Ben Spencer MP: speeches

Speeches

• 20 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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• 20 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  It is often said that Parliament is the conscience of the nation, but I believe that it is also its safeguard. There are people who will benefit from physician-assisted suicide, as implemented in this Bill, but there are also people who will be harmed: those with mental illness, those in care homes, those who feel a burden, those who are made to feel a burden, and those who are abused. The Bill’s safeguards are inadequate. The Royal College of Psychiatrists, the Royal College of Physicians—of which I am a member—and the Royal College of Pathologists, and countless doctors, professionals and charities, have all been ignored in pursuit of absolutist principle above understanding. It is a facile interpretation of autonomy to give it no bounds or to ignore its prerequisites. We must hear the concerns and act accordingly today, for who are we if not the champions of the vulnerable and the voice of the voiceless? The question before us today is this: do we believe that this harm to the vulnerable is worth it? I say it is not. I say we vote down this Bill.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I thank the hon. Member for his intervention. Of course, these are difficult things to disentangle. People will say, “You would say this, wouldn’t you, Ben?”, but we should get the person in front of a psychiatrist or a clinical nurse specialist working in psychiatry. This is what psychiatry does; this is what it is about. That is why I tabled amendments to ensure that the person is put in front of a psychiatrist as part of the process to deal with the blind spot. [ Interruption. ] Apologies, Madam Deputy Speaker; I will finish now. My amendment would ensure that the code of practice clarifies the interaction with services.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Will the hon. Lady give way on that point?

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Before I come to the substantive part of my speech, I would like to pick up on the comments of the hon. Member for North Warwickshire and Bedworth (Rachel Taylor). I have signed the amendments tabled by my right hon. Friend the Member for Salisbury (John Glen). I support them because I think the panel needs strengthening. It is not the case that courts have to be adversarial. Tribunals are set up to be inquisitive. In fact, the mental health tribunal is set up to be inquisitive. That is why, in Committee, I tabled amendments to use a tribunal panel as the mechanism for scrutinising decision making. It has been a real pleasure to listen to the debate, particularly in relation to the prohibition of advertising, because the debate started to move to focus on the issue of suicide promotion and prevention. I have been quite concerned from the beginning that that has not been part of what we have been talking about. Duties to prevent suicide—whether they be doctors’ duties under article 2 of the European convention on human rights, the NHS’s clinical duties around suicide prevention, or duties relating to the Mental Health Act 1983—are a blind spot in the Bill. The reason why the issue has not been focused on until now is that the Bill has been framed as the assisted dying Bill, as opposed to the assisted suicide Bill. I blame myself in part for that, because I started by called it physician-assisted suicide, but then I started using the term “assisted dying” because it was in common parlance and it was what everyone was using. The problem is that it frames it as something else. It frames it as reducing the dying process as opposed to what it is, which is an act to end somebody’s life. That is why the Bill amends the Suicide Act, and it is why I have tabled similar amendments on how it is conceptualised.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I think I am pushing it. I tried to intervene on the hon. Member for Spen Valley (Kim Leadbeater) to ask what she thinks about that. She is welcome to intervene on me now if she has further points to add. Otherwise, I ask the Minister to address those points.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Will the hon. Lady give way?

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Will the hon. Lady give way?

