ongoing separate additional annual reports on abortion complications as there is no operational need to do so. I hope noble Lords will understand and some noble Lords have made this point, we have to uphold the duty of care not to legislate when there are other reasonable
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processes available as there are in The question is that clause 1 stand part of the bill? As many as are of that opinion, say, "Content". are of that opinion, say, "Content". Nobody is content. Of the contrary, "Not content". I think the content "Not content". I think the content do have it. I'm sorry about that. The question is that they speak the The question is that they speak the title of the bill? As many as are of that opinion, say, "Content". Of the contrary, "Not content".
The contents have it. That can clause at contents have it. That can clause at the committee's proceedings, the the committee's proceedings, the And the House is now to be in committee on the Crown Estate
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(Wales) Bill, Lord Wigley. I beg to move to move the House did now resolve itself into a
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did now resolve itself into a committee upon the bill. As many as are of that opinion, say, "Content". Of the contrary, say, "Content". Of the contrary, say, "Content". Of the contrary, Before we start on that, Baroness Harris of Richmond will be taking Harris of Richmond will be taking part remotely and I remind the committee that unless their leading group remote speakers speak first, group remote speakers speak first, after the mover of the lead after the mover of the lead amendment and may therefore speak to other amendments in the group, ahead of members who have tabled them.
We of members who have tabled them. We now come, in clause 1, amendment one, Lord Hollick.
13:39
Lord Harlech (Conservative)
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Lord Harlech (Conservative)
I rise to open this group of amendments, in my name and in so doing declare my farming and land management interest, in Wales. I begin by paying tribute to the noble Lord, Lord Wigley, for he is a long-standing service to Wales and his clear and consistent advocacy for greater Welsh autonomy. There is much we agree on and would like to think work together, in raising Welsh interest in your Lordships' House. Not least helping to see the Welsh rugby team resurgent in the not too distant future.
His passion is beyond question and his commitment to Welsh interest is evident in this bill. But My Lords, while I respect the intent I regret to say that this is the wrong bill, introduced at the wrong time, with the wrong outcomes for the people of Wales. Amendments number one and number six standing in my name and seek a straightforward but essential steps to safeguard the revenues from the Welsh Crown Estate should continue to be paid by the Exchequer. At a time when public finances are under enormous strain, diverting these vital funds, away from the UK exchequer is neither prudent, or responsible.
These revenues are used and not just in Wales but across the UK, for the benefit of all our citizens. And let's ask plainly. Will these funds be better managed by the Labour run Welsh Government? A government whose track record is one of failure and misplaced priorities. Just look at the 20 mile-per-hour speed limit debacle. A policy that has stifled economic activity, hit small businesses and left the public exasperated. As I can see the noble Baroness, Baroness Bennett of Manor Castle is at the moment.
What confidence can we possibly have that the same Ministers won't use Crown Estate revenues to fund get more policies that the Welsh people do not support. Without stealing his sandwiches, amendment to an eight proposed, by my noble friend, Lord Moynihan seek to retain the borrowing cap at 25% at its net asset value. This is not ideology, and basic financial stewardship. The Crown Estate is managing critical assets like RC beds and land. A financially secure estate is vital to its long-term success and excessive borrowing put that borrowing at risk.
Whether devolved or not, that principle must hold. In the mid-three introduces a necessary backstop, a powerful HM Treasury to impose conditions, if the devolved Crown Estate in Wales fails in its functions. Again, this is not an act of hostility but of responsibility. Sadly, we have seen it time and time again that when left unchecked, the current Welsh Government has not always acted in the public interest. The safeguard will ensure that the Crown Estate essential duties, environmental, economic and judiciary are upheld, to the standards of the public expect.
Indeed, clause 1 stands apart and exist because of this bill, at its core is premature. We have only just passed a new Crown Estate Act, it is simply not wise to begin carving out individual frameworks, before we have seen how the new national law has embedded in. This is based more on politics and policy. Finally, well refer to my noble friend called Monaghan in the reporting element. I will say this. Any serious consideration of devolving the Crown Estate must be preceded by rigorous evidence, not ideological aspiration.
A report on the impact of finances, land management and environmental standards should be the starting points, not the afterthought. So to conclude My Lords, one of respect the noble Lord Wigley's ambition, I must urge caution. The people of Wales deserve better than this bill deserves. They deserve good governance, sound management a real accountability. Sadly this bill does not honour
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that, I beg to move. Clause 1, page 2, line 6, leave out from the management of the end out from the management of the end of line 7. Baroness Harris of
His passion is beyond question and his commitment to Welsh interest is evident in this bill. But My Lords, while I respect the intent I regret to say that this is the wrong bill, introduced at the wrong time, with the wrong outcomes for the people of Wales. Amendments number one and number six standing in my name and seek a straightforward but essential steps to safeguard the revenues from the Welsh Crown Estate should continue to be paid by the Exchequer. At a time when public finances are under enormous strain, diverting these vital funds, away from the UK exchequer is neither prudent, or responsible.
These revenues are used and not just in Wales but across the UK, for the benefit of all our citizens. And let's ask plainly. Will these funds be better managed by the Labour run Welsh Government? A government whose track record is one of failure and misplaced priorities. Just look at the 20 mile-per-hour speed limit debacle. A policy that has stifled economic activity, hit small businesses and left the public exasperated. As I can see the noble Baroness, Baroness Bennett of Manor Castle is at the moment.
What confidence can we possibly have that the same Ministers won't use Crown Estate revenues to fund get more policies that the Welsh people do not support. Without stealing his sandwiches, amendment to an eight proposed, by my noble friend, Lord Moynihan seek to retain the borrowing cap at 25% at its net asset value. This is not ideology, and basic financial stewardship. The Crown Estate is managing critical assets like RC beds and land. A financially secure estate is vital to its long-term success and excessive borrowing put that borrowing at risk.
Whether devolved or not, that principle must hold. In the mid-three introduces a necessary backstop, a powerful HM Treasury to impose conditions, if the devolved Crown Estate in Wales fails in its functions. Again, this is not an act of hostility but of responsibility. Sadly, we have seen it time and time again that when left unchecked, the current Welsh Government has not always acted in the public interest. The safeguard will ensure that the Crown Estate essential duties, environmental, economic and judiciary are upheld, to the standards of the public expect.
Indeed, clause 1 stands apart and exist because of this bill, at its core is premature. We have only just passed a new Crown Estate Act, it is simply not wise to begin carving out individual frameworks, before we have seen how the new national law has embedded in. This is based more on politics and policy. Finally, well refer to my noble friend called Monaghan in the reporting element. I will say this. Any serious consideration of devolving the Crown Estate must be preceded by rigorous evidence, not ideological aspiration.
A report on the impact of finances, land management and environmental standards should be the starting points, not the afterthought. So to conclude My Lords, one of respect the noble Lord Wigley's ambition, I must urge caution. The people of Wales deserve better than this bill deserves. They deserve good governance, sound management a real accountability. Sadly this bill does not honour
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that, I beg to move. Clause 1, page 2, line 6, leave out from the management of the end out from the management of the end of line 7. Baroness Harris of
13:43
Baroness Harris of Richmond (Liberal Democrat)
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Baroness Harris of Richmond (Liberal Democrat)
of line 7. Baroness Harris of Richmond is taking part remotely and she isn't there. Good. I invite than a barrister speak.
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I am speaking to the amendments in this group, on behalf of these benches and in doing so I confirm benches and in doing so I confirm the strongest support we expressed at second reading, for this bill. There was a sense of outrage, when President Trump attempted to squeeze President Trump attempted to squeeze an agreement, for the extraction of rare minerals out of Ukraine, rare minerals out of Ukraine, without payment. His argument was of that capital and equipment sent to that capital and equipment sent to Ukraine by Congress, under the leadership of President Biden was a not about, as had previously been not about, as had previously been thought, but alone.
That is the thought, but alone. That is the outrage felt in Wales. It's the natural assets are exploited, without any benefit to the people of without any benefit to the people of Wales. At second reading Lord Wigley referred to the flooding of terrarium. And the political consequences which followed, including very probably his presence in this House. The purpose of the conservative amendments is to ensure that income or assets of the Crown Estate in Wales. With the property rights in land, are highly valuable rights in relation to the Welsh zone should fall under the control of the Senedd.
Or its Ministers. Rents and profits should whizz up the motorway to launch in the Treasury, as they always have. Even when it was called Watling Street. Perish the thought that some Welshmen, in the tradition will get his hands on the loot. You might call that a conservative principle. The government's reaction is to say our accountants cannot possibly do the sums. What comes from Wales could be anything between nil or £1 billion. As has been pointed out at second reading, they did precisely that, until 2021.
In Scotland, they worked out the income of the Crown Estate, now. The Minister said, at second reading, the profits of the Crown Estate, in Scotland, are deducted from the block grounds. Is that really the case? Is the Scottish Government getting nothing from the oil revenues? The nationalist were going to run the whole country on those at to run the whole country on those at We call for these conservative amendments to be rejected out of hand. Lord Thomas is more constructive as we can see from his later amendments.
He accepts the argument as expressed by Lord Moylan. The government are in the process of delicate negotiations which the transfer of management to the Welsh Government immediately might interrupt. He is proposing a transition period during which the existing commissioners must consult and take into account the views of Welsh Ministers and provide them with the view to transparency with all of the information they require concerning capital income, direct expenses and costs. He rightly wishes to challenge the suggestion it is all too difficult to sort out.
We support him entirely in this. Although we would like clarity from the Minister as to what precise negotiations would currently be affected if the bill as drafted came into force? Thank you my Lords.
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I rise very briefly to speak on
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I am speaking to the amendments in this group, on behalf of these benches and in doing so I confirm benches and in doing so I confirm the strongest support we expressed at second reading, for this bill. There was a sense of outrage, when President Trump attempted to squeeze President Trump attempted to squeeze an agreement, for the extraction of rare minerals out of Ukraine, rare minerals out of Ukraine, without payment. His argument was of that capital and equipment sent to that capital and equipment sent to Ukraine by Congress, under the leadership of President Biden was a not about, as had previously been not about, as had previously been thought, but alone.
That is the thought, but alone. That is the outrage felt in Wales. It's the natural assets are exploited, without any benefit to the people of without any benefit to the people of Wales. At second reading Lord Wigley referred to the flooding of terrarium. And the political consequences which followed, including very probably his presence in this House. The purpose of the conservative amendments is to ensure that income or assets of the Crown Estate in Wales. With the property rights in land, are highly valuable rights in relation to the Welsh zone should fall under the control of the Senedd.
Or its Ministers. Rents and profits should whizz up the motorway to launch in the Treasury, as they always have. Even when it was called Watling Street. Perish the thought that some Welshmen, in the tradition will get his hands on the loot. You might call that a conservative principle. The government's reaction is to say our accountants cannot possibly do the sums. What comes from Wales could be anything between nil or £1 billion. As has been pointed out at second reading, they did precisely that, until 2021.
In Scotland, they worked out the income of the Crown Estate, now. The Minister said, at second reading, the profits of the Crown Estate, in Scotland, are deducted from the block grounds. Is that really the case? Is the Scottish Government getting nothing from the oil revenues? The nationalist were going to run the whole country on those at to run the whole country on those at We call for these conservative amendments to be rejected out of hand. Lord Thomas is more constructive as we can see from his later amendments.
