Respiratory Health

Nadine Dorries Excerpts

Tuesday 3rd February 2015 Westminster Hall

[Several hon. Members]

rose—

[Nadine Dorries (in the Chair)]

Order. We will have a series of votes starting at 3.31 pm, so it would be great if Members could bear that in mind if we do not want to have to suspend the sitting and then return.

NHS Patient Data

Nadine Dorries Excerpts

Tuesday 25th March 2014 Westminster Hall

[Grahame M. Morris (Easington) (Lab)]

I congratulate my hon. Friend on securing this timely debate, which is raising some important issues that we need clarity on. We have just come from a seminar in which the Health Committee had some expert witnesses. Does she agree with the conclusions put forward there about the need for clarity before we go ahead with this data collection? I am thinking particularly about the cyber-security review, safeguards on anonymous or pseudo-anonymous data, separating out purposes for controls, a tighter definition of the care data—

[Nadine Dorries (in the Chair)]

Order. Mr Morris, this is a 30-minute debate, so can you keep your intervention short, please?

[Grahame M. Morris]

I will. I just want to mention governance arrangements as well.

--- Later in debate ---

[Grahame M. Morris]

My hon. Friend is being very generous about interventions. Again, she makes an excellent point. We need an effective audit trail. If these data sets are being sold on, we need some effective control. That should be stopped. I hope that the Minister—

[Nadine Dorries (in the Chair)]

Order. Barbara Keeley.

[Barbara Keeley]

I, too, hope that the Minister will address that.

I want to give an example of data use approved by the Data Access Advisory Group of the Health and Social Care Information Centre, because I think that it is instructive. Minutes from the group’s July meeting show that the advisory group approved the use of hospital episode statistics data for HSpot Ltd and its FindMeHealth application. HSpot Ltd had requested HES data, including consultant codes, with the intention of publishing those data online to enable patients to compare procedures by hospital and clinician. Online information about FindMeHealth says that it is

“a new independent UK comparison site offering choice…to the growing number of people who are choosing to self-pay for private healthcare.

FindMeHealth compares prices across the top self-pay procedures and gives users access to the very latest data from NHS and private sources”.

What we have here is a kind of “Go Compare” website for private health care.

Much was said about uses of patient data in the debate on the Care Bill. The Minister said that information from the HSCIC

“may be disseminated for the purposes of ‘the provision of health care or adult social care’ or ‘the promotion of health’.”—[Official Report, 10 March 2014; Vol. 577, c. 136.]

Does the Minister think that the definition that he gave us extends to the HSCIC granting the release of patient data so that commercial companies can run comparison websites on the top self-pay procedures?

We need much greater transparency, and I thank hon. Members present for the questions that they have put on this matter. We need greater transparency from the Health and Social Care Information Centre, but we also need it about the other data sources and the other places where data are held. The chair of the information centre, Kingsley Manning, said in his speech last week that one of its key measures of success might have been that it was

“safely below the radar of public attention”,

but that organisation is no longer below the radar of public attention. Indeed, the organisation has become the story because of the errors that it has made, which mean that hon. Members and the public have discovered just how their confidential medical data are being used by insurers, by commercial companies and even on systems in the United States.

If people look at social media, as I did last night, they will see that there are many comments about just how much distrust people now feel towards the HSCIC. The organisation, as I said at the start, has claimed an “innocent lack of transparency”, but others accuse it of evasiveness and half-truths. As I have detailed, giving misleading answers to the Health Committee on established facts about who works for the organisation does not help.

All that has to change. Hon. Members, including me in this speech, have talked about ways in which the situation should and must change, and I hope that the Minister understands the vital need for that.

--- Later in debate ---

[Grahame M. Morris]

The Minister is arguing that the scheme is an extension of what happened before, but there is clearly a quantum difference. There is general agreement that it is a wonderful thing to have data sets for research and public health purposes. The difficulty that the public have, about which we need to restore confidence, is when that information is being used for marketisation—for marketing purposes—by commercial reusers. I am not reassured by the Minister’s comments, but he has an opportunity to correct the problem in the House of Lords.

[Nadine Dorries (in the Chair)]

Order. Mr Morris, that is a very long intervention.

[Dr Poulter]

It is difficult to reply fully to such debates when we have very lengthy interventions, of which the hon. Gentleman is very fond. I would like to spell out to him what the quantum difference is. The Government have, through the 2012 Act, put in place safeguards for data protection that the previous Government never had. In particular, under the 2012 Act, data can be used only for the benefit of the health and social care system. We have put in place the safeguard that people can opt out from having their data collected and used. Those safeguards were not in place when the previous Government—

Oral Answers to Questions

Nadine Dorries Excerpts

Tuesday 25th February 2014 Commons Chamber

[Jane Ellison]

Although the Abortion Act does not mention gender specifically, the Government are clear that abortion on the grounds of gender alone does not meet the criteria set out in the Act. If evidence comes to light that doctors or organisations are sanctioning abortions for that reason alone, we will refer it to the police.

[Nadine Dorries (Mid Bedfordshire) (Con)]

The Minister is quite right that the Abortion Act does not state that the practice is illegal. Organisations such as Marie Stopes International operate under an ethical and professional framework in which they state that they will not perform abortions on the basis of sex selection. However, the chief executive of BPAS has said that

“there is no legal requirement to deny a woman an abortion”

if she wants to abort a female. The Government commission abortion services from BPAS and Marie Stopes. Does the Minister not think it is about time to have a closer look at BPAS, which is headed by a chief executive who condones sex-selection abortions?

[Jane Ellison]

That is exactly why we want to reissue the guidance on this matter. I cannot add to what I have said. I say with complete clarity that the Government’s view is that sex-selection abortion—abortion on the grounds of gender alone—is illegal and we will report it to the police if we are given evidence of it.

Group B Streptococcus (Newborn Babies)

Nadine Dorries Excerpts

Thursday 7th November 2013 Commons Chamber

[Nadine Dorries (Mid Bedfordshire) (Con)]

I am delighted and honoured to have secured this debate on group B streptococcus, which is also known as group B strep or GBS. GBS is the most common cause of serious infection in newborn babies. In the UK, it is the most common cause of meningitis in babies in their first weeks of life. With prompt and aggressive treatment, most sick babies will recover from GBS infection, but even with the best medical care, about 10% of them will die, and some of the survivors will suffer lifelong problems, including 50% of those who recover from GBS meningitis.

The subject was last raised in the House 10 years ago by my right hon. Friend the Member for Witney (Mr Cameron), who is now Prime Minister. There has been some progress but, given his current position, it would be encouraging if we could see more. I shall quote his words at the end of my speech.

The rate of confirmed cases of group B strep infection in newborn babies increased by almost 50% between 1991 and 2010. The true rate of infection, which includes cases that are not confirmed through the identification of the bacteria, but in which GBS is strongly suspected by clinicians, is likely to be several times higher. The issue is therefore not only serious, but one that is becoming more serious.

We have known for a long time that the key risk factor for a newborn baby in developing GBS is the mother carrying GBS at delivery. The UK guidelines state that if GBS has been detected during the current pregnancy from a swab or culture from a pregnant woman, she should be offered intravenous antibiotics in labour to minimise the risk of GBS developing in her newborn baby.

The UK’s risk-based strategy to reduce GBS infection in newborn babies was introduced by the Royal College of Obstetricians and Gynaecologists in 2003, but there is no evidence that it has appreciably reduced the incidence of this devastating infection. In 2003, there were 229 reported cases of GBS infection in babies aged nought to six days; in 2011, there were 281 cases. On that evidence alone, I suggest to the Minister that the risk-based strategy has failed demonstrably and that we need to consider new alternatives.

One UK case study found that 21% of women carried GBS, and that 22% had risk factors for GBS infection developing in their newborn baby and would therefore be offered intravenous antibiotics in labour. However, only 29% of women with risk factors actually carried GBS. Using risk factors alone means that a high proportion of women not carrying GBS will be offered intrapartum antibiotics, while many actually carrying it will not.

