Modern Slavery Bill

Written evidence submitted by The British Medical Association (BMA) (MS 08)

The British Medical Association (BMA) is a voluntary professional association and independent trade union which represents doctors and medical students from all branches of medicine all over the UK. It has a total membership of over 153,000.

Executive Summary

· The BMA supports the development of a Modern Slavery Bill [1] and believes that it is right to introduce legislation that attempts to tackle these crimes and their effects. However, there are a number of areas in which we have concerns.

· The Government must provide clarity on the remit of the Anti-Slavery Commissioner - in particular whether the NHS will be required to report and of any additional duties that may be placed on healthcare workers. The Government must set out clearly what the requirements of any duty to co-operate with the Commissioner will entail.

· The proposals for a scheme of child trafficking advocates in Part 4 of the Bill should be extended to cover victims of slavery and exploitation as well as human trafficking. We also have concerns about the duty to notify the National Crime Agency set out in Clause 44.

· The Government should take action to ensure fair and ethical practices in supply chains. It is disappointing that the recommendations of the Modern Slavery Bill Evidence Review and the Joint Committee on the Draft Modern Slavery Bill for legislation to encourage transparency in supply chains on UK products and imports has not been incorporated into proposed legislation.

Background

1. The BMA’s interest in the Bill is primarily related to the role of healthcare professionals in identifying and supporting victims of modern slavery and human trafficking. We also have an interest in promoting ethical procurement in the NHS and eradicating modern slavery from Government supply chains.

2. We submitted evidence to the pre-legislative scrutiny process and were pleased to see a number of recommendations made by the Joint Committee on the Draft Modern Slavery Bill [2] incorporated into the Bill. However, there remain several areas where we feel the proposed legislation could be improved or clarified to focus on preventing these crimes, recognising the issues at an early stage and ensuring a high level of awareness and training amongst key staff.

The Offences

3. The BMA has concerns about the use of the term ‘young’ in Clause 3 of the Bill. This section ought to make explicitly clear that it refers to someone who is under the age of 18.

Anti-slavery commissioner

4. The BMA has concerns about the lack of clarity in the Bill on the remit of the Anti-Slavery Commissioner, in particular whether the NHS will be required to report and of any additional duties that may be placed on healthcare workers.

5. The Government’s response to the pre-legislative scrutiny of the Bill [3] specifically lists local authorities and health and educational establishments amongst the agencies the Commissioner will be expected to work with, but the Bill itself simply refers to ‘specified public authorities.’ We believe that the Government should indicate more clearly which authorities are likely to be included and provide further details of the requirements of any potential reporting system.

6. We welcome proposals for the Commissioner to provide information, education or training for front line professionals, however we are concerned that at present the wording of the Bill states the Commissioner ‘may’ do so. The BMA believes that it should be a mandatory duty of the Anti-Slavery Commissioner to ensure appropriate resources are dedicated to the training of frontline professionals, that duplication of effort as a regional or local level is minimised, and that standardisation of education and training across England and Wales is more likely to be facilitated.

Protection of Victims

7. We are pleased to see that the Government has responded to calls from the Joint Committee on the Draft Modern Slavery Bill to set out on a statutory basis what support should be offered to victims.

Child Trafficking Advocates

8. The BMA welcomes Clause 41 of the Bill which provides the Secretary of State with the power to make arrangements for a system of specialist child trafficking advocates. This will address the specific problems faced by child victims and their vulnerability to being re-trafficked. However, we would like to see the advocate scheme extended to victims of exploitation, slavery, servitude and forced or compulsory labour. We see no reason why this aspect of victim protection should not be extended to cover child victims of all the offences outlined in the Bill.

Identifying and Supporting Victims

9. The BMA welcomes Clause 42 of the Bill which mandates the Secretary of State to issue guidance to public authorities in relation to identifying and supporting victims. The guidance will cover the sorts of things which indicate that a person may be a victim of slavery or human trafficking and arrangements for the provision of assistance and support.

10. We are pleased to see that provisions to set out victim support on a statutory basis have now been included in the Bill, and that standardised training for frontline professionals will be provided. We believe this is essential to enable the early identification of cases of modern slavery and human trafficking, and to provide appropriate support for the victims of these crimes. Victim protection should include a comprehensive package of health and social care provision and we would welcome consultation on the guidance prior to its publication.

Duty to notify the National Crime Agency

11. Clause 44 of the Bill places a duty on ‘specified public authorities’ to notify the National Crime Agency (NCA) if they have reasonable grounds to suspect that an individual may be a victim of human trafficking. Although the specified authorities are to be determined by regulations at a later date, it would be helpful for the Government to make known, at this stage, its intentions about which bodies will have a legal duty to report issues to the NCA and whether this would include medical professionals.

12. The BMA would have serious concerns about any attempt to introduce mandatory reporting for medical professionals. While there are likely to be very few cases where a healthcare professional would not report a suspicion of trafficking, we believe that a degree of professional discretion is required in order to ensure that doctors can take account of the individual circumstances and always act to ensure the protection of the patient.

13. We are pleased that the wording of Clause 44 has been amended to specify that the disclosure of information relating to an adult will require consent. However, the position regarding the disclosure of information about child victims and adults lacking the capacity to consent, including for reasons of fear and intimidation which are not covered by mental capacity legislation, remains unclear. We would welcome further clarification on the Government’s intentions in these cases as we believe it is imperative that doctors are able to maintain their professional discretion.

Supply chains

14. The BMA supports the recommendations of the Modern Slavery Bill Evidence Review [4] and the Joint Committee on the Draft Modern Slavery Bill for legislation to encourage transparency in supply chains of UK products and imports. It is disappointing that these recommendations have not been incorporated into the Bill and that that government has said it will continue to promote transparency on a voluntary basis. We believe that this does not go far enough and we will continue to call for further legislation to prevent the exploitation of workers.

15. The BMA has been advocating fair and ethical medical trade in the NHS and believes that Government agencies should take the lead to ensure fair and ethical practices in their supply chains. The Bill has the potential to impact on a range of procurement contracts that are worth up to £40 billion of annual NHS expenditure. These supply chains employ hundreds of thousands of people worldwide. There is a growing body of evidence [1] that, in some cases, the basic employment rights of people in these supply chains are being exploited.

16. We strongly believe that the Bill should require suppliers to demonstrate their commitment to labour standards by showing that they have a system in place for recognising labour issues and for dealing with these appropriately. This should be considered a qualifying statement: those who do not demonstrate a commitment to improving working conditions where required are disqualified as a supplier.

17. All NHS authorities, trusts and clinical commissioning groups who procure should undertake a risk assessment of their procurement activities and instigate appropriate action to protect working conditions, human rights and environmental protection in the supply chain. Labour rights should not be considered in balance with cost, but adhere to minimum standards should be an absolute requirement. Mandatory reporting by NHS authorities, trusts and clinical commissioning groups will also be necessary to ensure that action taken is monitored and progress is measured.

August 2014

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