He accepts the argument as expressed by Lord Moylan. The government are in the process of delicate negotiations which the transfer of management to the Welsh Government immediately might interrupt. He is proposing a transition period during which the existing commissioners must consult and take into account the views of Welsh Ministers and provide them with the view to transparency with all of the information they require concerning capital income, direct expenses and costs. He rightly wishes to challenge the suggestion it is all too difficult to sort out.
We support him entirely in this. Although we would like clarity from the Minister as to what precise negotiations would currently be affected if the bill as drafted came into force? Thank you my Lords.
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I rise very briefly to speak on
13:48
Baroness Bennett of Manor Castle (Green Party)
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I rise very briefly to speak on behalf of the Wales Green party against all of the amendments in this group. I have to say the noble this group. I have to say the noble Lord, Lord Harling perhaps misinterpreted my reaction. I was astonished he should be addressing the issue, not just in the direction of travel but that he should not be taking seriously the fact the statistics showed the 20 privacy limits saved about 100 deaths and serious injuries on both roads when they were in impact, when they were in force.
I think that should be, those saved lives and people's lives being transformed for the worse by serious injury is not something that should be taken in any way lightly. should be taken in any way lightly. It is not -- it is a pity it is not a note. TfL showed a 30% decrease in serious deaths and injuries in London. There is a range of measures affecting that. 15% perhaps from other measures but 20 mile-per-hour is a significant factor in reducing deaths and injuries on roads.
Surely everyone wants that to happen. It is a great pleasure to follow the noble Lady, Baroness Harris of Richmond. She has far more personal connection with this than me. The passion in his speech leaves me really with little to add. Except the fact the Crown estate in Wales is drawing on resources. The resources surely should stay in Wales. This is a basic democratic principle. The lack of which the concentration of power and resources here in Westminster is a problem all around the country.
Particularly for the nation of Wales is indeed growing. The fast-growing interest in independence from Wales and those who wish to maintain the union might like to think about what position they are taking on this bill. Because not being able to have the returns from their own resources is something that is increasing
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anger in Wales. I spoke at Second Reading in favour of... What guarantee can the noble
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What guarantee can the noble Baroness give that where this bill is passed the revenue from it would is passed the revenue from it would be distributed equally throughout Wales and not just concentrated in Cardiff and the surrounding area in revenues -- as revenues currently
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are? Responding to the noble Lord I have to say Wales seems a more have to say Wales seems a more democratic electoral system under democratic system unlike Westminster where we have the government who where we have the government who runs 34% of voters and is in control. If we are looking at democratic distribution of resources then we are a lot better off in the Senate then you are in Westminster. I think I was about to finish though I just simply will repeat.
The statement Wales Green party very strongly backs this bill and would oppose these amendments. More power
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to Lord Wigley. I rise to government amendments to, three, eight and nine standing my name on the Order Paper. I seek my name on the Order Paper. I seek to explain why I oppose clause 1 stand part of the bill. In doing so I declare my interest as set out on the register with particular
Baroness Bennett of Manor Castle (Green Party)
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I rise very briefly to speak on behalf of the Wales Green party against all of the amendments in this group. I have to say the noble this group. I have to say the noble Lord, Lord Harling perhaps misinterpreted my reaction. I was astonished he should be addressing the issue, not just in the direction of travel but that he should not be taking seriously the fact the statistics showed the 20 privacy limits saved about 100 deaths and serious injuries on both roads when they were in impact, when they were in force.
I think that should be, those saved lives and people's lives being transformed for the worse by serious injury is not something that should be taken in any way lightly. should be taken in any way lightly. It is not -- it is a pity it is not a note. TfL showed a 30% decrease in serious deaths and injuries in London. There is a range of measures affecting that. 15% perhaps from other measures but 20 mile-per-hour is a significant factor in reducing deaths and injuries on roads.
Surely everyone wants that to happen. It is a great pleasure to follow the noble Lady, Baroness Harris of Richmond. She has far more personal connection with this than me. The passion in his speech leaves me really with little to add. Except the fact the Crown estate in Wales is drawing on resources. The resources surely should stay in Wales. This is a basic democratic principle. The lack of which the concentration of power and resources here in Westminster is a problem all around the country.
Particularly for the nation of Wales is indeed growing. The fast-growing interest in independence from Wales and those who wish to maintain the union might like to think about what position they are taking on this bill. Because not being able to have the returns from their own resources is something that is increasing
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anger in Wales. I spoke at Second Reading in favour of... What guarantee can the noble
**** Possible New Speaker ****
What guarantee can the noble Baroness give that where this bill is passed the revenue from it would is passed the revenue from it would be distributed equally throughout Wales and not just concentrated in Cardiff and the surrounding area in revenues -- as revenues currently
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are? Responding to the noble Lord I have to say Wales seems a more have to say Wales seems a more democratic electoral system under democratic system unlike Westminster where we have the government who where we have the government who runs 34% of voters and is in control. If we are looking at democratic distribution of resources then we are a lot better off in the Senate then you are in Westminster. I think I was about to finish though I just simply will repeat.
The statement Wales Green party very strongly backs this bill and would oppose these amendments. More power
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to Lord Wigley. I rise to government amendments to, three, eight and nine standing my name on the Order Paper. I seek my name on the Order Paper. I seek to explain why I oppose clause 1 stand part of the bill. In doing so I declare my interest as set out on the register with particular
13:51
Lord Moynihan (Conservative)
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Lord Moynihan (Conservative)
the register with particular reference to my chairmanship of unsure when projects, although not contracted in this space I work in this space worldwide. Before I comment on my amendments would like to place on record the considerable sadness I have in finding myself in opposition to the noble Lord, Lord Wigley. Who saw me through my backbencher ministerial career in the other place. I always viewed him as a trusted friend and outstanding politician. He is recognised as such across both sides of both houses.
I put that down to the English influence on him. Which I fire not mistaken came from his birth in Derby. And education in Manchester. Turning to the amendments, two and eight seek to ensure this bill is in line with the borrowing limits as the Crown Estate. Ostensibly it is reasonable to ask why is borrowing limits or prudent? It is because there is considerable strategic commercial risk associated with devolving and transferring the functions of the Crown Estate in Wales to Welsh Ministers.
It looks at specifically the most recent publicly of figures for asset values in Wales is from August 2023, freedom of information request. Which stated in property values in sterling offshore wind energy marine... A total of millions which were focuses on those offshore wind energy's, particularly wind but not exclusively wind. Which is some 93% marine energy of those assets. It is something I think we need to focus on in terms of considering this on in terms of considering this bill.
Taking a 25% debt to asset value would be buying up to £213 million. It would need to be against Welsh assets. To this value. Currently as it stands -- as I understand it it states Scotland does not have borrowing powers so even if my amendment was accepted it would be asymmetry in terms of opportunity. Yet the difficulty of taking sense of these figures and therefore the security required for borrowing is further compounded by a number of economic factors. The first is the creation of global instability in the sector.
The international renewable market is experiencing that instability. In no small part due to the changes of US tariffs and green subsidy for policies. In challenging local conditions it is crucial the UK market can present a united and stable environment give confidence to investors in the sector and developers to commit their capital and projects to the UK. There is a ready difficulty in doing so. For those who follow this area in net zero, the cancellation of Hornsea for last month because of the economics of the project just proves how volatile the sector is and how uncertain it is.
At present. The benefit of the current structure of the Crown Estate is an ability to balance investments and reduce risk exposure costs and across England and Wales. Ensuring more robust and sustainable growth in a way the devolved Welsh entities would struggle to replicate and capitalise on the immediate opportunity which exists. Neither strength nor economics of scale would exist if this bill went through. Any further fermentation could signal -- fragmentation could signal regulatory uncertainty reducing the U.K.'s attractiveness as a destination for clean and McLean energy investment and harming the UK economy.
The second point in the second reason of the amendment is because of the UK systems wide approach to tackling Energy Security and Net Zero ambition of the government. It gives a basis to the fact the Crown Estate is first and foremost with the energy try and across the UK and in Wales. And the development of offshore wind in particular and the groundbreaking new technologies which are even more risky, particularly the ones which are considered for floating offshore wind energy -- wind generation it becomes to see.
In this transition to renewable energy, offshore wind requires a highly coordinated approach. Preventing seabed management -- fragmenting seabed management through devolution would disrupt... Through the national system operator and the UK government and this could delay grid collection decisions and undermine strategic adherence of the contrast for differences at auctions. My genuine belief is that a transfer to Welsh Ministers would be counter- productive to the Welsh economy. That is what we should be thinking about in the context of this bill.
And to Welsh jobs, growth in the sector. So I would like briefly to address the noble Baroness, Lady Bennett's comments. Because the Celtic Sea which is what we are talking about and the role of the Crown Estate that they play in deescalating Andy stimulating the supply chain is crucial. I believe those who want to transfer the Crown assets from the UK back to Wales may find themselves misguided if they feel the Welsh acreage of the Celtic Sea represents some sort of 530 carat diamond, the rates of Wales.
The reality is and I found this at the cost of many many months if not years of negotiation as Minister for in the other place on the treaty which went across the median liar of Norway and the UK. There is a very similar issue to the proposed Celtic Sea developments between the pretty even split between English and Welsh waters. The delineation is highly,. It is not a straightforward North, -- it is not a straightforward North Sea divide and there is a kaleidoscope of interest.
Fragmentation of control of the project would be counter-productive in my view. It would take more time, be economically inefficient and would be particularly sensitive to different organisations were trying to make sure that economic opportunity which would benefit the people of Wales as well as the people of the United Kingdom was curtailed or set into a political quagmire of negotiations and quagmire of negotiations and differences. The quagmire of delineations in the sea like the North Sea like the Celtic Sea is equally as important.
It is an important factor when you consider the scale of this project in the totality of the Crown Estate assets. With this scale in mind I think it is important to reflect on the integrated and complex nature of the supply chain which will back up that project. I think it is unrealistic to expect every component in the supply chain to be available in Wales. That is why I tabled these amendments. I think it is not just the major port of Tolbert which is critical in this round, Bristol is equally as important.
Transfer operations in Wales would create jurisdictional and logistical bottlenecks impeding the rollout of offshore wind energy's. My concern and reasons for curtailing -- for tabling these amendments is to make sure there is no in addition to the development of these interesting opportunities and particularly the offshore opportunities that will exist and benefit the people of Wales and particularly those in the south-west. The evidence presented in the future of offshoring -- offshore wind shows the further opportunity in the Celtic Sea is not in Welsh Water and is further away.
There is an aspect of this that is covered by Northern Ireland as well. There is a triple lock on this project which would need to be looked at. That is the reason why I tabled my amendments. The Welsh coastline presents a significant opportunity, regardless of the position of projects in the seabed. It is in the best interests of both Wales and the Crown Estate to ensure this potential is fully realised so the coastal communities can benefit the coastal communities can benefit from the offshore resources.
It is important to contrast this for example with Scottish seabed and Scottish waters. Which are materially distinct, creating no overlaps or conflicting regulation and contrasting financial systems. Finally I emphasise my belief not only is this important as was heard during the passage of the Crown Estate but the operational independence of the Crown Estate is critical. Enabling it to maximise the economic opportunities and take an apolitical and long-term decision in line with its statutory purpose. To impose oversight in Wales, Welsh Ministers or through the Treasury would significantly impact the ability of the commissioners to carry out their functions.
