I beg to move amendment 1, page 6, line 8, at end insert—
‘(c) after paragraph (f) insert a new paragraph as follows—
“(g) independent information, advice and counselling services for women requesting termination of pregnancy to the extent that the clinical commissioning group considers they will choose to use them.”.’.
With this it will be convenient to discuss the following:
Amendment 2, page 6, line 8, at end insert—
‘(2A) After subsection (1) insert a new subsection as follows—
(1A) In this section, information, advice and counselling is independent where it is provided by either—
(i) a private body that does not itself provide for the termination of pregnancies; or
(ii) a statutory body.”.’.
Amendment 1221, in clause 14, page 9, line 37, at end insert—
‘( ) After paragraph 8 insert—
“Provision of independent information, advice and counselling services for women requesting a termination of pregnancy
8A (1) A local authority must make available to women requesting termination of pregnancy from any clinical commissioning group the option of receiving independent information, advice and counselling.
(2) In this paragraph, information, advice and counselling are independent where they are provided by either—
(a) a private body that does not itself refer, provide or have any financial interest in providing for the termination of pregnancies; or
(b) a statutory body.’.
Amendment 1252, page 9, line 37, at end insert—
‘( ) After paragraph 8 insert—
“Provision of advice relating to unplanned pregnancy
8A The Secretary of State must ensure that all organisations offering information or advice in relation to unplanned pregnancy choices must follow current evidence-based guidance produced by a professional medical organisation specified by the Secretary of State.”.’.
Amendment 1180, in clause 240, page 226, line 31, at end insert—
‘(1) Regulations must require NICE to make recommendations with regard to the care of women seeking an induced termination of pregnancy, including the option of receiving independent information, advice and counselling about the procedure, its potential health implications and alternatives, including adoption.
(2) The regulations must require health or social care bodies or any private body that provides for the termination of pregnancies to comply with the recommendations made by NICE under subsection (1).’.
Four weeks ago I was not sure whether I would get to the point where I could speak in the Chamber today. This has been a long and hot-under-the-collar summer. Following my announcement of my intention to table the amendment, I have been threatened with being throttled, car-bombed, burned alive and a host of other distasteful and unpleasant ways in which I would meet my end.
I shall not go into detail about any of these responses to my amendment. Needless to say, some of them involved bodily functions to a graphic degree, and some of the scatological messages were unbelievable. I will not repeat the bile that has poured into my inbox every day. I do not think there is anything that I or my staff could be threatened with, or that we could read or be told now, that would elicit any shock from us. There is nothing worse that we could hear.
Before I go into the detail of the amendment, I shall talk about a significant and substantial shift as a result of the amendment. It has always been the tradition of the House that abortion issues have been discussed and debated in the Chamber and the media have commented on what happened, usually in a reasonable way. But the amendment has changed the game for ever. All Members in all parts of the House know, particularly from the 2008 debate, that we debate with passion. I would say that the 2008 debate was one of the best debates of the previous Parliament. However, we all remain courteous and friendly with each other following the debates. The usual parliamentary knock-about and the usual games take place—I shall say more about that in relation to the amendment in a moment—but the debate usually takes place here and the media comment on what happens here as it happens.
I have no greater opponent in the House on this issue than Ms Harman. In 2008 she was the whipper-in and the mover behind what happened in that debate, but I have no greater respect for almost any other woman in the House than I do for her. I hugely respect what she has achieved for women and humanity, and I know that she approaches the issue honourably, as I hope I do. It is incredibly sad, therefore, that my summer has been made so difficult not by Opposition Members, who have all been incredibly quiet, but by the nastiness and the response of the left-wing media and union-funded organisations.
The past four weeks have been incredibly difficult. The campaign against the amendment has been co-ordinated by an organisation known as Abortion Rights, which is funded by Unison and a number of other small unions. It also received membership contributions, but, as I was told in a meeting with the organisation, it is largely funded by the unions and Unison is the biggest contributor. [ Interruption. ] I am not saying that every penny is not accountable; I am just informing the House that the campaign has been funded by the unions. I do not think that there is a problem with that.
I will tell the hon. Lady exactly who funds my campaign—nobody. Neither I, nor my office has received a single penny. Here, to me, is the disadvantage of the amendment. The unions can contact Members’ constituents and ask them to e-mail individual MPs, but I cannot afford to promote the amendment in that way. The press barons, whom the unions have fed with their response to the amendment, can pour what they want into the newspapers, but I cannot. What we have seen is an absolute divide.
Will the hon. Lady please tell the House exactly who funds the Right to Know e-mails that many of us have received in our constituency inboxes?
I absolutely will—that is why I am here—but it is important to explain the context and the background to some of misinformation that Members have received in their inboxes. This is my opportunity to correct the misinformation MPs have been fed about the amendment.
The amendment has created a divide that was not present before, including in 2008. The Guardian and The Times and the union-funded Abortion Rights have mounted a campaign against the amendment. I must say that the core Conservative vote newspapers, The Daily Telegraph , the Daily Mail and so on, have been supportive, so this chasm and the politicisation of abortion has begun as a result of the amendment and as a result of the unions and the left-wing media.
There are lots of comments being made from a sedentary position, Mr Speaker, but The Times has actually fed that divide directly and repeated much of the information it has been given. I want to answer some of the accusations made about me in response to the amendment. I do not have the press barons’ money to mount and fund a campaign. I have not received a penny. In fact, I am broke. My office has not received a penny in funding.
I have also been accused of being a religious fundamentalist. Like 73% of the country, I am a member of the Church of England and have Christian beliefs, but I am not sure when that became a crime and prevented me from having an opinion. On Saturday, The Guardian printed a flow chart showing the conservative Christians who are supposed to be mounting a sphere of influence with the amendment. I did not know who
95% of the people mentioned were or the organisation they represent. If I followed Islam or Judaism, I wonder what the response would have been to such a flow chart in
. I found the chart absolutely reprehensible and disgusting.
I absolutely will not.