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Motion made, and Question proposed, That this House do now adjourn.—(Claire Perry.)

[Nadine Dorries]

Researchers stated:

“The most striking finding that has implications for clinical practice and policy is the low sensitivity of risk factor based screening, compared with PCR or culture tests in predicting maternal and neonatal GBS colonisation—”

[Andrew Selous (South West Bedfordshire) (Con)]

I warmly commend my hon. Friend on bringing the issue before the House. I have a constituent who lost a child as a result of it, so it is something that I take seriously. Is my hon. Friend pleased, as I am, to see that Public Health England is now adopting gold standard enriched culture testing in its eight regional laboratories? Does she welcome that as a small advance in this important area?

[Nadine Dorries]

I welcome my hon. Friend’s intervention, and I will go on to talk about the gold standard culture medium.

The researchers continued that the sensitivity of such screening was

“below that which we considered to be a minimally acceptable sensitivity for our study—which calls into question the validity of the current UK policy. Moreover, consistent with previous evidence of practice variation, the risk factor-based screening policy was poorly adhered to, with one-third of women with indications for IAP not treated.”

Despite those authors and numerous others recommending routine screening as cost-effective in the UK, the UK national screening committee continues to recommend the risk-based approach.

Most countries that have national strategies against GBS infection offer routine antenatal testing for GBS. Those countries have seen the incidence of early onset disease fall dramatically, such as by more than 80% in the US and Spain. That compares favourably with the result of the risk-based approach in the UK under which, as I have said, the number of infections has increased. If we know that the risk-based strategy we are adopting is not working because infections are beginning to increase, yet countries such as Spain are seeing an 80% reduction, should we not consider the cost-effectiveness of moving to a system that we know will reduce the number of poorly babies in our intensive care units that have GBS-induced meningitis and other complications?

Studies show that testing for GBS in late pregnancy, as well as offering tests to women found to carry GBS or who have other recognised risk factors, is more cost-effective than the current risk-based strategy. A risk-based strategy is poor at predicting women who will be carrying GBS in labour, and therefore women for whom antibiotics in labour would potentially prevent devastating infections in their newborn babies.

Recently published research shows that although women want to be informed about GBS and offered testing for it during pregnancy, that is not happening. At less than £12, the tests are not that expensive, and the antibiotic recommended during labour if a woman is found to carry GBS in pregnancy is cheap and cost-effective. It is penicillin, which is shown to be exceptionally safe, as well as being a narrow-spectrum drug that is unlikely to cause greater resistance later.

Most NHS pathology services currently use culture media that are general purpose and identify GBS in only about 60% of carriers. At the request of the chief medical officer, Dame Sally Davies, the enriched culture medium test that my hon. Friend mentioned will be made available throughout England from 1 January 2014. That will identify about 90% of carriers, and it is the gold standard for that purpose, under Public Health England’s regional laboratory standard operating procedure. The results of the GBS test are about 85% predictive of carriage status for up to five weeks. It should be used to identify GBS carriage wherever there is an indication. These sensitive tests have not previously been widely available within the NHS when requested by the health professionals and pregnant women.

I have some key questions for the Minister. Will he use this debate as an opportunity to make a statement welcoming the gold standard enriched culture medium test for group B strep carriage, which is being made available from January 2014 and which can be used to assess carrier state if there is an indication? From this point on, how does the Minister plan to reduce the incidence of GBS infection in newborn babies when the current risk-based strategy, introduced in 2003, has been shown not to be effective? Is there a target rate for GBS infection in newborn babies? I have always derided targets, but in this case setting a target for the reduction of GBS infections may be a way to introduce routine testing.

Will the Minister confirm that the audit of practice suggested by the UK national screening committee to establish how well the new guidance is being implemented at a national level will study the actual practice taking place in maternity units, rather than simply being an audit of policies without any check on whether they are being applied in practice, because we know that these policies are not being put into practice in maternity units? What is the time scale for the feedback and advice to trusts about how they can further improve their adherence to the RCOG and National Institute for Health and Care Excellence guidelines on the prevention of neonatal GBS disease? What provision is being made for telling pregnant women about the risk of GBS infection in their babies? What provision is being made to educate relevant health professionals about the prevention of GBS in newborn babies and the forthcoming availability of the gold standard ECM test? Do midwives and practitioners in maternity units even know that this gold standard test is being introduced in 2014?

UK guidelines recommend that when GBS carriage is found by chance during a pregnancy, it should trigger the offer of antibiotic prophylaxis in labour. Why should a woman with unknown GBS carriage status be denied the opportunity to find out if her baby is at risk?

I would like to pay tribute to the tireless work of Group B Strep Support, the charity and campaign group that has been working to raise awareness of this issue and reduce the death toll. I also have a constituent who has sadly lost a baby to GBS. The group has been a great help to me in preparing for this debate following a meeting with my constituent. Ten years ago, my right hon. Friend the Prime Minister said in his Adjournment debate:

“Group B Strep Support’s aim, which I support, is for the routine test to be offered to all pregnant women, with those who are found to have GBS at the 35 to 37-week stage being automatically offered intravenous antibiotics.”

He said to the then Minister:

“I hope that the Minister will show great urgency over the issue”.—[Official Report, Date; Vol. 408, c. 267WH.]

My right hon. Friend supported the introduction of routine testing: I echo his sentiments exactly.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I congratulate my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) on securing this debate and raising this very important issue. The death of a baby is devastating for parents and their families. It is important that we do all we can to minimise the risk of such deaths. My hon. Friend has presented a strong case, but, as I shall set out later, it is equally important that we are guided in our decisions by professional, evidence-based advice to ensure that any action taken does not lead to potentially greater adverse outcomes or unintended consequences.

Group B streptococcus is one of many bacteria that can be present in the human body. It is estimated that about one pregnant woman in five in the UK carries GBS. Around the time of labour and birth, many babies come into contact with GBS and are colonised by the bacteria. Most are unaffected, but a small number can become infected.

If a baby develops group B strep less than seven days after birth, it is known as early-onset group B strep. Most babies who become infected develop symptoms within 12 hours of birth, and it is estimated that about one in 2,000 babies born in the UK develop early-onset group B strep, or about 404 babies a year—my hon. Friend made these points earlier. Most babies who become infected can be treated successfully and will make a full recovery, but even with the best medical care, one in 10 babies diagnosed with early-onset group B strep will unfortunately die.

The infection can also cause life-threatening complications, such as septicaemia, pneumonia and meningitis. One in five babies who survive the infection will be affected permanently. Early-onset group B strep can cause problems such as cerebral palsy, deafness, blindness and serious learning difficulties, and rarely can cause infection in the mother—for example, an infection in the womb or urinary tract, or more seriously an infection that spreads through the blood, causing symptoms to develop throughout the whole body.

It is worth reflecting on how the UK compares internationally on rates of group B strep. The reported rate per 1,000 births is 0.38 in the UK; in the USA, where there is testing, it is 0.41; in Spain, 0.39; in France, 0.75; in Portugal, 0.44; and in Norway, 0.46. Even in comparison with countries where there is routine group B strep screening at 35 to 37 weeks, therefore, the UK has relatively low levels of group B strep.

It is also worth setting out some of the general improvements in maternity care that are helping to reduce group B strep and improve the quality of care available to women. We all agree that women should receive high-quality and safe maternity services that deliver the best outcomes for them and their baby. Maternity services feature prominently in the key objectives set out in the first mandate between the Government and NHS England. As set out in the mandate, we want all women to have a named midwife responsible for ensuring she has personalised, one-to-one care. To help deliver that, there has been significant investment in the maternity work force. Since May 2010, the number of full-time equivalent midwives has increased by 6.5%—just under 1,500—and in addition there are currently in excess of 5,000 midwifery students in training. There has, therefore, been considerable investment in maternity services to ensure much more personalised care and, consequently, much safer care for women and their babies.