And create lasting and shared prosperity for the nation and jobs in Wales. Whilst ostensibly attractive this bill without any amendments would be economically disadvantageous to Wales. That is my main driver. It is for those reasons I beg to move the motion standing in my name. I have not got time to cover the last one but suffice to say I do think it would be real benefit if we do pass this bill in having a review after one year. Not just what has happened in Wales but potentially what is to in Wales but potentially what is to
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RIs to speak ruefully on this. -- I rise to speak briefly on this. I
I put that down to the English influence on him. Which I fire not mistaken came from his birth in Derby. And education in Manchester. Turning to the amendments, two and eight seek to ensure this bill is in line with the borrowing limits as the Crown Estate. Ostensibly it is reasonable to ask why is borrowing limits or prudent? It is because there is considerable strategic commercial risk associated with devolving and transferring the functions of the Crown Estate in Wales to Welsh Ministers.
It looks at specifically the most recent publicly of figures for asset values in Wales is from August 2023, freedom of information request. Which stated in property values in sterling offshore wind energy marine... A total of millions which were focuses on those offshore wind energy's, particularly wind but not exclusively wind. Which is some 93% marine energy of those assets. It is something I think we need to focus on in terms of considering this on in terms of considering this bill.
Taking a 25% debt to asset value would be buying up to £213 million. It would need to be against Welsh assets. To this value. Currently as it stands -- as I understand it it states Scotland does not have borrowing powers so even if my amendment was accepted it would be asymmetry in terms of opportunity. Yet the difficulty of taking sense of these figures and therefore the security required for borrowing is further compounded by a number of economic factors. The first is the creation of global instability in the sector.
The international renewable market is experiencing that instability. In no small part due to the changes of US tariffs and green subsidy for policies. In challenging local conditions it is crucial the UK market can present a united and stable environment give confidence to investors in the sector and developers to commit their capital and projects to the UK. There is a ready difficulty in doing so. For those who follow this area in net zero, the cancellation of Hornsea for last month because of the economics of the project just proves how volatile the sector is and how uncertain it is.
At present. The benefit of the current structure of the Crown Estate is an ability to balance investments and reduce risk exposure costs and across England and Wales. Ensuring more robust and sustainable growth in a way the devolved Welsh entities would struggle to replicate and capitalise on the immediate opportunity which exists. Neither strength nor economics of scale would exist if this bill went through. Any further fermentation could signal -- fragmentation could signal regulatory uncertainty reducing the U.K.'s attractiveness as a destination for clean and McLean energy investment and harming the UK economy.
The second point in the second reason of the amendment is because of the UK systems wide approach to tackling Energy Security and Net Zero ambition of the government. It gives a basis to the fact the Crown Estate is first and foremost with the energy try and across the UK and in Wales. And the development of offshore wind in particular and the groundbreaking new technologies which are even more risky, particularly the ones which are considered for floating offshore wind energy -- wind generation it becomes to see.
In this transition to renewable energy, offshore wind requires a highly coordinated approach. Preventing seabed management -- fragmenting seabed management through devolution would disrupt... Through the national system operator and the UK government and this could delay grid collection decisions and undermine strategic adherence of the contrast for differences at auctions. My genuine belief is that a transfer to Welsh Ministers would be counter- productive to the Welsh economy. That is what we should be thinking about in the context of this bill.
And to Welsh jobs, growth in the sector. So I would like briefly to address the noble Baroness, Lady Bennett's comments. Because the Celtic Sea which is what we are talking about and the role of the Crown Estate that they play in deescalating Andy stimulating the supply chain is crucial. I believe those who want to transfer the Crown assets from the UK back to Wales may find themselves misguided if they feel the Welsh acreage of the Celtic Sea represents some sort of 530 carat diamond, the rates of Wales.
The reality is and I found this at the cost of many many months if not years of negotiation as Minister for in the other place on the treaty which went across the median liar of Norway and the UK. There is a very similar issue to the proposed Celtic Sea developments between the pretty even split between English and Welsh waters. The delineation is highly,. It is not a straightforward North, -- it is not a straightforward North Sea divide and there is a kaleidoscope of interest.
Fragmentation of control of the project would be counter-productive in my view. It would take more time, be economically inefficient and would be particularly sensitive to different organisations were trying to make sure that economic opportunity which would benefit the people of Wales as well as the people of the United Kingdom was curtailed or set into a political quagmire of negotiations and quagmire of negotiations and differences. The quagmire of delineations in the sea like the North Sea like the Celtic Sea is equally as important.
It is an important factor when you consider the scale of this project in the totality of the Crown Estate assets. With this scale in mind I think it is important to reflect on the integrated and complex nature of the supply chain which will back up that project. I think it is unrealistic to expect every component in the supply chain to be available in Wales. That is why I tabled these amendments. I think it is not just the major port of Tolbert which is critical in this round, Bristol is equally as important.
Transfer operations in Wales would create jurisdictional and logistical bottlenecks impeding the rollout of offshore wind energy's. My concern and reasons for curtailing -- for tabling these amendments is to make sure there is no in addition to the development of these interesting opportunities and particularly the offshore opportunities that will exist and benefit the people of Wales and particularly those in the south-west. The evidence presented in the future of offshoring -- offshore wind shows the further opportunity in the Celtic Sea is not in Welsh Water and is further away.
There is an aspect of this that is covered by Northern Ireland as well. There is a triple lock on this project which would need to be looked at. That is the reason why I tabled my amendments. The Welsh coastline presents a significant opportunity, regardless of the position of projects in the seabed. It is in the best interests of both Wales and the Crown Estate to ensure this potential is fully realised so the coastal communities can benefit the coastal communities can benefit from the offshore resources.
It is important to contrast this for example with Scottish seabed and Scottish waters. Which are materially distinct, creating no overlaps or conflicting regulation and contrasting financial systems. Finally I emphasise my belief not only is this important as was heard during the passage of the Crown Estate but the operational independence of the Crown Estate is critical. Enabling it to maximise the economic opportunities and take an apolitical and long-term decision in line with its statutory purpose. To impose oversight in Wales, Welsh Ministers or through the Treasury would significantly impact the ability of the commissioners to carry out their functions.
And create lasting and shared prosperity for the nation and jobs in Wales. Whilst ostensibly attractive this bill without any amendments would be economically disadvantageous to Wales. That is my main driver. It is for those reasons I beg to move the motion standing in my name. I have not got time to cover the last one but suffice to say I do think it would be real benefit if we do pass this bill in having a review after one year. Not just what has happened in Wales but potentially what is to in Wales but potentially what is to
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RIs to speak ruefully on this. -- I rise to speak briefly on this. I
14:01
Lord Harper (Conservative)
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Lord Harper (Conservative)
agree with the complexity of some of the economic issues. I was involved in that when Under-Secretary of State for transport. They do overlap. If you split those it will make it harder to land those economic opportunities. I want to touch briefly on what Baroness Bennett said about the 20 mile-per- hour speed limit in Wales. I will not dwell on it because it's not the subject of the bill. She should have mentioned that the original proposals by the Welsh Government, this is their own impact assessment, carried a cost to the Welsh economy of £4.5 billion.
You have to balance that against the lives saved and decide whether that balance is correct and whether that cost of £4.5 million done in a different way would achieve a better outcome. So I just put that on the record to balance out the argument. She is pulling faces at me, but that is the impact assessment of the Welsh Government. They costed that policy at £4.5 billion, so that is their figures if she wants to take it up with them.
The final point I wanted to make is just to pick up the point that the noble Lady made about with the revenues go. It's worth pointing out that through the Barnett formula the Welsh people are net beneficiaries of the UK exchequer. It is not clear from the bill as proposed by the noble Lord what impact transferring revenues of the Crown Estate has on the Barnett formula. Whether it will be netted off and leave the same amount of money going to the Welsh Government, or whether it will be an increase, but the point is all the revenues that flow from the Welsh public into the Exchequer, more revenue goes back because they are net beneficiaries.
There is no unfairness here to the people of Wales. Taxpayers in the rest of the United Kingdom will look unfavourably of -- on more revenue been channelled to the people of Wales at a time when the public finances are so stretched. The picture is more complex than some noble Lord have said and for those reasons I strongly support, I am
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happy to give way. For clarification with the noble Lord like to make it clear that that Lord like to make it clear that that figure of 4 billion he gave was over
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three decades. I am happy to make that point. It's still a very significant sum of money, and if you do what is normally done in the circumstances, normally done in the circumstances, looking at the cost versus the benefit, I would argue that it is benefit, I would argue that it is not a good return. That is of course the reason as well as the enormous popularity of that policy that the Welsh Government responded to the political pressure from my party and political pressure from my party and from the public and changed that policy quite significantly.
They policy quite significantly. They themselves are not persuaded by themselves are not persuaded by those arguments. Just before I was just going to finish, for those reasons I have set out, I strongly reasons I have set out, I strongly support the amendments tabled by my noble friends and I hope very much that the House in due course will get a chance to support them.
You have to balance that against the lives saved and decide whether that balance is correct and whether that cost of £4.5 million done in a different way would achieve a better outcome. So I just put that on the record to balance out the argument. She is pulling faces at me, but that is the impact assessment of the Welsh Government. They costed that policy at £4.5 billion, so that is their figures if she wants to take it up with them.
The final point I wanted to make is just to pick up the point that the noble Lady made about with the revenues go. It's worth pointing out that through the Barnett formula the Welsh people are net beneficiaries of the UK exchequer. It is not clear from the bill as proposed by the noble Lord what impact transferring revenues of the Crown Estate has on the Barnett formula. Whether it will be netted off and leave the same amount of money going to the Welsh Government, or whether it will be an increase, but the point is all the revenues that flow from the Welsh public into the Exchequer, more revenue goes back because they are net beneficiaries.
There is no unfairness here to the people of Wales. Taxpayers in the rest of the United Kingdom will look unfavourably of -- on more revenue been channelled to the people of Wales at a time when the public finances are so stretched. The picture is more complex than some noble Lord have said and for those reasons I strongly support, I am
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happy to give way. For clarification with the noble Lord like to make it clear that that Lord like to make it clear that that figure of 4 billion he gave was over
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three decades. I am happy to make that point. It's still a very significant sum of money, and if you do what is normally done in the circumstances, normally done in the circumstances, looking at the cost versus the benefit, I would argue that it is benefit, I would argue that it is not a good return. That is of course the reason as well as the enormous popularity of that policy that the Welsh Government responded to the political pressure from my party and political pressure from my party and from the public and changed that policy quite significantly.
They policy quite significantly. They themselves are not persuaded by themselves are not persuaded by those arguments. Just before I was just going to finish, for those reasons I have set out, I strongly reasons I have set out, I strongly support the amendments tabled by my noble friends and I hope very much that the House in due course will get a chance to support them.
14:05
Lord Thomas of Cwmgiedd (Crossbench)
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Lord Thomas of Cwmgiedd (Crossbench)
By way of background we have had the benefit of Lady Harris of Richmond speaking as to what makes this issue I would describe as ultimately as a hearts and minds issue. The acquisition of the Crown Estate in Wales, by conquest and by the imposition of English laws. The exportation as it is perceived in Wells as them being a resource, and the fact that Scotland has been allowed to control its own estate do turn this into an important political and hearts and minds issue.
