Lord Cameron of Lochiel
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(1 day, 15 hours ago)
Lords ChamberMy Lords, I start by thanking the noble Baroness, Lady Bennett of Manor Castle, for setting out the context behind this debate, which takes place against a backdrop in this country of large-scale funding by anti-abortion groups across the piece and almost daily articles in our newspapers about anti-abortion. That is one of the reasons why we have seen an increase in women being arrested. Noble Lords were very careful in the statistics they selected. Some chose to talk about 2018-22. It is undeniable that in the last three or four years there has been a huge increase in the number of women being investigated.
There are three groups of people in your Lordships’ House. There are those who are fundamentally opposed to abortion, and we have heard from many of them today speaking to many of the amendments. There are those who, like me in speaking to my Amendment 459C, support a woman’s right to make informed choices and who, for the last 10 years, have followed this debate about decriminalisation. To those who say that this was brought in as a measure by the back door, suddenly sprung on the House of Commons, that is wrong. For 10 years we have been discussing decriminalisation. Dame Diana Johnson brought Bills before another place. We have had a great deal of discussion about it at different stages. Then there is a third group: the people who have doubts. The speeches of the noble and learned Baroness, Lady Butler-Sloss, and the noble Lord, Lord Hogan-Howe, typified some of them. They are the people who I want to talk to today, because they have some concern that this is not right.
In my preparation for today’s debate, which I have been thinking about for several weeks, I thought about a parallel and I went to the point that the noble Lord, Lord Pannick, went to, so I am sorry he is not in his place. I went to the fact that in 1961—a very good year in my opinion—this House debated the decriminalisation of suicide. I went, with the assistance of the Library, to look through the Hansard reports of that debate and the parallels are striking. At the point when it came into Parliament, what was the first criticism? That this had been sprung on us and was too big an issue to be brought in in this way. Yet there had been 10 years of debate prior to that by people who thought this was not the right way to deal with this issue. People in the Church had great debates about it. I suggest noble Lords read those Hansard reports, because the debates both here and in the House of Commons are profound. They are succinct, which is perhaps something we should relearn, because it is quite clear that there is no correlation between length of debate and quality of debate. These were people who were profoundly concerned about a moral issue and about what signal Parliament would be giving out were it to take this very grave step.
I will quote just one speech that took place not in the House of Lords but in the House of Commons. At Third Reading, the Conservative Minister Charles Fletcher-Cooke said:
“Because we have taken the view, as Parliament and the Government have taken, that the treatment of people who attempt to commit suicide should no longer be through the criminal courts, it in no way lessens, nor should it lessen, the respect for the sanctity of human life which we all share. It must not be thought that because we are changing the method of treatment for those unfortunate people we seek to depreciate the gravity of the action of anyone who tries to commit suicide”.
I suggest that there is a very strong and clear parallel with our debate. As the noble Lord, Lord Pannick, said, there are two evils here, and we have to decide between them.
Charles Fletcher-Cooke went on:
“One of the consequences of removing from the ambit of the criminal law this hitherto crime of attempted suicide is that it may be feared that some people may not be reached through the Mental Health Act; that there will be some who will not submit themselves to voluntary treatment, and cannot be persuaded by then medical advisers or members of their family to receive treatment. It may be apprehended that some gap in the welfare of the country may follow from that”.
He then said:
“We would all agree that it would be quite wrong either to keep the present criminal structure or to impose a new one purely for what we believe to be a very small minority. But we shall watch the situation and the Government will keep an open mind. We will see whether that small number increases and if a proposal not involving the odour of criminality is put forward to meet the situation, we shall certainly look at it again”.—[Official Report, Commons, 28/7/61; cols. 822-23.]
Two noble Lords talked about deterrence. Behind our deliberations today has been a fear that, if we cease to treat these women under the criminal justice system, we are somehow saying that what they do is less grave. I do not agree with that. I hope that, if I had taken part in that debate in 1961, I would have understood the point that they were making then, which is the same as the one we are making now: if somebody is so desperate that they would do this, they will not be in the right place if they end up in the criminal justice system. This is a medical issue.
