Complications from Abortions (Annual Report) Bill [HL]

Baroness Brinton Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I offer Green group support for the proposition from the noble Baroness, Lady Thornton. I almost feel that I do not need to, given that the noble Baroness, Lady Freeman of Steventon, very powerfully made the argument that the Bill unnecessarily exceptionalises abortion when there are very comparable procedures conducted in similar procedural ways—hip replacements and cataract operations. Yes, we need to improve the collection of statistics, but we do not have a Bill before us to do that. By definition, the exceptionalising that is going on is very obvious.

I want to pick up on two comments made by the noble Lord, Lord Weir of Ballyholme, and most respectfully to disagree with him. The noble Lord said that what is happening in the US is not relevant here. I spoke at Second Reading about the influence and money flowing from the United States of America into the UK. I can update your Lordships’ House on that. I was going back as far 2014, and a chapter of a book I wrote addressing these issues. This has been highlighted by Peter Geoghegan, who wrote Democracy for Sale, and others. The so-called Alliance Defending Freedom from the US provides massive funding. In 2020, it put £324,000 into a 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. We are debating this Bill in the context of that flood of US money seeking to influence what is happening in the UK.

I put Written Question HL6542 to the Government about this. I am afraid that the Government are not taking this with the seriousness that it deserves for defending our democracy. The Answer referred to lobbying of the Government and what measures the Government have in place. We need to think about the measures that we need across 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 noble Lord, Lord Weir, also said that the context did not really matter. However, this Bill appears before us in the context of more than 60 MPs in the other place backing one amendment—there is another one too—to decriminalise abortion, to end the exceptionalisation of abortion right across our law. That would make this Bill look particularly strange and ill-fitting. For those reasons, I support the proposition from the noble Baroness, Lady Thornton.

[Baroness Brinton (LD)]

My Lords, unfortunately, I too was unable to be at Second Reading. I speak today to support the stand part notice from the noble Baroness, Lady Thornton, and on what the noble Baroness, Lady Finn, said about the important review of data collection—actually, across the health sector, as I will explain, but particularly of data relating to abortions.

The noble Baroness, Lady Thornton, spoke of how some elements of this short Bill are inconsistent, which makes it unable to deliver what the noble Lord, Lord Moylan, hopes for, despite what he said—I will come on to explain why—even if it were the right thing to do. I agree with the points that the noble Baroness, Lady Thornton, made.

One issue at the heart of this inconsistency is the use of patients’ confidential health personal data. There is an absolute presumption by patients that their health personal data will always be kept confidential between them and their medical practitioners. Indeed, noble Lords may remember, when the then Government proposed care.data plans a few years ago, it became clear that we were likely to move to a US-type system of allowing researchers, insurers et cetera access to anonymised and pseudonymised data. I can tell the noble Baroness, Lady Lawlor, that, during that debate, it was important to note that it is possible to reverse most anonymised and pseudonymised data, particularly when dealing with an unusual circumstance. Once you have one or two identifiers, you can get to a very small geographic position very quickly—sometimes to a postcode, frankly. Therein lies the problem: confidentiality is lost.

More worrying were the original proposals in the Bill that became the Police, Crime, Sentencing and Courts Act 2022, which gave the police and the Home Secretary—then Priti Patel—the power to demand from any relevant person or authority, which included health authorities at the time, to see data that might be of interest in an investigation. I was working on that Bill and, when I queried this power in your Lordships’ House, it transpired that it was not just for suspects of crime but for anyone connected with the incident, who might or might not be a witness. That went completely against everything in a doctor’s sacred oath of confidentiality with regard to their patient. I am pleased to say that, following my amendments to that Bill and pressure from doctors, the then Clause 16(4)(a) was modified to prevent access to health data compared to data from other bodies, where it still sits.

That was followed by a debate, on the Health and Care Bill, about the use of patients’ personal health data for research. My noble friend Lord Clement-Jones, other noble Lords and I made it very clear that assuming that anonymised or pseudonymised data could not be reverse-engineered was not acceptable. Out of that, a new system of a black box, where the anonymity of patients is guaranteed, was introduced.

However, abortion data is different because it is not within these safeguards. The Abortion Act 1967 requires that the woman’s name and date of birth or a personal identifier must be submitted on every abortion and provided to the Chief Medical Officer via the abortion notification system. While, as others have said, this data includes complications prior to discharge, the “Hospital Episode Statistics” referred to in Clause 1(3)(b) of the Bill from the noble Lord, Lord Moylan, are based only on abortion data from trusts, which are not linked to abortion records. This means that the data is coming from two different sources, which are collecting different data. As the briefing from BPAS tells us, neither dataset actually captures all abortion complications, nor can the hospital episode statistics be analysed by methods of gestation or abortion—another difference, yet again. I do not think that the noble Lord, Lord Moylan, covered that point of disparity when he spoke earlier. My worry is that the annual report would not actually reflect the wider picture.

The second issue that I will raise is of those other delicate areas that might inadvertently be drawn into this type of reporting on complications of abortion. In the debate earlier today in your Lordships’ House, 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”—a ghastly phrase. I still had remnants inside my body that needed to be removed to ensure a “complete abortion”—an even more ghastly phrase. In the middle of my grief at losing my first baby, the medics were talking about “abortion”.

