Sex-selective Abortion

Baroness Knight of Collingtree Excerpts

Monday 7th December 2015 Lords Chamber

Asked by

[Baroness Knight of Collingtree]

To ask Her Majesty’s Government whether they plan to take action to protect unborn girls from abortion for the sole reason of their sex.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, abortion on the grounds of gender alone is illegal, and we have made this very clear on a number of occasions. The Government published an analysis on 27 August this year which found no substantiated evidence of gender abortions taking place in Great Britain. We are committed to continuing to monitor this issue carefully and will examine any evidence that comes to light.

[Baroness Knight of Collingtree (Con)]

My Lords, I am most pleased to hear what my noble friend just told us. Why are there constantly reports in the papers of such abortions being carried out? It seems to be fairly usual if we look at the papers. Is he as concerned as I am that there seems to be no great battle against this?

[Lord Prior of Brampton]

My Lords, abortion on the basis of gender alone is illegal; there should be no doubt about that. There is no evidence at all on a population basis of any such abortions taking place. However, my noble friend has mentioned that there is anecdotal evidence to the effect that that may not always be the case. To that extent, she is right to be eternally vigilant about these matters. If it is happening, it is totally unacceptable, abhorrent, and against everything we stand for in this country.

Gender-based Violence: Screening

Baroness Knight of Collingtree Excerpts

Monday 9th March 2015 Lords Chamber

[Earl Howe]

I do agree. Sexual health and HIV services are already sensitive to the risk of domestic violence, including gender-based violence, in their routine consultations. One of the most important elements in that is to have an environment and atmosphere that is welcoming, comfortable and calm, so that it engenders a sense of trust. Most sexual health clinics have developed local templates to identify those at risk of domestic violence, with signposting and referral to police and other support services if needed.

[Baroness Knight of Collingtree (Con)]

My Lords, could there be a greater example of gender violence than the acceptance that it is perfectly legal to abort an unborn child who is a girl? There is so much disagreement about that—I know my noble friend agrees that it is a wrong policy and ought to be illegal—but the fact is that abortion nursing homes do it every day, and there is great uncertainty about whether this is illegal or not. Ought it not to be quite clear that it is an illegal practice?

[Earl Howe]

My noble friend has emphasised an issue which I am sure all noble Lords feel equally strongly about. The Department of Health has been quite clear that abortion on grounds of gender alone is illegal. We reissued that guidance last year in no uncertain terms. It is a pity if there is any misconception about that.

NHS: Accident and Emergency Services

Baroness Knight of Collingtree Excerpts

Wednesday 7th January 2015 Lords Chamber

[Earl Howe]

I recognise that issue. Having said that, we currently have a record number of A&E doctors in the NHS, which is good, and across the system we have 1,800 more doctors and 4,700 more hospital nurses than we had a year ago. However, being an A&E doctor is a stressful occupation, and doctors are sometimes tempted to go overseas. We are concerned about the loss of any A&E doctor, and that is being looked at in conjunction with the royal colleges and the BMA.

[Baroness Knight of Collingtree (Con)]

My Lords, there can be no doubt that the figures which we have been given by the Minister need to be looked at very carefully. It would be a miracle if this enormous demand could be faced with no financial troubles at all. However, does he recognise that there is quite a bone of contention, and that the argument is building up that those who bear the heat and the burden of the day working in A&E departments seem to get a fairly small salary compared to the enormous sums that are paid out to managers within the health service? I do not know whether it would be possible to rein that back a little, but if that is the case, it seems very unfair.

[Earl Howe]

I am grateful to my noble friend. Of course, rates of pay are a sensitive matter, and it is true that the constraints on pay rises over recent years have had an effect on the attractiveness of particular careers in the health service. We can do little about that in the short term, but there are ways and means of improving the work-life balance and working lives of those who work in the health service, even if we cannot increase their pay at the current time.

Abortion (Sex-Selection) Bill

Baroness Knight of Collingtree Excerpts

Tuesday 16th December 2014 Lords Chamber

Asked by

[Baroness Knight of Collingtree]

To ask Her Majesty’s Government what action they intend to take following the First Reading of the Abortion (Sex-Selection) Bill in the House of Commons on 4 November.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, abortion is traditionally an area where there is a free vote on Private Members’ Bills. We have made it clear on numerous occasions that abortion on the grounds of gender alone is illegal. We take this issue very seriously and will continue to monitor birth ratios and consider any evidence that comes to light.