I want to mention some of the other lies that have been printed about me. I have been accused of wanting to reduce the number of abortions by introducing the amendment. That is absolutely not the objective. However, if any individual in the street was asked about the amendment and told that it might bring down the number of abortions, would they say, “Well, that’s a good thing,” or would they say, “We’re proud of the fact that 200,000 abortions a year are performed in the UK”? That is the highest number in western Europe. Would the individual in the street say that that is a good thing? No, they would say that it probably would be a good idea if something could help to bring that number down. I do not want to restrict access to abortion. The amendment is not about restricting access. I do not want to return to the days of Vera Drake-style back-street abortionists. That is not what the amendment is about. I am pro-choice, although I am presented as pro-life in every newspaper. The pro-life organisations are in fact e-mailing pro-life MPs to tell them not to vote for the amendment. I am pro-choice. Abortion is here to stay.
It is absolutely ridiculous that the amendment has been portrayed as something that would restrict access to abortion. The amendment is about medical practitioners making to a woman who presents at their surgery or organisation an offer of independent counselling, not compulsory counselling. Every single day I have read a headline stating that the amendment is intended to drive women into the arms of religious fundamentalists via compulsory counselling. That is absolutely not true. Any Member who rose and claimed that the amendment would make counselling compulsory would be being untruthful. It is nothing more than an offer. It is an offer made to some women who, when presenting at a GP’s practice, may have doubts, may be confused and may feel that they would like to accept. That is all it is—an offer. I find it very difficult to understand how anyone can object to a vulnerable woman being made an offer of counselling when she is suffering from a crisis pregnancy.
I thank the hon. Lady for giving way, and I commend her courage and perseverance. Does she share the concern of many in this House and outside about the businesslike and commercial decisions that are taken in relation to abortion and feel that, because one hour of counselling a week for everyone is not enough, it is wrong that a commercial industry has been made out of abortion? Does she agree that when abortion becomes a business, the feelings of people have been lost?
Well, that comment is probably the most fatuous we will hear in the debate, and probably the most disrespectful to women. I would like to know what the hon. Gentleman thinks about the report published last week in the British Journal of Psychiatry that women who have an abortion are twice as likely to suffer from mental health problems. Of course, I realise that the report he quotes from was probably written by men. I realise that the women who go through abortion and suffer as a result do not go back to the Royal College of Obstetricians and Gynaecologists to give feedback.
My hon. Friend was right to introduce her remarks to the House and highlight the unacceptable personal attacks that have been made against her, which denigrate an issue of vital importance and interest to the whole House. The House needs to rise above that in today’s debate. With regard to evidence of change, could she indicate what research she has done on how much face-to-face counselling takes place in organisations such as the British Pregnancy Advisory Service, for example?
I thank my hon. Friend, and in a moment I will come on to the difference between counselling and consultation, and what is available to women.
Another piece of misinformation that has been put about is the idea that the amendment would prevent or delay the abortion process. Again, that is incredibly untrue. Counselling would be delivered within 24 to 48 hours, and the abortion process would take seven to 14 days to arrange. This amendment, this offer of counselling, is not for women who have made up their mind and—fantastic for them—want to go straight to the abortion clinic; it is for women who may be in distress. The counselling would be delivered within 24 to 48 hours, so there would be no delay whatever to the abortion process. In fact, many women who accepted the offer of counselling and proceeded to an abortion would proceed empowered, because they would have had the opportunity to talk through their situation with someone totally impartial—
I want to finish this point, and then I will give way.
The counsellor would be completely impartial, give no advice or direction and be entirely independent, so if the woman had been through the process and then continued to abortion, she would do so knowing that she had talked through her options with somebody.
I have spoken to organisations that provide counselling and have 80,000 registered counsellors throughout the UK. [Hon. Members: “Who?”] The British Association for Counselling and Psychotherapy. I asked, “If somebody required counselling, was at a GP’s practice and a telephone call was made, how long would it take to get a counsellor to a particular woman?” The answer was that counselling could be delivered in the GP’s practice, at another venue or in the woman’s home, and that it could be anything from immediate to within 48 hours.
Registered counsellors, who have e-mailed me regularly since the amendment was tabled, say that they would love to work—counselling is a growing industry—and to have the opportunity to work with women in that situation. Unfortunately, however, counselling is available on the NHS only via the abortion provider or via the hospital.
I am grateful to my courageous and honourable Friend for giving way. As 147 babies were terminated after 24 weeks in the past year—a 29% increase on the previous year—does she agree that such counselling should also include the fact that many of those terminated babies, who had minor disabilities such as cleft lips, cleft palates, half an ear or having only one ear, could have been dealt with through modern cosmetic reconstructive surgery?
I thank my hon. Friend for that comment. That is a different debate, but he highlights an important issue, and it is abhorrent that 147 babies were aborted for cleft palate, hare lip and minor cosmetic issues. I have a godson who had a club foot, and he was a wonderful young boy and is a wonderful young man. I find it quite amazing that anybody would choose to abort a baby because they had a club foot, but that is an issue for another day. The amendment does not cover it, but it is an important point.
Does my hon. Friend share my incredulity at those Opposition Members who maintain that an organisation such as BPAS—the British Pregnancy Advisory Service—can be independent in its counselling, when in its March 2011 report and financial statement it notes that
“an increase in procedures of 13 per cent against the background of falling national trends in 2010-11” is
“a significant achievement”?
How can the opponents of the amendment maintain that there is no fiscal link and no conflict of interest?
That is a very important point, and in a moment I will come on to the financial link and the financial incentives, with some other information that we have.
That is precisely the next point in my speech; my hon. Friend must have been looking over my shoulder!
I now turn to the counselling provision available to women today. Many women do not want or need counselling. They find out that they are pregnant and know exactly what they want to do, but those are frequently the women who are supported—who have partners, family and friends who will support them through that awful situation. No woman wants to have an abortion, but many know that they have to, for various reasons, and this amendment is not about them. A mystery shopper, however, recently approached several abortion clinics posing as a young woman who was pregnant and unsure of what to do. Every time I mention BPAS there is a howl from Opposition Members, but I am going to mention it in this instance, because this is irrefutable evidence.