The very helpful briefing from the Royal College of Obstetricians and Gynaecologists points out that the differing terms that can be entered into hospital coding are “induced miscarriage” and “spontaneous abortion”. It says:

“This can result in a code being applied for an abortion complication when it should have been for a miscarriage complication and vice versa.”


This is not just about words such as “spontaneous abortion”. Following on the speech from the noble Baroness, Lady Bennett, in the USA, since the Dobbs case, miscarriage has increasingly been brought into the debate about abortion. West Virginia has one of the toughest sets of abortion laws, allowing it only for cases of rape, incest or if the woman has an ectopic or totally non-viable pregnancy. But it gets worse. Last week, in Raleigh County, West Virginia, the prosecuting attorney, Tom Truman, advised women to get in touch with police, law enforcement or a doctor if they were worried that they might be charged with mishandling foetal remains. The example cited was the arrest of a woman for disposing of foetal remains in her bins. He said that a number of criminal charges under state code, including felonies, could be levied against a woman who flushes foetal remains, buries them or otherwise disposes of them following an involuntary abortion, also called a miscarriage. A West Virginian woman in my situation, which I talked about earlier, could well be prosecuted. The miscarriage that I referred to is not unusual. I lost the tiny foetus down the toilet, and I was distressed beyond measure. In West Virginia, you would now have to retrieve the foetal remains or be at risk of prosecution.

I am sure that there is absolutely no intention in the UK for this to happen, but the debate happening in the US is beginning to colour the debate we are having here. I am very clear that the problem is that some people want miscarriage to be treated as suspicious. They clearly are not medics. It is thought that 15% to 20% of pregnancies end in miscarriage. It is surprisingly common, and good luck to that prosecutor in West Virginia. He is going to spend his entire time on people reporting miscarriage. Above all, the issue of miscarriage and spontaneous abortion is yet another that muddles the data proposed in this annual report and demonstrates, sadly, that it is not fit for purpose.

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, I was here for Second Reading and I was here to hear the noble Lord, Lord Moylan, tell us about how the abortion landscape is shifting quite rapidly. Between Second Reading and today, we saw a vivid example of just how that landscape is shifting and why it needs to shift very rapidly, because we saw the conclusion of the trial of Nicola Packer. Thankfully, the jurors recently cleared the 45 year-old of illegally terminating her pregnancy. She suffered more than four years of police and criminal proceedings.

In fact, the number of women being prosecuted on suspicion of breaking abortion laws has increased over recent years, so the landscape is getting worse. That is partly why I am very pleased to support the noble Baroness, Lady Thornton, in opposing the clause standing part, because the Bill does nothing to improve the abortion landscape. Personally, I am quite surprised that the noble Lord, Lord Moylan, has brought it back today to Committee, because it was made evident to us at Second Reading by the Minister and other speakers, including my noble friend Lord Scriven, that it was absolutely unnecessary and very unhelpful. Indeed, we heard from the noble Baroness, Lady Freeman of Steventon, today exactly why that is.

I hope that this House will soon have the opportunity to debate and enact real change, along the lines of the two amendments tabled in the other place, referred to by the noble Baroness, Lady Bennett. I want to check something with the noble Lord, Lord Moylan. He said at Second Reading—and I expect he is thinking it again today:

“What is so strange about the advocates of choice in this debate is that they are so defensive; they speak as if they are surrounded by conspiracy ... If I thought I was surrounded by conspiracy, I would want to live in a world of facts and not hide myself from them”.—[Official Report, 13/12/24; cols. 1994-5.]

Preterm Birth Committee Report

Baroness Brinton Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Brinton (LD)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Blackstone. I congratulate the noble Lord, Lord Patel, and his committee on this excellent report. It takes the recommendations of Lady Cumberlege’s 2016 report, Better Births, on to a new, more detailed, more expert level—including, very importantly, experts by experience—by assessing our hospitals preterm birth services in the light of the decade that has followed.

I talked to Lady Cumberlege late in 2016 about the Better Births report, because my first two identical granddaughters were born in May 2016 at 29 weeks, just like those of the noble Baroness, Lady Blackstone. They were at heightened risk because they had twin-to-twin 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 my daughter-in-law lived the full experience of preterm birth and its after-effects full on for four years, so although I want to focus on the recommendations and the Government’s response, it is in the context of probably the most intense period of our family’s lives.

I need to say at the start that these two now nine year-old twins are healthy, active and intelligent, which is only possible because Kingston Hospital, the Evelina hospital and their local community services, as well as organisations such as the Twins and Multiple Births Association and Bliss, delivered everything that they needed to survive and grow. The noble Baroness, Lady Seccombe, talked about the importance of health visitors; they are as pressurised as our GPs and we need more of them.

The committee’s report is excellent, and the expertise of its members, especially its chair, the noble Lord, Lord Patel, is evident in the recommendations. But, as I have said, I want to look, from these Benches, at the Government’s responses to the report. It is good that they have in principle accepted the report’s recommendations, but it is their implementation that I want to ask about. I echo the question from the noble Baroness, Lady Bennett, about staffing levels and working practices for midwives, which other noble Lords have also spoken about.