[Nadine Dorries]

For the reasons I highlighted, we know that the risk-based strategy is not working effectively. Does the Minister not agree that in countries that have routine testing the chances are greatly improved? He drew comparisons with the US, France and other countries, but we do not know what their figures would be if they were using our risk-based strategy. The fact is that they are routinely testing, so does he not agree that only if we were also routinely testing could we make a like-for-like comparison with other countries? Also, why specifically does the UK, a sophisticated country with sophisticated maternity services, not routinely test?

[Dr Poulter]

I will come to those points a little later, but I will try to reassure my hon. Friend. Given that the majority of babies who die from group B strep are born prematurely, testing at 35 to 37 weeks would not benefit them. Tragically, they would have died in any case, so the screening test to prevent them from dying would not have been effective. I will say a little more about that later, if she will allow me to make some progress.

I pay tribute to my hon. Friend for raising this issue, because the first challenge is to raise general awareness of group B strep among the health care work force and women more generally. The Department of Health is working with the NHS, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the National Institute for Health Research health technology assessment team and the pharmaceutical industry to raise awareness of group B strep and reduce the impact of this terrible infection. The Royal College of Obstetricians and Gynaecologists has produced an information leaflet for women who are expecting a baby or planning to become pregnant, and this sets out information about group B strep infection in babies in the first week after birth and the current UK recommendations for preventing group B strep in newborn babies. In addition, information is also available on the NHS Choices website.

As hon. Friends will agree, the focus must be on preventing early-onset group B strep infection from occurring in the first place. The Royal College of Obstetricians and Gynaecologists published updated guidelines on prevention of early-onset group B strep infection in neonates in July 2012, which takes into account the latest evidence. It is important that services undertake local clinical audits to ensure the effective use of intrapartum antibiotic prophylaxis as recommended by the guidance. Following the publication of the revised guidance, the UK national screening committee suggested a formal audit of practice to establish how well the new guidance is being implemented at a national level.

The RCOG, in partnership, with the London School of Hygiene and Tropical Medicine, has now appointed a clinical research fellow to carry out a one-year audit across the UK, which will undertake a review to see how units have revised and updated their local protocols since 2006, using well-designed case studies to gather specific information about maternity unit policies by asking clinicians whether they would screen for group B strep and/or other intrapartum antibiotic prophylaxis in the circumstances described. It will also assess the extent to which current maternity information systems are able to provide data on whether women have had an antenatal culture for group B strep, whether women have been given intrapartum antibiotics and, if so, the antibiotics prescribed, the dose and duration and whether the women had particular risk factors such as intrapartum fever. The audit aims to provide feedback and advice to all participating trusts about how they could further improve their adherence to the RCOG guidelines on the prevention of neonatal group B strep disease.

Clinical audit is a tool that is incredibly valuable in improving the quality of patient care. It is something that trusts do very often on an ad hoc basis. The fact that we now have a national audit focused on group B strep disease will help to standardise practice across all maternity settings and improve the quality of care that is available, so that we can look at which women are more vulnerable and susceptible to developing group B strep and, therefore, reduce infection rates.

[Nadine Dorries]

That is encouraging news but again the focus is on women who are at risk of group B strep. I am advocating that all women should be tested for group B strep. I recommend that every pregnant woman I meet now buys a kit to test for group B strep. It is encouraging and positive to hear what my hon. Friend the Minister is saying but it is still focusing on the at-risk women, which is what the risk strategy does now. We need to move from that and away from the at-risk women. We need to move from 35 to 37 weeks and forward to full-term and routine testing of all women for group B strep.

[Dr Poulter]

I am hopeful that the audit by the RCOG nationally—something I discussed with the group B strep groups and the chief medical officer at a meeting this time last year to progress the work at a greater pace—will put us in a better position to understand in particular which women are at high risk, whether birth units are picking up on those women in a timely manner and how we can improve the situation throughout the country. In the past there has been quite a lot of variation in practice, broadly based on the RCOG guidelines, but it is important—knowing the devastating effects of this illness—that we put together a comprehensive audit tool that gathers data at a national level so we can spread good practice and good guidance throughout. If my hon. Friend will be patient I hope to address some of the broader issues about screening later.

--- Later in debate ---

[Dr Poulter]

I would be delighted to do so. It is important to consider the confounding factors that arise in any research. For example, there is some evidence of different rates of carriage of group B strep among different population groups. Also, the clinical treatment of the disease in hospitals—which is separate from the screening process—can vary from country to country. We have to set the data alongside other practices that take place at local level in order to interpret them in the right way. I would be delighted to write to my hon. Friends, and to any other hon. Members who are interested, with that broader general information.

I shall turn now to the question of routine screening for group B strep. The UK national screening committee advises Ministers and the national health service in all four countries on all aspects of screening policy, and supports implementation. At its meeting on 13 November 2012, the screening committee recommended that antenatal screening for group B strep carriage at 35 to 37 weeks should not be offered, as my hon. Friend the Member for Mid Bedfordshire has pointed out. That is the reason for the debate. The reasons given included the fact that the currently available screening tests cannot distinguish between women whose babies would be affected and those that would not. As a result, about 140,000 low-risk pregnant women would be offered antibiotics in labour following a positive screening test result. The overwhelming majority of those women would have a healthy baby without screening and treatment. In other words, a woman who had screened positive for group B strep at one point in her pregnancy might not necessarily be carrying it at the time of delivery, and up to 140,000 women a year could be given antibiotics during labour even though they did not need them.

On the back of the evidence, concern was also expressed, understandably, about resistance to some of the antibiotics used to prevent early-onset group B strep, about the long-term effects on the newborn and about the potential for anaphylactic reactions in labour. Many of us will recall the report of the chief medical officer for England, in which she expressed particular concern about the risks posed by antibiotic resistance because of overuse. The use of antibiotics on that size of population could create a risk of resistance developing, which would have adverse consequences.

[Nadine Dorries]

I am interested in what the Minister has just said. As I mentioned in my speech, we are talking about a penicillin, a narrow-spectrum antibiotic. I know the Minister’s background, and he will know that GPs would prescribe it for a throat infection. This is a widely and commonly used antibiotic. Does he not think that these expressions of concern are over-egging the pudding slightly?

[Dr Poulter]

In the report that the chief medical officer published earlier this year, she made the point graphically that the overuse of antibiotics among people who do not need them can lead to resistance developing in bacteria. We know from hospital super-bugs such as MRSA and VRSA that many other resistant strains of bacteria are developing. Part of the challenge is to see responsible prescribing adopted more broadly across the NHS, to ensure that antibiotics are being targeted at the people who will benefit directly from them. The chief medical officer’s concern is that the screening that my hon. Friend is proposing could lead to many tens of thousands of women being given antibiotics inappropriately at the time of delivery, because they were not carrying group B strep at the time, and that that could result in resistance developing. We already know about the devastating consequences of group B strep infection, and the development of further resistant strains could be an unintended consequence of such screening that none of us would want to see. We need to be mindful of that possibility, as I believe the national screening committee was when it made its recommendations.

The majority of babies who die from early-onset group B strep are premature and are, sadly, born too early to be helped by screening at 35 to 37 weeks. Data from 2001 show that, in that year, there were 39 deaths due to group B strep, of which 25 occurred prematurely—that is, before the 35th week of pregnancy, when any screening would have been carried out. Those deaths would therefore not have been prevented by a screening programme.

