Complications from Abortions (Annual Report) Bill [HL]

Baroness Lawlor Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

[Baroness Freeman of Steventon (CB)]

My Lords, as part of my work in Cambridge, which is in my register of interests, I was involved, and still am, in the making of decision aids to help NHS patients make decisions about their healthcare treatments. Part of my work was to find the evidence about the risks and benefits of different treatment options, so I am very familiar with the lack of data in many respects on the efficacy and, in more cases, side-effects of different treatment options.

I would absolutely stand by any Bill that aimed to improve the data for individuals to make decisions, but I do not see why abortion is being singled out in this way in this particular Bill. I am bearing in mind the Chief Whip’s notes, and although I could speak for some time on the lack of data for side-effects in many treatments I will give just two examples. I was involved in the decision aid for osteoarthritis in hips. Hip replacements are an example where, again, we have large numbers of treatments being done outside of NHS clinics. We are really lacking in long-term follow-up, particularly asking patients about the really important patient-reported outcome measures—the things that are important to them. Cataracts are another example. It is one of our biggest and most numerous operations, and more than half of them are done outside of NHS clinics. Again, you would think that actually asking how many people would say afterwards that their vision has improved would be a very basic thing, but we are lacking that data.

I would absolutely love to have more data on side-effects and the efficacies of these things, including side-effects that are not expected and not on the official list to be collected. I did a decision aid on gall bladder surgery. Diarrhoea is a very common outcome of this surgery—in more than 10% of cases—and yet it is not often recorded. Sexual dysfunction is a side-effect of many treatments, but it is not something that patients want to bring up. These are all really important.

There are so many issues about data, but if you look at the data on abortion statistics and complications, you find that the 2023 report is very good. It highlights the numbers that patients would need to make decisions. The rates are not changing every year. We do not update our decision aids every year. The data remains stable, unless there is a very dramatic change in clinical practice.

I would absolutely support the better collection of data, and I am hoping there are opportunities to do that in the future. But on this particular occasion, I very much support the noble Baroness, Lady Thornton.

[Baroness Lawlor (Con)]

My Lords, I do not support the noble Baroness’s opposition to Clause 1 standing part of the Bill. My noble friend Lord Moylan has mentioned the 2023 analysis by the Office for Health Improvement and Disparities. It based its evidence solely on NHS England statistics: the database of admissions, A&E attendance and outpatient appointments. Using this data, different outcomes were recorded. It used only the data contained in records for patient admissions and for abortion-related complications as the primary or secondary diagnosis, not those for incomplete abortions that did not have a further complication. We see, therefore, that the complication rate varies depending on the evidence that is before the statistician.

For these reasons, there is little disagreement among the groups concerned that we all, whether parliamentary or non-parliamentary, want good data collection. Some of us are more concerned with data collection on one kind of procedure, and others with another, but, now that we are updating and digitising the NHS system, this seems an opportunity to improve data right around the system. But this should not be excluded, and I do not think that 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 to encourage the best statistics.

My noble friend referred to some of the changes that we have seen. The position has changed since the statistics were last checked for compliance with the code of practice for statistics in 2012, with the increase of medically induced abortions from 48% to 85%. In England and Wales, 75% of abortions were completed at home. As a result, complications may not be recorded on the HSA4 forms that are the basis for the present statistics under the abortion notification service. With women administering medication at home, if there is a complication, they may go to their GP surgery, dial 111 or go to A&E. The fact that these episodes are complications will not necessarily be recorded on the HSA4 forms that are used to compile the reports we have. But it has been used, which is why I find this a statistically interesting debate, by the 2023 analysis, which I mentioned on opening, and it can be used.

For these reasons, I welcome that the statistics regulator is going to check on the compliance and that the Department of Health and Social Care has agreed to this—I applaud that. The timing is quite important. As the NHS system is digitised, it can prepare things so that the records can be read digitally, accurately and cheaply, with the data on complications from abortions entered into the system. I suggest that, as my noble friend Lord Moylan proposed, the compliance check should be instituted in advance of digitisation so that the statistics authority can then report on—and, as a result, the Department of Health can be made aware of—where and what digitisation is needed, so that the records can be used in digital form cheaply and with the transparency that we need for statistics. This will save money on any further necessary updates later.

I do not take the point that some noble Lords have made about confidentiality. Confidentiality is extremely important—I agree with all confidentiality requirements; it is vital if one is to have trust in one’s health service and provider—but these things are done by codes. As far as I know—I ask the Minister to correct me if I am wrong—every operation has codes. People are not named, but there are codes for referring to whatever procedures take place. This is very useful for digitisation.