In all the speeches we have heard today from noble Lords trying to chip away at telemedicine, the one thing that they have not dealt with is the point made to us by the people who see these desperate women: if we do anything to stop them being in contact with the medical profession, we put them in danger, and we will never get them out. In listening to the noble Lord, Lord Hogan-Howe, I wondered whether police officers find themselves in other situations where someone has done something illegal that might have had a profound effect on their health. Is the first thing that comes into the police officer’s mind that the person should go to the criminal justice system, rather than making sure that they are medically safe? That is what we are doing throughout this debate: we are treating these women as being exceptional.
We should do what we have been doing for the past 10 years. The noble Baroness, Lady Fox, is right that Clause 191 could be far more radical than it is. It is not radical; it is a very small adjustment to say that, if women are that desperate, they deserve medical treatment. All the amendments that have been debated today are just barriers in the way of that happening. I hope that people in this House, just as has been done at the other end, will realise that we are back to the same dilemma we had in 1961 and that we should do the right thing by desperate people.
Lord Cameron of Lochiel (Con)
My Lords, this has been a full, difficult and passionate debate, and I thank all noble Lords who have taken part. I know that issues of conscience such as this arouse very strong feelings, but I am pleased that we have managed to keep the debate respectful, as we always do in your Lordships’ House.
At the outset, I recognise that there are two aspects to this debate that we must firmly and definitively distinguish. The first is a matter of substance and the second is a matter of procedure. More specifically, the first is about the merits of the substance of Clause 191 and the second is about the process by which it became part of a government Bill.
On the first matter, that is an issue of conscience, and on this the Opposition do not and will not take an official position. I acknowledge that there is a multitude of views across the Committee, and indeed within my own party. That diversity of opinion is to be expected and welcome, but this is and always has been a matter of personal conscience.
However, the second matter is very different. Regardless of one’s views on the rights or wrongs of decriminalisation, the process by which Clause 191 was inserted into the Bill was, on any view, insufficient and, as a matter of procedure, deficient. The amendment was proposed on Report in the other place by Tonia Antoniazzi MP. It was not discussed in the Public Bill Committee or a Select Committee. As others have said this evening, it received 46 minutes of Back-Bench debate. Many Members in the other place were limited to less than five minutes of speaking time. On such an issue of profound social change, in no way can that be described as a full and proper debate—compare that to the vigorous debate we have had today.
Because this was an amendment to legislation brought in on Report and not part of the Bill as introduced or as amended in Committee, and because it was not government policy, this proposal has not undergone any of the usual stages of policy formation. As your Lordships will well know, where a major change to the law is proposed, the Government would normally publish a White Paper or Green Paper, commission an expert panel or review, gather evidence, conduct a public consultation, and publish an impact assessment and relevant supporting documents. The policy proposal would then be published as part of the Bill. It would be subject to detailed scrutiny in a Public Bill Committee, where witnesses would be invited to give evidence. None of these steps has been taken. Whatever one’s views on the merits of Clause 191, that is not a recipe for good law.
Let us just pause and reflect on the wide variety of issues that have arisen today—the amendments themselves cover a lot of ground. We have discussed issues of police procedure and investigation, a panoply of medical issues, and issues around potential coercion, telemedicine, prosecution policy and the vulnerability of women. There is a multitude of difficult and intricate issues to cover.
It is interesting that, when Parliament considered the Abortion Bill in 1967, the abolition of the death penalty and, more recently, the legalisation of gay marriage, all were introduced as separate Bills that underwent the full process of parliamentary scrutiny. Indeed, your Lordships Committee is currently considering another piece of social legislation, the Terminally Ill Adults (End of Life) Bill. Despite being a Private Member’s Bill, that Bill has been subject to a rather more robust process and more significant scrutiny than this clause before us today. Of course, that is absolutely right; these are matters that, if we get them wrong, could have severe and perverse consequences. Again, whether or not noble Lords support Clause 191, the Committee is being asked to pass judgment on a provision to alter fundamentally the legal status of abortion, for right or wrong, without the possession of all the necessary evidence.