It has been estimated that up to 49,000 women carrying GBS at 35 to 37 weeks of pregnancy may no longer be carriers when receiving treatment during labour. Studies of the test suggest that between 13% and 40% of screen-positive women will no longer be carriers at the point of delivery. There is also a potentially detrimental impact on maternity services, increasing the medicalisation of labour, with the increase in hospital births and increases in the birth rate that we are seeing. We know that once there is one intervention in labour, it can lead to other interventions and a high rate of Caesarian section when it might not have been necessary in the first place. I am not saying that that would always be the case and absolutely not with GBS—far from it—but we know that when a woman enters a medicalised pathway in a maternity unit, it can often lead to interventions that might otherwise have been unnecessary and that are sometimes quite distressing for the woman during labour. This is particularly the case when many of the women potentially put on prophylaxis would no longer be carriers of GBS.

The advice from the UK national screening committee is consistent with that of the Royal College of Obstetricians and Gynaecologists and the National Institute for Health and Care Excellence. I believe we have talked through a number of the issues about why that recommendation was made.

In the brief time remaining, it would be worth mentioning some of the research that is going on. It is estimated that a vaccine for GBS is approximately five years away from development. First-stage trials have now been undertaken, and wider population-based studies for safety and efficacy are in place in high-prevalence areas such as South Africa. I am sure we would all agree that a vaccine would be a very effective solution to GBS, and I shall certainly do all I can to push and nudge to make sure that such a vaccine is brought forward in as safe and appropriate and as timely a manner as possible.

[Nadine Dorries]

Is the Minister informing us that that vaccine would be widely available? Let me ask him once more—after everything he has said today, for which I am incredibly grateful—why does he think countries like Spain, the United States and others have introduced routine testing when we still seem to be opposed to it?

Health and Social Care

Nadine Dorries Excerpts

Monday 13th May 2013 Commons Chamber

[Nadine Dorries (Mid Bedfordshire) (Con)]

My speech will be in two halves. I shall talk first about health care issues, as this is a health debate.

I welcome the Care Bill, particularly its commitment to social care. I feel that words such as “compassion” are sometimes missing from our discussions on health care. Before I say more, let me welcome publicly, for the first time, the right hon. Member for Cynon Valley (Ann Clwyd) to her position as head of a review body that will examine NHS complaints.

As many Members know, I was a nurse in a former life, and it was a profession that I absolutely loved. I was, I think, a committed nurse. I lived in a nursing home, and often worked for more hours than I was supposed to. I would go into the hospital on my days off to visit patients who had no relatives. I was not alone in that; most of the nurses in my nursing home behaved in the same manner. I pay tribute to a nurse who started work on the same day as me, on 5 November 1975: Helen Windsor, who contacted me recently. For all these years, she has been delivering the same committed care that she delivered in 1975.

I suppose many people will say that that was a long time ago, and it was, but I think that qualities such as compassion, kindness and caring are timeless. It does not matter when they were being delivered; they should be delivered in the same way today. Unfortunately, however, I—like many other Members—regularly receive complaints from constituents about the standard of nursing care. I mentioned Helen Windsor because I want to pay tribute to the nurses who deliver good care.

I recently visited a constituent in hospital, an 89-year-old man with no relatives. It was interesting that the right hon. Member for Cynon Valley mentioned nail clippings, because I had already written down that I intended to raise the subject. That constituent was agitated because his nails were serrated and were catching on the cardigan that he was wearing as he sat in his chair. When I asked the nurse whether she could cut his nails—he said that he had been asking for it to be done himself—she replied “No, I can’t. We are not allowed to do that.” So I took an emery board out of my handbag and filed his nails myself. I know that sometimes, as Members of Parliament, we feel that we are social workers, but I had never imagined that I would extend my role to the nail care and general hand hygiene of a constituent in hospital—but I did.

Unfortunately, on a number of occasions recently I have sat in a hospital and witnessed nursing care being delivered to my own daughter. Only a few weeks ago, when she was on a hospital trolley waiting to go into the operating theatre—distressed, anxious, upset—we witnessed nurses holding conversations over her head about intimate details of their love lives and their social lives, which, while she was in pain, my daughter had no interest in hearing. Not only was she subjected to those intimate details of their private lives; she was also subjected to a lack of care. She was completely ignored on that trolley. Yes, she was about to go into an operating theatre and be dealt with, but it is when patients are in that condition that they need nursing care most. They need to be reassured. They need to be calm. They need to know that everything is going to be OK. However, there was no interest in that.

The most appalling thing that happened was that, just before my daughter went into the operating theatre, one nurse told the other that she was going to the bathroom, and then gave exact details of what she was going to do there. I cannot think of a more polite way of putting it in the Chamber. It was a totally inappropriate conversation to be having outside the doors of an operating theatre.

A constituent who recently came to see me in my surgery told me that, when in hospital following a road traffic accident, she had noticed after a few days that her bottom sheet had not been changed and was bloodstained. Each day she wrote the date around the border of the bloodstains. When she left hospital 10 days later, she left that bottom sheet for the nurses to see, with the dates written in a pattern around the bloodstains. During those 10 days, no sheets had been changed. We used to change the sheets every day, and that was possibly excessive, but I think that, given that we are constantly trying to find ways in which to deal with, beat and get on top of hospital-acquired infections, bloodstained sheets indicate a lack of care.

I do not want to labour the point about complaints, because I know that a number of other people have already done so, and I feel that it is now the remit of the right hon. Member for Cynon Valley. Rather, I want to discuss immigration and its impact. We send £53 million per day to Europe, which limits our dealings with the rest of the world—in fact, the Prime Minister is trying to tackle that issue today. Labour will not commit to a referendum. Do Labour Members not see that that £53 million a day could be spent on dementia care, on Alzheimer’s care, on young carers? There are so many things we could do with that money.

People were asked one question when we went into the Common Market: do you want to go in, yes or no? They should be asked the same question to exit. If we can go to the electorate on behalf of the Liberal Democrats with a referendum on the alternative vote in a matter of months, why do we have to wait years to offer them a referendum on an issue as big as the European Union? Do we not realise what a self-serving, self-interested bunch we seem to people out there, when we can call an expensive national referendum on AV, yet obfuscate and delay on the question of European Union membership?

It is no good saying that people are not interested in this issue, because they are: it is the subject of almost every other question I am asked when I go out in my constituency. People now know exactly how much we are spending on the European Union, and they do not believe that leaving will cost us 3 million jobs. They would like a piece of the action in China, which reported growth of some 9.5% in the past year. They want some of the action taking place in the BRIC countries. That is where they want to trade—not in a sick and failing Europe that is getting sicker by the day.

I want to add my voice to those who have spoken out on this issue, and I would definitely join the two Cabinet Ministers in voting to be out. I would vote no tomorrow, and I know many of my constituents would. I completely support the measures in the health Bill in the Queen’s Speech, which will be well received by everybody, but I want to add my voice to the case for an in/out referendum. We must find a way to deliver that. We know that the Prime Minister means what he says; but if we can do it on AV, we have to do it on the EU: otherwise, people will not believe us.

--- Later in debate ---

[Mr Barron]

It was not a Government report but a Select Committee report, and I do not remember it, quite frankly.

Community cohesion is important and has been important in this country for centuries—not just since we joined the European economic area or the EU expanded to 27 countries, with people having the right to come and work here, as indeed we have the right to go out and work in other EEA countries. A lot of this debate is distasteful and is not the truth. In a recent by-election, a political party that is not represented here and I hope will not be was saying that, as of January next year, probably nearly half the population of Bulgaria will come and work in this country. That is nonsense, and neither Back Benchers nor Front Benchers should have a knee-jerk reaction to that type of debate. We should have sensible debates about what immigration does or does not do in this country.

[Nadine Dorries]

Can the right hon. Gentleman provide evidence for his numbers? Can he tell us how he knows what the numbers will be? Can he quote from some extensive research that proves this?

[Mr Barron]

I was quoting from the rhetoric put into the daily press during the Eastleigh by-election. I think the figure given was that about 3 million Bulgarians will be coming to this country—

[Nadine Dorries]

How does the right hon. Gentleman know that that is not the figure?