The individual posed at a central London clinic as a 26-year-old pregnant woman who did not know what to do, and she asked for counselling. I shall come on to the difference between counselling and consultation, but she said that she did not know what to do, because she had been given the immediate consultation, was not sure whether to go through with the pregnancy, and therefore wanted an abortion. She was told that, at that very busy clinic in central London, one hour of counselling was available at one set time per week. I believe that when she revealed her identity she was offered another hour.
In fairness to BPAS, it says that it has flexibility in the system and can offer more hours. Why did it not do so? If it has flexibility, how much is there?
I am very grateful—[ Interruption. ] The hon. Lady says something from a sedentary position. I wholly deprecate the fact that she has had threats made, but it is inappropriate to bring forward this amendment to this Bill, because if we are going to consider abortion we should be considering the whole issue in the round, not just appending something to this kind of Bill. As she knows, I disagree with her, but she will also know also that the whole point of counselling, in any circumstance, is to allow a person to come to the right decision for themselves. That is precisely what BPAS, Marie Stopes and others provide, because any counsellor who does not do that is not worth their salt.
I would love to hear how the hon. Gentleman knows that that is what happens in Marie Stopes and BPAS. He always speaks on such issues as someone with huge experience, but I am highlighting at this moment what happens. If he thinks that one hour per week, at a set time at a busy London clinic, for the entire throughput of women having abortions, is enough counselling, so be it; that is his opinion.
I should like to make this point before I take any more interventions, because I also want to defend BPAS. I do not want it to look as if I am attacking the organisation, because it, and probably more so, Marie Stopes, do what they do—the clinical procedure of carrying out abortion—incredibly well. The service that they provide for the NHS is absolutely vital, and I do not want to see Marie Stopes or BPAS disappear or to diminish their roles. They have a job to do, and they do it well. Their job is the provision of clinical abortions, and I want that to continue.
Will my hon. Friend confirm that it is still safe for those of us who do not have concerns about the counselling that BPAS and Marie Stopes offer to support her amendment, because it does not prevent BPAS and Marie Stopes from offering counselling? I, for one, have no such concerns, yet I am prepared to vote for her amendment, because it does not prevent those organisations from offering advice. Will she confirm that?
My hon. Friend is not totally correct, because the whole purpose of the amendment is to separate out the financial situation. I shall come on to that in a moment. I disagree with my hon. Friend, and if she listens to the rest of the debate she will understand why. I do not believe that the place where an abortion was carried out is the right place for someone suffering from post-abortion distress to receive their counselling—a situation that many women suffering from post-abortion distress have told me about.
I am grateful to my hon. Friend and parliamentary neighbour. May I for a second take the debate from the general to the particular? I think that she is on to something. I mentioned a 23-year-old constituent of mine who, having been to an abortion clinic, then went to a clinic such as my hon. Friend advocates. It was then her decision: she decided to change her mind, and today has a beautiful three-month-old daughter. She is pleased that she had the opportunity for that counselling, which no one forced her to take. That is why I think my hon. Friend is on to something.
I hope that my hon. Friend is talking about the Crisis pregnancy centre in Dunstable, which I have visited along with many others. It does amazing work with young women.
Marie Stopes International said in the briefing that it sent to all MPs that only 2% to 2.5% of women who go through the abortion counselling process opt to keep the child. Does my hon. Friend agree that that may indicate an incredibly poor success rate among counselling services?
I will give way in a minute.
There is a huge disparity between the figures that show both where a woman received her counselling and her decision. In 2008, BPAS announced that the proportion of women who came to it and decided not to proceed with an abortion was as high as 20%. Unfortunately, freedom of information requests asking for the figures and the contracts with PCTs show that that is not true: the real figure is 8%, and sometimes even lower in some PCTs. I am not sure why an abortion organisation would say that its figures for women who do not proceed to an abortion are higher than they actually are.
There is a huge disparity in the figures, and the freedom of information request shows an even bigger disparity. Marie Stopes had told me—I hope I get this right—that the proportion of women who go to the organisation and do not proceed to termination is about 15%, although I do not know what freedom of information requests would show about those figures. The fact is that abortion providers are saying that 20% or 15% of women do not proceed to abortion, although freedom of information requests show that the figure is 8%, as was shown in the press this week. I have no idea why there is that disparity, or why they would say that the figure is 20% when it is not.
The hon. Lady has rightly probed the relationship between counselling and abortion on behalf of those of us who feel uncomfortable about that relationship. However, does she agree that 90 minutes does not seem like a long time for us to debate the implications of what is going on? The Bill is substantively about the nature of the NHS, and not about abortion provision. In that light, I urge her to consider whether it is appropriate to divide the House on this issue.
I am not going to take any interventions for a few minutes. I would like to go back to the fact that only one hour of counselling is available in a busy London clinic. I ask Members, just for a moment, to put themselves in the shoes of a 16-year-old girl who turns up at that clinic and does not know what to do. She is pregnant and panicking. Some of her friends tell her to have an abortion and some tell her not to. She does not want to tell her parents because she is scared of doing so. Her boyfriend is saying to her, “You’ve got to have an abortion and get rid of it.” That is a mish-mash of the four or five stories a day that we hear in my office.
The girl starts vomiting in the morning and carries on all day. She feels sick and ill and cannot think straight. She is not sleeping because she is scared stiff. She has not gone to school for more than a week because she thinks that people there will be able to tell that she is pregnant. She is out of her mind with worry. She turns up at a clinic and is told, “Sorry, that one appointment’s been taken. You’ll have to go to Richmond.” The girl does not even know where Richmond is, and she has never even been to hospital without having her mum with her.
I would like hon. Members to think about what it is like for that 16-year-old girl, and what they have against a GP or somebody else offering that girl an hour’s counselling so that she can talk through the issues and reach the right conclusion for her, non-advised.
I know that others want to speak. I have been speaking for a while and I want to get to the end, so I will keep going for a bit longer. I will take interventions in a minute. [Interruption.]
Order. The hon. Gentleman should withdraw that remark.
I am grateful to the hon. Gentleman. Let us try to maintain proceedings on an even keel. The hon. Gentleman has said that he is sorry, and that is fine.
As I said, I do not want to look as if I am knocking abortion providers. As a nurse, I assisted with many terminations. I do not want to look as if I feel that there is no place for abortion provision. I am pro-choice and do not want to return to those other days.