I have tried to approach this through the amendments I have put forward to recognise that. And in saying that it is an important hearts and minds issues, the view of the Welsh government that it wants devolution, the overwhelming majority of Welsh authorities want devolution and for the reasons I have tried to summarise, there ought to be devolution of the Crown Estate Wales. What has bedevilled this problem is a failure to understand and give effect to the difference between ownership and benefit from an asset and management of an asset.
an asset and management of an asset. Those of us who may be fortunate enough to have the odd spare penny or two, know the difference between allowing someone else who is better qualified to manage assets, but actually, ensuring that the policy towards those assets and the ultimate benefit is to the owner and that is an important distinction that I have sought to make. The first step is to try and identify what is it that is the Crown Estate in Wales.
Is it valuable, does it have any revenue? You may recall that in the second reading debate I spent a little time, and I am not going to do that today because it is unnecessary, going through the accounts of the Crown Estate commissioners in respect of Wales. The revenue and asset values down for the year ending March March 2021 were clear, but there was nothing in the accounts there after. I challenged the Minister and the Financial Secretary of the Treasury why an account could not identify the assets and the income.
I am immensely grateful to him and the Chief Executive of the Crown Estate commissioners and one of the Commissioners for a meeting I had with him. Having checked with him, and I am happy to say he agrees I can say this, I was told by him that in the financial statements for next year, that is the year ending 26 March, it is the Commissioner's intention to provide a separate breakdown for Wales of the assets and revenue. Now, that does show that you can identify what is Welsh that you can identify what is Welsh and what is English and you can show the result of revenue streams, the result of capital expenditure, an awful lot of the obfuscation that has occurred can be got rid of.
I don't want to comment any further. Let us wait for those accounts to be produced. But it does, I think, bring to an end the argument that you cannot really say what is Welsh and what is English, what is the benefit from it? We will know, and it is a great pity this was not done it is a great pity this was not done before. I think what is before us now is if this hearts and minds issue is to be addressed and dealt with, how do we take this forward? I do think that it would be very helpful for us to hear from the Minister as to the discussions that have been taking place between his colleagues, I assume they are his colleagues in Cardiff, and his colleagues here in London as to dealing with this hearts and minds issue, and as Lord Moynihan has been careful to stress, obtaining economic benefits from Wales.
The distinction I tried to draw between the ownership and benefit from the assets and the management of the assets. That is why I put forward the amendments that stand in my name, amendments for and seven. First of all, Russia (Sanctions) (EU Exit) (Amendment) (No. 4) Regulations 2023 is to set a timetable. It is no use having a bill it seems to me that transfers Some preparatory work and a timetable to reassure investors and others that the transfer is orderly.
Therefore Amendment four and amendment seven put forward a timetable. I have only put those dates forwards as indicative. Obviously those are matters for detailed discussion between the government in London and the government in Cardiff as to the right timetable. But providing that during that period, although the Crown Estate Commissioners remain completely in control, they ought to take the account of the views of Welsh ministers, but not be bound by them, and that the income there of in the meantime is properly identified.
This really provides a bridging period dealing with the issue of the transfer of the assets, but allowing their management to continue. Therefore, really trying to address the problem that as I understand it some government ministers have put forward that all of this would wreak havoc with investment and jobs in Wales. I do regard that as a fallacy. I do regard when one really looks at what we are talking about, it is accepting that the Crown Estate in Wales is a national asset of the Welsh people, but accepting that there needs to be an orderly transfer.
As for the future, I put down a separate amendment, number five, which I would like to address in the second group of amendments because it addresses this fundamental misunderstanding that is used to try and justify the preparation of an injustice, which
I have tried to approach this through the amendments I have put forward to recognise that. And in saying that it is an important hearts and minds issues, the view of the Welsh government that it wants devolution, the overwhelming majority of Welsh authorities want devolution and for the reasons I have tried to summarise, there ought to be devolution of the Crown Estate Wales. What has bedevilled this problem is a failure to understand and give effect to the difference between ownership and benefit from an asset and management of an asset.
an asset and management of an asset. Those of us who may be fortunate enough to have the odd spare penny or two, know the difference between allowing someone else who is better qualified to manage assets, but actually, ensuring that the policy towards those assets and the ultimate benefit is to the owner and that is an important distinction that I have sought to make. The first step is to try and identify what is it that is the Crown Estate in Wales.
Is it valuable, does it have any revenue? You may recall that in the second reading debate I spent a little time, and I am not going to do that today because it is unnecessary, going through the accounts of the Crown Estate commissioners in respect of Wales. The revenue and asset values down for the year ending March March 2021 were clear, but there was nothing in the accounts there after. I challenged the Minister and the Financial Secretary of the Treasury why an account could not identify the assets and the income.
I am immensely grateful to him and the Chief Executive of the Crown Estate commissioners and one of the Commissioners for a meeting I had with him. Having checked with him, and I am happy to say he agrees I can say this, I was told by him that in the financial statements for next year, that is the year ending 26 March, it is the Commissioner's intention to provide a separate breakdown for Wales of the assets and revenue. Now, that does show that you can identify what is Welsh that you can identify what is Welsh and what is English and you can show the result of revenue streams, the result of capital expenditure, an awful lot of the obfuscation that has occurred can be got rid of.
I don't want to comment any further. Let us wait for those accounts to be produced. But it does, I think, bring to an end the argument that you cannot really say what is Welsh and what is English, what is the benefit from it? We will know, and it is a great pity this was not done it is a great pity this was not done before. I think what is before us now is if this hearts and minds issue is to be addressed and dealt with, how do we take this forward? I do think that it would be very helpful for us to hear from the Minister as to the discussions that have been taking place between his colleagues, I assume they are his colleagues in Cardiff, and his colleagues here in London as to dealing with this hearts and minds issue, and as Lord Moynihan has been careful to stress, obtaining economic benefits from Wales.
The distinction I tried to draw between the ownership and benefit from the assets and the management of the assets. That is why I put forward the amendments that stand in my name, amendments for and seven. First of all, Russia (Sanctions) (EU Exit) (Amendment) (No. 4) Regulations 2023 is to set a timetable. It is no use having a bill it seems to me that transfers Some preparatory work and a timetable to reassure investors and others that the transfer is orderly.
Therefore Amendment four and amendment seven put forward a timetable. I have only put those dates forwards as indicative. Obviously those are matters for detailed discussion between the government in London and the government in Cardiff as to the right timetable. But providing that during that period, although the Crown Estate Commissioners remain completely in control, they ought to take the account of the views of Welsh ministers, but not be bound by them, and that the income there of in the meantime is properly identified.
This really provides a bridging period dealing with the issue of the transfer of the assets, but allowing their management to continue. Therefore, really trying to address the problem that as I understand it some government ministers have put forward that all of this would wreak havoc with investment and jobs in Wales. I do regard that as a fallacy. I do regard when one really looks at what we are talking about, it is accepting that the Crown Estate in Wales is a national asset of the Welsh people, but accepting that there needs to be an orderly transfer.
As for the future, I put down a separate amendment, number five, which I would like to address in the second group of amendments because it addresses this fundamental misunderstanding that is used to try and justify the preparation of an injustice, which
14:13
Lord Sandhurst (Conservative)
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Lord Sandhurst (Conservative)
My Lords, the amendments in this group relate to the operation of the group relate to the operation of the Crown Estate in Wales under the newly devolved approach. I should newly devolved approach. I should say at the outset that on this side of the House we are opposed to this bill in principle. I know that the bill in principle. I know that the noble Lord Lord Wigley brought noble Lord Lord Wigley brought amendments to the Crown Estate Act during its passage through your Lordships House.
The Official Opposition then were clear at that point that the government should resist those amendments. As my noble resist those amendments. As my noble friend Lady Vere of Norbiton said then, we have set the Crown Estate then, we have set the Crown Estate on a very different path as a result of that legislation and now is not the time to frustrate that process the time to frustrate that process with a very different proposal in the direction of the Welsh part of the Crown Estate.
That argument was right then, it is right now. Amendments one and six in the name of my noble friend Lord Harlech would require the revenues of the Welsh part of the Crown Estate to be paid to the Exchequer after the devolution and transfer of functions to anybody. This would ensure that the existing revenues go to the Exchequer, which as we all know from the rumours about the spending review next week is already in great need of income. If control of the functions of the Welsh Crown Estate were to be devolved, but the revenues continue to be paid to the Exchequer, that would at least achieve part of the noble Lord Lord Wrigley's aim without depriving the Exchequer of much-needed revenue.
Perhaps he is open to that. My noble friend Lord Harper has raised interesting and cautionary points about the Barnett formula more generally. Amendments to an date in generally. Amendments to an date in the name of Lord Moynihan seek to ensure that the Welsh Crown Estate is bound by the same borrowing limits as the Crown Estate itself. As noble Lords will recall from the passage of the previous bill, my noble friends Baroness Vere of a button and Lord Howard of Rising spoke at length and press the ministers to secure that borrowing limit.
We are pleased that ministers accepted those calls and implemented a borrowing limits, even though this was placed on a statutory footing. This amendment, the amendment which my noble friend Lord Moynihan has tabled six to ensure the Welsh Crown Estate is similarly bound by and appropriate limit on their borrowing and here I should mention of course the important points which he has made about the impact which is transfer would have on the future of energy in this country as a whole and on Wales in particular and the difficulties in apportioning that.
Amendment three in the name of my noble friend Lord Moynihan seeks to have a backstop to prevent mismanagement of the Welsh estate. We know how poorly Wales is so I her current devolved government. Whether it is education, healthcare or economic outcomes, Wales So much of this is the responsibility of the Welsh Government. Given that backdrop it's understandable noble Lords are little more than reticent about proposals take another step down that road with a body as important as the Crown Estate with such big assets.
We on these benches share the concern that motivates my noble friend in his amendment and we would be interested to hear from the Minister whether the government might consider some form of backstop such as the one proposed by this amendment. Amendment four and seven amendment. Amendment four and seven the name of Lord Thomas I think reflects legitimate concerns about the untimely transfer of these powers in the event that this bill is passed. Clearly a sudden change so soon after we have passed the Crown Estate Act which sets a very different direction of travel for the Crown Estate would be very disruptive to that new direction.
Perhaps Lord Wigley would respond to that point in his remarks at the conclusion of this group. In summary, we have serious concerns about the transfer of the Welsh parts of the Crown Estate to a devolved framework. There are many important issues that must be addressed for this proposal could go forward. We look forward to hearing
**** Possible New Speaker ****
from Lord Wigley. Before I start my speech I would
**** Possible New Speaker ****
Before I start my speech I would just like to pay tribute to our Armed Forces who participated in D- Day 81 years ago today. I mention if Day 81 years ago today. I mention if I may the 2nd Battalion of the South
The Official Opposition then were clear at that point that the government should resist those amendments. As my noble resist those amendments. As my noble friend Lady Vere of Norbiton said then, we have set the Crown Estate then, we have set the Crown Estate on a very different path as a result of that legislation and now is not the time to frustrate that process the time to frustrate that process with a very different proposal in the direction of the Welsh part of the Crown Estate.