Indeed, during the debate on the clause in the other place, when discussing wider abortion law reforms, Tonia Antoniazzi, who as we know proposed Clause 191, said:
“More comprehensive reform of abortion law is needed, but the right way to do that is through a future Bill, with considerable collaboration between providers, medical bodies and parliamentarians working together to secure the changes that are needed. That is what a change of this magnitude would require”.—[Official Report, Commons, 17/6/25; col. 305.]
I agree that these are changes of magnitude. A separate and distinct Bill would be a better way forward. Comprehensive reforms of legislation on social matters should have considerable collaboration between all relevant stakeholders. That has not happened with Clause 191. It is fair to say that, whatever one’s views on the moral element of the change, Clause 191 is so far-reaching, consequential and of such magnitude that it is questionable whether it is appropriate for it to be bolted on to the side of a crime and policing Bill.
Finally, I turn to the approach of the Government to Clause 191. Ultimately, this is now a clause in a government Bill. The Government may or may not have wanted it in the Bill, but, regardless of their neutrality, this clause is now in their Bill. If the Bill passes with Clause 191 remaining, it will be the Government’s job to implement it. It will unequivocally be government legislation.
Does the noble Lord believe that the 379 MPs who voted for this were duped into it in some way?
Lord Cameron of Lochiel (Con)
I do not think I suggested that for a moment—I do not accept that at all. I am pointing to the fact that this is a government Bill. It may not be the Government’s place to take a view on issues of conscience such as this, but it is their role and duty to ensure the coherence of the statute book and general good governance, and, of course, to implement the law of the land. I therefore have a couple of questions for the Minister. Are the Government satisfied with the process by which Clause 191 has been included in their Bill, and, if not, do they have any concerns whatever about that process? Further, the Government now face a binary choice: either they want the clause to remain in the Bill or they do not. It is not enough, with the greatest respect, for the Government to sit on the fence. I ask the Minister to answer that question as well.
In conclusion, on behalf of the Official Opposition, we take no view on the substantive issues of conscience here, but we have concerns about the process. This reform should have been subject to the usual consultations. It is a hugely complex, controversial, intricate area of policy-making, which deserves the fullest legislative process possible, and it has not had the usual procedures and rigorous scrutiny from start to finish of the legislative process. That is a matter of very great regret.
The Parliamentary Under-Secretary of State, Ministry of Justice (Baroness Levitt) (Lab)
My Lords, the Government recognise that there are strongly held views across your Lordships’ Committee on this very sensitive issue. The noble Lord, Lord Cameron of Lochiel, is of course correct that the Government maintain a neutral stance on abortion in England and Wales. We remain of the view that it is for Parliament to decide whether it is in favour of this or not. That is not sitting on the fence—that is actually deferring to the will of Parliament. It is for Parliament to decide the circumstances under which abortion should take place, allowing your Lordships to vote according to conscience. The Government will not stand in the way of change, if that is what Parliament decides.
The noble Lords, Lord Bailey and Lord Jackson of Peterborough, and the noble Baroness, Lady O’Loan, asked what the Government intend to do in certain situations. I remind your Lordships that this was not a government amendment, and therefore it is a matter for your Lordships. If this is the will of Parliament, the Government will ensure that the law is enacted.
That said, the Government must of course comment on the practical effects, workability and coherence with the statute book of any proposed legislative amendments. On 17 June last year, the Minister for Victims and Violence Against Women and Girls set out in the other place observations on what is now Clause 191. As this is already a matter of public record, I hope that your Lordships will forgive me for not repeating what she said, save that I have been asked the specific question by the noble Baronesses, Lady Ludford and Lady Falkner, about the effect of Clause 191 on the Abortion Act in how it deals with offences. The legal position is that the Abortion Act is unaffected by Clause 191. What Clause 191 does is to disapply the offences created by Sections 58 and 59 of the Offences against the Person Act 1861 and the Infant Life (Preservation) Act 1929, but only for a woman who acts in relation to her own pregnancy. The offences still apply to third parties. I reassure the noble Baroness, Lady Falkner, that any man behaving in the way she described would still be potentially committing an offence.