[Baroness Knight of Collingtree (Con)]

My Lords, did my noble friend note that at the end of the First Reading debate on the Bill 181 MPs voted for it and only one voted against it and the tellers counting the vote against insisted that their votes be counted in favour of the Bill? Does he consider that this indicates acceptance of the evidence that abortion for gender reasons is going on and is causing very grave concern? Even a Minister saying in this House that this is illegal does not make it so: only a parliamentary Bill can do that. If gender equality means anything at all, surely the protection of the lives of baby girls is a matter of urgency.

[Earl Howe]

My Lords, the legal position is not in doubt. It is illegal to abort a foetus based solely on its gender. The Abortion Act states that two practitioners have to be,

“of the opinion formed in good faith”,

that the woman had grounds for an abortion. It is for doctors, in line with any guidance from their professional bodies, to satisfy themselves that they are in a position to give the opinion and to defend it if challenged. We refreshed the guidance in May of this year to make the position crystal clear.

Health and Social Care Act 2012: Risk Register

Baroness Knight of Collingtree Excerpts

Wednesday 9th July 2014 Lords Chamber

[Earl Howe]

The Government of which the noble Lord was such a distinguished member took the same approach to risk registers. Of course, transparency is an important principle in health and care. It is important to drive up performance and expose institutional failure, and I believe there is a revolution taking place in the level of transparency and access to health and care information. I am sure we are agreed on that. The point that I sought to make earlier is that when it comes to policy-making within government, Ministers and civil servants are entitled to some safe space, so the principle of transparency has to be moderated to a certain extent. That is the balance that we have struck.

[Baroness Knight of Collingtree (Con)]

My Lords, is it not the case that a recent independent Commonwealth Fund report said that Britain had the best and safest healthcare system of all the 11 wealthiest nations? Since we know that the NHS is the biggest organisation and business of its kind in Europe, with all the opportunities for it to go wrong, is this not an extremely telling assessment of the real situation?

[Earl Howe]

I agree completely with my noble friend. The Commonwealth Fund report covers the period from 2011 to 2013—exactly when we were in the middle of reforming the NHS. The findings of the report were a credit to all those working on the front line of the healthcare system throughout that period of change.

Abortion

Baroness Knight of Collingtree Excerpts

Thursday 3rd April 2014 Grand Committee

Asked by

[Baroness Knight of Collingtree]

To ask Her Majesty’s Government what steps they intend to take to investigate reported law breaking by those carrying out terminations of pregnancies.

[Baroness Knight of Collingtree (Con)]

My Lords, normally, when a Bill has been debated, taken through Committee and approved by both Houses, it is signed by the Queen and becomes an Act. After that, those breaking it will face possible arrest, fines or even imprisonment—unless it is the Abortion Act 1967. I well recall its passage; there were firm reassurances that its strictures would not permit abortion on demand. Today, more than 7 million abortions later, we have exactly that. So much has the Act been watered down and its safeguards ignored that it is now being quoted to warn those who will soon vote on euthanasia. It is an apt comparison because both deal with life and death. The warning is that the triple lock of the Falconer Bill is modelled on the wording of the old 1967 Act and will turn out just as ineffective.

The Abortion Act is four pages long and contains only seven sections. At least four seem to be broken regularly, yet it is impossible to get details of investigations into this law-breaking or about any resulting prosecutions. Section 1 lists a vital condition on which abortion became legal: that two doctors must see and examine the patient and certify that the operation would be legal. The object of that was to ensure that—on such a serious matter as the death of a child—a second opinion had been sought and two doctors separately concurred. Last year, the NHS’s own inspectors found bundles of forms signed by doctors in 14 hospitals, certifying that they had seen and examined the patient. Their medical and independent judgment agreed that she met the conditions for a legal abortion. All these doctors lied. I understand that there were 76 of them. They had neither seen nor examined the woman; they and the doctors who subsequently performed the abortion broke the law. Falsifying official forms is perjury.

Never, until now, has it been acceptable to pass the job of dealing with law-breakers from the British courts to those representing the professions or trade unions of the very people breaking the law. The GMC dealt with that case, which would have been fine if it had just been a question of medical ethics but it was not—it dealt with the law of the land. The medical profession is now saying that since it thinks that a second opinion is unnecessary, it will not seek one. Surely it must be Parliament, not doctors, that decides what the law says. The Act is unequivocal: involving two doctors is its first condition. Nowhere does it give a proviso that any part can be ignored if anyone disagrees.

Section 1 also rules that no abortion is legal unless the woman’s heath or mental state would be at risk without one, or if her existing children faced physical or mental abnormalities of some kind if she did not have it. Are such judgments routinely made? I have met and talked to a number of girls who have had a termination. Not one has ever been able to tell me of tests or questions about that, or checks on their children’s likelihood to be made ill, mad or slightly mad. Very few of those I spoke to had any children at all.