The Government’s response begins by assessing the challenges ahead for 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 showed that it is effectively all spent already. Can the Minister say whether there is sufficient resource this year and in future years to effect the changes that the Government aspire to, not just during this Parliament but immediately, this year and next year?

At the start, the Government’s response speaks about the excellence of the NHS’s Saving Babies’ Lives Care Bundle, but notes that its application is inconsistent. Is there specific funding to ensure that the bundle can be delivered consistently across the country by April 2026? The same is true of the key targets to reduce the rate of preterm births, given that the previous target of reducing the rate to 6% by this year will not be met, as others have said. The Government’s response is silent on new targets to replace this, citing only the challenges. Can the Minister tell us when new targets will be announced?

The Government cite the £50 million NIHR challenge fund, created a year ago by the previous Government to provide researchers and policymakers with resources to assess new ways to tackle maternity disparities and poor pregnancy outcomes. I agree that this is vital, but when will the reports be concluded and published? The noble Lord, Lord Winston, spoke of the importance of more research on miscarriage. He is right. That should be considered too.

The noble Baroness, Lady Goudie, set out how important early advice and guidance is to help to reduce rates of preterm birth, and recommendation 2 sets out the advice and access to information that future parents need long before the pregnancy. I welcome the Government’s endorsement of this, but much of it is funded through the public health budget, which is notoriously under pressure. The noble Baroness, Lady Bennett, highlighted this, and the noble Baroness, Lady Sugg, and the noble Lord, Lord Weir, also talked about the real problems of financial inequalities.

There is also a reference to the GP postnatal check-up six to eight weeks after birth being carried out in full. The proposals are excellent, but do our currently hard-pressed GPs have the capacity to deliver this vital check-up in the detail that is actually needed?

Recommendation 3 focuses on clinical guidance for preterm birth care. My daughter-in-law’s experience of a complex pregnancy, with twin-to-twin transfusion and not just one but both girls’ lives at risk, was absolutely textbook. The delicacy with which the risks were explained to her and my son and the care before, during and after the operation in utero at 16 weeks on her girls, were breathtaking. Things seemed to happen so fast, but all the staff we encountered as a family were caring and careful. When the girls arrived at 29 weeks we were all ready, but a couple of days beforehand we were warned that there might not be two NICU incubators at Kingston, and one of them might have to go to Southampton, the nearest NICU with a space—yes, Southampton. Can you imagine two new parents, one of whom has had a caesarean, trying to manage two babies in NICUs 60 miles apart? The noble Baroness, Lady Penn, was right to raise this issue. Luckily, on the day, they had two incubators at Kingston; I suspect that another family was sent to Southampton. Will there be a review of the number of NICU incubators to prevent this happening?

We were warned that one of the twins might have severe problems or not survive. She did—all 700 grams of her. The noble Baroness, Lady Bertin, spoke about the tiny size of these babies. My son could hold baby A—her whole body—in the palm of his hand. The care for both in those first few days in NICU was outstanding and supportive. The other baby—all of 1.5 kilograms—came home, but A’s issues, which were not unusual for a baby of her size and problems, continued. After a few weeks, she moved to the Evelina hospital and remained there until she was 10 months old. NICU, PICU, and then the long-term Snow Leopard ward were all extraordinary. Yet we watched our children manage one twin at home in Barnes and the other in hospital in Waterloo, as well as my son holding down his job and the stress that it put on the pair of them.

I thank the noble Baroness, Lady Wyld, for her Neonatal Care (Leave and Pay) Act, which will undoubtedly help families. The noble Baroness, Lady Penn, said that we need better parental leave, and she is right. The legislation that Jo Swinson led in coalition was a start, but we all knew that it was just a first step.

Recommendations 5 and 6 on parental accommodation for neonatal support are just the tip of the iceberg. We—the grandparents, aunts, uncles and friends—all had the privilege of supporting our children. In my case, I was able to be at the Evelina most mornings, but this was a first for us, too. As the noble Baroness, Lady Bertin, pointed out, the start of the report quotes a parent saying:

“The impact of prematurity does not end upon discharge from a neonatal unit”—


so true. A had a ventilator, and a nasal and then gastric tube, until she was nearly four. We were trained by the Evelina Hospital to manage these so that we could babysit both girls and stay overnight to give their parents a break. Without it, they could have had no respite. Care was not available from the local community.

Recommendation 9 suggests that NHS England should take action to deal with follow-up assessments, especially the one at the age of four. Our family had the benefit of an effective series of follow-up assessments, even though by that stage, A had a clear dislike of people in white coats—and who can blame her? At her final assessment she walked firmly and bravely through the door. We were thrilled that she did not have to return again. By then, the speech and language therapists had supported her into excellent speaking. Her hole in the heart had healed, and she no longer needed that damn ventilator, although she still finds running difficult, unlike her twin.

The baby who used to wave over the river at granny’s office, also known as the House of Lords, every night from her ward, Snow Leopard Ward, now has a passion for wild cats and sponsors snow leopards at Marwell Zoo. She has no memory of what happened, but she would not be with us without every single one of the professionals who were there for her, her twin and their parents from the moment of that first scan at Kingston Hospital. My hope is that the report by the noble Lord, Lord Patel, and government action will ensure that this is the case for all families facing this extraordinary time in their lives, because a consistently delivered service will not just save the lives of preterm babies, but improve the quality of their lives.

