Medicines and Medical Devices Bill

Lord Alton of Liverpool Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Lord Alton of Liverpool (CB)]

My Lords, I declare an interest as vice-chair of the All-Party Parliamentary Group on Hormone Pregnancy Tests. I want to raise two issues: Primodos, which is part of the investigation conducted by the noble Baroness, Lady Cumberlege; and the violation of human rights in the trading and misuse of organs and human tissue, referred to earlier by the noble Lords, Lord Hunt of Kings Heath and Lord Collins, and the noble Baroness, Lady Northover.

The Minister knows how much I admire the noble Baroness, Lady Cumberlege, but I reiterate my whole hearted support for her report and recommendations, and I place again on record my admiration for the sensitive way in which she collected evidence, dealt with the many people who were affected by these scandals and brought forward these admirable recommendations. Parliament must now ensure that the report does not gather dust. The Royal College of Surgeons rightly draws attention to the review’s recommendation of a patient safety commissioner, as referred to earlier, and I look forward to hearing from the Minister what we are going to do about that.

It is over 10 years since I first questioned Ministers about Primodos after a man called Karl Murphy came to my university office and showed me the disabilities with which he has had to live all his life. Following the recent Sky TV documentary, he emailed me last week saying:

“the lies and deceit I have seen regarding this drug is an utter disgrace … I really do hope that the Government and Bayer have some respect and understanding of what these families are going through.”

The redoubtable Marie Lyon has refused over all these years to let this scandal be swept under the carpet, and I am glad that the Minister heard from her first-hand only yesterday. She made a telling point to me that in appointing Stephen Lightfoot, an ex-director of Bayer, as the new chair of the MHRA, they have clearly learned absolutely nothing about conflicts of interest and public perception and confidence. In the light of such appointments and reports of five scientists walking out of a task force for back pain after finding out that a briefing paper was funded by the drug company Grünenthal, perhaps the Minister will say what the Government will be doing to police conflicts of interest and the suppression or manipulation of data.

If Primodos teaches us anything, it is the importance of the independent assessment and scrutiny of all clinical trials. But, like others, I would like to see the Bill tackle the misuse of human tissue and organs. In the letter sent yesterday by the Minister, he says the

“government takes these allegations seriously and we continue to monitor all available evidence”,

but monitoring is simply not enough.

Two years ago, in August 2018, along with Professor Jo Martin, the president of the Royal College of Pathologists, I wrote to the Times after the NEC in Birmingham hosted the exhibition referred to by the noble Lord, Lord Collins. It was called “Real Bodies” and from the company Imagine Exhibitions. The exhibition consisted of human corpses and body parts. It advertised those exhibits as

“real human specimens that have been respectfully preserved”.

They were categorised as “unclaimed bodies”, with no relatives to identify them. As we heard, in advance of the American equivalent of that exhibition it was stated in a disclaimer —after a settlement with the New York State Attorney-General—that these human remains could be those of persons who were incarcerated in Chinese prisons. Imagine Exhibitions admitted that there was no documentation to prove the identities of the cadavers, yet they were permitted to enter the UK to be put on public display for commercial gain. Human tissue from abroad has no consent or traceability requirements to enter the UK, nor do we prohibit commercial gain. However, we should do and this Bill gives us the opportunity to do it.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020

Lord Alton of Liverpool Excerpts

Friday 24th July 2020 Lords Chamber

[Lord Alton of Liverpool (CB) [V]]

My Lords, the Minister referred to the situation in Leicester. There is concern here in the north-west about the situation in Blackburn. I hope he will refer in his reply to local restrictions.

I want to underline the concerns raised about scrutiny. Under the cover of Covid, we are in increasingly grave danger of legitimising these kinds of proceedings and putting a thin veneer of respectability on the actions of the Government. The Minister’s department should carefully study this week’s critical report by the Delegated Powers Committee on its approach to the new Medicines and Medical Devices Bill. By now he must surely be aware that parliamentarians are outraged by the failure to answer Parliamentary Questions, sometimes for months on end, as referred to by the noble Lord, Lord Harris.

These regulations, which significantly eased the lockdown from 4 July, have already been in effect for three weeks prior to this debate, so this is retrospective, simply going through the motions, with one-minute speeches that are inadequate to explore the implications for dissent and protest. The Commons has not even had that opportunity and has now risen for the Recess. This simply will not do.