That argument was right then, it is right now. Amendments one and six in the name of my noble friend Lord Harlech would require the revenues of the Welsh part of the Crown Estate to be paid to the Exchequer after the devolution and transfer of functions to anybody. This would ensure that the existing revenues go to the Exchequer, which as we all know from the rumours about the spending review next week is already in great need of income. If control of the functions of the Welsh Crown Estate were to be devolved, but the revenues continue to be paid to the Exchequer, that would at least achieve part of the noble Lord Lord Wrigley's aim without depriving the Exchequer of much-needed revenue.
Perhaps he is open to that. My noble friend Lord Harper has raised interesting and cautionary points about the Barnett formula more generally. Amendments to an date in generally. Amendments to an date in the name of Lord Moynihan seek to ensure that the Welsh Crown Estate is bound by the same borrowing limits as the Crown Estate itself. As noble Lords will recall from the passage of the previous bill, my noble friends Baroness Vere of a button and Lord Howard of Rising spoke at length and press the ministers to secure that borrowing limit.
We are pleased that ministers accepted those calls and implemented a borrowing limits, even though this was placed on a statutory footing. This amendment, the amendment which my noble friend Lord Moynihan has tabled six to ensure the Welsh Crown Estate is similarly bound by and appropriate limit on their borrowing and here I should mention of course the important points which he has made about the impact which is transfer would have on the future of energy in this country as a whole and on Wales in particular and the difficulties in apportioning that.
Amendment three in the name of my noble friend Lord Moynihan seeks to have a backstop to prevent mismanagement of the Welsh estate. We know how poorly Wales is so I her current devolved government. Whether it is education, healthcare or economic outcomes, Wales So much of this is the responsibility of the Welsh Government. Given that backdrop it's understandable noble Lords are little more than reticent about proposals take another step down that road with a body as important as the Crown Estate with such big assets.
We on these benches share the concern that motivates my noble friend in his amendment and we would be interested to hear from the Minister whether the government might consider some form of backstop such as the one proposed by this amendment. Amendment four and seven amendment. Amendment four and seven the name of Lord Thomas I think reflects legitimate concerns about the untimely transfer of these powers in the event that this bill is passed. Clearly a sudden change so soon after we have passed the Crown Estate Act which sets a very different direction of travel for the Crown Estate would be very disruptive to that new direction.
Perhaps Lord Wigley would respond to that point in his remarks at the conclusion of this group. In summary, we have serious concerns about the transfer of the Welsh parts of the Crown Estate to a devolved framework. There are many important issues that must be addressed for this proposal could go forward. We look forward to hearing
**** Possible New Speaker ****
from Lord Wigley. Before I start my speech I would
**** Possible New Speaker ****
Before I start my speech I would just like to pay tribute to our Armed Forces who participated in D- Day 81 years ago today. I mention if Day 81 years ago today. I mention if I may the 2nd Battalion of the South
14:17
Lord Wilson of Sedgefield (Labour)
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Lord Wilson of Sedgefield (Labour)
Wales borderers and the Durham industry the infantry. Aside on the beaches, we will never forget the sacrifices. The government position was made clear in debates on this topic during the passage of the reason Crown Estate Bill it continues to be a pleasure to speak in the Committee stage of this bill and we should all recognise the passion Lord Wigley has shown on this issue. Just to prewar noble Lords there will be a time during my speech when the Durham accent comes into contact with the Welsh language so just be aware of that.
I would like to thank Lord Thomas, Lord Hollick and Lord Moynihan for their thoughtful contributions and accompanying amendments related to the operational framework and of any devolved whilst Crown Estate entities, I would also like to welcome the contributions by Baroness Harris, Baroness Bennett and Lord Harper as well. Amendments one and six would ensure that the revenues from the Welsh Crown Estate would still be paid into the Exchequer. Amendment to would replace parameters and borrowing, amendment three will allow the Treasury to impose whatever conditions it sees fit onto the scheme for ensuring expeditious exercise of the functions of the Crown Estate in Wales.
Amendment nine would require the Secretary of nine would require the Secretary of State to produce a report on the effectiveness of devolving the management of the Crown Estate. Amendments four and seven would delay the transfer of the functions in respect of the Crown Estate in Wales for a period of three to seven years after the passing of the bill while establishing interim arrangements including requiring the Crown Estate Commissioners to engage with Welsh ministers when exercising their powers in relation. Property rights or interests in Wales rights in relation to the Welsh zone in order to enable an orderly and order to enable an orderly and planned transfer to publish financial information about the Crown Estates in Wales and to pay the proportion of the consolidated revenue account distributable to the consolidated fund which is attributable to the Welsh Crown Estate to the Welsh Consolidated Fund.
As this House has said previously, the government believes the Crown Estate has it is currently operated across the England, Wales and Northern Ireland provides the best outcome for Wales and the wider United Kingdom. Devolution of the Crown Estate would risk fragmenting the energy market and delay our progress towards net zero. The Crown Estate has played a critical role in positioning kingdom is one of the more significant global markets for offshore wind over the past 20 years, it has also helped position Wales at the forefront of clean energy technology and growth with North oil offshore windfarm becoming Wales and the United Kingdom's first major offshore renewable energy project in 2003 during leasing round one.
Subsequent leasing round including round for delivering offshore wind benefits to Wales. More recently, in fact last month in a boost United Kingdom's clean energy transition the Crown Estate announced a capacity increase program, seven fixed offshore wind farms will increase the amount of power produced by offshore wind by adding additional turbines to projects already at sea. This includes the RLM more in North Wales and in addition the ongoing leasing round five floating offshore wind in the Celtic Sea. It is expected to deliver significant jobs and supply chain benefits to local communities in Wales and the south-west.
The benefit of these projects are felt in the local communities and supply chains across Wales. For instance Crown Estate recently invested £1.2 million in Welsh tidal stream energy through the demonstration zone owned and managed by in Ynys Mon social enterprise. The Morrice title scheme set to become the largest tidal energy project in Europe. In fact recent past Crown Estate Act which has broadened the scope of the Crown Estate investment and borrowing powers means it is uniquely placed to drive forward growth generating projects in Wales.
But this is not all the new act achieves. As noble Lords will remember the government was pleased to support the amendment by Lord Hain. This was a thoughtful and positive step will see the appointment of two additional Crown Estate commissioners, each with an additional responsibility to advise on conditions in Wales and Northern Ireland respectively. This will ensure the board continues to work in the best interests of Wales while delivering its statutory duties set out in legislation. It takes time to set up new processes for such appointments.
However I would like to reassure noble Lords that the to reassure noble Lords that the Treasury is working on plans to these appointments to ensure they fit the public appointments recruitment process and comply with the governance. An important feature of those appointments is that the devolved governments reserve the right to be consulted over them. Some noble Lords have argued that Wales would benefit financially from devolution of the Crown Estate. Let me set out why the government does not believe this to be the case.
The funds generated by the Crown Estates funds generated by the Crown Estates , more than £4 billion over the last decade, already benefit Wales in two ways. Firstly, those Crown Estate revenue support UK government spending on vital public services in Wales in reserved areas. Secondly, in areas which are devolved to Wales when the UK government fund spending in England the Welsh Government receives funding through the Barrett formula. Even if the devolution could be achieved without risking the revenues generated in Wales, this would not automatically lead to an increase in available funding to the Wales government.
For example, in the case of Scotland where the Crown Estate is devolved, the Scottish Government receive block grant reduction to reflect the profits they retain from Crown Estate Scotland following his devolution. To answer Baroness Harris's point, in previous debates noble Lords questioned why it is that the Crown Estate does not report on income generating Wales, in particular Lord Thomas spoke passionately, I thank him for his contributions on this matter including today in relation to the The case put forward at second reading the Crown Estate met with the noble Lord Lord Thomas to explain in more detail the challenges around reporting separate capital and revenue accounts according to administrative and geographical boundaries.
However the Crown Estate recognised the desire for greater understanding through a Wales lens have committed to reviewing reports for Wales in the 2025/26 annual report and accounts. I thank the noble Lords from across the House for their engagement on this matter and finally in response Lord Thomas and just to make it clear, the government will continue to discuss these issues with the first Minister and the Welsh Government to ensure that Wales sees the full benefit of the Crown Estate.
**** Possible New Speaker ****
I am very grateful to all colleagues who participated in this debate, we are in committee therefore I'm not going to be
I would like to thank Lord Thomas, Lord Hollick and Lord Moynihan for their thoughtful contributions and accompanying amendments related to the operational framework and of any devolved whilst Crown Estate entities, I would also like to welcome the contributions by Baroness Harris, Baroness Bennett and Lord Harper as well. Amendments one and six would ensure that the revenues from the Welsh Crown Estate would still be paid into the Exchequer. Amendment to would replace parameters and borrowing, amendment three will allow the Treasury to impose whatever conditions it sees fit onto the scheme for ensuring expeditious exercise of the functions of the Crown Estate in Wales.
Amendment nine would require the Secretary of nine would require the Secretary of State to produce a report on the effectiveness of devolving the management of the Crown Estate. Amendments four and seven would delay the transfer of the functions in respect of the Crown Estate in Wales for a period of three to seven years after the passing of the bill while establishing interim arrangements including requiring the Crown Estate Commissioners to engage with Welsh ministers when exercising their powers in relation. Property rights or interests in Wales rights in relation to the Welsh zone in order to enable an orderly and order to enable an orderly and planned transfer to publish financial information about the Crown Estates in Wales and to pay the proportion of the consolidated revenue account distributable to the consolidated fund which is attributable to the Welsh Crown Estate to the Welsh Consolidated Fund.
As this House has said previously, the government believes the Crown Estate has it is currently operated across the England, Wales and Northern Ireland provides the best outcome for Wales and the wider United Kingdom. Devolution of the Crown Estate would risk fragmenting the energy market and delay our progress towards net zero. The Crown Estate has played a critical role in positioning kingdom is one of the more significant global markets for offshore wind over the past 20 years, it has also helped position Wales at the forefront of clean energy technology and growth with North oil offshore windfarm becoming Wales and the United Kingdom's first major offshore renewable energy project in 2003 during leasing round one.
Subsequent leasing round including round for delivering offshore wind benefits to Wales. More recently, in fact last month in a boost United Kingdom's clean energy transition the Crown Estate announced a capacity increase program, seven fixed offshore wind farms will increase the amount of power produced by offshore wind by adding additional turbines to projects already at sea. This includes the RLM more in North Wales and in addition the ongoing leasing round five floating offshore wind in the Celtic Sea. It is expected to deliver significant jobs and supply chain benefits to local communities in Wales and the south-west.
The benefit of these projects are felt in the local communities and supply chains across Wales. For instance Crown Estate recently invested £1.2 million in Welsh tidal stream energy through the demonstration zone owned and managed by in Ynys Mon social enterprise. The Morrice title scheme set to become the largest tidal energy project in Europe. In fact recent past Crown Estate Act which has broadened the scope of the Crown Estate investment and borrowing powers means it is uniquely placed to drive forward growth generating projects in Wales.
But this is not all the new act achieves. As noble Lords will remember the government was pleased to support the amendment by Lord Hain. This was a thoughtful and positive step will see the appointment of two additional Crown Estate commissioners, each with an additional responsibility to advise on conditions in Wales and Northern Ireland respectively. This will ensure the board continues to work in the best interests of Wales while delivering its statutory duties set out in legislation. It takes time to set up new processes for such appointments.