Covid-19: Day of Reflection

Baroness Brinton Excerpts

Thursday 20th March 2025 Lords Chamber

[Baroness Brinton (LD)]

I congratulate the right reverend Prelate the Bishop of London on securing this important topical debate and on her excellent introduction to the very wide range of issues contained in it. I shall divide my time into two areas: first, bereavement support to people since Covid but not only because of Covid; and, secondly, the effect of Covid deaths on their loved ones and on wider society.

On deaths at the beginning of Covid during lockdown, through our social conventions for grieving and marking the life of a special person who has died, saying goodbye to a loved one on a phone or a tablet via a nurse holding it up in hospital was extremely hard. Then there were the limited numbers of people being permitted to be at a funeral. However, I have to say that the one benefit has been Zoom funerals. If you cannot be there in person, it is now normal to be able to join online or even see it afterwards, which is an important part of the grieving process.

On new styles of funerals and their cost, to which the right reverend Prelate referred, I am concerned about the advertisements for extremely cheap funerals that are constantly on TV at the moment. I notice that they are just beginning slightly to qualify what is on offer. People do not understand what is on offer. I wonder whether we need to address the issue about advertising regulation for these funerals, because people often buy in advance and then discover that there is literally no service or gathering whatever and there is no way they can mark the cremation of the person either—there is nothing. For some people, it may be the right thing, but I know that many funeral directors are frustrated, because they can offer cheaper funerals than most people imagine. The average price was cited earlier, but they are certainly trying to make sure that they can provide it.

The other big issue is the British style of mourning, if I may put it that way; to call it restrained would be an understatement. There are cultural differences in our own communities, but also in Europe. The first open-coffin funeral that I went to was for a Latvian relative, and everybody at the funeral went up to kiss the person in the coffin. I was 20, and I think it would be fair to say that I was horrified, because it is just not within our culture. One problem with Covid was that all those different cultural ways of saying farewell were probably even more inappropriate. Covid removed our ability to mourn, and I therefore welcome the growth of “grief cafés”, where people can come together to talk about preparing for grief, recognising that somebody is going to die, but also, after they have died, having a safe space where people can come together in an entirely safe and relaxed environment to chat about death and how it is affecting them.

I also want to mark the role of leaders of religions and belief in supporting families and friends and the individual on that journey to death and afterwards. That was one of the hardest things that we lost during Covid. Being on the end of a phone was extremely difficult—unless the weather was fine and you could have a meeting outside—and it transformed the experience, and not in a good way.

I also want to talk about how grief affects children. That journey of grief and saying farewell is very different for anybody under about 16. We fostered two children of a friend of ours, and the vicar and the chaplain of the hospice guided them, aged 10 and 12, and ourselves in what was going to happen. They encouraged us to take the children to see their mother after she had died, when our natural reaction would have been not to do that. But it was the right thing to do, because they were happy to do it, and it helped them to recognise that she was gone for ever. The support that we got from our faith leaders and our wider church community made an enormous difference.

I turn now to the consequences of Covid. I was health spokesperson for what we might describe as the whole of the first big period of Covid, up until December 2022. The most shocking thing that happened was that certain doctors abused the DNACPR decision-making. Never again must these be taken without something on a patient’s file showing that they have explicitly been part of the decision-making, even if it was not their decision, or, if they do not have capacity, that their attorney or next of kin has also been part of it. It was particularly unfortunate that many very elderly people with dementia and those with learning disabilities were given DNACPRs without their and their families’ knowledge.

For those families who lost people who were on the front line during Covid without proper PPE, can the Minister say whether the Government will follow the recommendations for pandemic preparedness in the first report of the Covid-19 inquiry, to ensure that we can protect front-line staff when—not if—the next pandemic arrives? I add to that the front-line staff who survived severe Covid but have been medically retired and are now fighting the NHS, which says that, because these well-loved staff—who served for many years and are important to our NHS—cannot confirm when they caught Covid, they are therefore not entitled to compensation. This is unjust. I know two people whom that has affected very badly. They were in PPE made of black plastic bags right at the start, and both caught Covid within the first three weeks.

Those who died very early on, pre-vaccination, were overrepresented by, as I am sure you will remember, those described as “clinically vulnerable”—I am one of that number and I survived Covid. They are still overrepresented in deaths today, even though the number of Covid deaths is much lower. This winter, we have seen a large number of deaths from flu and pneumonia. Part of the problem is that Ministers, past and present, tell us that Covid is over, but it is not. The consequence of that is sometimes long Covid, but it also affects decisions about whether Covid is airborne or not.

UKHSA and NHS England tell us that Covid is not airborne transmitted and that the main transmission is usually through contact with droplets. The WHO disagrees with this and changed its definition two years ago. Why? Because the WHO realised that the size of the virus was small enough to mean that it is airborne. That is important because that requires masks and ventilation for those who may be at risk. The WHO says that we should consider using masks if at risk. I would love us to get to the stage of Japan and China, where if you have a bad cold and you are going on the underground, you put a mask on. That has not been in our culture, but it would help those who remain at home because they are so clinically vulnerable that they do not feel safe going out.