Stroke Treatment

Baroness Lawlor Excerpts

Wednesday 27th March 2024 Lords Chamber

[Lord Markham (Con)]

I am delighted to hear those good examples. As I say, we have had some very good results. The challenge is to ensure that everyone can have the sort of experience that the noble Baroness has had, which we are keen to do.

[Baroness Lawlor (Con)]

My Lords, does my noble friend agree that it might be worth looking further into post-stroke care, following what the noble Lord on the Cross Benches said? I have visited hospitals in France, where post-stroke patients, be they of working age or non-working age, are encouraged to get back to work and be fit for work. Sadly, in my own local hospital I have seen academics of working age discharged without provision for the speech therapy or physiotherapy which would allow them to continue working. This is something that we could learn from our French friends.

[Lord Markham (Con)]

That is what these SQuIRe centres are about—trying to roll out best practice. As I mentioned, I have seen fantastic examples, including simple things such as at Leighton Hospital, which gets every patient, not just stroke patients, to exercise for a couple of hours each day. That makes a difference to their length of stay and their ability to go back into the community and into the workplace.

Foetal Sentience Committee Bill [HL]

Baroness Lawlor Excerpts

2nd reading
Friday 22nd March 2024 Lords Chamber

[Baroness Kennedy of The Shaws (Lab)]

I am perfectly happy to say that some innocent dupes are used by some of the organisations funded in this way.

This organisation claims that its tireless work helped the United States Supreme Court overturn Roe v Wade, which guaranteed the right to abortion. The ADF has supported controversial anti-abortion activity in this country, including supporting and funding protesters outside clinics. We are seeing the ramping up of spending to bring US-style abortion politics into our country.

[Baroness Lawlor (Con)]

May I ask the noble Baroness what precisely this has to do with a Bill proposing a committee of research and analysis?

--- Later in debate ---

[Baroness Lawlor (Con)]

My Lords, I am grateful to my noble friend Lord Moylan for introducing this Bill for a foetal sentience committee to review understanding of foetal sentience and to inform policy. It is a pleasure—indeed, I am humbled—to follow the noble Lord, Lord Alton, with whose views I find myself so often in agreement. The last time was in a committee that discussed China. I find him the most persuasive of human rights defenders in this Chamber and have done since I arrived.

This is a modest Bill, with modest aims: to approach policy in this area in the same way as in others, through consultation and the careful weighing of specialist evidence. That, as you would expect, continues to change, with new research and new evidence. In this area especially, there are many disagreements about the weight given to different parts of the evidence, and specialists themselves often change their views, as indeed has been pointed out earlier in this debate.

In particular, there are now doubts about whether some of the physiological assumptions that have dominated the debate are justified. Emphasis has often been placed on the role of the thalamus, a group of cells centrally in the brain that helps to control how sensory and motor signals are passed from one part of the cerebral cortex to another, and of the cortex, the grey matter that has a role in memory, thinking, learning, reasoning, problem-solving, consciousness and functions related to the senses. The emphasis has been often focused on them in respect of the perception of pain, but some researchers regard this as too narrow. There is, therefore, very good reason for all this complex, controversial and developing material to be weighed by an independent committee that can help advise government and parliamentarians to make and shape policy and legislation.

The approach already exists in the case of animal welfare, as we have heard, where there is a committee on animal sentience—see the Animal Welfare (Sentience) Act 2022. I see it as a model for the Bill. Indeed, as we heard earlier, in the UK, the foetus of protected animals in the case of a mammal, bird or reptile is protected when half the gestation or incubation period of the relevant species has elapsed, as set out in Section 1 of the Animal (Scientific Procedures) Act 1986. This Act regulates the use of protected animals in any experiment or other scientific procedure which may cause pain, suffering, distress or lasting harm to the animal. It is important that, as a society, we do not knowingly and unnecessarily inflict pain. We have legislated to stop this happening in protected animals and prenatal animals. We should now extend this welfare to our own species, and a small but significant step in doing so is to gather and sift the relevant evidence.

I understand that one reason why some, including the noble Baroness on the Benches opposite, oppose this Bill is that they see it as a covert attack on the present abortion laws. If the committee is set up as proposed, they fear that it will, as the science develops, find more and more evidence that foetuses, as they like to regard them, are indeed prenatal babies, able to feel pain from an early stage, and that abortion is merely premature infanticide. Yet, however strong their views, they should not try to bury evidence that goes against them. They should be willing for the scientific picture to be fully understood and presented in all its nuances to policymakers, as this Bill proposes, and to make their arguments, just as those who oppose them should do in the light of this Bill.