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I thank the hon. Member for her intervention. Of course there are situations in which a decision to end one’s life is perfectly understandable—indeed, rational. I spent my career looking after people, many of whom presented to me and to medical services with thoughts about wanting to end their life. Many of them had mental illness. Some had terminal illness. The fundamental problem with the Bill is that it has a complete blind spot for those people who are highly vulnerable. It is scandalous that we have got to this point and are still having a debate about the core concepts. The Bill should have been dealt with properly from the start with a royal commission or a review so that we did not get to the point where we are still debating core principles on Report.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  I thank the hon. Lady for her intervention. Sensory over-stimulation can be a particular issue for those with autistic spectrum disorders. I have been concerned when I have looked after patients, and I have thought carefully about the challenges, particularly in general adult wards, of catering to the needs of people with autistic spectrum disorders or a learning disability. I would argue that that would apply broadly to anyone in a general adult hospital, irrespective of diagnosis—everyone has particular needs and sensitivities and we need to be mindful of that. I suspect this is something that the hon. Lady and I will disagree on, but I would consider an autistic spectrum disorder and a learning disability to be a mental disorder. It certainly is under the ICD-10 classification of mental and behavioural disorders. One problem with how this issue is framed in the Bill is, for example, where Rett disorder, which is also a pervasive developmental disorder, would come into it. Does it come under the term “autistic”? Where does a not otherwise specified pervasive developmental disorder come into it? I am not sure whether how the terms in the Bill will operate in real life has been thought through. I do not understand why we are not pushing for such a provision for every disorder and condition that people have when they come into hospital. That is why we are not focused on something like a treatability test, or otherwise. This has a specific real-life fall-out. If people need to be in hospital after 28 days and there is a deprivation of liberty, that is going to happen. It will not stop happening; with the best will in the world, and even with this Bill, it will keep on happening. People will either be detained under liberty protection safeguards, or they will end up being detained with anxiety related to their ASD or learning disability, which would place them within scope of the Mental Health Act. A further challenge and disparity in the Bill is that it does not affect forensic provisions. People could be keener to pursue a criminal prosecution of people with ASD or an LD because that would enable a longer stay in detention than 28 days. That is why in the pre-legislative scrutiny we suggested that there should be an option to get a pre-authorisation for detention beyond 28 days by going to a tribunal, which we thought might deal with some of the concerns raised. Personally, I like the idea of pre-authorisation in general beyond 28 days, and it is something that Professor Richardson spoke about in her review back in the late ’90s. The Government recognise that there are challenges with this area, which is why these changes are in the schedules. There is a recognition that, frankly, this is not workable, and we will see as the Bill progresses that there are broader concerns about how it operates. Another area of concern is nominated persons and parental responsibility. The Bill changes “nearest relative” to a “nominated person”, which means that people can choose who performs that important role under the 1983 Act. The nearest relative or nominated person can discharge someone from the powers of the Act, which would inevitably mean that they would be discharged from hospital—there are powers to bar people, but it is quite a high threshold. This measure is important because it will allow someone under the age of 18 to choose someone who is not their parent to have that important statutory power. We raised this issue in the pre-legislative scrutiny Committee. We could have a situation in which a 16-year-old with competence who is detained under the 1983 Act in hospital chooses their mate, or somebody else—not their parent or someone with parental responsibility—to have the power to discharge them from measures under the Act, which would inevitably mean them leaving hospital. The parent, who in such situations is often responsible in some way for the after care, would lose that power. I am concerned, as were the Lords, about the impact of that measure on the Children Act 1989. I think there is a serious problem in changing this area of law—we do not have this in physical health—and introducing the ability to give a statutory power to a non-parent. I know the Minister will look into that in the Bill Committee, but I think the Government will have to row back on that. They could easily amend the Bill to say that if someone is under the age of 16, the nominated person must have parental responsibility unless there is a good reason for them not to have it. Sixteen and 17-year-olds are a bit different, especially when people start getting close to 18 and there are other children’s rights, but I cannot see why we should legislate to let someone under 16 choose someone who does not have parental responsibility to have that important power. The third problem is that the Bill is silent on deprivations of liberty in A&E, which are ongoing. It has been a while since I worked in A&E, but there has always been the challenge of what to do with someone who turns up to A&E if the doctor thinks that they will probably need detaining under the Mental Health Act because they are suicidal or very unwell, and wants to keep them there while the assessment takes place. We can get through it using the Mental Capacity Act 2005, but it is messy. It would be a lot clearer for everybody if we said, for example, that section 5(2) of the 1983 Act, which allows for temporary detention, could apply to an A&E setting. There is a bunch of technical stuff about the interaction between deprivation of liberty and the Mental Capacity Act, but I suspect you will start giving me the evil eye, Madam Deputy Speaker, and telling me to move on if I start— [ Interruption. ] Madam Deputy Speaker says no, but I suspect that Members across the House might start doing that, so I will move on. Let me flag two things in the Bill. It allows for a discharge from hospital under supervised conditional discharge to a deprivation of liberty. That is in response to the case of Secretary of State for Justice v. MM, which involves a problem with how the law currently operates. As far as I know, in mental health law we have never had a situation where deprivations of liberty in the community were authorised under the Mental Health Act—someone had to be in a registered hospital. That is a big Rubicon to cross. I see why the Government need to tidy up this area of law, but I am not convinced that we have realised what a big Rubicon this is to cross. The operation of the Mental Health Act has always meant that someone was detained in hospital, but when they are in the community they are in the community. Someone might have certain restrictions placed on them by a community treatment order, or otherwise, but they are not deprived of their liberty in their home or in some other community setting that is not a registered medical hospital. I think that measure needs a bit more reflection. I believe that the majority of those who will undergo compulsory treatment under detention, certainly for a long period of time, under this legislation will be people with psychosis, such as schizophrenic forms of psychosis, schizophrenia and bipolar affective disorder, but lot of the debate and focus has been on non-psychotic illnesses. That is not to say that those illnesses are less important—they are certainly not less important, especially for those who experience them—but I am concerned that people with schizophrenia always get a raw deal. They are often marginalised by society and in terms of the amount of advocacy they have. In fact, a lot of the evidence that we reviewed in the pre-legislative scrutiny Committee focused on non-psychotic disorders, perhaps because sadly people often turn their backs on people with psychotic illnesses. Sometimes those people find themselves in a situation where their illness is so debilitating that they cannot advocate for themselves, so there tends to be a bias towards disorders such as dementia, ASD and LD, where there is someone to advocate, such as CAMHS or families who might push a little bit more. I am not saying that any condition is more important—I really want to stress that—but as parliamentarians, we do not necessarily understand that the bulk of the conditions that the Bill focuses on concern psychosis. Finally, I have spoken a lot about how psychosis can lead to people being detained in hospital and about the impact of that. Psychosis is a pretty terrible disease but it does not need to be: lots of people get better and it is one of the most treatable diseases. The Bill will help people to get better and we cannot lose sight of that.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  I appreciate the hon. Member giving way. There is a logical inconsistency, which is that people with autism and learning disability are looked after under mental health services for autism and learning disability. If the argument is, “Well, those conditions should not be within the scope of Mental Health Act”, one could make an argument that they should not be within scope of mental health services full stop.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  The hon. Member is of course very knowledgeable given his background as a mental health nurse. I would like to see in the Bill a provision setting out that, in order to detain someone for the purposes of health or safety, they must lack decision-making capacity for the detention to be authorised. For the prevention of harm to others, there are reasons to overcome autonomy in decision-making capacity, but I would like to see an additional component specifying that if the detention for assessment and treatment in hospital is purely based on health and safety and not on risk of harm to others, the patient must also lack capacity. Otherwise, people who have full and intact decision-making capacity can nevertheless come into the scope of the powers. The liberty protection safeguards are a bit of a mess, quite frankly, and the DoLS were clearly a substantial mess. It is interesting that the legislative scrutiny of the Bill points out that it is a missed opportunity not to tidy up some of the interface between the Mental Health Act and the Mental Capacity Act—a point that I will come to a little later in my speech. In terms of parity of esteem, bringing forward fusion law and gelling the Acts closer together needs to be the direction of travel. I hope that we do not have to waste another 20 years until we get the opportunity something like that. There is something else that we need to reflect on. It comes to my other points about the focus in the Bill, but I will reiterate it. The core focus of the Bill is on reducing detentions of people from black and minority ethnic groups, who are over-represented in detention. One of the key focuses in fixing that must be on socioeconomic deprivation—where we see socioeconomic deprivation, we see severe mental disorder following—but I worry that the Bill is a missed opportunity and will not do what is required to deal with those disparities. There are three problems with the Bill, and two things that I wish to flag. I am sensitive to the concerns that have been raised about people with autistic spectrum disorders and learning disabilities, and the advocacy regarding such people being in hospital. Being in a general adult ward is a challenging environment as it is, and it is particularly challenging for someone with an ASD or a learning disability. People can get stuck in hospital not really going anywhere. That concern applies to most disorders—I do not think it is unique, given the lack of community support services. I disagree, however, with the focus on ASD and LD above all other conditions. If we want to talk about non-progressive conditions, I do not understand why a brain injury, or Korsakoff’s dementia for example, are not within the scope of this measure. I do not understand why, rather than using the Bill to take people out of section 3 of the Mental Health Act, something like a bolstered treatability test is not used, which is what was in the Act before it was modified in 2007.