Independent Medicines and Medical Devices Safety Review

Lord Alton of Liverpool Excerpts

Wednesday 15th July 2020 Lords Chamber

[Lord Bethell]

I completely endorse the comments of my noble friend. To embellish his point, it has been very interesting to see through Covid how patients have had to track their own symptoms, take advice on 111 for themselves and, in millions of cases, look after themselves at home, possibly with telemedicine to support them. This may an inflection point in the attitude of many people to their health. I certainly welcome a revolution of patient power and putting patients first in our healthcare system.

[Lord Alton of Liverpool (CB) [V]]

My Lords, families and dedicated campaigners such as Marie Lyon have told the All-Party Parliamentary Group on Hormone Pregnancy Tests, of which I am vice-chairman, that they have unequivocal admiration for the noble Baroness, Lady Cumberlege, for compassionately understanding their pain and suffering and allowing them, for the first time in more than 50 years, to have hope. Does the Minister agree with the report’s conclusion that, when the first comprehensive study, in 1967, identified a link between congenital abnormalities and HPTs, Primodos should have been removed from the market and that this regulatory failure has seen justice delayed and denied? Will there now be an independent re-examination of the contested conclusions of the report of the expert working group? In implementing the Cumberlege recommendations without delay, what practical help and redress will be provided for families whose lives were irreparably blighted by Primodos?

[Lord Bethell]

My Lords, I completely share the view of the noble Lord and of the patient groups who have unequivocal admiration for the noble Baroness, Lady Cumberlege, who has done the nation a great service with this report. As he knows, the Primodos case is subject to legal dispute, so I cannot comment on it from the Dispatch Box, but no one can read the report without feeling great disappointment that those hardships were suffered by those women. It is of enormous regret to us all.

Health Protection (Coronavirus, Restrictions) (England) Regulations 2020

Lord Alton of Liverpool Excerpts

Tuesday 12th May 2020 Lords Chamber

[Lord Alton of Liverpool (CB)]

My Lords, the justification for not providing Parliament with a draft of these regulations, as is usual, has been

“the serious and imminent threat to public health”.

Notwithstanding that, the noble Lord, Lord Hunt of Kings Heath, is right to say that our duty is to ask awkward questions and to scrutinise. I will use my three short minutes to do that.

Confusingly, while these regulations impose restrictions and fines for members of the public breaking the lockdown, a Cabinet Minister has said of Covid-19, “let it run hot”. Our Minister, who replies for the whole Government, says that it was not his department that said this, but which of these strategies—carefully cautious or “let it rip”—is the Government’s position? When will he publish the scientific evidence behind the use of that phrase?

The Care Quality Commission is to investigate whether hospitals, some here in the north of England, might have broken the law by sending patients with Covid-19 back to care homes, where more than a quarter of Covid deaths have occurred. Managers and staff were not told that the patients being discharged were infected, triggering new fatal outbreaks among other residents. Will the Minister confirm that, in doing this, the law was indeed broken? When do the Government anticipate that the CQC will publish its report? Will the findings be presented to Parliament?

Will the Minister confirm that levels of coronavirus infection are probably at least five times higher among hospital and care home staff than in the wider population —I declare an interest in that one of my sons is an A&E doctor working in a hospital with Covid patients—and that coronavirus outbreaks in care homes are now leaking back into the community and driving the epidemic? Sir Ian Diamond, the head of the Office for National Statistics, says that the R number, referred to earlier by the noble Lord,

“is driven by the epidemic in care homes”.

Will these regulations be used to stop carers visiting multiple care facilities? If so, what thought is being given to the care needs of residents and ensuring that staff who are infected are properly isolated?

I have written to the Minister about the importance of giving public health officers and local councils greater control over tackling the outbreak in their communities. Sir David King, the former Chief Scientific Adviser, says this will be the only way to contain new peaks. Does the Minister agree? I also hope that the Minister agrees that the need for a national care service, locally administered but with central oversight, on a par with the National Health Service and with more than Cinderella status, is now self-evident and long overdue.