In order to avoid repeating myself later in this debate, I reiterate that the Government’s neutral position means that I will not be commenting beyond matters of workability and practical effect. As a shorthand, I am going to refer to conduct that could come within Sections 58 and 59 of the Offences against the Person Act and the Infant Life (Preservation) Act as abortion offences. I do not intend to address all amendments. There are some, such as Amendment 455 in the name of the noble Baroness, Lady Meyer, where we do not consider there to be significant workability concerns, particular operational implications or unintended consequences that your Lordships may wish to consider: it is a simple policy decision to be made. If I do not refer to any particular amendment, your Lordships may safely assume that that is because the Government regard it as a policy decision for your Lordships’ House without any operational or other matters to be considered. Finally, because this is a large group of amendments, I have tried to shorten my remarks to only the parts that I regard as being essential to bring to your Lordships’ attention. If anything is unclear, I encourage any of your Lordships to write to me so that I can provide a fuller explanation.
I begin with Amendment 456 in the name of the noble Lord, Lord Verdirame. It may be helpful for your Lordships to be aware of the usual circumstances in which certain offences require that the consent of the Director of Public Prosecutions, more usually, or that of the Attorney-General, more rarely, is required before criminal proceedings can be instituted. Generally, the concern to the DPP will be appropriate where either it is very likely that a defendant will reasonably contend that a prosecution for the offence would violate their convention rights or where there is a high risk that the right to bring a private prosecution might be abused and, if so, the institution of proceedings would cause the defendant irreparable harm. In general, prohibiting private prosecutions and ensuring that only the Crown Prosecution Service can prosecute is the check and balance used to mitigate these risks. If an offence involves national security or has an international element, the consent of the Attorney-General may be more appropriate. In response to the question asked by the noble Lords, Lord Verdirame and Lord Bailey, as to the statistics being relied on, it is not clear to me whether the data requested is collected, but I will make inquiries and write to the noble Lord.
I turn to Amendment 459 in the name of the noble Baroness, Lady Eaton. I can reassure the noble Baroness that the Government are clear that the law is also clear: sex is not itself a lawful ground for termination of pregnancy under the Abortion Act 1967. I can also reassure the noble Lord, Lord Hogan-Howe, on the same point. Accordingly, any third party, including registered medical practitioners, who terminates a pregnancy on the basis of the sex of the foetus alone would also be liable to prosecution under the relevant offences relating to abortion.
Turning to Amendments 459B and 502A in the name of the noble Baroness, Lady Maclean, it is worth noting that, as currently drafted, the deadline for the Secretary of State to lay the draft regulations and the deadline for Parliament to approve those regulations is the same in this amendment. Practically, then, the effect might be that, if the Secretary of State lays the regulations on the final day permitted, Parliament would not then have sufficient time to approve them before the deadline. As a result, Clause 191 would automatically cease to have effect, even though the Minister had complied with the requirement to lay the regulations. It is unclear from the amendment as drafted whether that is the noble Baroness’s intention or whether she intends to give sufficient time for both these processes to take place.
Amendment 460 in the name of the noble Baroness, Lady Stroud, and spoken to by the noble Baroness, Lady Foster, who is no longer in her place, would mean that women would no longer be able to have a consultation over the phone or by other electronic means before being able to self-administer medicine for early medical abortion at home, as is current practice. Instead, women would be required to attend an in-person consultation first before being able to take pills at home. The Committee may wish to note that the overall effect of this new clause would be to limit access to home use of early medical abortion pills because of lack of resources for abortion providers to hold in-person consultations. It could also reduce women’s access to early medical abortion due to travel distances, if they live in remote areas, or if they have difficulties attending a clinic for different reasons—for example, vulnerable women, women from more deprived backgrounds or women subject to coercion. The Government wish your Lordships to be aware that, given that the majority of abortions take place via this method, this new clause is likely to have a significant operational impact on access to abortions. That said, this is, of course, a matter of policy for Parliament.
Amendment 461H in the name of the noble Baroness, Lady Lawlor, is similar to Amendment 460 in that it seeks to introduce a requirement for an in-person consultation before medication to terminate a pregnancy may be lawfully prescribed. In addition, Amendment 461H would also require a scan, or what is described as a “clinically equivalent” alternative, to be conducted for all women to determine gestation before being able to take pills at home, whereas the current process is that an ultrasound scan is provided only in certain conditions where there is any uncertainty about gestation or where there is clinical need.