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  I rise to speak in support of the Bill. To begin with, I need to make a couple of declarations. I have a family member who is a consultant psychiatrist. I am now a non-practising general adult psychiatrist with an endorsement and years in psychiatry, and I previously worked as a consultant psychiatrist. I took part in the 2018 Wessely review as a panel member on the tribunal working group, and I was on the pre-legislative scrutiny Committee in the last Parliament. In a declaration of a more personal nature, this is an area that I feel passionately about. It is a great privilege to speak to this important piece of legislation and reforms going forward. The United Kingdom reforms its mental health legislation every 20 years or so. I did not want to correct the Secretary of State, but the first Mental Health Act was in 1959—I hope that was substantially before he was born, with reference to his earlier comments. The legislation has gone through various iterations from the original Lunacy Act and similar legislation in the 19th century. In the UK, we have always been at the forefront of reform to the law and to provisions and powers in this area. It is important in this Second Reading debate to focus on what the Mental Health Act is and what it does. Members have talked more broadly about the challenges of delivering mental health care currently, but it is important to reflect that the Mental Health Act is very specific and precise. It is about the regulation of detention—sometimes for assessment, sometimes for treatment—of people with mental disorder, and has a range of powers on aftercare and guardianship. It is focused on detention and assessment, or treatment, of people with mental disorder. We need that because there are times when people with severe mental illness become so unwell that they are unable to recognise their illness. Their illness puts their health at risk—predominantly through self-neglect or non-treatment. It puts their safety at risk, again through self-neglect, as well as through suicide. And, less commonly but critically, it puts them at risk of causing harm to others. The legal framework allows us to regulate compulsory treatment in that regard. It is absolutely critical that we have those powers so that, when people are so unwell that they do not recognise it and they lose agency, we can, as a compassionate society, take them into hospital and treat them, with a view to getting them back to themselves. I have used the 1983 Act countless times, applying it both to assessments and, as a section 12-approved doctor, to treatments, and I have used it as a responsible clinician. I suspect that I am one of the few Members of this House—certainly in this debate—who has had those roles and responsibilities. In terms of framing, it is important to reflect that one of the key changes in the 1983 Act, which is such an important piece of legislation, was that it was about restricting powers and ensuring that there were strong procedures for reviewing detentions. As a former health professional in this area, I am certain that all professionals working in it are mindful of the scope of powers that the Act provides. When applying restrictions, people do not use these powers in anger or without a great degree of thought and contemplation. The most intrusive intervention available to us in the health service is to detain and treat people in hospital or in secure hospital settings. Those powers are not taken lightly. A lot of concern was expressed at the start of the debate—and I am sure it will continue—about the way in which people have been treated in hospital. There have been some very high-profile scandals in which things have not worked well, to say the least, and care and treatment have been atrocious and abusive. However, people working in health and care in the UK are doing so because they want to see the best outcomes for their patients. Sometimes, they are limited in that because of the resources available. They do not use the Mental Health Act with a view to harming people, but with a view to helping them. Being detained under the Mental Health Act is not a prime facie harm; it is a treatment and a good thing. If someone needs to be detained and treated in hospital, they need to be detained and treated in hospital. If I became so unwell that I needed to be detained under the Act, I would want to be detained. Thankfully, I am not in that position today— [ Interruption. ] At least I believe that I am not, although the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), might have a different view on that. [ Laughter. ] Should I get to the point where I am so unwell that I cannot consider my own care, I would want the powers of the Mental Health Act to be used quickly, particularly if I were posing a risk to myself, my family and others, so that I can get better and back to living my life. I pay tribute to Baroness May of Maidenhead, who kicked this off, and to Professor Sir Simon Wessely—a good friend—Stephen Gilbert, Sir Mark Hedley and Rabbi Baroness Neuberger for their work in the 2018 review. There is a lot of good work in the Bill, from the greater focus on advance care planning and the more frequent detention reviews, which I recognise may bring a workforce burden, to the provisions on nominated persons. I will not go into the detail in this Second Reading speech, but I will focus on a few general points on which I think a bit more work needs to be undertaken. In some ways—I will have to message Sir Simon after this to ask his forgiveness—the Bill is a missed opportunity in that we have are not moving towards fusion law. For the benefit of those who are not all over the detail, at the moment the UK has two pieces of legislation regulating how to treat people in the absence of consent. The Mental Capacity Act 2005 came about from case law in the ’80s and ’90s and was codified in 2005. That Act broadly regulates physical health treatments for people who lack the capacity to consent—we have focused quite a lot on capacity in the recent debates on the Terminally Ill Adults (End of Life) Bill. The principles of the 2005 Act are autonomy and the functional capacity and best interests tests for people who lack capacity, meaning that we test someone’s capacity, and only if they lack capacity can we intervene in their best interests, sometimes by using deprivations of liberty. The Mental Health Act arose from a very different pathway. In its first days, it was more about the regulation of asylums. The Act is about status and risk. The gatekeeper conditions for the current Mental Health Act are that a patient has a mental disorder of a nature and a degree that requires assessment in hospital because of the risk to their health and to the safety of others. Capacity does not feature whatsoever. We have two pieces of legislation. One applies to the most severe mental disorders and deals with status and risk, and the other deals with autonomy and best interests. I strongly believe that the two need to be merged. We should use capacity and best interest frameworks to regulate treatment of mental disorder in the absence of consent—there are ways of doing that. I like the fact that we are starting to incorporate a bit more in the Bill.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I rise to speak to amendments 18, 30, 31, 17 and 32, which stand in my name. I will start with amendment 18. Many moral arguments on the need for the Bill have been proposed both inside and outside this place. Some of those arguments have addressed the desire for greater control at the end of life, but the vast majority have focused on the prevention of irreversible suffering. The principle of bodily autonomy—which I strongly support in the context of full decision-making capacity, with certain important caveats—is used to justify the rights that the Bill will grant. However, let us put aside the debate surrounding the Bill and focus on the text of the clauses, which is the task that we face on Report. The provisions are silent on suffering, silent on control and silent on all but a terminal illness with a prognosis of fewer than six months. If the principle is that we must prevent irreversible suffering, all those suffering irreversibly should be able to seek physician-assisted suicide. If the principle is that we should give people control—another level of expression of bodily autonomy—all adults who truly and freely consent with full decision-making capacity should be able to seek physician-assisted suicide. If those principles are circumscribed to an arbitrary definition of “terminal illness”, the inexorable conclusion must be that those patients’ suffering or autonomy are more important than those of others, or that their lives have less value. We have seen that position subtly imported into this debate. When requesting an assisted death is not framed as suicide because some perceive it as understandable, the underlying argument is, “If you’re terminally ill, of course you want to die—that’s understandable.” We must ensure that we do not, by accident or otherwise, enshrine in our statute book value judgments on the worth of the lives of the terminally ill or on the protections that they should enjoy like everyone else. I tabled amendment 18 to expand the scope of the Bill as much as I can to reduce the discrimination inherent within it. The maximum I could do was to remove the six-month restriction, but I wish the amendment could go further. I know that some Members will wince at this provision, but I ask them to ask themselves what the principles and values in the Bill are, how they are being applied and whether they are being applied equally. I believe that the Bill as drafted is incoherent and discriminatory. My amendment would introduce some moral clarity to the Bill. If we do not do so, the courts will. I turn to amendments 30 and 31. If we are to rely on the principle of autonomy to authorise physician-assisted suicide for terminal illness, the expressed choice must be true and free. Autonomy needs help, though. A true and free choice needs to be informed; a true and free choice cannot be made under coercion; a true and free choice requires decision-making capacity. I believe that, if we are to rely on the principle of autonomy for the most grave of decisions, there needs to actually be a choice. In the absence of relevant and available palliative care options, where is the choice? How can we rely on autonomy in the absence of choice? The prospect of people choosing physician-assisted suicide not because it meets their needs, but because their needs are unmet owing to a failure in the provision of palliative care, is a moral outrage. My amendments 30 and 31 would ensure that that does not happen.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Will the Minister give way?