Covid-19: Social Care Services

Lord Alton of Liverpool Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Alton of Liverpool (CB)]

My Lords, I too thank the noble Baroness, Lady Wheeler, for initiating today’s important debate.

Earlier this month I drew the Minister’s attention to the appalling death toll at Wavertree’s Oak Springs Care Home in Liverpool, where 16 people have died. For grieving loved ones and for the people who care for them, deaths in care homes are diminished when out of sight means out of mind. Even with a carer at your deathbed, it is a devastating and harrowing way to end your life in isolation. Surely more can be done to enable loved ones to visit and, where requested, to provide spiritual accompaniment, the sacraments and ministry, and for the skills of hospices and palliative care to be urgently made more widely available.

Carers have expressed concern to me—which I share—that the Government have said, in relation to the virus, “Let it run hot.” Is that still being said? Who authorised letters sent by GPs to care homes stating that their residents, including adults with learning disabilities, would be unlikely to be offered ventilation? It is impossible to say in advance that such treatment would not be appropriate or beneficial.

As we heard last week from the noble Baroness, Lady Warwick, deaths in care homes have quadrupled. The Financial Times yesterday estimated that some 10,000 have died of coronavirus in our care homes, while this morning the Daily Telegraph said it believed that the rate of attrition is about 400 every day. We have also learned that in Europe, half of all deaths have occurred in care homes. Meanwhile, only 25% of care workers have been able to access tests. Taking up a point made just a moment ago by the noble Baroness, Lady Barker, when will care homes be provided with adequate supplies of PPE and their staff routinely and regularly tested for the coronavirus? Without such tests, carers are having to self-isolate because they develop symptoms and do not want to risk killing the people they care for. No one can say that we did not know what we were facing.

Weeks ago, in Italy, it was said that the elderly in care were facing a massacre while from Spain there came deeply shocking reports of the corpses of elderly people being found in all but abandoned care homes. Given what we knew about this terrible unfolding tragedy, why were our care homes not locked down sooner, PPE not sent in immediately and tests not provided for all? Andrea Lyon, the manager of the Oak Springs Care Home, has said that the Government’s plans

“should have been ready to be actioned immediately, not three weeks down the line. I had to take care of my residents with less than 50% of my staff because the government didn’t have their action plan ready. It makes me very angry.”

That anger will have its day during an inevitable public inquiry, but if any good is to come out of this rupture in our equilibrium, there will need to be radical and fundamental change in everything from our supply chain resilience to national self-sufficiency, inequality and social solidarity. What the deaths in our care homes have made abundantly clear is that, alongside our National Health Service, we need a national care service. If a national care service emerged from the wreckage of Covid-19, it would represent a gain among so much loss comparable to the gain of the National Health Service in 1945.

Wuhan Novel Coronavirus: UK Citizens

Lord Alton of Liverpool Excerpts

Thursday 30th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend has raised an important point. While the UK is one of the first countries outside China to have developed a prototype laboratory test for this novel disease, there is as yet no vaccine. The WHO is co-ordinating the research effort in this area and is producing an R&D road map. As a nation we are actively involved in this because we have particular capabilities here. We will be contributing to a co-ordinated global effort not only to improve the diagnostics but to develop vaccine capabilities.

[Lord Alton of Liverpool (CB)]

My Lords, has the Minister seen the report this morning from the AFP saying that Russia has closed its borders with China? Does that not add to the need for the World Health Organization to declare this a world health emergency? Are we in discussions with it about that?

[Baroness Blackwood of North Oxford]

I think I have already made the point that we are in constant dialogue with the World Health Organization regarding all aspects of the response to this outbreak. That dialogue includes the declaration of a PHEIC, which would include a number of different elements, and the organisation is meeting on that today.

Safety of Medicines and Medical Devices

Lord Alton of Liverpool Excerpts

Thursday 28th February 2019 Lords Chamber

[Lord Alton of Liverpool (CB)]

My Lords, I join others in congratulating my noble friend Lord Carrington on his very well-judged maiden speech today.

In this welcome debate, my remarks will centre on Primodos—an issue I raised with the noble Lord, Lord O’Shaughnessy, while he was a Minister. Like the noble Lord, I pay tribute to Marie Lyon, who chairs the Association for Children Damaged by Hormone Pregnancy Tests. Assiduously and tenaciously, she has fought for justice for those whom big pharmaceuticals have often treated with irresponsible contempt. She and her husband have travelled down from Wigan today and are watching our debate.