Then there is Section 4, giving everyone the right to refuse to take part in an abortion if they have a conscientious objection. That is the law. The truth is that the NHS does not and will not employ any midwife who has such an objection. A very senior doctor in this House told me only last week that large numbers of them have emigrated. I have never heard even a whisper of any legal action against those who break Section 4. Why is that? The Act certainly does not deny a conscientious midwife the right to a job.

What investigations are being done on allegations and evidence that abortions happen because the unborn child is a girl? Last week, the Prime Minister stated firmly and clearly that that was illegal. If it is, surely checks should be going on into whether these reports are true. I wonder whether his statement was based on the words of my noble friend Lord Howe:

“Abortion on the grounds of gender alone is illegal … The Abortion Act is very clear on that point”.—[Official Report, 12/2/14; col. 639.]

I have checked the Act a number of times and all the amendments very carefully. There are no such words or clarity in the whole lot of them. It would amaze me if there had been, for none of us dreamed then that it would become possible to know the sex of an unborn child. The noble Lord, Lord Steel, would never have sanctioned gender abortions.

Abortion law surely lacks clarity on matters that need to be clear. Furthermore, it suffers from those who play with words to the extent that it permits terminations that were never intended to be legal. In no way do I seek in the debate this afternoon to discuss the right and wrongs of abortion—there are many different views in this House on that. I do not mean to go into any of that. All I ask is that the law, as passed by Parliament, should be clear and upheld. Surely that is not an unreasonable request.

Abortion

Baroness Knight of Collingtree Excerpts

Wednesday 12th February 2014 Lords Chamber

Asked by

[Baroness Knight of Collingtree]

To ask Her Majesty’s Government what action they intend to take in the light of recent analysis of the ratio of boys and girls in United Kingdom families suggesting that sex-selective abortion is taking place.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, it cannot be concluded from the recent analysis in the Independent newspaper that sex-selective abortions are taking place. We are absolutely clear that abortion on the grounds of gender alone is against the law and completely unacceptable.

[Baroness Knight of Collingtree (Con)]

My Lords, does my noble friend recall that when I last asked a Question on this matter in October, the House was informed that it was impossible to prosecute doctors known to be aborting on gender grounds because the evidence was not strong enough? However, has the Minister noted the findings of the national census of 2011, which show that between 1,400 and 4,700 fewer girls have been born recently? This, it was said, can be explained only by the fact that termination of girl babies is going on, even though my noble friend has said this morning and NHS spokesmen have warned that such operations are,

“against the law and completely unacceptable”.

When are the Government going to stop this practice, and what are the implications if they do not do so?

[Earl Howe]

My Lords, the analysis recently reported in the Independent newspaper was based on census data, as my noble friend pointed out, for households with usually-resident dependent children. The gender balance of dependent children in these households is affected by a number of events that occur after birth, such as the age at which dependent children leave the parental home. As there are a number of alternative explanations for these observations, it cannot be concluded from the Independent’s analysis that sex-selective abortions are taking place. The best available data on which to base gender ratio analysis continue to be births data, which were the basis on which we did our analysis last year. I can tell my noble friend that that analysis will be updated on an annual basis when new data are available.

NHS: Mid Staffordshire NHS Foundation Trust

Baroness Knight of Collingtree Excerpts

Tuesday 19th November 2013 Lords Chamber

[Earl Howe]

My Lords, I completely agree with the noble Baroness that the voice of the patient is an essential part of maintaining a culture of safety in the NHS. Improving the way in which the NHS manages and responds to complaints will be critical in shaping a culture that listens to patients and learns from them and ending a culture of defensiveness or, at worst, a culture of denial about poor care. That is why we welcome and accept the spirit of the review of the NHS hospital complaints system by Ann Clwyd MP and Professor Tricia Hart and the principles behind their recommendations.

On whistleblowers, the amendments to the NHS constitution have enhanced the protection for whistleblowers, but we are not complacent and we are already considering whether there is a need for more developments both to protect whistleblowers and to ensure that action is taken, where necessary, in response to concerns. We are looking, with the national regulators, at how whistleblowing concerns are dealt with at the moment and, where appropriate, we will introduce improvements to systems in the future.

[Baroness Knight of Collingtree (Con)]

My Lords, much of what my noble friend has said has given us satisfaction, but it is perfectly true, as we have already been reminded, that troubles were going on not only in the Mid Staffordshire area but all over the place. It is also true that it is not just the whistleblowers who warned time and time again about what was going on and who should have been listened to. I spent four or five years raising cases of people who had written to me. On one occasion I presented the then Minister, the noble Lord, Lord Hunt of Kings Heath, with a dossier of some 25 cases, all of which had been checked very carefully. All the details were correct, all the patients, or their relatives, had given permission for these cases to be raised and they were raised in this House. I am not blaming the noble Lord for failing to take these cases forward, or failing to listen to the arguments put out clearly in this House, because I think that he passed them on, but they were never properly investigated.