[Mr Barron]

If the hon. Lady will keep quiet, I can tell her that that was what was said, but there are fewer than 8 million Bulgarians living out there. Many Bulgarians have been living and working in this country for many years, because they met criteria outwith the criteria laid down when Bulgaria and Romania joined the EU. The whole debate is disgraceful, and we should get it into some perspective.

Induced Abortion

Nadine Dorries Excerpts

Wednesday 31st October 2012 Westminster Hall

[Nadine Dorries (Mid Bedfordshire) (Con)]

This is the first time I have spoken under your chairmanship, Mr Crausby. As I am a Chair now, I realise the job is not always as easy as it sometimes looks. It is a pleasure to serve under your chairmanship. I have quite a long speech, which will come as no surprise to many here, and I will try, with so many people putting in to speak, to speed up my speech and shorten it as I go along.

The last time I introduced a debate on the 20-week limit was during the parliamentary stages of the Human Fertilisation and Embryology Act 2008, but my amendment was defeated. At that time, it had been 18 years since the upper limit had been debated and voted on.

Abortion law is made in Parliament, and there should be no taboo on discussing it in Parliament. Abortion law should be debated and reformed here, yet each and every time I have raised an abortion issue in the House, one MP after another has risen to comment that this is not really the place to discuss abortion and that the Bill I seek to amend should not be hijacked by discussing abortion. There are many MPs, and I think I may include the hon. Member for Hackney North and Stoke Newington (Ms Abbott), who would quite like the Abortion Act 1967 to be put into a dark cupboard and left there, never again to be brought out and discussed. If we are not to discuss abortion in this House, I am not sure who is supposed to make up the laws as they go along.

As it stands, the 1967 Act is a joke. Everyone knows that in this country abortion is obtained on demand by whoever wants it, whenever they want it. I am pro-choice, and I believe that, up until 12 weeks, that should be the case. I am delighted that more than 90% of abortions in this country take place before 12 weeks. But Parliament’s reluctance and nervousness about reforming abortion law, or even discussing it, creates an atmosphere of disrespect for Parliament among abortion providers.

[Mr William Cash (Stone) (Con)]

I admire what my hon. Friend has done and the determination and courage that she has shown against enormous opposition.

[Nadine Dorries]

I thank my hon. Friend for that intervention. I am very flattered.

Due to the fact that the 1967 Act is so little discussed and its format is so archaic, over the past year we have seen a number of abortion providers flout the law. One of the reasons for that is that Parliament itself shows no respect for the law. In the past year, abortion clinics have been exposed using the law creatively to offer abortion illegally and criminally based on the gender of the pregnancy. In fact, the Care Quality Commission and the General Medical Council are now investigating, I believe, 14 cases of malpractice, and arrests have been made at other clinics. The Calthorpe clinic in Birmingham has been closed down and handed over to another provider.

Those cases point to an erosion of respect for the law by abortion providers. The culture of fear in Parliament, which is held by many MPs, on discussing abortion law has contributed, or may have contributed, to the situation. That has to stop.

[Mr Nigel Dodds (Belfast North) (DUP)]

I admire the hon. Lady’s courage and perseverance in bringing these issues to the House.

A Marie Stopes clinic has recently opened in Northern Ireland, a province where the law is very strict on abortion and where there is no support for the extension of the 1967 Act. Does the hon. Lady share my concern that the opening of the clinic may be an attempt to stretch the law, or even to get behind it?

[Nadine Dorries]

I am afraid that I have to disappoint the right hon. Gentleman—I discussed this with one of his colleagues yesterday—because I believe the law on abortion should be equal in all parts of the Union. Abortion law needs to be reformed in the UK, and there needs to be parity across the board. If any abortion provider is to come to Northern Ireland, Marie Stopes is probably the best bet. Marie Stopes is one of the most professional and non-advocacy-driven abortion providers. It has no political ideology and is concerned only for the health of the woman, and it operates in a professional manner. So I think that, if Northern Ireland is to have an abortion provider, Marie Stopes are the people to have. The law here needs to be reformed, and there needs to be parity on both sides of the water.

This year alone, three abortion clinics have been closed down. This is my last point: we must bring abortion law before the House because it needs to be reformed.

Following today’s debate, I have already applied to the Backbench Business Committee for a longer, dividable debate to be held next May. I am using today’s debate to give notice of that future debate. I want to give pro-choice and pro-life supporters ample time to prepare, to gather their research and to set their stall ready for a debate next May.

[Mark Field (Cities of London and Westminster) (Con)]

I join other Members in praising my hon. Friend for bringing forward this issue.

Is not one of the problems that—my hon. Friend alluded to this when she talked about pro-life and pro-choice Members of Parliament—this whole debate has become so unbelievably polarised? Many Members of Parliament see both sides of the argument and feel that our voice is often squeezed from the debate. It is particularly important that the voices of the vast number of legislators who, as she rightly says, should have a say on this matter are allowed to be heard, rather than the entire debate being polarised in the way that she describes.

[Nadine Dorries]

My hon. Friend is absolutely right. It is the almost ghettoisation of pro-life and pro-choice that has over the years prevented rational and reasonable discussion of abortion.

I am attacked by both pro-life and pro-choice, because I support abortion up to a certain point but I want independent counselling to be provided to women who seek abortion and I would like the upper limit to be reduced. So I fall foul of both camps. It is important that MPs such as my hon. Friend come forward—he has views that encompass both sides of the argument—as they can be more rational in their presentation.

I have applied to the Backbench Business Committee for a debate on a votable motion next May. Of course, a Back-Bench vote does not amend legislation. If the result of the vote endorses a reduction to 20 weeks, however, it will inform the Government that perhaps it is time to bring the 1967 Act back to the House on Government time.

[Neil Parish (Tiverton and Honiton) (Con)]

I too congratulate my hon. Friend on securing this debate. Does she agree that, since the 1967 Act, medical science has advanced so much that there is now a real need to reduce to 20 weeks the limit for the termination of pregnancies? I would prefer to see the limit much lower.

[Nadine Dorries]

Later in my speech, I will address the evidence for that.

After the forthcoming debate allocated by the Backbench Business Committee, if there is a positive vote, if the debate is strongly attended and if Parliament expresses a strong feeling, that will send a strong message to the Government to bring the 1967 Act back to the House.

In 1990, the 1967 Act was amended to reduce the upper limit from 28 weeks to 24 weeks. I hope there will be a fuller debate in May, but in the meantime, following today’s debate, I will write to the Royal College of Obstetricians and Gynaecologists guideline committee, enclosing a copy of the Hansard of our speeches today, and ask it to look again. 1990 was a long time ago. As my hon. Friend the Member for Tiverton and Honiton (Neil Parish) said, things have progressed and science has moved on.

If the RCOG guidelines committee advised, based on the evidence available at the time, that the upper limit should be 24 weeks—

[Kate Green (Stretford and Urmston) (Lab)]

Will the hon. Lady give way?

[Nadine Dorries]

I will give way only once more, as lots of people want to speak.

[Kate Green]

The hon. Lady implies—perhaps I misinterpret her—that the RCOG has not considered the guidelines since 1990. In fact, its most recent report was published in 2010, and it still says that foetal viability is very low up to 24 weeks. In fact, at 20 weeks it is 0%.

[Nadine Dorries]

I will address that point in a moment. I will not give way any more, as I know that lots of people want to speak.

I want to make it clear that my proposal to reduce the upper limit does not include babies with foetal abnormalities or, sadly, disabilities. That is a discussion to be held, as I have said, between parents and doctors. Abortion is available up until birth for foetal abnormalities. My proposal applies to abortions for social reasons.