Marie Lyon wishes me to thank the noble Baroness, Lady Cumberlege, and the Independent Medicines and Medical Devices Safety Review for taking the campaigners seriously. She tells me:

“The sensitivity shown to our members by the”,


review,

“team is appreciated and commended. I really do feel that”,

they and,

“Baroness Cumberlege … are committed to discovering the truth about the failures of the Drug Company and the Government Regulators and have a genuine desire to ensure justice is served”.

I add my own thanks to the noble Lord, Lord O’Shaughnessy, for his role in encouraging the establishment of the independent review, and I wholly endorse what he said earlier about the desirability of creating a national office for patient safety.

My interest in Primodos began in 2010, when a gentleman born with severe birth defects asked to see me at my university office in Liverpool. He believed that his disabilities were attributable to Primodos, a hormone-based pregnancy test first marketed in the UK in 1959 and produced by Schering AG, which was subsequently taken over by Bayer AG. Withdrawn from sale in the United Kingdom in 1978, tellingly it was also used in South Korea to abort the child in the womb.

Dr Isabel Gal’s 1960 research at Queen Mary’s Hospital for Children demonstrated a link between the drug and severe birth defects, and a review by the Committee on Safety of Medicines concluded that pregnant women should not use it. However, subsequent court cases failed to provide a conclusive outcome, as did a 2014 review by the Medicines and Healthcare products Regulatory Agency.

On 26 October 2010, I asked the Government several Questions. One was about the dosage of the constituents of Primodos; one asked for any documents that the Government held about its dangers to be placed in the Library; one was about the nature of the disabilities; one was about the help given to those affected; and one requested Ministers to meet the Association for Children Damaged by Hormone Pregnancy Tests.

In his reply at the time, the noble Earl, Lord Howe, said that the regulatory agency had no information on the number of children who are born with disabilities, nor did it have evidence. If there was no evidence, why did they ban the drug? As for meeting the victims:

“The MHRA therefore has no current plans to meet members of the Association for Children Damaged by Hormone Pregnancy Tests, people suspected to have been adversely affected by the drug Primodos, or with the pharmaceutical company, Bayer”.—[Official Report, 26/10/10; col. WA 265.]


Despite further letters and Questions, a 2017 report of an expert working group of the UK Commission on Human Medicines continued to state that there was no causal association. Yet in that same year, Sky News broadcast “The Secret Drug Scandal”, which found that evidence of an association had been destroyed by a UK regulator in the 1970s. I asked the Government for their response and,

“whether they will consider establishing a public inquiry into the alleged failure of the regulator at that time to protect public safety”.

In another Question, I asked whether they would examine why,

“no toxicology or testing was undertaken prior to the drug Primodos being licensed”,

and whether they were aware that,

“Primodos was being used as an abortifacient in some parts of the world whilst being sold in the UK for the purposes of pregnancy testing, and … that there may have been collusion between the drug manufacturer and the regulatory bodies”.

In another, I asked why Primodos had stayed on the market and no tests had been,

“ordered by the Committee for the Safety of Medicines under the Medicines Act 1971”.

In another, I asked them to,

“meet with Marie Lyon and representatives of the Primodos victims support group”,

and in another, asked why they were not funding research in Aberdeen and Cambridge examining the,

“likely effects on the child in the womb”.

Then, in February 2018, the right honourable Jeremy Hunt announced his welcome review to be led by the noble Baroness, Lady Cumberlege. I hope that when the Minister replies, she will tell us when it is likely to report and—perhaps more importantly—who will be responsible for taking forward its recommendations. Among other things, as we heard from the noble Baroness, the review will investigate any association between hormone pregnancy tests and their teratogenic effects, and whether the regulatory bodies could, and should, have acted on concerns sooner—and if they did not, why.

Meanwhile, a team at Oxford, led by Professor Carl Heneghan, the scientist responsible for identifying Thalidomide association, has discovered that pooled data show “a clear association” with several forms of malformation. Professor Neil Vargesson has carried out other work on zebrafish, which revealed anomalies that mirrored the adverse effects on victims of Primodos. Their studies were peer-reviewed and remain in the top percentile of scientific studies.