That would also reduce transmission of various viruses in schools. My regular hospital is Addenbrooke’s in Cambridge, which during lockdown devised a very cheap but effective ventilator that is now available on every ward. The staff also mask up very early on. However, in schools there is a large amount of transmission, not of Covid but of other viruses, because there is no ventilation in classrooms except that ordained by the head teacher.

That frustration is born out of the death of a very dear friend of mine who survived a major lung transplant at Papworth. When he went home, his care worker did not wear a mask and she gave him Covid. He died, after the long period he had spent in hospital and after all the NHS work to try to take care of him. The equation does not seem right there.

Can the Minister say, therefore, whether the Government will make sure that all the recommendations that come out of the Covid inquiry—not only those in the first report, which we have seen—mean that we keep our people safer, not only from Covid, and encourage our front-line staff, including those in the NHS, that where they work they will be able to work safely? Above all, given the tone and nature of this debate, will we be able to support people as they face death and the loss of loved ones in the future?

Health and Social Care: Winter Update

Baroness Brinton Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I want to echo the comments of the Secretary of State in the other place about the appalling treatment of Achamma Cherian, who was stabbed in the Royal Oldham Hospital last Saturday. It is absolutely intolerable for any member of NHS staff to be treated in this way. Can the Minister reassure your Lordships’ House that staff in A&E especially are protected, but also throughout our NHS?

I want also to start by thanking our NHS and social care staff for their remarkable effort. One of the problems that our NHS and social care staff have faced is total exhaustion since the winter of 2019-20. Immediately following the winter pressures, we were faced with a pandemic. Everybody in the NHS is now saying that this winter feels much worse, simply because it is yet another year of winter pressures.

Ambulance services have had to change their advice across the country to warn of being overstretched. A leaked memo from the West Midlands Ambulance Service says that patients who had collapsed with abdominal pain and vomiting, which are category 3 and 4 calls, and even, in the periods of highest demand, with heart attack or stroke, which is category 2, were told, “We don’t have an ambulance available to respond to you and it may be hours before one is available. Is there any way you can arrange safely to get to a hospital emergency department?”

I am minded to tell the House that, when I got a bus the other day that passed University College Hospital at Warren Street, a number of people got off who were clearly extremely unwell and being taken to the hospital by their families. What are the Government planning to do to support patients who need urgent ambulance services that are not available—for reasons that we understand are often to do with backlogs in A&E, queues and so on?

The Statement says that the experience of patients this winter is unacceptable, and we on these Benches agree. It is the opposite of a vicious circle: it is a circle of hell, not just for patients but for staff. I note that the Secretary of State commented in the Statement on what he saw when he was visiting, but worse is to come. We know from the Royal College of Nursing survey published earlier this week that we have patients dying in corridors, with nurses feeling absolutely unable to provide support for them.

It is not just 14 years of underinvestment; frankly, we are now seeing the problems of the wrong reforms that happened some years ago now. That has resulted in particular in pressure on primary care. The Statement focuses on hospitals but does not address the real crises that are going on in primary care.

In addition to the issues of funds and the planned extra doctors, who will take a while to come in, what are the Government planning to do to prevent hospitals constantly referring patients back to primary care when they need just an X-ray or a test, rather than being dealt with by the doctor they are seeing in hospital?

The emphasis of the Statement is obviously on the current high level of infections. It comments on the more than 5,000 patients in hospital beds with flu, but it does not say that we need to add to that RSV, pneumonia and Covid. The problem is that there is no weekly data from the UKHSA, which no longer collects and publishes such data. I hope the Government are prepared to consider reinstating that. An interesting graph on social media about two weeks ago set the peaks and troughs of all these infection spikes over the last three years against the increasingly long absences of NHS staff due to extended sickness, and they mirror exactly. I ask the Minister—who will remember that when she was in opposition, I asked this of many Ministers—what is happening in hospitals to encourage staff, when facing infection spikes, to wear masks and to encourage others to do so? This is about getting the basics right.

The Chancellor has made an investment this year. Compared to past winter investments to cover the winter crisis, how much is going to be there for the long term—or, by the time we get to March, will it all have been sucked up by the current winter crisis?

The Statement says that it is not too late to get yourself vaccinated. I have to tell noble Lords that, if you are a clinically vulnerable patient—and I count myself in that category—it is. GP services keep being given deadlines, which they pass on to patients. Patients then discover that they cannot get the vaccines at their local surgery. If they are inspired to go and find help elsewhere, that is fantastic. However, I suddenly got lots of texts from my surgery saying, “You haven’t been vaccinated yet. Go and get vaccinated”. I had been vaccinated. The problem is that the pharmacy database does not relate to the GP database. When will that be remedied? I have been going on about this problem for well over a decade. It is ridiculous that I have to intervene and say, “Actually I have had it—at your request”.

I have talked before about primary care, and it is shameful that the previous Government did not provide enough vacancies for newly qualified GPs last year. I credit this Government for providing some support and money this year to make sure that is happening. Will this continue to happen in future years or is it one-off, one year’s money? While the extra funding for general practice is welcome, it is not enough without the contractual change between primary care and secondary care. Have the Government taken account of that? It is not solving the real problem, which is that GPs and their staff are facing phenomenal pressure in their systems.

