Baroness Knight of Collingtree
To ask Her Majesty’s Government what steps they will take to prevent illegal abortion operations.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)
My Lords, an abortion may take place only on grounds under the Abortion Act 1967, as amended. Allegations of illegal abortions are taken very seriously by the Government and anyone suspected of acting outside the law will be referred to the police for investigation. It is for the Crown Prosecution Service to decide whether to prosecute individuals and for the courts to determine whether there has been a breach of the law on abortion.
Baroness Knight of Collingtree
My Lords, is my noble friend aware that Parliament passed the Abortion Act 1967 on very firm assurances that clear medical reasons would have to be agreed by two doctors, who examined the patient before an abortion could take place, and that abortion on demand would not happen? Is he aware that if Parliament had known that abortions would occur because the coming child was a girl when the mother wanted a boy, the Act would not have gone through? Did he note the Government’s Care Quality Commission’s findings that some doctors who have never even seen the patient are signing blank forms and leaving them in a handy place for use by colleagues, while others are aborting girl babies unwanted by the mother for no medical reason at all? What is being done to stop these illegal acts?
Earl Howe
My Lords, my noble friend raises some extremely important questions. The House will remember that reports came to light in February of pre-signing of the HSA1 forms—the approval forms that have to be signed by two doctors—and the CQC carried out a serious of unannounced inspections of all abortion providers in the light of that story to uncover any evidence of pre-signing. As a result, 14 NHS trusts were found to be non-compliant and clear evidence of pre-signing was identified. We await the outcome of investigations by the Metropolitan Police on that issue. Of course, as a department, we take it very seriously indeed.
On the issue of sex selection, my noble friend is absolutely right. The Act stipulates specific circumstances in which termination of pregnancy is permitted. Gender selection is not one of those circumstances. It is illegal for a practitioner to carry out an abortion for that reason alone, unless the certifying practitioners consider that an abortion is justified in relation to at least one of the Section 1(1) grounds in the 1967 Act. My noble friend will also be pleased to know that the Chief Medical Officer for England has written to all clinics and hospitals undertaking abortions to remind them of the provisions of the Abortion Act.
Lord Alton of Liverpool
My Lords, is the Minister familiar with a report that recently appeared in the Economist, which said that around 100 million abortions have taken place throughout the world on the basis of gender, which it calls “gendercide”? Does he not agree that in a country where routinely, every working day, there are some 600 legal abortions there is a real danger that, culturally, people imagine that it is simply a right to choose to take a life on whatever basis they believe it reasonable to do so? Can he therefore spell out again the illegality of taking the life of a child on the basis of its gender? Can he tell the House what penalties there will be when such actions occur and how long it will be before the police inquiries complete their course?
Earl Howe
In answer to the last question I have no firm information about when the police inquiries will complete their course. They have been ongoing for some months. The noble Lord, Lord Alton of Liverpool, is right to raise his concern, but I can again state emphatically that under the law of this country it is illegal to perform an abortion on grounds of sex selection alone. If evidence of such practices comes to light, the penalties are that the doctor or doctors concerned may be referred to the GMC. The Care Quality Commission will be called in and there will be the possibility of police investigation and prosecution resulting. This is not something that any provider of NHS-funded abortions should ever consider doing.
Lord Steel of Aikwood
Does my noble friend agree that the real scourge of illegal abortion occurred before the 1967 reforms, when every hospital in the land had patients admitted for septic and incomplete abortion, and up to 50 women a year died as a result of criminal abortion? Does he accept that, in addition to the gender selection question, another worrying feature is the number of women reporting for repeat abortions, who appear to be using abortion as a form of contraception? Does that concern his department?
Earl Howe
My Lords, I pay tribute to my noble friend for the role that he played in bringing the 1967 Act to the statute book. We have no particular evidence that repeat abortion is a rising issue. Contraception prevents the establishment of a pregnancy and the number of women visiting contraception clinics has, I am pleased to say, gone up, particularly among the young. We are seeing a fall in the number of abortions in the teenage age group. Unfortunately we are also seeing a rise in abortions in the 20 to 29 age group. While I agree with my noble friend’s initial comments, the focus of the public health effort has to be to bear down on the figures as we see them today and make sure that all women have access to contraceptive advice.
Baroness Gould of Potternewton
My Lords, the Minister has answered part of my question, but I shall question him a little further. First, I make the point that of course the law must be maintained at all time. Some of the arguments demonstrate attempts not to keep to the 1967 Act. Is it not therefore important that we stress what it says and maintain in absolute the Act as it stands? Any attempt to water down that Act would return us to the days of backstreet abortions and the deaths that followed them. Does the Minister agree—he mentioned this in his last point—that we should maintain proper, available contraceptive services for all ages? A lot of PCTs are not giving contraceptive services to the over-24s, which is why the abortion rate has gone up in that age group. Does he agree that there should be open access to contraceptive services for all ages and by all methods?
Earl Howe
My Lords, I agree with the thrust of the noble Baroness’s two points. In particular, I agree that there should be no departure from the terms of the 1967 Act, which is why the CMO took the trouble to write to all clinics and hospitals, as I mentioned earlier, to remind them of the provisions of the Abortion Act and in so doing to remind them that sex-selective abortions are illegal.
I must correct what I said earlier. I hope I did not give the wrong impression about repeat abortions. My briefing states that in 2011, 36% of women undergoing abortions had had one or more previous abortion. That proportion has in fact risen from 31% since 2001. Twenty-six per cent of abortions to women aged under 25 were repeat abortions, which is quite a high percentage.