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I am sorry but I really cannot, given the time restrictions. Amendment 17 pertains to the test of decision-making capacity. In English and Welsh law, we use the Mental Capacity Act 2005 to define capacity, and I believe it is right that the functional test of capacity is used in this Bill. We have common law tests of capacity in some circumstances, which arose before we had the Mental Capacity Act. However, the decision to end one’s own life was not permitted in the early case law leading up to that Act. There is no jurisprudence background or guidance. These capacity tests have not been done before. This test needs a bit more of a framework of support. Amendment 17 lays out the minimum information that needs to be understood as part of the functional test of capacity. Critically, that would include information about the current treatment options, about doing nothing and about proceeding under this legislation. It would make clear that physician-assisted suicide is not a medical treatment, but a personal choice about life and death. Without amendment 17, this Bill will fundamentally undermine the doctor-patient relationship. Doctors do not prescribe death, and this Bill must make that clear. I turn finally to my amendment 32. There has been some discussion about the inadequacies of the decision-making capacity test as gatekeeper. In effect, there may be circumstances in which, despite having capacity, the person is otherwise recognised as vulnerable. That is how our courts operate. The impact of depression or personality disorder on decision-making capacity can be subtle and elusive. I know, as I used to be a consultant liaison psychiatrist and did research in the area of decision-making capacity. This is tricky stuff to do, especially in the context of a request for an intervention, rather than a refusal. We should have trained psychiatrists at an early stage assessing capacity. They are expert at picking up these subtle cues and all the other stuff that is going on. A request for physician-assisted suicide should not be taken in isolation, and that needs to be understood and supported. We need someone who knows how to use the Mental Health Act, because if a doctor is doing the assessment, and they have a patient in front of them with a mental disorder, expressing a desire to end their life, they need to make sure that that patient gets the right and appropriate treatment. That may well be using the Mental Health Act. We need to make sure that this happens; I hope it would happen as part of the process as usual, but there is no safeguard in the Bill to make sure that it does. Psychiatrists turning up on the panel at the end is not good enough; they need to be there from the start. Finally, there are broader issues about the interaction with protections to save life, article 2, and a doctor’s duties. I will cover those in the debate on the second grouping, along with the incredible importance of the Bill’s interaction with the suicide prevention strategy.