To conclude, most people are saying that this is the worst crisis we have faced in years. Unlike other parties, particularly the former Government, I am not prepared to blame the current Government for that. I credit the Government for the steps they are taking, but will they look at the longer-term issues that need to be dealt with to get our NHS back in a stable condition so that patients can rely on the service, from ambulances through A&E, general practice and hospital service?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I pay tribute to staff in health and social care for their commitment all year round, but particularly when the pressures are on us all in the winter. The noble Baroness, Lady Brinton, mentioned the nurse who was attacked at Royal Oldham Hospital. Our thoughts and prayers continue to be with her, her family and friends, and we wish her a speedy recovery. I can assure the noble Baroness and your Lordships’ House that protection of staff, and freedom to work and move around without abuse, harassment and discrimination, are all very important to us as a Government. There will be more about that as we talk about the workforce plan.

Let me make a few general points. I thank the noble Baroness and the noble Lord, Lord Kamall, for their questions and observations, all of which are important. As the Secretary of State said in the other place, it is crucial that we are honest, and I hope by now that your Lordships’ House will realise that we are, as a new Government, not frightened to say what the reality is, which is why the noble Lord, Lord Darzi, was commissioned to look into the state of the NHS. The noble Baroness, Lady Brinton, asked about long-term issues and that is exactly where we are.

I acknowledge the significant pressures faced by the NHS this year. However, cold weather, a sharp rise in flu and other infections, and other stresses and strains are not unusual, and we should not be surprised that winter comes every year. It is not acceptable to be going into a crisis every year. We have also taken immediate action. For example, beating the backlog of waiting lists is crucial, as is the 10-year plan because it will create an NHS for all year round. In addition, the emphasis is on getting social care into the right place, both in the immediate and the long term, because—as noble Lords regularly and rightly say—it is inextricably linked with the NHS.

Both Front Bench speakers talked about data and planning and preparation. There was a great deal of planning and preparation for what was then the upcoming winter, which we are now in, across health and social care. In the words of my right honourable friend the Secretary of State, we have been doing our best with the hand that we have been dealt. The noble Baroness, Lady Brinton, acknowledged that and I am grateful for her acknowledgement and her support. Annual winter pressures will always exist, but they should not automatically lead to an annual winter crisis.

These issues will not be solved overnight. It is going to take time, but we believe it can be done. That is why we are making investments—the noble Baroness asked about investment. The Budget committed an extra £26 billion to health and care—not as a knee-jerk reaction but to allow us to plan now and for the future.

On planning and preparation, I assure your Lordships’ House that the Secretary of State meets senior leaders in social care regularly. He also meets the UK Health Security Agency and NHS England regularly. Those groups are key to Ministers keeping on top of this.

We also have an excellent national operations centre, which I pay tribute to—that goes to the point raised by the noble Lord, Lord Kamall. The data available from it allows a focus on individual hospitals and individual patient waiting times. As of last week, we were down to one critical incident across the country, which compares positively with the 24 that were in place before.

The noble Lord, Lord Kamall, asked about lessons learned—if I might paraphrase it like that. I assure the noble Lord that before the spring we will set out lessons from this winter and the improvements that we will make ahead of next winter. For me, that is very welcome, because that is about acting as quickly as possible and looking to the future.

The noble Baroness, Lady Brinton, spoke about primary care, which is key to taking pressure off. I know that the noble Baroness is well aware of the three key pillars of the 10-year plan, which will be available in the not-too-distant future. I am sure that your Lordships’ House will want to discuss that at length, and I will be pleased to do so. To take the points from both noble Lords, that is all about the move from analogue to digital, from treating sickness to prevention, and from hospital to community. Those are not just words; they will greatly assist with the long-term planning that I know both noble Lords are seeking.

The noble Baroness referred to primary care. We have committed to recruiting over 1,000 newly qualified GPs through an £82 million boost to the additional roles reimbursement scheme. The key thing about that is that it will increase the number of appointments delivered in general practice. If I might make another point to the noble Baroness, we recently made announcements about GPs being able to make a direct referral for tests and scans to stop the real “around the houses” of sending a patient to see a consultant, who then sends them away for the relevant tests and scans before they can see them in the round. That will do a lot to reduce waiting times and increase access.

The noble Baroness was right to raise corridor care. She will have heard the Secretary of State say that

“we will never accept or tolerate patients being treated in corridors. It is unsafe, undignified” ”.—[Official Report, Commons, 15/1/25; col. 364.]

He has also made it clear that he is ashamed of that situation. I say that in a spirit of honesty. That is a feeling I share. The Secretary of State also said that he could not, in all honesty, promise an end to corridor care by next year because, as he rightly observed, it will take time to undo the damage that has got us to this place. It will be through investment, reform and planning that we will be able to do that.

The noble Baroness also asked about winter funding. That is a very important point, because over many years we have seen last-minute winter funding arriving too late to make a difference, no matter the intention. This time, as I mentioned, the Chancellor allocated nearly £26 billion to the NHS for 2025-26 in the Autumn Budget. That means, in comparison with the funding that it would have got under the last Government, that the NHS will receive £2 billion more. For me, perhaps the most important point is the ability to plan ahead and factor in the need to support preparation for winter.

There are a number of other points that I could make and I am sure that noble Lords, as we move to further questions, will raise them. In the meantime, I thank both Front Benches for their interest and their questions, but also for their challenge.