However I would like to reassure noble Lords that the to reassure noble Lords that the Treasury is working on plans to these appointments to ensure they fit the public appointments recruitment process and comply with the governance. An important feature of those appointments is that the devolved governments reserve the right to be consulted over them. Some noble Lords have argued that Wales would benefit financially from devolution of the Crown Estate. Let me set out why the government does not believe this to be the case.
The funds generated by the Crown Estates funds generated by the Crown Estates , more than £4 billion over the last decade, already benefit Wales in two ways. Firstly, those Crown Estate revenue support UK government spending on vital public services in Wales in reserved areas. Secondly, in areas which are devolved to Wales when the UK government fund spending in England the Welsh Government receives funding through the Barrett formula. Even if the devolution could be achieved without risking the revenues generated in Wales, this would not automatically lead to an increase in available funding to the Wales government.
For example, in the case of Scotland where the Crown Estate is devolved, the Scottish Government receive block grant reduction to reflect the profits they retain from Crown Estate Scotland following his devolution. To answer Baroness Harris's point, in previous debates noble Lords questioned why it is that the Crown Estate does not report on income generating Wales, in particular Lord Thomas spoke passionately, I thank him for his contributions on this matter including today in relation to the The case put forward at second reading the Crown Estate met with the noble Lord Lord Thomas to explain in more detail the challenges around reporting separate capital and revenue accounts according to administrative and geographical boundaries.
However the Crown Estate recognised the desire for greater understanding through a Wales lens have committed to reviewing reports for Wales in the 2025/26 annual report and accounts. I thank the noble Lords from across the House for their engagement on this matter and finally in response Lord Thomas and just to make it clear, the government will continue to discuss these issues with the first Minister and the Welsh Government to ensure that Wales sees the full benefit of the Crown Estate.
**** Possible New Speaker ****
I am very grateful to all colleagues who participated in this debate, we are in committee therefore I'm not going to be
14:25
Lord Wigley (Plaid Cymru)
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Lord Wigley (Plaid Cymru)
therefore I'm not going to be tempted down the general arguments from several directions over the past hour or so, I want to thank Baroness Harris for coming in from a distance. Baroness Bennett for her contribution, the Lord for moving the amendment and Lord Moynihan and Lord Harper, Lord Thomas again for speaking to his amendment from whom we may fear Mackie or the moment, Lord Sanders and Lord Wilson, have I covered everybody? I hope so. I'm grateful to everybody who has participated.
It might assist colleagues particularly those who don't live in Wales, you don't keep up with every twist and turn in Welsh politics to know that by now of the 22 look Welsh local authorities, 21, a whole range of political allegiance and some of no overall political control, 21 all but one have passed resolutions calling for the devolution of the To Wales. This has been supported by Plaid Cymru, Labour, Liberal Democrats and I believe accepted by even some Conservative members and Reform UK councillors. Who are only too aware of the current feeling of injustice in Wales in this regard.
I mention has been made of the windmills in the sea, above to the north of Bloor North Wales, last night in question time noble colleagues who may have watched the program will have noted that the largest round of applause in that program came from when the suggestion was made that Wales should be benefiting from all those North along the coast. There is a very strong feeling about it and that's why the councils have passed 21/22 in support and I have little doubt that there are sympathy also in the 22nd hasn't.
In considering the amendments before today I hope we will bear these background points we will bear these background points in mind. And yes, by all means let's improve the bell by debating amendments and if appropriate passing amendments at report stage. I would urge that the bill be approved by this chamber and it would then be a matter for the other place to come to a resolution on it in due course if they are prepared to make the time available so that they can at least address the strong feelings of an overwhelming majority of Welsh councils.
I've noted the comments made by the Delegated Powers and Regulatory Reform Committee in their report last January that the powers conferred by section 52 a of the Wales act 2017 should be subject to scrutiny solely by both Houses of Parliament. While I understand the logic of that viewpoint, I personally would have preferred to have an evenhanded approach enabling the Senedd to voice an opinion. I do however note that Scottish parliament would not afforded such an opportunity, if that were the only issue at stake I would have course except in amendment to that end to facilitate the progress of the bill.
May I now address this first bank of amendment starting with amendment one moved by the noble Lord. Amendment one seeks in the words of the presenters this amendment to direct the monies raised by the Crown Estate in Wales to the coffers of the Treasury. And not to the government of Wales. This is nothing less than undermining the fundamental object div of the bill of course. As such does not improve the bill, but in effect works out as if the bill had been refused a second reading.
This seems to me to be a backdoor way of blocking the bill and I would be grateful to know if the movers of this amendment have secured the agreement of the leader of the Welsh Conservative party on this matter. If indeed Darren Miller MS has agreed to such a ploy it's an issue about which voters of Wales and various NFL actions would certainly be aware, and they will certainly be aware, and they will be. That -- let every voter be aware that the Tory party want resources of Wales to be put into the control Treasury mandarins rather than the elected representatives of Wales.
My Pliskova friends in Wales have experienced this in both the Senedd and in the National Assembly to the dismay of elected members of all parties. Let me give a specific example of that experience which Wales suffered at the sticky hands of the Treasury in Whitehall. Between 2007 and 2011 the Welsh Labour led government to their huge credit attempted to avoid the fiasco of year end stampede to spend revenue monies before the end of the financial year on any scheme that may be at hand irrespective of whether such expenditure represents the best value for money for the everyone knows this still happens the length and breadth of these islands and despite tightening of the rules the Treasury have not sorted that out.
20 years ago the Welsh Government devised the scheme whereby they accumulated all the year end revenue underspend into a capital fund which was allocated for the worthwhile projects such as building schools and hospitals, and the eight cumulated between 2007 and 2011 some £400 million which the then Labour government at Westminster was a process which had But when the Conservatives came to power in 2011, the Treasury directed this money should be clawed back by the Treasury and Wales lost all the benefit of that funding.
That is how much we can trust the Treasury. This is exactly what the Tory amendment before us today is drawn up to accomplish. It is once again to take away from Wales resources that have been accumulated in Wales, this time by the Crown Estate from within Wales. Don't take my for it, read the explanatory note. This amendment will ensure that any revenues from the Welsh Crown Estate would still be paid into the Treasury. Is the objective. They are quite open about it, but the people of Wales and the voters of Wales will be horrified to hear about that.
This is an argument that will take place in the hustings over coming months. It seems the Tory movers of this amendment have no faith in the ability of the Welsh Government to use the monies raised in Wells for the benefit of the people of Wales. The people of Wales will be able to judge whether it is his party or other parties that will be elected. They don't seem to have faith in the Tory Senedd spoke man faith in the Tory Senedd spoke man being a guardian of the finances.
If the other Tories don't trust them, why should the people of Wales trust why should the people of Wales trust them? It is not just the Tory Senedd members they disparage with this amendment. They also pour cold water on the Tory councillors in those 21 authorities who abstained, and some of whom privately support the Crown Estate been devolved to the Welsh Government. The two noble Lord who hurriedly penned this amendment less than 48 hours ago take the trouble to contact the councillors? Their silence says everything.
Or do they assume that noble peers know more than the elected councillors of Wales. Monmouth, Powys, Denbighshire, temperature Council. Denbighshire, temperature Council. The message should be powering home. Scotland passed over to Scottish hands the Crown Estate in Scotland. hands the Crown Estate in Scotland. They didn't... May I suggest peers who move this amendment would draw it. Building safeguards if they are deemed to be necessary, but don't do so with the subliminal message was incapable of using such resources that benefits Wales.
Is as insulting as it is inaccurate and I invite the mover of the amendment to withdraw it. I moved quickly onto the other amendments, which are attached to this group. Amendment to is unnecessary. I understand the wish to build in certain safeguards. However, I need lessons on financial probity. Clause 1, subsection 12, already is precluded with the words, the scheme must include such provision as the Treasury deem necessary or expedient. Subsections C and D are broad enough to allow the necessary safeguards and the generality of the powers given to the Treasury under subsection 9 covered the matters spelt out in the amendment.
With regards to amendment amendment. With regards to amendment three, this attempts to give the Treasury a total free hand to undermine the functions of the devolved government of Wales. As I understand it no such sweeping powers were given to Scotland. What is it that makes the movers of these amendment to assume that those governing wells are less competent. Could it be there is such a high opinion of the S&P that they did not believe safeguards work necessary. I'm sure the ghost of Alec Sam and will be looking down with a very broad grin.
I listen to what Lord Thomas said with interest and respect as I know from his interventions at earlier stages and in the context of the government's Crown Estate Bill that he does not do so with any agenda trying to subvert the intentions of the bill. I can understand that safeguards may need to be built into the bill. I would have been happier had the provisions in amendment four, line 4, stipulated no earlier than one year, no later than three years to minimise uncertainty of such uncertainty triggering, but if Lord Thomas wants to argue this further with a veritable amendment at report stage I will give it further consideration.
I will accept amendment five if Lord Thomas is minded to move it and report. The point of this legislation is to enable resources emanating from the Crown Estate in Wales to accrue to Senedd Cymru. The amendment states that the money, and I quote from the explanatory notes, "Would still be paid into the Exchequer. The movers of this amendment clearly do not trust the elected members of Wales with finances that spring from Wells. Even if there was a Conservative Welsh Government they were not trust them with such resources either." I hope the voters in May's election are taking good note.
Amendment seven provides safeguards which I can well understand and impart accept. I will flag up my reservations about subsection 2 that states the Crown Commissioners have a duty to take into account but not should be bound by the views of Welsh ministers as communicated to them by Welsh ministers. I could accept such wording if there was a caveat that if such views were embodied in a resolution of Senedd Cymru, then the commissioners would be legally bound by them.
I will be happy to discuss this further of report stage and I will happy to discuss with Labour, Liberal Democrats, crossbench and Tory colleagues. Amendment seven is either a probing amendment, which didn't seem to be the case when the noble Lord spoke to earlier, or it is a wrecking amendments, in which case I would urge the committee rejected. We come finally to amendment eight in the name of the noble Lord Lord Moynihan. I don't noble Lord Lord Moynihan.
I don't have a problem with this amendment. The asset value been reduced to 25% relates to the first set of regulations and therefore not to subsequent ones. I do believe this clause has been badly drafted and the reference in-line 72 subsection 2 does not make very much sense. I will suggest the proposers redraft will suggest the proposers redraft this if so minded for report stage. My Lords, it would be remiss of me not to thank the Minister for his attendance and for his intervention today in this debate, and indeed to the noble Lord and the Frontbench for the opposition.
The government have at earlier stages of the bill and in the context of the government's own Crown Estate Bill voice their opposition to devolving powers to Wales, although they are happy to see these powers devolved to Scotland. Scotland, why not Wales? The Welsh Government have numerous occasions shown their support for this. I apologise that I have had to speak at such length, but that was inevitable when all these amendments were strung together. So I would invite the proposal of amendment one to withdraw it and for the further amendments not to be moved on the understanding that we may return to some of them and possibly new ones when we consider this bill at when we consider this bill at Lord Harlech, withdrawn? Is it your logic pleasure that this amendment be withdrawn? It is by leave withdrawn.