• 7 May 2025 · Data (Use and Access) Bill [Lords] · Hansard source

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  I thank the Minister for his clarification and reiteration of that point, and again for his work with colleagues to take forward the issue, on which I think we are in unison across the House. New clause 21 is on directions to public authorities on recording of sex data. One does not need to be a doctor to know that data accuracy is critical, particularly when it comes to health, research or the provision of tailored services based on protected characteristics such as sex or age. The accuracy of data must be at the heart of this Bill, and nowhere has this been more high-profile or important than in the debate over the collection and use of sex and gender data. I thank the charity Sex Matters and the noble Lords Arbuthnot and Lucas for the work they have done to highlight the need for accurate data and its relevance for the digital verification system proposed in the Bill.

• 11 Mar 2025 · Data (Use and Access) Bill [ Lords ] (Third sitting) · Hansard source

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  I thank the hon. Lady for that clarification. Nevertheless, I think there is an overlap with the debate that took place in the Chamber last Friday on the ballot Bill introduced by the hon. Member for Whitehaven and Workington (Josh MacAlister), which has been dubbed the safer phones Bill. We all took part in that debate. During Friday’s debate, I highlighted the mounting research and evidence on the harm to adolescents’ mental health from social media platforms. Policy in this area needs to be developed based on the best data and evidence. In that regard, we also need to learn from the roll-out of the Online Safety Act 2023 and the implementation of Ofcom’s guidance on putting in place age assurance in relation to particular types of content and data. I welcome reports that the Government intend to commission the chief medical officer to review the harms associated with this area. It is disappointing that the Minister did not give a firm commitment on that from the Dispatch Box last Friday. Will he take the opportunity to do so today?

• 11 Mar 2025 · Data (Use and Access) Bill [ Lords ] (Third sitting) · Hansard source