First-cousin Marriage

Baroness Brinton Excerpts

Monday 20th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the point that the noble Lord is making, but this is a very complex topic in respect of which there is a great lack of reliable data. Any plans for any health information campaign anywhere clearly need to be considered carefully. Perhaps I can reassure the noble Lord that staff from the Genomic Medicine Service are already working with other national projects, such as Born in Bradford and Best Start for Life in Birmingham, to engage with the communities most affected by first-cousin marriage. Of course, any campaign plans for Shetland and Orkney will be a matter for the Scottish Government.

[Baroness Brinton (LD)]

My Lords, I am grateful to the Minister for referring to the Born in Bradford study because 18 months ago, it reported that over the last decade, the number of intra-cousin marriages in the Pakistani community had substantially fallen. The reasons for this were awareness of the risk of congenital abnormalities, young people staying in education longer, and changing family values. This is clearly a successful project. Is it being replicated elsewhere in the UK?

[Baroness Merron (Lab)]

The noble Baroness is right that consanguineous unions are decreasing. While it had the best data, the NIHR-funded study, Born in Bradford, to which the noble Baroness and I have referred, found that between 2000 and 2010, 39% of British Pakistani couples in Bradford were first cousins. However, that reduced by 27% by 2019, for the reasons suggested. Driving change across whole ranges of areas makes a difference, but it is important that we keep this in perspective and make any communications and support absolutely appropriate.

Hospice Funding

Baroness Brinton Excerpts

Monday 6th January 2025 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

I thank the noble Lord for his good wishes and extend my new year wishes to everybody in your Lordships’ House.

To clarify the situation, this is the biggest boost for hospice funding in a generation. It is £100 million in capital, and there is no intention, as the noble Lord asked, to have any less engagement with the third sector—in this case, the hospice sector. The £100 million in capital is for adult and children’s hospices, and £26 million is confirmed for children and young people’s hospices. This has been widely welcomed. The decision in respect of national insurance perhaps would not have had to be made had the financial situation inherited by this Government been somewhat different.

[Baroness Brinton (LD)]

My Lords, I am grateful to the noble Baroness for explaining about the capital grant, but can she get the Government to commit to a long-term revenue funding formula for hospices for those services that are equivalent to those provided in the NHS, so that they are rewarded financially on the same basis as the NHS fairer funding formula?

[Baroness Merron (Lab)]

I understand the point the noble Baroness is making, because planning ahead and certainty are key. I can confirm that my ministerial colleague, Minister Kinnock, will soon meet all major stakeholders to discuss long-term sustainability of funding. We are very aware of the difficulties that have been caused thus far and seeking a way forward.

Food and Drink Industry: Processed Sugar

Baroness Brinton Excerpts

Monday 14th October 2024 Lords Chamber

[Baroness Merron (Lab)]

Taking on board the noble Lord’s point, I feel that it is important that we support people to make healthier choices. The noble Lord will be aware of—and I hope will welcome—the Government’s focus on moving from ill health to prevention. We want to make sure that people live well for longer. It is not only about making informed and heathier choices but about having the means to do so. That is why I particularly want to commend the fact that we will be introducing the restrictions on junk-food advertising to children on TV and online. That will make a major contribution.

[Baroness Brinton (LD)]

My Lords, the Food Foundation review in January this year noted that 41% of multibuys were still high in salt, sugar and fat, with only 3% on fruit, veg and staples. The Minister referred to working with the supermarkets and major manufacturers. Is this issue being raised with them as well? Particularly with the cost of living crisis, it would be extremely helpful if more multibuys were for foods that were good for people, such as fruit and veg, as well as basic staples and carbohydrates.

NHS: Independent Investigation

Baroness Brinton Excerpts

Tuesday 8th October 2024 Lords Chamber

[Baroness Merron (Lab)]

I agree with my noble friend. I am pleased to inform the House that just this week I announced a number of pilot programmes, through which maternity staff will be taught and supported to better identify the signs of a baby in distress in labour, so that action can be taken more quickly, and which will help staff deal with obstetric emergencies during caesarean sections. Such actions help to avoid preventable brain injuries and are right for the baby and the mother. We also need to tackle the issue of the more than £4 billion cost of the lawsuits that have been brought over a number of years.

I have seen good examples of teamwork in Bristol and Surrey, to name just two, and there are many things that can be learned. We know what strategies work—one of which is listening to women—but the challenge is, how do we roll out what is successful, including from the pilot programmes? Following the recent report, which showed a devastating situation in maternity and neo-natal care, that is a high priority for this Government.

[Baroness Brinton (LD)]

My Lords, the excellent report of the noble Lord, Lord Darzi, refers to the stress our GPs are under and how patients are no longer flowing through the hospitals as they should. One issue is that hospitals are constantly referring patients back to their GPs when they are still on the same treatment pathway. Recently, a member of my family was at a post-op review following a pacemaker operation that had gone wrong. Her heart was still giving her problems, and she was told she had to go back to her GP to start the whole process again. Many patients in hospital clinics are being told to go back to their GP to get a scan or an MRI—which is one of the reasons why they were referred to the hospital. This is not fair on hard-pressed GPs and, above all, patients. Can this practice be stopped?