In the House of Commons, the Prime Minister said:

“Ministers are aware of the new study that has come out … and … that study will be looked at very carefully”.—[Official Report, Commons, 16/1/19; col. 1160.]


I welcome that. However, the raw data that Professor Heneghan needs to complete his review has not been made available. The All-Party Parliamentary Group on Hormone Pregnancy Tests, chaired by Yasmin Qureshi MP, and of which I am vice-chairman, has sent a freedom of information request for the data, but to date has not received a response.

Mrs Lyon has twice emailed the Medicines and Healthcare products Regulatory Agency, but has not received a response. I gave the Minister notice of my intention to raise this question today. This is tardy and unco-operative on the part of that body. I hope the Minister will be able tell us whether more can be done to take that forward.

Severely disabled children, cared for by family members now in their late 70s, are increasingly becoming the responsibility of their siblings. While their health deteriorates, many battle every day to support themselves. Some have died fighting to the very end to reveal the truth about the failures of the drugs company and the regulatory agencies. They have faced the implacable determination of regulatory bodies spending huge amounts of public money on ad hoc scientific reviews to cast doubt on the work of highly reputable scientists. Those who have suffered so grievously deserve much better than this.

Health and Social Care Act 2012

Lord Alton of Liverpool Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O'Shaughnessy]

My noble friend makes a very important point, which is that as we move ahead, even with the funding settlement, it is essential that the NHS becomes more productive. That means looking at whether there are medicines or treatments that are no longer producing the outcomes it was suggested that they would and taking those out of service. It is very important to state that this has to be a clinically led process. We have already begun that with certain low-value prescriptions. NHS England is now leading that process—as I say, it is clinically led—to look at whether there are other treatments that could be discontinued.

[Lord Alton of Liverpool (CB)]

My Lords, what does the Minister make of the poll that showed that 66% of British people would be prepared to pay more for the provision of the National Health Service? What is his view on a hypothecated tax to meet those needs?

[Lord O'Shaughnessy]

I am sure that the Chancellor will have taken that view on board and he will reveal his decisions in the Budget.

Abortion

Lord Alton of Liverpool Excerpts

Wednesday 6th June 2018 Lords Chamber

[Lord O'Shaughnessy]

As my right honourable friend the Secretary of State for Northern Ireland set out in her statement yesterday in the debate, we are aware of the decision coming imminently tomorrow and that both we and the Northern Ireland Executive will consider that judgment carefully.

[Lord Alton of Liverpool (CB)]

My Lords, will the Minister agree that the caricature of the people of Northern Ireland as living in some antediluvian society has to be measured against a law that has led in Great Britain to some 9 million abortions—that is one every three minutes, 20 every single hour and 600 every working day, with one in five pregnancies now ended by abortion, and abortion up to and even during birth in the case of babies with disabilities, leading to 90% of all babies with Down’s syndrome being aborted? Is that something that we have a right to export to Northern Ireland, or do we not have a belief in devolution and the right of people in Northern Ireland to make up their mind on that issue for themselves?

[Lord O'Shaughnessy]

I would not presume to make a caricature of the people of Northern Ireland in one way or another. What this debate has demonstrated is that there are deeply held beliefs in this area and, of course, there are significant consequences of decisions on abortion law in one regard or another. It has emphasised that those decisions, which are incredibly significant, ought to be made by the people whom they affect, via the elected representatives whom they put in power.

Abortion (Disability Equality) Bill [HL]

Lord Alton of Liverpool Excerpts

Report stage (Hansard): House of Lords
Friday 24th February 2017 Lords Chamber

[Lord Alton of Liverpool (CB)]

My Lords, I will speak against the amendment and support the noble Lord, Lord Shinkwin, in bringing the Bill forward. The noble Baroness, Lady Tonge, and the noble Baroness, Lady Barker, who is sitting in front of her, will not be surprised that we take a diametrically opposed view of this and not for the first time in our lives. They will recall that the reason I left their party was their proposition that abortion should become party policy rather than a conscience question. I have always been saddened that this issue should be politicised. Diametrically opposed views can be sincerely held for perfectly good reasons.