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  I listened carefully to the Minister’s remarks on the Government’s position on the public interest test, which was extensively debated in the other place. I have a great deal of sympathy with what their lordships were trying to achieve in parts of that amendment. We are talking about the secondary use of data for scientific research and, as I understand it, the public interest test is used in other types of scientific research tests—for example, with public health data. Therefore this is not something which is completely alien to the concept of defining scientific research. However, I do concede there is an issue with how one can define scientific research. I think what people are nervous about—particularly in some of the conversations I have around this new definition of scientific research for use for secondary data processing—is this being hijacked by artificial intelligence data companies as a way of getting around some of the challenges with using big datasets for which they do not necessarily have licensing arrangements. I know we are going to come on to that later in the Bill. I would be grateful if the Minister could explain his thoughts and considerations about removing this public interest test. How would that interact with some of the concerns about AI and data use? From a personal perspective, my concept of scientific research has an altruistic component to it. At least with the scientific research with which I was involved, the whole point was that it was information that is shared freely. Clearly there are challenges and considerations on which one needs to focus when it comes to research being done for commercial benefit. I know part of the debate in the other place was about commercial versus non-commercial research. It is important that scientific research can be commercial. In fact, it must be. However, I appreciate that there is a sentiment that their lordships were putting forward as part of the test. I would be grateful if the Minister could address, first, some of the concerns around AI companies and secondly how we can capture the essence of scientific research so that when people are do secondary data analysis it is done properly. When it comes to the audit component, a lot of this data analysis is people marking their own homework. Some of the data is not going through human rights committees and being scrutinised in that sense. What assurances can the Minister give that the process will operate properly and that research that is scientific will be legitimately so once these clauses are passed?

• 11 Mar 2025 · Data (Use and Access) Bill [ Lords ] (Fourth sitting) · Hansard source

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  This part of the Bill is a concatenation of different provisions relating to data, which is one of the reasons why I think the Bill is so glorious; it covers such a wide scope of things to sort out. I will speak to some of the deeper debates that we will have later, but I am quite glad to start off by speaking to clause 121. As a former doctor—my wife is a doctor too—I particularly welcome these provisions and the opportunity they provide to ensure that health data can be shared properly. I would say to the Minister that the issue is not merely carrying around patient notes; certainly, in my experience the issue is whether patient notes turn up in the first place at all. As somebody who does not work in the health service any more, I see the other side, where the burden is quite often on the patient to provide their notes or to give information repeatedly that different parts of the system already have. That is a wholly inefficient way of doing things. One of the benefits of having the NHS set up as it is must surely be the ability to have coherent approaches to the sharing of data, so that we do not have this situation with notes. It is not merely an inconvenience. Patients can be exposed to repeated tests and repeated imaging, all of which have a degree of iatrogenic harm and risk, plus delays to progressing. My former field of work was psychiatry, and the places where I worked were very quick to adopt electronic patient records, noting not only the importance of data sharing, but the risk of retraumatising people when repeated disclosures of traumatic events are required—in part, I worry, because that data is not shared as effectively as it could be. I raised the point on Second Reading that changes in this area will need to be supported by ensuring that hospitals and healthcare settings have access to IT of sufficient quality to support the new systems. Can the Minister provide an update on his strategy—although I recognise it is not precisely his strategy; it is shared with the Department of Health and Social Care—on renewing NHS IT infrastructure and ensuring that the necessary kit is put in place so that the provisions can be rolled out to maximum advantage? This is about not merely the sharing of data, but the fact that faxing information is no longer required, and we must have the computer infrastructure necessary for data sharing.

• 7 Mar 2025 · Protection of Children (Digital Safety and Data Protection) Bill · Hansard source

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  I am going to resist the temptation to be drawn into a discussion about research methodology in this area, although I have to tell the hon. Gentleman that I am very tempted to talk about the importance of case series data and qualitative data in terms of what people are telling us and what we are seeing ourselves, compared with cross-sectional or longitudinal studies or cluster studies looking at the impact of different schools. What I will say is that the stories of what children are being exposed to that we have heard in this debate and that we have all heard from our constituents are horrific—I do not think anyone would disagree with that. Clearly, we need to protect children from that. At the heart of the Bill is the desire to drive forward our scientific understanding of the effects of smartphone and social media use on children’s mental health, learning and social development. I hope we hear a commitment from the Minister that the Government will conduct a detailed review in this complex area where so much is at stake, but I would also expand it further. Any analysis must take a clear-eyed approach to both the advantages and disadvantages offered by technological developments such as smartphones and internet access, looking at both the benefits to young people of increased connectivity and access to information, and even apps that help to manage health conditions such as diabetes at school and away from home, which will transform the lives of children and young people, and the increasing body of research that demonstrates the damaging effects of excessive smartphone and social media use on children and adolescents.

• 4 Mar 2025 · Data (Use and Access) Bill [ Lords ] (First sitting) · Hansard source