A study by the Centre for Sexual Health Research at the university of Southampton and the School of Social Policy, Sociology and Social Research at the university of Kent found that 41% of women who have second-trimester abortions do so because they were not sure about having an abortion and took a while to make up their mind to ask for one. I believe that one positive effect of reducing the limit to 20 weeks might be to focus the mind slightly sooner than 23 weeks. Because abortion is available until 24 weeks, there is a laxity, as people have a prolonged period to make up their mind. The research says that women took a long time to make up their mind. Maybe reducing the upper limit will help.

It is clear to me that we cannot allow the present situation in our hospitals to continue. In one room in a hospital, there might be a premature poorly baby born at 22 or 23 weeks at whom the NHS will throw everything it has to help it survive. In another room in the same hospital, a healthy baby will be aborted at 24 weeks. Dr Max Pemberton recently wrote in The Daily Telegraph that

“many doctors are uncomfortable with the current cut-off point. It is not something we openly discuss, because we know it is a highly emotive area. But privately, many doctors will express discomfort that the current legislation is inherently illogical and inconsistent. Any doctor who has found themselves in the neonatal intensive care unit of a hospital will be acutely aware of it. In the same hospital where doctors are trying to save a premature baby born at, say, 23 weeks, a woman down the corridor is legally allowed to undergo a late-stage abortion on a foetus of the same gestation. So on the one hand we throw considerable money and resources to try to save a baby’s life, while on the other we sanction its destruction.”

I have consistently made that argument for the past seven years. The medical profession cannot make two arguments. Doctors cannot say that a poorly baby’s life is worth trying to save from 20 or 21 weeks onwards while stating at the same time that there is no chance of life up to 24 weeks, so it is okay to abort up until that point. There is an inconsistency in retaining 24 weeks. Should there be a case to say that doctors should not try to save the life of a poorly baby born before 24 weeks’ gestation? Can hon. Members imagine the uproar if we said, “Okay, the RCOG has said that viability is 24 weeks, so we really shouldn’t be saving premature babies before 24 weeks”? We should say, “No, the point of viability is 24 weeks, so we should stop. Wipe out the neonatal units, wipe out the premature units. Viability is not consistent before 24 weeks.”

Doctors cannot have it both ways. They cannot say in the NHS, “We try to save babies from 20 weeks because they are viable,” and then say, “We abort at 24 weeks because they are not.” The two arguments cannot stand. That is an anomaly, and it must end.

[Dr Sarah Wollaston (Totnes) (Con)]

Will the hon. Lady give way?

[Nadine Dorries]

No. I have said that I will not give way any more. I must crack on, because lots of people want to speak.

Some people ask whether medical science in the area has moved on. Is there a difference between the science in 2008, when we had the vote, and the science today? The answer is that viability can never be proven. Until healthy women agree to allow healthy babies to be aborted at 20 weeks and we then try to save them, we can never actually know what viability is.

[Dr Wollaston]

Will the hon. Lady give way on that point?

[Nadine Dorries]

I will give way, but this is the last time.

[Dr Wollaston]

I thank the hon. Lady for giving way. On that point, we are not trying to save babies at 20 weeks. No babies survive at 20 weeks’ gestation. If she refers back to the British Medical Journal paper considering two periods of survival, the increase in survival of pre-term babies after the 2000 period was due entirely to babies born at 24 and 25 weeks. The absolute limit of survival is about 22 weeks; that is when we try to save them. Will she please stop suggesting that the NHS is capable of saving babies at 20 weeks? It is simply not true.

[Nadine Dorries]

Maybe the NHS should stop trying to save babies from 20 weeks. My neighbour 10 years ago was a 22-week survivor. Although she had slight problems, they did not prevent her from going to school and living a full and wonderful life. Babies do survive from 22 weeks, which is my argument for viability. If the RCOG wants to say that viability is at 24 weeks, it must look at the living babies born at 22 weeks and say, “That’s wrong.”

The only measure of viability that we have is the premature poorly baby—the baby who arrives early for a reason. Doctors must fight to deal with two complicated situations: whatever made the baby arrive prematurely, and the fact that it has arrived prematurely, which involves lung function and other things. I am afraid that a healthy aborted baby and a premature poorly baby cannot be compared, particularly not at 23 weeks.

I have been asked in numerous interviews, and only this week by Victoria Derbyshire during the filming of a “Panorama” programme, “How do you know that aborted babies are healthy babies?” For the record, between 96 and 97 out of every 100 babies are born healthy. The viability argument needs to be discussed in the context of what we do in our neonatal and premature baby units, and what we do in terms of abortion. The two must be compared.

I want to discuss sentience, because it is an argument for life. We know that a baby can feel pain in the womb before 20 weeks. If a woman’s stomach is poked post-20 weeks or earlier, it can wake up the baby. Thanks to Professor Stuart Campbell’s amazing and pioneering work with 3D imaging, we can see how a baby in the womb responds to stimuli, and thanks to the work of Professor Sunny Anand, we know exactly how a foetus responds, due to how it reacts to anaesthetic during in-utero operations.

While a research fellow at Oxford, Dr Anand became aware that many premature and early gestation babies died during in-utero operations due to shock induced by pain during the procedure. General thinking at the time, in the 1980s, was that no baby could experience pain before birth—that until birth, a baby was not sentient. In his pioneering work, Dr Anand developed anaesthesia to be delivered to foetuses. Thanks to that work, introduced at the John Radcliffe hospital, anaesthetising babies during in-utero operations is now standard procedure, and babies now live.

Dr Anand went on to continue his work and research in America. When I sat on the Science and Technology Committee, we considered abortion, and one of the members of that Committee—Evan Harris, the former Member for Oxford West and Abingdon, who lost his seat at the last election—described Professor Anand as a little doctor from Little Rock. Dr Anand did much of his further research in America, first at the university of Arkansas and now as the St Jude chair for critical care medicine and professor of paediatrics, anaesthesiology and neurobiology at the university of Tennessee health centre in Memphis.

My only point in relation to Evan Harris’s comments about Professor Anand is that Dr Anand is a gentle, polite academic who is well renowned and respected and has a successful career. To describe such a man as a little man from Little Rock, and to have binned and not considered the evidence on abortion that he presented to the Science and Technology Committee, was a travesty. I complained about it to the Clerks at the time, and I will continue to complain about it, as it tainted the report. If a foetus can feel pain stimuli, it is a sentient being. Anyone who feels, is. They exist. If one feels, one is a human being.

I move to the feminist argument. As the mother of three young adult daughters, I am a strong believer in a woman’s right to choose. Never, ever would I want to see a return to the bad old days of backstreet abortionists, or restricted access to early abortion. Do I champion this issue from the perspective of religion? No, I do not. I do not come to this from a religious perspective. I champion this from the perspective of compassion, humanity and civility. I believe in the right to choose, but, provocatively, I would like to throw this in: what about the female baby, post-20 weeks? I often hear the argument, “It is a woman’s right to choose.” What about healthy female babies who are aborted at 24 weeks?

I champion this issue because I believe passionately in the reduction of the upper limit. When I visit pregnancy crisis centres, I hear women who are undergoing counselling. Some actually say, “I would have preferred an option other than ending my baby’s life.” Well, there are other options. That is one of the reasons why I tabled the counselling amendment—there are always other options.

I would like to talk about the truth about abortion. It is not just articulate, clever women who abort; vulnerable women are coerced. They are the women who are seen by pregnancy crisis centres. Not every woman who has a late-term abortion for social reasons actually wants one. I was staggered to hear what one MP who came up to me the other day said. Her actual words were, “Every woman who wants an abortion knows exactly what she is doing.” Well, in her rather slick, well-educated Oxbridge world and her leafy shires I am sure they do, but what about the young Asian girl who was recently marched into a clinic in floods of tears by two family members? No one knew her age, but she was marched in by two family members for an abortion. Is that a one-off story? No. Speaking to abortion providers, that happens on a regular basis.