The noble Baroness, Lady Tonge, and the noble Lord, Lord Winston, have spoken as doctors. I am only the humble father of a doctor but I had the chance earlier this week to speak to two eminent doctors, one a former president of one of the royal colleges and the other a former president of the BMA, both of whom are opposed to the amendment. For one this is because of the danger of misdiagnosis. She gave me the specific example of a baby whose mother had been told it had a fatal foetal disability, but this did not turn out to be the case when it was born. The other said that it is far better to go ahead with the pregnancy and for the baby to be delivered in order to help the mother at that stage. I will come back to that point in a moment, because it is borne out by the guidance of the Royal College of Obstetricians and Gynaecologists in the submission it made on this subject in 2010.

We can disagree about these things, but let us at least accept that there is a disagreement. I wish that the noble Lord, Lord Winston, had been able to bring forward his amendment in Committee, when we would have been able to have a more robust argument and discussion about it. It is strange that this amendment should be laid before your Lordships’ House at 24 hours’ notice before Report. Since it has been, I have done my best to discuss it with others who know more about these things than I do. In 1990, when a Member of another place, I moved my only amendment in 18 years in the Commons on which there was an equality of votes. Mr Speaker Weatherill—who became Lord Weatherill—had to use his casting vote for the status quo. He was one of my two sponsors when I became a Member of your Lordships’ House and I know through subsequent discussions with him how disturbed he was that he was not able to follow his conscience that day but had to follow precedent in upholding the status quo. My amendment sought to ensure that, in the 1990 amendment to the 1967 Abortion Act, the nature of the disability would be placed on the green form authorising the abortion. I was challenged by Harriet Harman who said that it was scaremongering for Professor John Finnis, one of the country’s leading experts on jurisprudence, to suggest that the legislation as drafted could lead to abortion on the grounds of cleft palate. As noble Lords know from the figures that have been produced, there have been abortions post-24 weeks’ gestation on the grounds of cleft palate. Notwithstanding the examples the noble Lord gave a few moments ago, 90% of all babies diagnosed with Down’s syndrome in this country are now routinely aborted.

I have never described the Department of Health as being responsible for eugenics and I would never do that, nor do I believe that doctors in this country are. The noble Lord, Lord Shinkwin, has said that society slides into eugenics when these things become normative. Therefore, I hope that when the noble Lord replies to the debate, he will tell us exactly what the list of disabilities is that cannot be diagnosed before 24 weeks’ gestation. Despite my own strongly held views about the law—indeed, 8 million abortions have taken place in this country since 1967, there are around 600 every working day and one in five pregnancies is now ended on those grounds—this Bill is not about that. This Bill is about equality legislation and discrimination, and whether a child with a disability should be treated differently from an able-bodied child.

I simply point out to your Lordships that there is a certain irony, as the very last words spoken by the Minister at the Dispatch Box in the previous debate on a Bill about car parking were about ensuring equality of opportunity for disabled people to be able to park in car parking spaces. All Members of your Lordships’ House have properly campaigned over the years on the rights of disabled people, and have a huge reputation in this country for asserting those rights. Is there not an inconsistency if we campaign for ramps to be attached to public buildings in this country but say that it would be better that someone with a disability had not been born in the first place? What sort of message does that send?

I do not think that people like me can put forward arguments such as this if we are just anti things. One of the things in which I got involved in my own city of Liverpool was the building of the first baby hospice in the country, Zoe’s Place, of which I continue to be a patron, and others have since been opened. It was built specifically to help mothers in this situation. You have to be positively for the unborn child but for the mother as well in these tragic and very difficult circumstances.

I admire medicine when it is at its best. The noble Lord, Lord Winston, and I sometimes disagree. Nevertheless, he knows that I admire hugely a lot of the work that he has done. When noble Lords such as the noble Lord, Lord Winston, are able to develop—as they are doing—surgery in utero to deal with things such as spina bifida, that is good science and good medicine marching hand in hand with good ethics. However, if I were to say to the noble Baroness, Lady Barker, for instance, that I was in favour of abortion beyond 24 weeks for reasons such as gender, race or—if it could be diagnosed—orientation, what would your Lordships say to me? I hope that they would rebuke me. That is why I argue that we should treat disability in precisely the same way as those issues.