Order. It is important that the hon. Lady makes it clear to whom she is giving way.
The central point of disagreement for many people is the implication in the amendment that the abortion providers—BPAS has presence in my constituency—are incapable of providing impartial independent counselling to those who come to them.
The manager and staff at the centre in my constituency have said that they find insulting the idea that when they are giving counselling they are somehow seeking to persuade those who come to them to have an abortion, when that is not the case. In fact, when I visited BPAS recently a couple of young ladies had come to the centre intending to go through with an abortion but subsequently decided not to because of the counselling that they received.
All I can say is that we will look at the freedom of information figures that have come from the clinic in the hon. Gentleman’s constituency. If what he says is the case, that must have been the year’s allocation for that clinic, because the FOI request information that we have received does not show that.
No, I will carry on for a bit longer.
I want to talk about the difference between consultation and counselling. I doubt very much whether the constituents of the hon. Member for Streatham had counselling; I think they probably had consultation. There is a big difference. Every woman who turns up at an abortion clinic has a consultation, but that is about the medical process—the side effects and what is going to happen. Every e-mail that we receive from women on this subject involves a consultation. This is how the law stands today; my hon. Friend Anna Soubry might want to listen to this, as most of the way through she has been nodding in agreement with the adverse comments.
When a woman turns up at an abortion clinic, the clinic does not offer counselling. It does offer consultation, but the woman has to ask for counselling; it is not offered. She has to ask—or the doctor in the clinic has to see that a woman is in a particular position, or be alarmed enough by her state to offer counselling. I want to make the point very clear: counselling is not offered, but has to be asked for. [Interruption.] Someonesays from a sedentary position that it is, but if it is, the centre is operating outside the guidelines, because counselling is not offered.
I am sure that many abortion providers do their level best to give advice, but that is not the point being made. Surely in any field of endeavour it is not appropriate for the provider of a service to give the so-called independent advice. That is the key point—and, frankly, the only point.
As I have said to many people, I will come on to the financial situation and the reasons for it.
To recap, the amendment proposes that abortion clinics make an offer of counselling, which they do not make because under the guidelines they have no provision to make it—the woman has to ask for it.
Last week, The British Journal of Psychiatry reported that women who abort are twice as likely to suffer from mental health problems.
I do not want to ban abortion—I want it to continue—but should we not be taking better care of our young girls and women? Should we not be offering them something better? How do women get to the position of suffering mental health problems as a result of abortion?
The hon. Lady will be aware of facts and figures that indicate that a number of people who have had abortions regret it afterwards. Does she feel that if the consultation process is done correctly and the information is shown to the person who wishes to have the abortion, they would perhaps then decide that the child they are carrying could develop into a young lady and have life? Does she feel that the consultation process is clearly where the issue has to be addressed and that the emphasis has to be on the counselling, not on the abortion?
The hon. Gentleman makes a point that is pertinent to his own beliefs. What I believe about counselling is that no advice should be given, that there should be no direction, and that it should be completely impartial. It should be an influence-free zone—a bubble—where a woman can sit and talk through the issues with somebody who is not guiding her. That is what counselling should be.
Every single day I receive e-mails from women who do not want other women to experience what they have experienced—who do not want their daughters to go through what they have gone through. I receive e-mails from staff who are working in, or have worked in, abortion clinics. I am in dialogue with some very senior members of staff of a number of organisations and abortion clinics across the UK—
No, I will not give way again.
Those members of staff are themselves not necessarily happy with the guidelines and the way in which they are forced to operate. I speak to people at abortion clinics across the UK who would like the guidelines to change because they do not necessarily feel that women receive the counselling that they should receive because it is not offered but has to be asked for.
I hope that the quality of counselling is determined by the professional bodies by which the counsellor is accredited—they determine the standard of counselling. It does not matter whether counselling is for an abortion, for cosmetic surgery, or for anything else—it has a defined manner in which it is delivered, which is that advice is not given, that influence is not asserted, and that it is totally impartial. Any counsellor who is trained as such and accredited by a professional body delivers counselling in that manner.
Let me return to the mental health issue and the e-mails that I receive on a daily basis. One of the problems—
My hon. Friend has twice quoted the Royal College of Psychiatrists and asserted that there is a much higher rate of mental illness after termination of pregnancy, but the RCP has made it clear—any Member can look online at the draft of its very comprehensive evidence review—that we have to compare like with like. In other words, we have to make a comparison with rates of mental illness after unwanted pregnancy. Looking at the rates after unwanted pregnancy, we see that there is no difference between the rate of mental illness after termination of pregnancy and live birth. Indeed, the biggest predictor of mental ill health after a termination of pregnancy is whether somebody was suffering with problems beforehand.
The hon. Lady makes the assumption that I want women to continue with unwanted pregnancies. That is not the case. I have made the point that abortion is here to stay for any woman who wants an abortion. The amendment simply proposes that any woman who feels that she wants or needs counselling can be offered it—that is all. I find it very difficult to understand why the hon. Lady would feel that anybody in a crisis pregnancy should not be offered counselling. Why should they not?
Dr Huppert, who is currently fulfilling his role as Dr Evan Harris’s vicar on earth, expressed the view that everything is fine at the moment. Does my hon. Friend share my concern that it is routine for primary care trusts absolutely to refuse to reveal the financial relationship they have—for instance, with Marie Stopes or BPAS—on the basis of commercial confidence, and that it takes freedom of information requests to get that information? The system is clearly not working, and if we want transparency and openness, things have to change.
My hon. Friend is absolutely right. Not only that, but the accounts of BPAS and Marie Stopes, which are revealed via the Charity Commission, can sometimes be three years out of date—we do not get to see them until three years later. That is amazing when one considers that the Charity Commission is paid £60 million of taxpayers’ money each year.