As drafted, it is unclear what is meant by “other clinically equivalent means” when determining the pregnancy’s gestation. Your Lordships may also wish to consider the likelihood that Amendment 461H would also result in additional costs being incurred because of either additional machines having to be bought and staff trained to provide an ultrasound for every woman seeking an early medical abortion, or the alternative, which would be to remove scanning capacity from the provision for other needs. Operationally, the requirement to have a face-to-face appointment and scan may also introduce additional waiting times for abortion care. This would have a particularly negative impact on those awaiting early medical abortion, but it might also have an impact on abortions at a later stage because of loss of system capacity. This could have the effect—unintended, we presume—of more abortions taking place later on. As with Amendment 460, the overall effect of this new clause would be to limit access to home use of early medical abortion pills because of resource issues in relation to the requirement in every case to hold in-person consultations and offer scans.
Amendment 461A in the name of the noble Baroness, Lady Coffey, seeks to apply the criminal standard of proof to medical assessments and decision-making. Your Lordships may wish to note that the operational effect of this additional burden of proof is that it is likely that women would no longer have a consultation over the telephone or by other electronic means before being prescribed medicine for early medical abortion at home, as is the current practice. Instead, women would need to attend an in-person consultation and have an ultrasound. So, for similar reasons to those I have already given in relation to Amendments 460 and 461H, Amendment 461A is likely to limit access to home use of early medical abortion pills and thus result in more abortions being undertaken at later gestation.
Amendment 461, tabled by the noble Baroness, Lady O’Loan, seeks to create a new offence of intentionally encouraging or assisting a termination that is contrary to the Abortion Act 1967. We understand the noble Baroness’s amendment to be intended to work in the following way: a person would be guilty of committing such an offence whether or not a successful termination occurs and the amendment would also require the Secretary of State to issue guidance on the offence following consultation with appropriate stakeholders.
Clause 191 provides that a pregnant woman cannot commit an abortion offence in relation to her own pregnancy, meaning such terminations would no longer be considered unlawful under the Abortion Act 1967. As a result, Amendment 461 would apply only where a third party encourages or assists someone other than the pregnant woman. Your Lordships should be aware that this is already captured by existing encouraging or assisting offences under the Serious Crime Act 2015. Therefore, Amendment 461 would create an overlapping offence. Additionally, your Lordships may wish to note that, in any event, third parties can also still be prosecuted at the moment under primary offences such as Sections 58 or 59 of the Offences against the Person Act 1861 or the Infant Life (Preservation) Act 1929.
I turn now to Amendment 461B, tabled by the noble Lord, Lord Bailey of Paddington. Safeguarding is an essential aspect of abortion care and all abortion providers are already required to have effective arrangements in place to safeguard children and vulnerable adults in compliance with the department’s required standard operating procedures for the approval of independent sector places for termination of pregnancy in England. Your Lordships may wish to consider that the Royal College of Paediatrics and Child Health has published national safeguarding guidance for under-18s accessing early medical abortion services, which seeks to ensure that all abortion providers have robust safeguarding in place. We expect all providers to have due regard to this safeguarding guidance.
The thing about Amendment 461C, bearing in mind what the noble Baroness, Lady Thornton, has said, is that quite a lot of this data is collected. Clearly, it was late this year, and there would be no point in doing a JR on the basis of that.
I understand that not every abortion happens at the point at which the sex of the foetus is known, but that data would be worth collecting, given the concerns that exist about gender or sex-selective abortion. It might be worth the ONS adding the question to the questionnaire or HSA4 form in the future.
Last year, the collection rate on ethnicity was 92%, but it would be useful to understand what further work the ONS might be doing to try to get that up to 100%.
Lord Cameron of Lochiel (Con)
My Lords, I thank all those who have spoken in this debate, and my noble friend Lord Jackson of Peterborough for tabling these amendments. I have already set out at length the view of the official Opposition on what we see as the procedural issues with Clause 191 in my response to the previous group. I will not repeat myself, but simply refer your Lordships to my previous comments.