What about the young women who have waited to have their abortion because they did not want to have it, and who then found themselves being coerced by partners or others? One woman at a pregnancy crisis centre that I went to aborted at 24 weeks because she had been told by her partner and other family members that it would be beaten out of her if she did not. Not every women makes the decision because she went to university and marched up and down streets in Oxford and chanted about women’s rights. Lots of women are actually incredibly vulnerable. It seems to me as though many of the women who make the feminist “women’s right to choose” argument have no regard whatever for those women. In pushing one particular mantra and ideology, no consideration is taken of those women at all.

It is assumed, and I am told, that it is a woman’s right to choose, and that by wanting to limit from 24 weeks and by wanting to introduce counselling, what I am trying to do is limit a woman’s right to choose. Well, let me inform everybody that a woman’s right to choose is limited because the upper limit is at 24 weeks. To say that a woman’s right to choose is being limited is nonsense—it is already limited. It is limited because at 24 weeks it is felt that a baby is viable. I argue this: a baby’s life is viable before 24 weeks, so it is time to reduce the limit, because this is 2012, not 1990. I hope we live in a society that is civilised and compassionate, and which cares for vulnerable women who do not want to have abortions and are forced to do so. I hope that we would give as much consideration to those women as we do to the Oxbridge-educated, articulate women who change their job and want to have an abortion.

Some of the women who end up at pregnancy crisis centres do so because they are scarred and need counselling, which is not available to them, because they aborted at a very late stage. Those women are more likely to suffer mental health consequences than those who abort at an early stage. If we do not go for the viability argument; if we do not look at sentience and all the other arguments I have made; if we just decide to disregard the fact that in one hospital, there might be two babies, one being aborted at 23 weeks and another having her life saved at 20 and if we choose to ignore all that, let us just decide that we should be a little more considerate to the women who find themselves forced into a situation in which they have a late-term abortion.

I hope that the Backbench Business Committee grants the next debate on this issue next May. I hope that there will be a vote. I hope that, by then, enough information will have been put before hon. Members for them to decide that what they want to do is what the public want to do. I finish on this note: I am overwhelmed by the amount of support that I have received from members of the public in wanting to reduce the limit. The more this is debated, as it should be, the more public opinion will become informed, and the more MPs will realise that what they need to do in this place is carry out the will of their constituents, not follow their own political ideology.

--- Later in debate ---

[John Pugh (Southport) (LD)]

Such debates in this place—I have attended a few—are deeply polarised, and often quite unpleasant, between those who assert the right to life and those who equally emphatically assert the right to choose, which is strange because both rights are then usually qualified by those who uphold them. I think all hon. Members would agree that there are circumstances where either right can be overridden and I know no one who does not believe this. The dividing issue between hon. Members in this Chamber is the limits of abortion, and such a debate is necessarily about how much or how little abortion is permissible. To be honest, those who argue for limits often favour much less abortion, or rare abortion, and constrained choice for the woman. That by itself is not an argument against discussing the limits rationally.

We are not helped much by the fact that two sorts of argument are given for abortion in law: one is about the preferences or the good of the woman, where her mental health, usually, and sometimes her physical health is the issue; the other is about the hypothetical preferences of the foetus, in cases of severe abnormality, where gross deformity or suffering is in prospect. There are, therefore, two different sorts of abortion, and it is not obvious to me that the same limits should apply to both types. A problem in discussing the current limits is that the cases that would immediately be affected by a small reduction would disproportionately fall into the latter category—deformity and so on. Such cases are rare and untypical, and that slightly skews our debate. It is a mistake, in this debate, to confound the two types of abortion.

Much, perhaps most, current debate has been centred on the viability of the foetus at certain stages—its ability to survive with or without medical assistance outside the womb. Of course, that varies depending upon the quality of that medical assistance, which we would all agree has improved enormously. On my way here, I read a story in Metro of a baby who survived being born below the abortion limit and was looking happily out of the pages of the paper. This kind of evidence is often cited as new scientific evidence about what we can achieve. We may achieve still more in future.

Some argue that we should not think simply of the survival of the foetus, but of its ability to thrive, lead a quality life, have full use of mental faculties and so on. It is legitimate to say that mortality and impairment is high among babies born prematurely.

[Nadine Dorries]

On the important matter of viability, the hon. Gentleman will be aware that, post-20 weeks, the method of aborting a baby is to administer a lethal injection into the baby’s heart via the mother’s abdomen, to ensure that the baby is delivered dead, not alive. That is why that procedure was invented, created and introduced. That in itself is an argument for viability below 24 weeks, because if there was no chance of viability below 24 weeks, there would be no need to introduce a lethal injection procedure.

[John Pugh]

I accept that point, but we must be aware that there is an argument that the abortion limit should be set at a point where a statistically significant number of foetuses can be shown not just to have survived, but to have thrived. That position is somewhat arbitrary. I see no obvious reason why obstetrics should not continue to improve and the issue continue to haunt us.

I find all this talk about survivability somewhat confusing, because at no stage is the human infant capable of independent survival. Some societies, and indeed some philosophers, have argued that a severely deformed infant born at full term, incapable naturally of living without abnormal intervention and presenting all those features that would have justified abortion should be allowed to perish or may be killed. I do not accept that view, but I recognise that it has been put.

What scientific evidence shows about survival prospects strikes me as relevant but not crucially so. Survivability is only relevant because it stands proxy for something else. No one argues that a baby that can survive and show all the signs of conscious, individual life was not conscious from the moment of its birth and capable of wilful behaviour, having feelings, sentience and so on. Equally, it is hard to argue that were they in the womb that would not also be exactly the case. To kill such a baby, or a baby of such an age, while it is in the womb is thus, logically, to kill a sentient, conscious, wilful and, indeed, innocent human being, and one needs a good reason to justify that type of behaviour. The paramount wishes of the mother simply do not seem to be a good enough reason.

Where consciousness can be presumed, or to put it more strongly, where complete unconsciousness cannot be assumed, the rights of the child in my view would ordinarily trump the rights of the mother. A precautionary principle should kick in, but it clearly does not do so within the existing framework. That is why it is important that we have this debate.

I accept that there is a different argument to be had about the destruction in the womb of human life that we would all agree not to be conscious, and that falls back upon religious views about respect for individual human life, including the potentially, but not actually, conscious. The mediaeval Church made that distinction. But the argument that we must take sentience seriously rests upon our ordinary moral intuitions about the value of individual existence. The debate simply will not go away until we align the law with our basic moral intuitions. I applaud those, including the Secretary of State for Culture, Media and Sport, who simply alerted us to this fact and indicated that we really must have this debate.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Crausby. I congratulate my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) on securing this debate on a subject in which she has a long-standing interest. I have listened to the views expressed by Members, and I acknowledge that many of them are deeply and strongly held. The nub of both sides of the debate is best encapsulated by the speeches of the hon. Member for Feltham and Heston (Seema Malhotra) and my hon. Friend the Member for Congleton (Fiona Bruce). They gave speeches based on their beliefs, knowledge and sound arguments.

[Nadine Dorries]

Will the Minister give way?

[Anna Soubry]

Forgive me, but I want to make progress, because the clock is against me. I will give way when I have made some points. In the short time available, it is important that I make some of the main points in my speech.

It is right that abortion is a matter of conscience. It is important to respect the views of all individuals and accept that we have different views, whichever side of the political fence we sit on. My hon. Friend the Member for Southend West (Mr Amess) reminded us that certain Cabinet members have expressed their own views on the upper limit for legal abortions. They all made it clear that those are their own personally expressed views. I want to make it quite clear that, notwithstanding the fact that some Cabinet members may want a reduction in the upper limit, the Government have no plans to bring about a change to the time at which an abortion can be carried out. I want to stress that point again, so I repeat: we have no plans to review the Abortion Act 1967.