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  Amendments 10 and 11 seek to remove certain provisions that were introduced in Committee in the other place. I thank Sex Matters for its work, but also many people in this policy area who have tried to focus on the importance of data accuracy and validity when it is used. I hope we all agree that it is important that data, when it is collected—in fact it is a principle of data collection and maintenance—is accurate and correct and that there is no point holding or using data if it is incorrect. Biased data is worse than no data at all. Therefore, I do not understand—especially given the extra use of the data that will come as part of digital verification services—why the Minister and the Government are not keen on the provision to stipulate that public bodies that hold sensitive data should be certain of its accuracy, particularly when the data is going to be passed on and used as part of digital verification services. I am confused by the resistance to ensuring that the data is correct, particularly when we anticipate that it will be used as part of a far bigger spectrum. It will be consumed by a digital verification service in which it is not routine to go back and look at the original paper records. The only dataset to be relied on will be some Oracle Excel spreadsheet or whatever database is used by public authorities. This debate has become more acute with regard to the importance of sex data. It is critical that sex data is available to protect public spaces and to be used in scientific research to allocate someone’s sex as part of medicine and healthcare. I speak as a former doctor, and I guess I should declare an interest in that I am married to a doctor. The use of sex data is critical in medical screening programmes, such as cervical screening and prostate screening, to understand and interpret investigations. It is critical that the data is accurate; otherwise, there is a danger that research will not be appropriate or will produce bad results, and there is also a potential degree of medical harm. It is critical that we get sex data correct when it is being used. I do not agree with the argument that requiring the disclosure of sex data is either disproportionate or somehow a breach of the European convention on human rights. The whole point of digital verification services is proportionate disclosure. In fact, we have heard speeches from both sides of the Committee about proportionate disclosure, and limiting the amount of personal data that is passed on as part of a digital verification service. My challenge is, quite simply, that if somebody is collecting sex data as part of a verification system, why are they doing so? If they do not need to know what someone’s sex is, it should not be collected. Digital verification services allow people to choose their proportionate disclosure. There will be times when sex data is required for renting a property—that example has been used before—because people may want to rent properties in single-sex accommodation. I may argue that is a proportionate disclosure. If it is a standard rental property in another situation, it is probably a non-proportionate disclosure. Another argument has been made that it is needed to triangulate data to verify ID. Again, that does not seem to work, because the whole point of a digital verification service is to allow someone to have a digital ID framework and use different points to verify. The perversity of this debate is that these schemes and their proportionate disclosure protect people’s identities. They protect people from non-disproportionate disclosure. We need to make sure that the data we are using is accurate and correct, and that it says what we want it to say when someone is inquiring about somebody’s sex. If somebody is asking for sex data but they do not need it, people should be able to say no, which the existing provisions allow for.

• 12 Feb 2025 · Data (Use and Access) Bill [Lords] · Hansard source

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  As a self-professed data geek— [ Interruption. ] The Minister looks quite surprised at that. Well, I am now self-professing myself as a data geek, and it is a real pleasure to wind up this important debate on behalf of the official Opposition. As the original architects of the Bill, the Opposition welcome the fact that the Government have recognised the potential of these Conservative-led policies to make people’s lives easier by being able to prove identity quickly when dealing with statutory agencies and service providers; to streamline and enhance public service delivery, such as by harmonising the information available to healthcare professionals across NHS settings; and to boost economic growth through the innovative use of smart data. In short, this Bill will bring into effect the previous Government’s ambition to harness and exploit data as the currency of the digital age. The staggering pace of recent technological advances presents not only enormous opportunity, but challenges that demand further scrutiny. Earlier, the shadow Secretary of State, my hon. Friend the Member for Havant (Alan Mak), rightly pointed out some of the areas where the Government’s approach to the science and technology sector conflict with the outcomes that they want. We have had an extensive debate today with hon. Members covering a range of topics, some of which I shall refer to shortly. Perhaps it is ironically apt that the Data (Use and Access) Bill has had so many iterations and this recursive Second Reading, but I must pay tribute to those who have been working before us to get it to the state it is in today. Much of the Bill is technical and uncontroversial, but some of it still needs to be thrashed out and debated, and I look forward to taking it through in Committee. I would like at this point to pay tribute to Lord Markham and Viscount Camrose. I was particularly pleased to hear the Government’s response with regard to security around the underground assets register. I also pay tribute to my right hon. Friend the Member for Maldon (Sir John Whittingdale), who I am sure is glad that he is not doing another Second Reading speech and hopefully not taking the Bill through Committee for this side, and of course to Baroness Owen for the incredible work that she has done. The tribute paid to her by my hon. Friend the Member for Huntingdon (Ben Obese-Jecty) was far better than anything I could put together from this Dispatch Box, and I thank him for his comments. By my count, we have had 15 or 16 Back-Bench speakers, and I would like to draw particular attention to the intervention from my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright), who pointed out the wranglings that took place in the House of Lords regarding data that is used for scientific purposes. I am sure that the definition of public interest will be discussed in further detail in Committee. I also particularly liked the speech from the hon. Member for Dewsbury and Batley (Iqbal Mohamed). As I have said, much of this Bill—this big tome—is in some ways uncontroversial. Many Members focused on a few specific areas, but I was interested that he looked at the whole scope of the Bill, particularly around the civil liberties components and the GDPR issues, which is what much of the core of the Bill is about. There are a few points I would like to focus on, starting with data accuracy. My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who is not in her place, remarked that to empower the public and businesses to take full advantage of the speed and simplicity offered by digital verification services, there must be a high degree of confidence in the accuracy of the data provided by public authorities. In the other place, the Minister acknowledged this concern, stating that, as far as the data underpinning digital identity is concerned, “we must have a single version of the truth”. —[ Official Report, House of Lords, 21 January 2025; Vol. 842, c. 1620.] However, he did not support the amendment seeking to guarantee the accuracy of data held by public authorities for the purpose of digital verification services, and nor did the Secretary of State in his opening remarks today. While the reliability of the data that supports digital identity is fundamentally important across the board, an area of particular importance is the accurate recording of biological sex. This is vital for ensuring that services such as medical care are delivered properly and to protect female-only spaces. Biased data is worse than no data, and wrong data is worst of all. We call on the Government to ensure that data is robust and accurate as a matter of priority. We must ensure the digital infrastructure is in place to support the Bill’s aims. We welcome the inclusion of provisions for NHS data sharing, and I should declare an interest as a former doctor whose wife is a doctor. I have spoken many times of the importance of data sharing. We focus on AI, but we need to get the basics right. NHS data sharing, if implemented effectively, will enable the fast and seamless transfer of patient data between healthcare settings. It will lead to better clinical decision making and improved outcomes for patients, and the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) will be able to see his patients more efficiently and more effectively. I pay tribute to the strength of his argument, and I hope he takes the mantle I had when my party was in government of pushing for this to happen as quickly as possible. To harness those benefits, the Government have acknowledged that healthcare settings’ IT systems will need to meet common standards to facilitate data sharing across platforms. The previous Government set out a bold plan for upgrading the nation’s digital infrastructure. This Government must continue and expedite that work to ensure the NHS has the tools it needs to implement the Bill’s reforms. Finally, on the important subject of AI and copyright, the powerful debate both in the other place and here highlights the challenges, the complexities and the importance of making sure we get this right, particularly on the Government’s proposal for a data mining opt-out, as mentioned in the consultation. Many Members have raised that point, including my right hon. Friend the Member for Maldon and the hon. Members for Scarborough and Whitby (Alison Hume), for Stirling and Strathallan (Chris Kane), for Perth and Kinross-shire (Pete Wishart), for Bury North (Mr Frith), for Knowsley (Anneliese Midgley) and for Cheltenham (Max Wilkinson). We cannot hold back the tide of change that AI has brought with it, nor can we put the genie back in the bottle, but we must do everything in our power to protect and promote our creative industries so that they can continue to thrive and grow, as they did with the support put in place by the previous Government during the pandemic. The Government’s consultation on AI and copyright remains under way. My hon. Friend the shadow Secretary of State spoke about the overwhelming need for the Government to respond to the consultation as soon as possible. The Government must engage constructively with the industry and the official Opposition to identify solutions that turbocharge our developing AI industry while protecting and boosting the growth of our creative sector. All of us, both those who work in the creative sector and those who benefit from it, understand just how important it is for our national identity. Live music is one of my passions. It was the thing I missed most during the pandemic. The idea that we could end up causing harm to our creative industry fills me with horror. The Opposition want to make sure we get this right, not only for those whose livelihoods depend on the industry but for all of us. This is complicated and difficult. If it were not, there would already be an answer—the Europeans would have an answer. This is a difficult situation that we need to get through.