Lord Moynihan, amendments to entry, not moved. Amendment four, Lord Thomas, not moved. Amendment five, in clause 1 amendment five,
**** Possible New Speaker ****
Lord Thomas. The reason why I separated out
It might assist colleagues particularly those who don't live in Wales, you don't keep up with every twist and turn in Welsh politics to know that by now of the 22 look Welsh local authorities, 21, a whole range of political allegiance and some of no overall political control, 21 all but one have passed resolutions calling for the devolution of the To Wales. This has been supported by Plaid Cymru, Labour, Liberal Democrats and I believe accepted by even some Conservative members and Reform UK councillors. Who are only too aware of the current feeling of injustice in Wales in this regard.
I mention has been made of the windmills in the sea, above to the north of Bloor North Wales, last night in question time noble colleagues who may have watched the program will have noted that the largest round of applause in that program came from when the suggestion was made that Wales should be benefiting from all those North along the coast. There is a very strong feeling about it and that's why the councils have passed 21/22 in support and I have little doubt that there are sympathy also in the 22nd hasn't.
In considering the amendments before today I hope we will bear these background points we will bear these background points in mind. And yes, by all means let's improve the bell by debating amendments and if appropriate passing amendments at report stage. I would urge that the bill be approved by this chamber and it would then be a matter for the other place to come to a resolution on it in due course if they are prepared to make the time available so that they can at least address the strong feelings of an overwhelming majority of Welsh councils.
I've noted the comments made by the Delegated Powers and Regulatory Reform Committee in their report last January that the powers conferred by section 52 a of the Wales act 2017 should be subject to scrutiny solely by both Houses of Parliament. While I understand the logic of that viewpoint, I personally would have preferred to have an evenhanded approach enabling the Senedd to voice an opinion. I do however note that Scottish parliament would not afforded such an opportunity, if that were the only issue at stake I would have course except in amendment to that end to facilitate the progress of the bill.
May I now address this first bank of amendment starting with amendment one moved by the noble Lord. Amendment one seeks in the words of the presenters this amendment to direct the monies raised by the Crown Estate in Wales to the coffers of the Treasury. And not to the government of Wales. This is nothing less than undermining the fundamental object div of the bill of course. As such does not improve the bill, but in effect works out as if the bill had been refused a second reading.
This seems to me to be a backdoor way of blocking the bill and I would be grateful to know if the movers of this amendment have secured the agreement of the leader of the Welsh Conservative party on this matter. If indeed Darren Miller MS has agreed to such a ploy it's an issue about which voters of Wales and various NFL actions would certainly be aware, and they will certainly be aware, and they will be. That -- let every voter be aware that the Tory party want resources of Wales to be put into the control Treasury mandarins rather than the elected representatives of Wales.
My Pliskova friends in Wales have experienced this in both the Senedd and in the National Assembly to the dismay of elected members of all parties. Let me give a specific example of that experience which Wales suffered at the sticky hands of the Treasury in Whitehall. Between 2007 and 2011 the Welsh Labour led government to their huge credit attempted to avoid the fiasco of year end stampede to spend revenue monies before the end of the financial year on any scheme that may be at hand irrespective of whether such expenditure represents the best value for money for the everyone knows this still happens the length and breadth of these islands and despite tightening of the rules the Treasury have not sorted that out.
20 years ago the Welsh Government devised the scheme whereby they accumulated all the year end revenue underspend into a capital fund which was allocated for the worthwhile projects such as building schools and hospitals, and the eight cumulated between 2007 and 2011 some £400 million which the then Labour government at Westminster was a process which had But when the Conservatives came to power in 2011, the Treasury directed this money should be clawed back by the Treasury and Wales lost all the benefit of that funding.
That is how much we can trust the Treasury. This is exactly what the Tory amendment before us today is drawn up to accomplish. It is once again to take away from Wales resources that have been accumulated in Wales, this time by the Crown Estate from within Wales. Don't take my for it, read the explanatory note. This amendment will ensure that any revenues from the Welsh Crown Estate would still be paid into the Treasury. Is the objective. They are quite open about it, but the people of Wales and the voters of Wales will be horrified to hear about that.
This is an argument that will take place in the hustings over coming months. It seems the Tory movers of this amendment have no faith in the ability of the Welsh Government to use the monies raised in Wells for the benefit of the people of Wales. The people of Wales will be able to judge whether it is his party or other parties that will be elected. They don't seem to have faith in the Tory Senedd spoke man faith in the Tory Senedd spoke man being a guardian of the finances.
If the other Tories don't trust them, why should the people of Wales trust why should the people of Wales trust them? It is not just the Tory Senedd members they disparage with this amendment. They also pour cold water on the Tory councillors in those 21 authorities who abstained, and some of whom privately support the Crown Estate been devolved to the Welsh Government. The two noble Lord who hurriedly penned this amendment less than 48 hours ago take the trouble to contact the councillors? Their silence says everything.
Or do they assume that noble peers know more than the elected councillors of Wales. Monmouth, Powys, Denbighshire, temperature Council. Denbighshire, temperature Council. The message should be powering home. Scotland passed over to Scottish hands the Crown Estate in Scotland. hands the Crown Estate in Scotland. They didn't... May I suggest peers who move this amendment would draw it. Building safeguards if they are deemed to be necessary, but don't do so with the subliminal message was incapable of using such resources that benefits Wales.
Is as insulting as it is inaccurate and I invite the mover of the amendment to withdraw it. I moved quickly onto the other amendments, which are attached to this group. Amendment to is unnecessary. I understand the wish to build in certain safeguards. However, I need lessons on financial probity. Clause 1, subsection 12, already is precluded with the words, the scheme must include such provision as the Treasury deem necessary or expedient. Subsections C and D are broad enough to allow the necessary safeguards and the generality of the powers given to the Treasury under subsection 9 covered the matters spelt out in the amendment.
With regards to amendment amendment. With regards to amendment three, this attempts to give the Treasury a total free hand to undermine the functions of the devolved government of Wales. As I understand it no such sweeping powers were given to Scotland. What is it that makes the movers of these amendment to assume that those governing wells are less competent. Could it be there is such a high opinion of the S&P that they did not believe safeguards work necessary. I'm sure the ghost of Alec Sam and will be looking down with a very broad grin.
I listen to what Lord Thomas said with interest and respect as I know from his interventions at earlier stages and in the context of the government's Crown Estate Bill that he does not do so with any agenda trying to subvert the intentions of the bill. I can understand that safeguards may need to be built into the bill. I would have been happier had the provisions in amendment four, line 4, stipulated no earlier than one year, no later than three years to minimise uncertainty of such uncertainty triggering, but if Lord Thomas wants to argue this further with a veritable amendment at report stage I will give it further consideration.
I will accept amendment five if Lord Thomas is minded to move it and report. The point of this legislation is to enable resources emanating from the Crown Estate in Wales to accrue to Senedd Cymru. The amendment states that the money, and I quote from the explanatory notes, "Would still be paid into the Exchequer. The movers of this amendment clearly do not trust the elected members of Wales with finances that spring from Wells. Even if there was a Conservative Welsh Government they were not trust them with such resources either." I hope the voters in May's election are taking good note.
Amendment seven provides safeguards which I can well understand and impart accept. I will flag up my reservations about subsection 2 that states the Crown Commissioners have a duty to take into account but not should be bound by the views of Welsh ministers as communicated to them by Welsh ministers. I could accept such wording if there was a caveat that if such views were embodied in a resolution of Senedd Cymru, then the commissioners would be legally bound by them.
I will be happy to discuss this further of report stage and I will happy to discuss with Labour, Liberal Democrats, crossbench and Tory colleagues. Amendment seven is either a probing amendment, which didn't seem to be the case when the noble Lord spoke to earlier, or it is a wrecking amendments, in which case I would urge the committee rejected. We come finally to amendment eight in the name of the noble Lord Lord Moynihan. I don't noble Lord Lord Moynihan.
I don't have a problem with this amendment. The asset value been reduced to 25% relates to the first set of regulations and therefore not to subsequent ones. I do believe this clause has been badly drafted and the reference in-line 72 subsection 2 does not make very much sense. I will suggest the proposers redraft will suggest the proposers redraft this if so minded for report stage. My Lords, it would be remiss of me not to thank the Minister for his attendance and for his intervention today in this debate, and indeed to the noble Lord and the Frontbench for the opposition.
The government have at earlier stages of the bill and in the context of the government's own Crown Estate Bill voice their opposition to devolving powers to Wales, although they are happy to see these powers devolved to Scotland. Scotland, why not Wales? The Welsh Government have numerous occasions shown their support for this. I apologise that I have had to speak at such length, but that was inevitable when all these amendments were strung together. So I would invite the proposal of amendment one to withdraw it and for the further amendments not to be moved on the understanding that we may return to some of them and possibly new ones when we consider this bill at when we consider this bill at Lord Harlech, withdrawn? Is it your logic pleasure that this amendment be withdrawn? It is by leave withdrawn.
Lord Moynihan, amendments to entry, not moved. Amendment four, Lord Thomas, not moved. Amendment five, in clause 1 amendment five,
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Lord Thomas. The reason why I separated out
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Lord Thomas of Cwmgiedd (Crossbench)
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The reason why I separated out this amendment is that it deals with an issue we too often neglect when we speak about devolution and that is the working of the union. It seems to me that what this debate has, and the debate on the previous amendments, has brought into clear focus and failure to distinguish the positives of devolution. Is giving two nations is giving two nations what they aspire to, what they feel what they aspire to, what they feel they should have as a matter of hearts and minds.
As Lord Wigley has said there is enormous support for the devolution of these powers, but there is also an important issue to remember. We are part of a union and what the Crown Estate shows and exemplifies is that you can give powers to be devolved in certain areas, but then you should work together. And why I put in the amendment that suggested that the Crown Estate Commissioners have this power to take the management of the Crown Estate in Wales from the Welsh Government in accordance with the investment policy of the Welsh Government and being consulted about it, so that it could be a model of the way in which the union operates to benefit economically.
Spending a great deal of my time in Wales, I hope it is something the government understands that there is an understands that there is an enormous feeling of hostility in the way the government has run the Welsh Dealt with what happens in Wales. It does seem to me that it is important that we do two things. We recognise national aspirations and accept, as Lord Wigley has said, that what you give to Scotland you ought to give to Wales because you recognise them as having the same national aspirations.
But on the other hand we need openly and transparently to work together where it is in the common interest, and as Lloyd Moynihan's remarks have shown, working together in the energy sector is essential. I therefore wish for this particular point to be debated separately to bring home to His Majesty's loyal opposition who His Majesty's loyal opposition who were not very good at it when they were in power and to this government before it is too late, the absolute essentials of making it clear that you respect nationhood.
You respect what has been done by way of devolution, but you show that you will work together to benefit each of the nations by cooperation and joint policies where it is in the overwhelming national interests. The Crown Estate epitomises the recognition of national aspirations, but where it compels working together and that is the lesson much broader than this particular bill, but is one which is, as a strong believer in the union, I think we too often forget here in London and we don't recognise the pluses devolution have brought.
The fact that we cannot roll back on it, but how much more effort needs to be put into working together and this provides the perfect model. I beg to move this amendment.