[Baroness Merron (Lab)]

I am sorry to hear of the circumstance that the noble Baroness raises. I agree with her about the pressure on GPs who, of course, are working harder than ever. We know, not just through the Darzi report but through much evidence, that discharge into the community has to take place at the right time and with the right support, and that is not the case at present. I will certainly take up the specific thing the noble Baroness asks for and look into it in far greater detail, because this is clearly a practice, as she described, that is not supporting patients or GPs but working against them.

Vaginal Mesh Implants: Compensation

Baroness Brinton Excerpts

Thursday 5th September 2024 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I thank the noble Baroness, Lady Cumberlege, for securing this debate and for her unstinting commitment to ensuring that victims of vaginal mesh, sodium valproate, Primodos and other medical problems and scandals continue to have their voices heard. Her report for the last Government, First Do No Harm, published five years ago now, was extraordinary and impossible to ignore, and those of its recommendations that have been implemented have started to change the way that support for patient victims is delivered. I hope—and I will come back to this later—that it is also starting the change in culture that we need to see inside the NHS. We all love our NHS and sometimes it can be hard to admit that some of the senior doctors within it are not the best people to support patients and ensure that patients feel they are getting the right help they need when things go wrong.

I am particularly pleased about the role of the Patient Safety Commissioner, which I remember us debating in 2020. Dr Henrietta Hughes is making a brilliant start, and I thank the noble Baroness, Lady Bennett, for the comments that she made about that. However, I repeat a question I asked when the post was first set up: is the office of the Patient Safety Commissioner getting enough resources to do the job that she so clearly has to? I have no doubt that she is a very able woman but I am concerned about the volume that her office is dealing with.

I pay tribute to the victims of not just vaginal mesh but sodium valproate and Primodos, who have continued to tell their stories. We know that repeatedly telling your story is painful too, but we need to hear them. I thank the noble Baronesses, Lady Sugg and Lady Wyld, and the noble Lord, Lord Mancroft, who told his friend’s personal story, all of whom reminded us of how dreadful the position is. While the difference between these problems and the infected blood scandal is that we are not seeing fatalities, we underestimate the long-term life changes that all these victims have faced, some of them the children of those who were fed medicines during pregnancy, not one of them at fault at all in any way.

There is one voice that we have not heard: that of the NHS whistleblowers. I shall mention one person of whom I had not been aware until there was an article about her in the British Medical Journal earlier this year. Sohier Elneil is a urogynaecological surgeon and an expert in women’s pain. She is the founder of the first NHS vaginal mesh removal centre and a tireless champion of supporting the victims and sorting out the problems. I was shocked to read that, after she started talking about this issue in 2005, she was excluded from events by doctors, then personally attacked and reported to the General Medical Council multiple times, mainly by fellow consultants—those who were the biggest implanters of mesh. She said:

“I was very upset. It felt like a war. They were saying I was removing mesh and harming patients unnecessarily”.


Professor Elneil continued with her campaign, and I have to say that her story did not stop there. She also uncovered some of the doctors being encouraged with financial incentives from the providers of vaginal mesh. It is good that both Henrietta Hughes’ report and that of the noble Baroness, Lady Cumberlege, said that things needed to become transparent. The last Government refused to allow those records to go on to the register at the GMC but they should be on that register, not kept elsewhere, because if a member of the public wants to find something out, the GMC will be the first place they go. Can the Minister say whether that will happen?

Others have already talked about the time limit. I shall make brief mention of the issue relayed by the noble Baroness, Lady Berridge, about the type of inquiry and the ability to make effective reports. In my portfolio I have covered virtually all these inquiries over the past 18 months, and I have heard every single group of victims say that another inquiry has provided the right response for them. None of the inquiries has yet been resolved—even those, such as the Post Office Horizon inquiry and the infected blood inquiry, which we think have been resolved. If the Government will not revisit the deadline, they will be dragged kicking and screaming into a higher level of inquiry as more cases are revealed. Please can the Government, preferably via the Cabinet Office, bring together the learning from all these inquiries about what goes wrong in government to make these things happen?

Palliative and End-of-life Care: Funding

Baroness Brinton Excerpts

Wednesday 4th September 2024 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is right in her observations, and we certainly recognise that times are difficult, particularly for many voluntary and charitable organisations including hospices, for example, due to the increased cost of living. We are working alongside key partners and NHS England to proactively engage with stakeholders, including the voluntary sector and independent hospices, because we want to understand the issues they face and to seek solutions to them.

[Baroness Brinton (LD)]

My Lords, the charity Together for Short Lives has found that the NHS local funding for children’s hospices has dropped by 31% in the last three years. Worse, the previous Government’s £25 million children’s hospices grant has been given to local integrated care boards, many of which have delayed distributing it. As a result, the children’s hospice movement is in real crisis. Please will the Government urgently review the funding that government has in the past put aside for children’s hospices, to make sure that they receive it?

[Baroness Merron (Lab)]

As the noble Baroness said, in 2024-25 the £25 million in funding from NHS England was distributed, for the first time, via integrated care boards. As I understand it from the previous Government, that was in line with NHS devolution. We will carefully consider the next steps on palliative and end-of-life care funding much more widely in the coming months and will take on board the comments of the noble Baroness and other noble Lords.