This, for me, is about the women who have contacted me and asked me to propose this amendment on their behalf, and I have to dedicate some of this speech to them. Every day I receive e-mails and speak to people—
I constantly speak to people at a high level across the abortion industry, and they always tell me that no woman goes through those doors wanting to be there. All women’s stories are the same; there is a theme that runs through every single one. The individual circumstances may be different, but the stories all start in the same way and with the same questions: “Will I lose my job or won’t I lose my job?”; “Will he leave me or won’t he leave me?”; “Will my parents kick me out or won’t they kick me out?” The questions are all the same; there are no surprises. Many women say that once they are referred—
Perhaps this is not about this particular debate on the amendment, but I have to say that some of us in this House have the conviction that the emphasis seems to be on the right of the woman and that it is about time we spoke about the right of the unborn child. They have rights too.
No, I want to continue for a bit longer.
The diagnosis of pregnancy happens very quickly. One can buy a pregnancy testing kit for £1. It is possible that the reason some women suffer distress following an abortion is that they can be tested before they have even missed their first period. For some women, that is fantastic and they go straight for an abortion when they find out. For others, however, it all happens so quickly that they can be aborted by the time they are seven or eight weeks pregnant, and then afterwards, when the pressure has gone and the coercion has disappeared, they realise—
May I just finish this point? When those women would have been 10 weeks pregnant, two or three weeks after the abortion, they realise that they could have worked it out and that they could have got there somehow. That is when the problems are beginning to kick in. That is why an increasing number of women are becoming very anxious about the fact that they do not receive pre-abortion counselling. That is why I receive so many e-mails and why other organisations receive them.
I want to place it on the record that as somebody who wants a reduction in the time limit on abortions provided in this country; who wants independent counselling to be provided; who has seen many patients who have had mental health problems post-abortion, such as self-harming and depression over 10 years; and who has been present at a termination and watched an eye go past in a tube, with a cursory reference made to it by the consultant, unfortunately I am frustrated by the way in which the amendment has been tabled. Chris Bryant made the point that abortion as an issue should be talked about in the round. As a consequence, I cannot support the amendment, but that does not mean that I do not support the principles and the desire to make abortion as infrequent in our society as possible.
I thank my hon. Friend for his candour. However, I inform him that opportunities to debate abortion in this House do not come very often. In fact, the last time it happened was in 2008 when I had to table an amendment to another Bill, which was controversial. The same criticism was made that the amendment should not have been tabled to that Bill. The fact is that the Government do not make provision for abortion to be discussed in this House. Therefore, it either has to be attached to a Bill like this or it does not happen at all, unless one is drawn first in the ballot for private Members’ Bills.
Yes, but my point is that this is such an emotive subject—we can tell from the responses on both sides of the House that people feel passionately about this—that the debate needs to be calm and considered and the language both here and in the media must not be inflammatory or incendiary, because if it is, it polarises the debate and those of us who want to see progress towards abortion not being so prevalent in society get terribly frustrated.
The amendments are grouped, but when I spoke to the Table Office last night, I was told that I would speak to amendment 1 and that amendment 1 would be pressed to the vote. I hope that the Clerks will clarify that. [ Interruption. ] I will take advice from the Clerks, but when I spoke to the Clerk last night, I was told that it was amendment 1. [ Interruption. ] My hon. Friend Andrew Selous is going to find out for me now.
On the offer, the amendment would provide space and time to talk and think for women who are feeling confused—that is all.
I now come to the financial arrangements between abortion clinics and counselling providers. If anybody in this House were to take out a mortgage today, the person who sold them the mortgage would have to refer them elsewhere for independent advice. If it was a husband and a wife, I believe that they would have to go to separate advisers, because they cannot both take advice about taking out the mortgage from the same person. I wonder why we feel it is appropriate that organisations that take £60 million a year of taxpayers’ money and are paid to carry out abortions give advice on the procedure.
I am a former director of the largest patient organisation in Europe, which provides services on the commissioning side and the provider side through advice and support. It is a charity that deals with long-term conditions. We had to follow extremely strict rules to ensure that there was no conflict of interests and we could not provide commissioning services to an area of the country if we were also on the provider side. Why does she think that that situation has not existed for this particular area of health care?
Because, unfortunately, abortion provision and counselling is never scrutinised thoroughly or legislated on. No legislation happens in this place to deal with abortion. It is an issue that can never be debated. People shy away from debating abortion because of the uproar that results so things do not happen that perhaps should happen. If one is to have cosmetic surgery and it is deemed that it might have a psychological effect, one would be offered independent counselling. That does not happen with abortion.
No, I would like to continue on the financial incentives.
BPAS and other organisations would say that they do not have to meet targets and that they have no financial concerns. However, BPAS has advertised for business development managers, whose primary function is to increase its market share—those are its own words in the advert. If an organisation advertises that it wants to increase the number of abortions, can we trust it to provide vulnerable women who walk through the door with the counselling that they need? On pensions mis-selling, this place has separated by law the people who provide and sell pensions from the people who advise on pensions.
No, I am going to close. I thought long and hard about tabling this amendment. Like so many issues concerning abortion, it is a highly emotive area. There are those who believe that the right to an abortion is so sacred that, no matter what, it should never be touched, debated or reformed. There is not a single MP in this House who has not been asked by a constituent about their beliefs on this issue. I am sure that many prefer, understandably, to fudge a response, particularly when the reaction to discussing abortion can be so aggressive, as I have found to my cost.
The amendment is about one thing and one thing only: providing women with more choice. It would allow women who are at their most vulnerable greater access to support. It must be wrong that the abortion provider that is paid £60 million to carry out terminations also provides the counselling when a woman feels strong or brave enough to ask for it. If an organisation is paid that much for abortions, where is the incentive to reduce them?
I will move on to the tactics that have been used in this House to thwart the amendment. I wish to be very clear and will take no more interventions. I went to see the Prime Minister regarding this amendment and he was very encouraging. In fact, it was at the Prime Minister’s insistence that I inserted the word “independent”. I have attended a meeting at the Department of Health at which it was decided what process would be implemented to make this a reality.
Last weekend, the former MP for Oxford West and Abingdon, Evan Harris, who has spent most of the day in the office of Dr Huppert—he is still here, tabling his amendments—turned up on the airwaves expounding the theory that there is no evidence of a problem, that the amendment is unnecessary as nothing needs to be fixed, that the status quo should remain and that the abortion industry should be allowed to continue under the veil of secrecy that it has.