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Lord Thomas of Cwmgiedd (Crossbench)
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The reason why I separated out this amendment is that it deals with an issue we too often neglect when we speak about devolution and that is the working of the union. It seems to me that what this debate has, and the debate on the previous amendments, has brought into clear focus and failure to distinguish the positives of devolution. Is giving two nations is giving two nations what they aspire to, what they feel what they aspire to, what they feel they should have as a matter of hearts and minds.
As Lord Wigley has said there is enormous support for the devolution of these powers, but there is also an important issue to remember. We are part of a union and what the Crown Estate shows and exemplifies is that you can give powers to be devolved in certain areas, but then you should work together. And why I put in the amendment that suggested that the Crown Estate Commissioners have this power to take the management of the Crown Estate in Wales from the Welsh Government in accordance with the investment policy of the Welsh Government and being consulted about it, so that it could be a model of the way in which the union operates to benefit economically.
Spending a great deal of my time in Wales, I hope it is something the government understands that there is an understands that there is an enormous feeling of hostility in the way the government has run the Welsh Dealt with what happens in Wales. It does seem to me that it is important that we do two things. We recognise national aspirations and accept, as Lord Wigley has said, that what you give to Scotland you ought to give to Wales because you recognise them as having the same national aspirations.
But on the other hand we need openly and transparently to work together where it is in the common interest, and as Lloyd Moynihan's remarks have shown, working together in the energy sector is essential. I therefore wish for this particular point to be debated separately to bring home to His Majesty's loyal opposition who His Majesty's loyal opposition who were not very good at it when they were in power and to this government before it is too late, the absolute essentials of making it clear that you respect nationhood.
You respect what has been done by way of devolution, but you show that you will work together to benefit each of the nations by cooperation and joint policies where it is in the overwhelming national interests. The Crown Estate epitomises the recognition of national aspirations, but where it compels working together and that is the lesson much broader than this particular bill, but is one which is, as a strong believer in the union, I think we too often forget here in London and we don't recognise the pluses devolution have brought.
The fact that we cannot roll back on it, but how much more effort needs to be put into working together and this provides the perfect model. I beg to move this amendment.
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Lord Sandhurst (Conservative)
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Lord Sandhurst (Conservative)
the Marshalled List. ACRE my Lords, I can speak briefly to this final amendment, number five, in the name of the noble and learned Lord Lord Thomas. He has made thoughtful and powerful contributions to our debate today, not least as he has said as a This amendment of his would create a This amendment of his would create a strong framework for powers to enter agreement the Crown Estate for performance of specified matters in relation to the management or investments of the Welsh Crown Estate by counsel.
I have listened carefully to the noble Lords arguments and he has made a powerful case for his amendment. But as I said in my remarks, my more general remarks to the previous group, we do have serious concerns about the direction set this bill. Now is not the time to take forward proposals for devolution of the Welsh Crown Estate. But that said, if this bill is to go forward, we hope Lord Wigley will listen carefully to constructive remarks made by Lord Thomas and my noble friend Lord Hollick, Lord Moynihan and Lord
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Harper. Thank you. As I indicated when I spoke previously I would be minded to previously I would be minded to accept this amendment if it was Romeu -- moved at report stage.
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As I've already said the government believes that the Crown Estate as it currently operates
I have listened carefully to the noble Lords arguments and he has made a powerful case for his amendment. But as I said in my remarks, my more general remarks to the previous group, we do have serious concerns about the direction set this bill. Now is not the time to take forward proposals for devolution of the Welsh Crown Estate. But that said, if this bill is to go forward, we hope Lord Wigley will listen carefully to constructive remarks made by Lord Thomas and my noble friend Lord Hollick, Lord Moynihan and Lord
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Harper. Thank you. As I indicated when I spoke previously I would be minded to previously I would be minded to accept this amendment if it was Romeu -- moved at report stage.
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As I've already said the government believes that the Crown Estate as it currently operates
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Lord Wilson of Sedgefield (Labour)
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Lord Wilson of Sedgefield (Labour)
Estate as it currently operates across England Wales and Northern Ireland provides the best outcomes for Wales and the wider United Kingdom. I will not repeat the arguments set out earlier in this debate on that, I think Lord Thomas again for his considered contributions to this debate. The amendment we are debating now, amendment five would permit the Crown Estate Commissioners to exercise specific management and investment functions on behalf of Welsh ministers. I would remind the House that existing statute provides Crown Estate with independence and autonomy to set and achieve its goals.
The government believe that the Crown Estate should continue to operate in this way, as a commercial business independent from government, because it has shown itself to be a trusted and successful organisation. With a proven track record and effective management. Even if the proposal in this amendment was being suggested for the Crown Estate in its current form, it would be important to ensure this independence was preserved in respect of any functions it took on behalf of ministers. More broadly as I previously set out the garment will continue to discuss with the First Minister and the Welsh Government to ensure that Wales sees the full benefit of the Crown Estate.
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Before Lord Thomas winds up, can I just say that I completely endorse and agree with his views about cooperation. There is absolutely no doubt whatsoever that that is vitally important in the relation between Wales and the United Kingdom between Wales and the United Kingdom in this context. My arguments have not been principally political at any stage during this Committee stage. My argument is that the lion stage. My argument is that the lion share of the Crown Estate assets in Wales require to be maximised in Wales require to be maximised in terms of economic value to Wales, that there should be the overarching that there should be the overarching control and involvement of the Crown Estate as is currently set up.
I Estate as is currently set up. I believe that would be the most efficient and efficacious way of maximising the value of those assets in the Celtic Sea and that was the reason that I pushed this argument so strongly, not because of future political arrangements. I think essentially after that project comes to fruition and benefits all concerned, there may well be an opportunity to look at the political realities that have been put forward by Lord Wigley and indeed Lord Thomas.
I think that is the reason why the government have taken the position that they have, I endorse that strongly, it's a cross-party view but it is one that has driven -- is driven from my perspective on the economic realities of those assets in Wales at this time and we should still make sure that there is maximum cooperation between all interested parties, the Crown Estate and the locally interested parties in Wales to make sure that the in Wales to make sure that the projects we have been discussing in the context of this bill are brought to fruition to the maximum economic benefit of both the United Kingdom as a whole and indeed, Wales.
as a whole and indeed, Wales.
The government believe that the Crown Estate should continue to operate in this way, as a commercial business independent from government, because it has shown itself to be a trusted and successful organisation. With a proven track record and effective management. Even if the proposal in this amendment was being suggested for the Crown Estate in its current form, it would be important to ensure this independence was preserved in respect of any functions it took on behalf of ministers. More broadly as I previously set out the garment will continue to discuss with the First Minister and the Welsh Government to ensure that Wales sees the full benefit of the Crown Estate.
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Before Lord Thomas winds up, can I just say that I completely endorse and agree with his views about cooperation. There is absolutely no doubt whatsoever that that is vitally important in the relation between Wales and the United Kingdom between Wales and the United Kingdom in this context. My arguments have not been principally political at any stage during this Committee stage. My argument is that the lion stage. My argument is that the lion share of the Crown Estate assets in Wales require to be maximised in Wales require to be maximised in terms of economic value to Wales, that there should be the overarching that there should be the overarching control and involvement of the Crown Estate as is currently set up.
I Estate as is currently set up. I believe that would be the most efficient and efficacious way of maximising the value of those assets in the Celtic Sea and that was the reason that I pushed this argument so strongly, not because of future political arrangements. I think essentially after that project comes to fruition and benefits all concerned, there may well be an opportunity to look at the political realities that have been put forward by Lord Wigley and indeed Lord Thomas.
I think that is the reason why the government have taken the position that they have, I endorse that strongly, it's a cross-party view but it is one that has driven -- is driven from my perspective on the economic realities of those assets in Wales at this time and we should still make sure that there is maximum cooperation between all interested parties, the Crown Estate and the locally interested parties in Wales to make sure that the in Wales to make sure that the projects we have been discussing in the context of this bill are brought to fruition to the maximum economic benefit of both the United Kingdom as a whole and indeed, Wales.
as a whole and indeed, Wales.
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Lord Thomas of Cwmgiedd (Crossbench)
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difference between what I have put forward and Lord Moynihan. But first forward and Lord Moynihan. But first I would like to thank everyone for listening patiently to what I had to listening patiently to what I had to say. I do believe that at the end of the day it is very very important to recognise as one sees across the world to the importance of what is world to the importance of what is stirred up by nationhood. It is stirred up by nationhood.
It is important to try and analyse the way in which economic benefits can be in which economic benefits can be conferred, and although I listen to all the arguments, it still seems to me that the compromise which I put me that the compromise which I put forward, namely recognise nationhood and national aspiration, but and national aspiration, but cooperate to provide economic in a fit is something -- benefit, is something for now and not a distant time in the future. Having listened
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to all the arguments and seeing the views of the House of course I withdraw my amendment. Is a urologic pleasure that this amendment is withdrawn? It is by amendment is withdrawn? It is by leave withdrawn. Amendment six not moved. Amendment seven Lord Thomas moved. Amendment seven Lord Thomas not moved. The question is that clause one stand part of the bill stop As many are of that opinion say, "Content", and of the contrary, "Not content". The "Contents" have "Not content". The "Contents" have it.
Lord Moynihan amendment eight is it. Lord Moynihan amendment eight is not moved. And amendment nine not moved. The question is that clause to stand part of the bill. As many to stand part of the bill. As many are of that opinion say, "Content", and of the contrary, "Not content". and of the contrary, "Not content". The "Contents" have it. -- Clause 2. The question is this be the title of the bill. As many are of that the bill. As many are of that opinion say, "Content", and of the contrary, "Not content".
The "Contents" have it. That concludes the committee's proceedings, the house will now resume.
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The committee of the whole house
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The committee of the whole house to which the Crown Estate Wales bill was committed has gone through the
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was committed has gone through the same and has directed me to report at your Lordships without amendment. I beg to move that the House do now resume. Adjourn.
It is important to try and analyse the way in which economic benefits can be in which economic benefits can be conferred, and although I listen to all the arguments, it still seems to me that the compromise which I put me that the compromise which I put forward, namely recognise nationhood and national aspiration, but and national aspiration, but cooperate to provide economic in a fit is something -- benefit, is something for now and not a distant time in the future. Having listened
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to all the arguments and seeing the views of the House of course I withdraw my amendment. Is a urologic pleasure that this amendment is withdrawn? It is by amendment is withdrawn? It is by leave withdrawn. Amendment six not moved. Amendment seven Lord Thomas moved. Amendment seven Lord Thomas not moved. The question is that clause one stand part of the bill stop As many are of that opinion say, "Content", and of the contrary, "Not content". The "Contents" have "Not content". The "Contents" have it.
Lord Moynihan amendment eight is it. Lord Moynihan amendment eight is not moved. And amendment nine not moved. The question is that clause to stand part of the bill. As many to stand part of the bill. As many are of that opinion say, "Content", and of the contrary, "Not content". and of the contrary, "Not content". The "Contents" have it. -- Clause 2. The question is this be the title of the bill. As many are of that the bill. As many are of that opinion say, "Content", and of the contrary, "Not content".
The "Contents" have it. That concludes the committee's proceedings, the house will now resume.
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The committee of the whole house
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The committee of the whole house to which the Crown Estate Wales bill was committed has gone through the
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was committed has gone through the same and has directed me to report at your Lordships without amendment. I beg to move that the House do now resume. Adjourn.
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