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.