I received a message informing me that the former Member for Oxford West and Abingdon had approached the Deputy Prime Minister’s office and exerted pressure. In fact, he tweeted exactly that, saying that he had applied pressure on the Deputy Prime Minister, who had now forced the Prime Minister to make a climbdown. Basically, a Liberal Democrat—in fact, a former MP who lost his seat in this place—is blackmailing our Prime Minister and our Government. Our Prime Minister is being put in an impossible position regarding this amendment. Our health Bill has been held to ransom by a former Liberal Democrat MP, who has focused on this amendment.
The interesting thing is that ComRes polling shows that 78% of the public support the amendment.
Order. I apologise for interrupting the hon. Lady, but there is so much noise in the House that it is sometimes difficult to know whether somebody is seeking to intervene or standing for another purpose. Point of order, Mr Martin Horwood.
I am grateful to the hon. Gentleman. My understanding at present is that there has been no breach of order. However, I would say to Nadine Dorries and to the House that temperate language, moderation and good humour are the essential features referred to in “Erskine May”, and it is best if they inform our debates.
Thank you, Mr Speaker.
I think our Prime Minister has been put in an impossible position. I want every Liberal Democrat Member to know that in the polling that was done, support for the amendment was 78% among the public, but it was highest among those who voted Liberal Democrat in the 2010 election, at 84%.
It is time to make a decision not informed by the Liberal Democrats, and without being blackmailed by a Liberal Democrat or held to ransom by the Liberal Democrats. It is time to make a decision based on our conscience. I say to hon. Members: be prepared to stand by your view today for a long time, as it will be on everyone’s parliamentary record. In weighing up whether to support the amendment, Members should bear in mind the fact that 78% of the public support it. This is why we are here as Members of Parliament—to make difficult decisions such as this, not to be blackmailed or held to ransom. This is why we are MPs—because our constituents expect us to be brave. They expect us to stand up in the face of blackmail and be accountable.
It does not happen very often in the House, but we have a conscience vote. It hardly ever happens, but we are all personally answerable for the decisions that we take. This decision is about nothing more than supporting an offer of counselling to vulnerable women who may need it and who may use it as a lifeline.
How many times do I have to say no to my hon. Friend?
This is about being accountable for our views, which is what Parliament is all about. I do not see why we should shy away from putting our positions on the record. If Members want to stand in the way of a woman’s basic right to independent counselling, then they should vote against this proposal. However, if they want to ensure that a woman can have access to very basic support, they should vote for the amendment. It is up to them—support these reasonable measures to provide all women with independent counselling, or stand in the way of that basic support.
This vote is about women. I want every woman in this country to be able to look every MP in the eye and ask, “How did you vote for me and my daughters? What was the decision that you took?” Every MP will be accountable for that vote and that decision today.
The decision to seek an abortion may be the most serious and difficult that many women face in their lives, and I think it deserves some seriousness and calm in this debate.
For nearly five decades, this House has been in agreement that abortion and matters related to it should be above mere party and partisan politics. For nearly five decades, there has been a settled pro-choice majority in this House and in the country, and for nearly five decades the House has believed that when Members of all parties have religious or ethical objections to abortion, their right to vote against it should be absolutely respected. However, this amendment is not about that. It is a shoddy, ill-conceived attempt to promote non-facts to make a non-case.
I am afraid that we are an hour into an hour-and-a-half debate, and I am anxious to allow time for other Members to speak.
The case that the amendment is intended to make is that tens of thousands of women every year are either not getting counselling that they request, or are getting counselling that is so poor that only new legislation can remedy the situation. I might say, after many years in the House, that in matters of this kind, if legislation is the answer we have almost certainly asked the wrong question.
The amendment is the opposite of evidence-based policy making. We know that the British Medical Association advises its members:
“A decision to terminate a pregnancy is never an easy one. In making these decisions, patients and doctors should ensure that the decision is supported by appropriate information and counselling about the options and implications.”
We know that the Royal College of Obstetricians and Gynaecologists guidance on abortion states:
“Women should be given counselling according to their need—including post-abortion if she needs it. All women should be offered standalone counselling. The counselling should include: implications counselling (aims to enable the person concerned to understand the…course of action…); support counselling (aims to give emotional support in times of particular stress) and therapeutic counselling (aims to help people with the consequences of their decision and to help them resolve problems which may arise as a result)”.
We know that Department of Health regulations state:
“Counselling must be offered to women who request or appear to need help in deciding on the management of the pregnancy or who are having difficulty in coping emotionally”.
We also know that all the clinics that have been discussed in the debate are inspected and regulated.
Yet the proposers of the amendment are asking us to believe, on the basis of purely anecdotal evidence, that tens of thousands of doctors, nurses and charity workers involved in the 190,000 abortions a year are wilfully ignoring both the law and the guidance of the British Medical Association and the Royal Colleges. They go further than that, arguing that tens of thousands of doctors, nurses and charity workers are merely in it for the money. They imply that those men and women are involved in some sort of grotesque piecework. It is almost as though they were paid per abortion. The proposers of the amendment, I might add, also seem to be arguing that thousands of women do not actually know what they are doing. It tells us something about the validity of their claims that they are obliged to smear tens of thousands of doctors and nurses to make any kind of case. No wonder that a journalist for
—no friend of the liberal left, but one who happens to have served as a lay member of the Royal College of Obstetricians and Gynaecologists—last weekend described the amendments as a “senseless and sinister bid” to cut abortions.
I agree with my hon. Friend. Any evidence that we have heard has been anecdotal—we have heard of a 16-year-old’s journey and of e-mails that hon. Members have seen but that I have not. However, my hon. Friend makes a real point. The conclusion of the consultation might be that a termination takes place, but this is the only procedure in this country that requires the informed consent of two doctors. Government Members besmirch doctors by saying that such things happen daily, but that is not true. From my nine years on the General Medical Council, I recognise that we have good ethical guidelines for doctors. Nothing is done without the informed consent of two medical practitioners.
I would be more willing to give way were we not so far advanced in a debate that will last for only an hour and a half. I was not aware that so many Back Benchers wanted to contribute, because they have not hitherto tried to intervene.