It is upsetting that for such a long period warnings were being given and were allowed somehow to filter into the ground and away, or into the past. I particularly warned about the practice, which was fairly unknown at that time, of failing to feed patients because food was put too far away from them and other examples. I worry about the people who suffered for those long years when something could have been done if those responsible at the grass roots had taken care of what was being said in this House. I beg the Minister not to leave aside the really serious point that cases raised with great sincerity and truth in this House should be regarded and not just pushed aside in the future.

[Earl Howe]

My Lords, my noble friend should be listened to with great care. Of course, I remember those cases. I was not the Minister in charge at the time she submitted those cases to the Department of Health, but she shared them with me, and I share her concerns, which are, of course, directly relevant to the matters we are discussing today. We have the new duty of candour and in April the Enterprise and Regulatory Reform Act strengthened the main whistleblowing legislation introduced by the Public Interest Disclosure Act so that an individual who suffers harm from a co-worker as a result of blowing the whistle now has the right to expect their employer to take reasonable steps to stop this. The idea is to ensure that people do not feel intimidated from speaking up. The Care Quality Commission is using staff surveys and the whistleblowing concerns it receives as part of the data in its new intelligent monitoring system. That data will guide the CQC about which hospitals to inspect. Since September, the commission’s new inspection system includes discussions with hospitals about how they deal with whistleblowers and handle them.

Care Bill [HL]

Baroness Knight of Collingtree Excerpts

Tuesday 29th October 2013 Lords Chamber

[Earl Howe]

I tried to explain that there is none. There is no primary duty in statute on the National Health Service to promote spiritual well-being, which is why we are trying to make the Bill entirely consistent with that position. We have aimed for a system built around individuals and I have tabled my amendment to make absolutely clear that a person’s beliefs, spiritual or otherwise, should be taken into account in this personalised approach to care.

As noble Lords may expect, I asked my officials to consider my noble friend’s proposal and whether anyone could benefit under his amendment who would not do so under the Government’s amendment. The advice that I received is clear that no such example can be found. I struggle to understand why my noble friend might feel it necessary to divide the House on this matter if he is minded to do so.

[Baroness Knight of Collingtree (Con)]

Does my noble friend appreciate that only very recently we were given a sharp lesson? Unless a law is clear in its wording for those who have to live by it, any interpretation can be put on it. He will well remember what has happened regarding the Abortion Act. Because it was not thought necessary at the time to put certain wording in, it is assumed that it is legal to ignore it.

[Earl Howe]

I agree with my noble friend, which is precisely why I am resisting the word “spiritual”. I do not think that that is a concept that is well defined in law and I think that it could give rise to enormous confusion. It is for that very reason that I am resisting the suggestion of my noble friend.

I hope that noble Lords will agree that my amendment achieves the aim of ensuring that a person’s beliefs, including those of a spiritual nature, are taken into account where that is important to the individual concerned. I propose that local authorities may promote an individual’s spiritual well-being by taking their beliefs into account, while avoiding any negative consequences. I hope that the House will agree not to follow my noble friend in this instance.

NHS: Foundation Trusts

Baroness Knight of Collingtree Excerpts

Tuesday 16th July 2013 Lords Chamber

[Earl Howe]

My Lords, there is no doubt—and we have never denied this—that there will be a hard core of organisations which will be very difficult, if not impossible, to bring to foundation trust status. For those trusts, it is necessary to look at other options, including, for example, mergers. That work is being taken forward. Although some trusts are in deficit, the NHS TDA is working very hard to mitigate those deficits in-year and when the first quarter board papers are published in September we will know what its predictions are for all trusts for the current year. I will come back to the noble Lord on the report of Sir Ian Carruthers because all FOI decisions are reviewed at regular intervals to make sure they are current. I want to make sure that there is a plan to release that information in due course. I am sure that there is.

[Baroness Knight of Collingtree]

My Lords, following yesterday’s Written Statement, in which the Government indicated total support for the review carried out so expertly by the noble Baroness, Lady Neuberger, on the Liverpool Care Pathway, can my noble friend the Minister confirm that the trusts will take immediate action to implement its recommendations?

[Earl Howe]

My Lords, I hope my noble friend will allow that that is a little wide of the Question on the Order Paper, which is about bringing trusts to foundation trust status. Nevertheless, I refer my noble friend to the Written Answer which was published in Hansard yesterday and which sets out the immediate steps we have taken to instruct all hospitals to review all patients currently on the Liverpool Care Pathway and to make sure that there is a named, responsible clinician for every patient at the end of life.