• 13 Jan 2025 · Hospice and Palliative Care · Hansard source

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  I thank the hon. Member for Wimbledon (Mr Kohler) for speaking so eloquently in this important debate, and for securing it. I also thank the Backbench Business Committee. Hospices are fantastic places, and all of us in this country are lucky to have them. People go to hospices not to die, but to live the last few days or weeks of their life. While I am pleased that the assisted dying Bill has led to a renewed interest in hospice and palliative care, I am sad that so much of the focus has been on death and the dying process, rather than on the broader support and care offered by hospices and palliative care providers—sometimes over many years—to people who have illnesses that may be life-limiting, and who require certain types of medical intervention to manage their symptoms. That is a very important part of the work that hospices and palliative care teams do, but as I say, much of the focus is often on the death process, rather than the treatment given to those with chronic conditions. Speaking as a former consultant psychiatrist, it would be remiss of me not to mention the psychological support and mental health interventions by palliative care teams and hospices. They are experts in pain relief. Palliative care teams brought a lot of relief to me when, as a junior doctor, I tried to manage very difficult situations in patient care. They are experts in analgesic components. It is important to recognise the palliative care teams working in not only hospices but hospital settings and the community to alleviate people’s symptoms. I pay tribute to the fantastic local hospices and care teams in the Runnymede and Weybridge constituency, at Woking & Sam Beare hospice, which I have visited and is a fantastic place, and at Princess Alice hospice, based in Esher. We also benefit from Shooting Stars, in the constituency of the hon. Member for Twickenham (Munira Wilson). I hope to visit that one day. I thank all the teams who work in those hospices for delivering care and support, but also for keeping the hospices running, and for their vital fundraising. Many people support hospices in lots of different ways, including through direct donations and organising fundraising events, and I am pleased to have been to fundraising events for Woking & Sam Beare hospice. In fact, a week or two ago, I went to the Chertsey panto, which has been running for 12 years. It supports the Woking & Sam Beare hospice. The performances, if one can call them that, have raised £60,000. The panto has to be seen to be believed; one will never forget the Chertsey panto after one has gone to it. The team who organise and run it are absolutely fantastic. It is a fantastic institution and raises a lot of good money for the hospice. We also have charity shops. There is a great one in Weybridge that has been raising money for quite some time. I pay tribute to everybody for what they do, no matter how big or small, to support our hospices and our palliative care sector.