Some colleagues have expressed their surprise that yet again we are discussing women’s reproductive rights in this House, but they should not be surprised. Abortion has never stood on its own as a technical issue; it is part of a century-long debate about women’s sexuality, womens’s rights and women’s freedoms. Sadly, for some people that is apparently still contested ground in 2011. Some even argue that the proposals are best seen as part of a wider push on the socially conservative agenda that has been so successful for right-wing politicians in America. Thankfully, in this country, that agenda has come up against a determination to keep such issues above party politics, the absence of a Fox News pumping out socially conservative propaganda 24 hours a day and British common sense.
I could say many things on the lack of an evidence base behind the amendments, but let me say this: women—both individual women and women in general—have been called in aid in this debate, and indeed they face very real problems in this society, here in 2011. They face spiralling unemployment as a direct consequence of the coalition’s policies and the sexualisation of our culture, which affects younger and younger female children—[ Interruption. ] I hope that hon. Members listen to this, because it is a point that many mothers and fathers will understand. Too many young women in communities up and down the country think that the only road to fame and fortune is to pump their bottom and their breasts full of silicone and tout themselves as some sort of media celebrity. Another issue is the number of very young women who have been badly parented, who have children too young and who, with all their good intentions, parent their own children badly in turn. Even in an era of financial constraint, those are the issues that this House should be addressing.
Nobody is saying that arrangements in relation to counselling cannot be improved. I believe that Dr Huppert has tabled a good amendment to that effect, which some of us hope finds favour in another place. However, the Bill and the amendment are not appropriate for a full and careful debate on abortion. The amendments deal with matters that are amply covered by existing law and regulations.
The hon. Lady is making an excellent speech and has outlined the fact that there is adequate provision for counselling in the status quo. Doctors, nurses and other medical professionals who must deal with such situations every day have adequate measures in place, as the Royal College of Obstetricians and Gynaecologists has outlined. They do not look only at the medical consultation, but at the whole patient, as we have heard. If that means that counselling is required, they will ensure that their patient gets it. Does she agree that this is not the place for the amendment, which serves no purpose, and that we need to get on and debate the Bill?
I am grateful to the hon. Gentleman, who is, of course, a practising doctor who knows a great deal more about these matters than many of us in the House.
As hon. Members have heard, the amendments deal with matters that are amply covered by existing law and regulations that are well known to doctors and nurses. They deal with matters that must, at the end of the day, be between a woman and a doctor. I deprecate the extent to which amendment 1 is an attempt to import American sensationalism, confrontation and politicisation into these issues in a way that will be of no benefit to ordinary women.
There is no evidence base for the amendments, and on the basis of all the recent polls there is no substantive support for amendments of this nature. Legislation addressing the issues raised by Government Members is already in place. This House should have more respect for the medical profession and for the vulnerable women who put themselves forward for abortion in one of the most difficult periods in their lives, rather than support an amendment of this nature, which is spurious and baseless. I urge the House emphatically to reject the amendment.
I feel that I need to start by saying that this debate is about women; it is not about hon. Members. It is about ensuring that women get the very best possible services that they not only need but deserve.
There was much comment and speculation ahead of the debate, not all of it accurate or helpful. It might therefore be useful if I explain the Government’s approach to meeting the spirit of the amendments without primary legislation. I associate myself with my hon. Friend Dr Lee, who urged calm and balance. Today’s debate has not necessarily reflected either of those things.
How do the Government intend to meet the spirit of the amendments?
I need to make a little progress.
The Bill gives new public health functions to local government. In some cases, the steps that local authorities must take will be prescribed in regulations, which include the provision of sexual health services and abortion services. That will be a duty of local authorities and not of clinical commissioning groups—some of the amendments in the group have caused confusion about that. We intend to specify in regulations that local authorities must ensure that part of what they commission is a choice of independent counselling.
Amendments 1 and 2 would fragment the service by splitting responsibility for the commissioning of counselling and for the commissioning of the rest of the service. If they and amendment 1221 were to be made, clinical commissioning groups and local authorities would have different but overlapping duties in relation to independent counselling, and the definition of “independent” would be different for each. We would have a fragmented service, which none of us wants. Most women go to their GP, which is not the same as a clinical commissioning group, or they self-refer to an abortion provider, so amendment 1221 would not work.
None the less, the amendments have highlighted some important issues. There are indeed no quality standards for abortion counselling, and women are not always offered the opportunity to have counselling. It is worth repeating that we want counselling to be provided by appropriately qualified people who offer non-judgmental, therapeutic support, and who act according to their professional judgment, in the best interests of their clients, without undue influence or regard to outside interests.
I know there has been considerable interest in exactly what “independent” should mean and in whether it must automatically mean independence from the abortion service provider in every possible way. That is not a simple question, and it is certainly not as simple a question as the amendments imply. There are permutations of financial, organisational and clinical independence to be considered. For example, would the amendments mean that a self-employed counsellor who had a contract with a charitable abortion provider for two days a week was independent on the other three days, or not?
Before we legislate, we want to think through all the implications—including financial and legal—of a definition. We also want to consult widely and publicly as part of our proposals to help us ensure that we really improve services for women at what we all know is an extremely difficult time in their lives. We need to consult the public; indeed, we need to consult the women about whom we are talking. We have heard passionate contributions this afternoon, and I want to harness and corral them to create the calm and balance that we all want to be established, so that we can consult and arrive at the best conclusions. I also stress that the regulations would be subject to affirmative resolution.
Whether women want to take up the offer of independent counselling will be a matter for them, but we are clear that the offer should be made. Ms Abbott mentioned the post-abortion period. That is a critical time on which there is little focus.
I am afraid that time is against me.
I hope that what I have said reassures my hon. Friend Dr Huppert, who I believe is trying to be helpful, but we do not support any of the amendments. We intend to ensure that the independent counselling offered to women follows the highest standards of good practice. My hon. Friend’s amendment 1252 is therefore unnecessary, as well as, we believe, unenforceable as currently drafted. It does not define “information or advice”, and crucially, it does not mention independent counselling. Counselling is different from advice and support. However, the Government support the spirit of the amendments, and we intend to present proposals for regulations after consultation. Not only is primary legislation unnecessary, but it would deprive Parliament of the opportunity to consider the detail of how the service will develop and evolve.