I said that I would return to what the Royal College of Obstetricians and Gynaecologists had to say. There were two things, one of which shocked me, when I read the details of what happens in late abortion of this kind. This is the college’s description, not mine:

“Intracardiac potassium chloride … is the recommended method to ensure fetal asystole. After aspiration of fetal blood to confirm correct placement of the needle, 2-3 ml strong … is injected into a cardiac ventricle. A repeat injection may be required”.


It goes on to describe other ways of doing this. This is a late abortion. Babies have been born and lived from 23 weeks’ gestation, so this is beyond viability that we are talking about. The college also states:

“Most women will be unaware that, within the NHS, medical abortion induced by drugs is the procedure usually offered after 14 weeks of gestation. The prospect of labouring to deliver a dead fetus will be difficult for many and discussions about the procedure will require sensitive handling by experienced staff. Although the prospect of labour in these circumstances is especially daunting, some women gain some satisfaction from having given birth and have welcomed the chance to … hold their baby”.


The college goes on to talk about the options that need to be offered for pain relief,

“and whether the woman might want to see the baby and have mementoes such as photographs and hand and footprints … She will … be made aware of information from a postmortem … These discussions are likely to be distressing for the woman and her partner”.

So let us be very clear that this is a tragedy for everyone involved.

I turn to the noble Lord’s amendment. It states that,

“there is a high probability that the fetus will die”.

We are drafting legislation here. What does this mean? Is the probability 99.99990%, or 50%? How should a high probability be objectively defined in law? Why is that not specified in the wording of the amendment? I am very disturbed by the fact that the noble Lord’s amendment says that you may go on to carry out these procedures “shortly after delivery”, when the baby has been born alive. Is this a matter of minutes, hours, days, weeks, months or, arguably, even years? It needs to be clearly defined in law, otherwise it will be interpreted far too widely. That is why the amendment should have been brought forward in Committee, when we could have had a proper discussion about it. However, I hope that the amendment will be resisted and that the Bill in the name of the noble Lord, Lord Shinkwin, will be given a safe passage so that it will have a chance to go forward and there can be a proper debate about it in another place.

[Baroness Massey of Darwen (Lab)]

My Lords, I intended to speak much later but I have to emphasise something which the noble Lord, Lord Lester, said, that we often forget. This is not and should not be a political issue. It is often about the life and death of women. The remark made by the noble Lord, Lord Alton, for whom I have the deepest respect, about gender and race in comparison to disability, is unfortunate, to say the least.

We have to remember the history of abortion in this country. At one time, women who could not obtain an abortion for legal reasons resorted to what were called back-street abortions or self-abortions. Those were dangerous and often humiliating. Do we really want to go back to that? The Bill, if it is carried, could mean going back to that for women. I suspect that if our laws were changed to deny abortions at any stage we could see women’s lives put in danger, and that would be completely abhorrent. For those reasons and others, I cannot support the Bill.

I have the deepest respect for the noble Lord, Lord Shinkwin, but this is an emotive issue, and much has been said already. First, on disability, I read something recently by the disability rights advocate, Professor Tom Shakespeare, who himself has a disability. He said that prenatal diagnosis is not straightforwardly eugenic or discriminatory:

“Nor should we interpret a decision to have … a termination as expressing disrespect or discrimination towards disabled people. Choices … are not incompatible with disability rights”.


I agree with him.

Our laws on abortion, which we are fortunate to have, have been well debated and carefully constructed. They are supported by professional bodies and by the vast majority of the general public. Women overwhelmingly support testing for abnormality in a foetus, knowing that the result may cause them immense distress and difficult decisions.

We know that some conditions cannot be diagnosed within 24 weeks. In fact, some can be diagnosed only within the third trimester. I find the Bill quite punitive. We know that parents find a decision on abortion difficult and distressing. They think not only of themselves —they are not being selfish—but of the whole family, possibly including children who have already been born. Such parents need support, advice and often grief counselling. It is not a simple matter. Medical services take account of this distress—my noble friend Lord Winston spoke eloquently about that—and I know some parents who have been advised and helped to hold a funeral for the aborted baby.

While this is an emotive Bill, we have to consider the rights of women and of the family, and think about the impact that it might have in particular on women who used to go for those back-street abortions.