My noble friend’s amendments relate to the provision of information and statistics relating to abortions and complications arising from abortions. As has been highlighted by my noble friend Lord Moylan in his Private Member’s Bill on this topic, there is an issue with the collection of data for complications from abortions. To conclude, I hope the Minister will be able to set out what action the Government are taking to improve the collection of data for such complications.
Baroness Levitt (Lab)
My Lords, the amendments in this group all relate to reporting requirements and monitoring abortion services. It is important to say again that the Government are neutral on this. My remarks are limited to workability, operational concerns or possible unintended consequences. I am not going to speak to all the amendments, only those where there are particular issues that should be brought to the attention of the Committee.
Amendment 457, tabled by the noble Lord, Lord Jackson of Peterborough, as currently drafted means that parts of the information that would be required are broad and the exact meaning is not always clear, raising practical workability issues. Not all the information required may be readily available, and producing an annual report would require the Department of Health and Social Care to take on additional reporting responsibilities, with associated costs.
Amendment 458, also in the name of the noble Lord, Lord Jackson of Peterborough, seeks to require the Secretary of State to produce an annual report detailing complications from abortions procured contrary to the Abortion Act. Determining whether specific cases fall within the report’s remit would require investigations to determine whether they could be considered to be contrary to the Abortion Act. This could necessitate involvement from medical professionals or other public bodies to review individual circumstances.
Further, as I have just said in relation to Amendment 457, as currently drafted parts of the information required are broad and the exact meaning is unclear, raising questions about practical workability. Not all the information required may be readily available; for example, it may not exist, it may require additional collection or it may be held across different systems, including the abortion notification system held by DHSC and patient records within the NHS.
Your Lordships may also wish to note that producing this annual report would require additional responsibilities with significant associated costs to the Department of Health and Social Care and other public bodies.
Amendment 461C would require the Secretary of State to publish an annual report disclosing data collected as required under Section 2 of the Abortion Act. I can confirm what has been said by my noble friend Lady Thornton: the Department of Health and Social Care’s abortion notification system already collects data on the self-reported ethnicity of the woman, when known, and complications that occur up until the time of discharge for all abortions. This data is published in the annual abortion statistics publication for England and Wales. However, as my noble friend Lady Thornton also commented, the abortion notification system does not currently collect information on the sex of the foetus, as most abortions are performed at an early gestation when the sex of the foetus will not usually be known.
On two further matters, the noble Lord, Lord Jackson of Peterborough, is correct: there has been a delay in the publication of the abortion statistics, but not for policy reasons. These are operational issues, which include moving to a new data processing system. We will announce dates for the publication of the 2024 data in due course.
Finally, on the question of sex ratios at birth, raised by the noble Baroness, Lady Coffey, the Department of Health and Social Care remains committed to publishing these statistics, and the publication dates for sex ratios at birth in the United Kingdom from 2018-22 and 2019-23 will be announced in due course.
Lord Cameron of Lochiel (Con)
My Lords, I thank my noble friend Lord Jackson of Peterborough for tabling these amendments. Again, I refer to comments that I made in the earlier group about procedure, during which I noted the absence of an impact assessment and consultation. My noble friend’s amendments attempt to insert those processes later on in the legislative stages, and reflect in some way what I said on that earlier group. I look forward to the Minister’s response.
Baroness Levitt (Lab)
My Lords, your Lordships have heard me say now on at least two occasions that the Government are neutral, and therefore my only observations are about workability and operational issues.
I can respond to the amendments in this group in the name of the noble Lord, Lord Jackson of Peterborough, very briefly. It is unclear whether Amendment 563 is intended as an alternative to Amendment 562. If it is not, they would create two parallel commencement powers for Clause 191, each imposing slightly different and conflicting obligations on the Secretary of State.
In any event, your Lordships may wish to consider that not all the information required to produce the report as described in the amendment may be readily available within the timeframe, and some of the areas to be considered—for example, standards of clinical oversight—are broad. Although the amendment does not specify the consequences of failing to meet the specified deadlines for consultation or reporting, its effect would be that missing these deadlines would prevent Clause 191 coming into force.