Amendment 1180 would oblige the Government to make regulations requiring NICE to produce guidance on abortion services. It would also oblige NICE to make specific recommendations in the guidance. That conflicts with other provisions in the same clause that prevent central interference in the substance of the NICE recommendations. Clearly that would seriously damage the independence of NICE and its reputation for evidence-based guidance. The second part of the amendment would require health or social care bodies, or private providers of abortion services, to comply with all recommendations made by NICE, which would effectively mean that NICE was setting essential requirements for abortion services, which is not its job or function. That is the role of the Care Quality Commission, and those standards and qualities are driven by good commissioning.
I will not, I am afraid. I must make progress.
This does not, of course, mean that NICE has nothing to contribute. Hon. Members may know that it is currently considering a draft library of NHS quality standards, which includes a proposed topic on abortion services. We may have an opportunity to air the issue further at that point.
I hope that hon. Members are reassured by our proposals and by my personal involvement in the issue.
Chris Bryant is clearly not reassured, but perhaps he will let me finish.
It is a very long time since I worked in a maternity unit, but I worked in one run by the Salvation Army, and I have seen many young women go through the trauma of an unplanned and unwanted pregnancy. Yes, we need to do a great deal more to prevent unwanted pregnancies from happening in the first place, but when faced with such a situation, young, and indeed older, women need help and support to make the decision that is right for them without interference from any vested interests. The amendments were tabled in a spirit of improving services for women, but they will not work. They will not deliver what my hon. Friend Nadine Dorries wants, or what I want. They will not work for women. I urge my hon. Friend to withdraw her amendment and to work with me to ensure that we secure the right services for women.
I will be brief, because I know that others wish to speak.
I thought that I would be addressing the House about an amendment with my name on it, but, for reasons unknown to me, my name was dropped from it. What I wanted to say, however—and it is reinforced by the way in which the Minister has approached the matter—is that while I thought that the original amendment involved an issue that we should consider, I believe that the Minister has dealt with it. Nadine Dorries and I embarked on this journey together, and my plea to her now is not to press the amendment. The Minister has provided us with an advance which I hope will signal a change in the temper of the abortion debate in the House.
This has been one of those debates in which people emphasise motives and rarely take voting records into account. I put my name to that amendment because in every vote on the subject that has taken place in the 30 years for which I have been in the House, I have voted against wrecking the Abortion Act, and I thought that there was an issue here that should be considered. However, I feel that the Minister has more than met the point, and she has widened the debate about what the inquiry will cover. I hope that the whole House will pay attention to her and to my hon. Friend Ms Abbott. Presumably a report will be produced once the consultation has been completed, and perhaps we shall then be able to have a debate opened by Front Benchers in which Back Benchers’ speeches are time-limited.
Despite what has happened today, I think it important for us to try to use this event to make it clear that we will have different debates about abortion in the House of Commons in future, for we should have such debates. We should be more concerned with facts, and less concerned with trying to put our sticky fingers into other people’s souls and pronouncing that they have failed.
I am delighted to have a chance to speak in the debate. It is tempting to respond to all the comments made by Nadine Dorries, but I shall avoid doing so. Instead, I shall make just two points.
“The hon. Lady has asserted many things to be facts that are not… Some of the things that she is saying are not borne out by the evidence.”—[Hansard, 20 May 2008; Vol. 476, c. 263.]
I think that that is extremely true.
I am afraid that there will not be time to go through all that. The hon. Lady challenged me to comment on some evidence that she had provided, and then would not allow me to do so. Dr Wollaston remarked on that.
“Where studies control for whether or not the pregnancy was planned or wanted, there is no evidence of elevated risk of mental health problems.”
As I have said, that is a much more detailed review.
Unfortunately, there is not sufficient time to cover all the other topics the hon. Lady would like to talk about. I congratulate her, however, as it takes a lot to unite Abortion Rights with the Society for the Protection of Unborn Children, both of which oppose her amendments. The SPUC has been very clear that it cannot ask MPs to support the amendments.
Let me move on, however, and ask whether there is actually a problem that we need to address: are there too many abortions? The best way to reduce the number of abortions is by empowering individuals, by providing better access to contraception and by providing better sex and relationships education at school to both boys and girls. Are there areas where we need better advice and counselling? Absolutely, there are. People who have had a miscarriage do not get the counselling support that they desperately need. We should focus attention on that. For all the reasons that have been discussed, I urge the House to reject these amendments.
I want to speak in favour of my amendment 1252, which proposes that evidence-based advice should be given. Although the Government will not support the amendment if it is put to a vote, I was pleased to hear that they accept the principle behind it, which is that we want that expert advice. I am not a medical doctor—I am not an obstetrician or gynaecologist—but they have clearly stated what they think the best advice is, and it should be followed. We should expect all groups giving advice to live up to this high standard. Women—all people—should get proper medical advice, and it should be the best advice available. They should not be misled, and they should not have made-up risks told to them. The Royal College of Obstetricians and Gynaecologists has excellent guidance from 2004, and all organisations should stick to it. I confirm that the British Pregnancy Advisory Service and Marie Stopes stick to that guidance, and so should all other groups.
I trust the Government when they say that they will stick to that advice—the best medical advice. I have some concerns about some of the Government’s other comments however, and I hope to have a chance to talk to the Minister in greater detail, although this debate has not been the forum in which to do that. I urge the House to stand up for what it believes in, to reject the presentation we heard earlier and to reject the amendments.
First, I should point out that Dr Huppert was referring to an older study.
We have heard a number of points of view. I take on board the comments of Mr Field and I appreciate the response from the Minister. She is my friend, and she has gone out of her way to understand the issue and to bring this debate to a calm and reasoned conclusion.
This debate is not just about my amendment. There are many people who support it, as I have frequently stated. [Interruption.] I have no idea why whenever I stand Chris Bryant always feels the need to continue chatting; he should just be quiet.
I heard what the right hon. Member for Birkenhead said, and I have listened to the Minister. Unfortunately, I am being urged by many other people, not least those who have told their stories, to go to a vote, because there are people who want a line drawn in the sand here. I shall therefore press amendment 1221 to a Division.
I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.