We are by no means complacent. When I was fortunate enough to be made a Minister, I made it clear that in the time I am in office I want a reduction in the number of abortions. We all want that, but there is a debate about how we best achieve it. I take the view that we best achieve it through better contraception and by empowering our young men and women to make the choices that they want to make, if they have a sexual relationship.

[Anna Soubry]

I will, but I want to make these points because they are important. I want better counselling services—

[Nadine Dorries]

Will the Minister give way on that point?

[Anna Soubry]

I will. I also want more work done on why so many women have more than one abortion, which is of great concern to people on both sides of the argument. There is a lot of work to be done.

I want to say something on counselling that may interest my hon. Friend the Member for Mid Bedfordshire in particular. As the new Minister with responsibility for this matter, I have carefully considered how we move forward on abortion counselling. I believe that the best way forward is about contraception, how we reduce the repeat abortion rate, how we empower young men and women and how we improve abortion counselling services for women generally. A committee was formed as a result of the measures that my hon. Friend tried to introduce. There is also a cross-party inquiry into unwanted pregnancy, led by my hon. Friend the Member for Hastings and Rye (Amber Rudd). I commend that. They will do important work and hear important evidence, but the simple reality is that we therefore no longer plan to undertake a separate consultation on abortion counselling. I am sorry if that disappoints members of the committee.

For the purposes of transparency, I will today place in the Library a short document on abortion counselling, representing the great work done by my predecessor, my hon. Friend the Member for Guildford (Anne Milton). I pay tribute to the work she did when she was Minister for Public Health, and to the cross-party committee, which looked at counselling arrangements for women requesting an abortion. I am extremely grateful for the work it did, and I thank its members for their efforts. I am sorry if there is disappointment, but we do not intend to change the law, so a separate consultation would be an otiose exercise.

[Nadine Dorries]

It is not a case of changing the law, but changing the Government’s commitment. The Government made an absolute commitment to consult. In fact, the British Medical Association moved a motion in agreement. Why have the Government changed their mind about the consultation on non-compulsory independent counselling?

[Anna Soubry]

The committee has done some good work. I do not think that it would be right to take the matter any further. I am sorry if that disappoints people, but that is my view. I can see no purpose in a consultation, because we do not intend to change either the law or the guidelines.

As the committee identified, counselling services throughout the NHS are patchy. That is not acceptable. It also decided that it is of primary importance that there are no delays when a woman seeks a termination of her pregnancy. That is why it is important that if a woman is going to have a termination, she does it as quickly as possible. The group was in unanimous agreement on that, which I welcome. There is other work to be done on counselling, but I take the view that that is not the primary issue that we should address, which is why I made the decision I did.

Oral Answers to Questions

Nadine Dorries Excerpts

Tuesday 12th June 2012 Commons Chamber

[Mr Lansley]

Yes indeed. There are serious public health challenges to be faced up to in Wales, and it would be much better if the Labour Government in Wales, instead of cutting the budget by 6.5% as they are planning to do, increased it in real terms as the coalition Government are doing in England.

[Nadine Dorries (Mid Bedfordshire) (Con)]

13. What improvements in health inequalities he anticipates by the end of the decade.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

The legal duties that we have introduced will ensure that health service commissioners have regard to the need to reduce health inequalities. The NHS and the public health outcomes framework will set out ambitions to reduce those inequalities in both health services and the health of the population. That is an ongoing area of work. We already have the indicators in the framework, but we also need the ambition to work on those inequalities.

[Nadine Dorries]

Central Bedfordshire council has a number of public health challenges such as establishing health and wellbeing boards. Does the Minister agree that those challenges would be much easier to achieve and more effective if agencies such as social services, education services and others worked together? Are the Government doing anything to help facilitate that?

[Anne Milton]

My hon. Friend is absolutely right that education, social services and health services need to be brought together. That is exactly why bringing public health into local government is critical. If we add to that list housing and local business services, we have the mix to turn around many people’s fortunes. Some of the 66 indicators in the framework are school-readiness, social connectivity, air pollution and chlamydia, and they will all require local government to work at every level with all agencies to reduce inequalities.

Health and Social Care Bill

Nadine Dorries Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I would not characterise this as an extension of the independent sector treatment centres programme. That is precisely what we do not need to do with the private sector. Under the Labour Government, the private sector was paid 11% more than the NHS, which was wrong, and in another place there is a legislative provision that will prevent discrimination in favour of the private sector. The Bill will carry forward exactly the principles and rules of co-operation and competition, as reflected in the panel set up under the previous Government. As NHS Future Forum set out, the reason for having that in the Bill, with Monitor exercising those responsibilities, is so that there will be a health sector regulator, rather than that being done without health expertise by the Office of Fair Trading.

[Nadine Dorries (Mid Bedfordshire) (Con)]

Some Conservative Members never criticised, and in fact supported, the previous Government when they introduced private health care providers into the NHS. In his letter, the Deputy Prime Minister said that the use of private health care firms has been explicitly prevented as a result of his involvement. Is that really true? If so, should someone not tell him who is running this Government?

[Mr Lansley]

My hon. Friend knows perfectly well that we are a coalition Government and, therefore, this is a coalition Bill that reflects the views of the whole coalition. To that extent, I reiterate to her and to the House that, as the Deputy Prime Minister has quite rightly said, the legislation will not allow discrimination in favour of the private sector in the way that the Labour party did.

Health and Social Care (Re-committed) Bill

Nadine Dorries Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries (Mid Bedfordshire) (Con)]

I beg to move amendment 1, page 6, line 8, at end insert—

‘(c) after paragraph (f) insert a new paragraph as follows—

“(g) independent information, advice and counselling services for women requesting termination of pregnancy to the extent that the clinical commissioning group considers they will choose to use them.”.’.

[Mr Speaker]

With this it will be convenient to discuss the following:

Amendment 2, page 6, line 8, at end insert—

‘(2A) After subsection (1) insert a new subsection as follows—

(1A) In this section, information, advice and counselling is independent where it is provided by either—

(i) a private body that does not itself provide for the termination of pregnancies; or

(ii) a statutory body.”.’.

Amendment 1221, in clause 14, page 9, line 37, at end insert—

‘( ) After paragraph 8 insert—

“Provision of independent information, advice and counselling services for women requesting a termination of pregnancy

8A (1) A local authority must make available to women requesting termination of pregnancy from any clinical commissioning group the option of receiving independent information, advice and counselling.

(2) In this paragraph, information, advice and counselling are independent where they are provided by either—

(a) a private body that does not itself refer, provide or have any financial interest in providing for the termination of pregnancies; or

(b) a statutory body.’.

Amendment 1252, page 9, line 37, at end insert—

‘( ) After paragraph 8 insert—

“Provision of advice relating to unplanned pregnancy

8A The Secretary of State must ensure that all organisations offering information or advice in relation to unplanned pregnancy choices must follow current evidence-based guidance produced by a professional medical organisation specified by the Secretary of State.”.’.

Amendment 1180, in clause 240, page 226, line 31, at end insert—

‘(1) Regulations must require NICE to make recommendations with regard to the care of women seeking an induced termination of pregnancy, including the option of receiving independent information, advice and counselling about the procedure, its potential health implications and alternatives, including adoption.

(2) The regulations must require health or social care bodies or any private body that provides for the termination of pregnancies to comply with the recommendations made by NICE under subsection (1).’.

--- Later in debate ---

[Nadine Dorries]

Four weeks ago I was not sure whether I would get to the point where I could speak in the Chamber today. This has been a long and hot-under-the-collar summer. Following my announcement of my intention to table the amendment, I have been threatened with being throttled, car-bombed, burned alive and a host of other distasteful and unpleasant ways in which I would meet my end.

I shall not go into detail about any of these responses to my amendment. Needless to say, some of them involved bodily functions to a graphic degree, and some of the scatological messages were unbelievable. I will not repeat the bile that has poured into my inbox every day. I do not think there is anything that I or my staff could be threatened with, or that we could read or be told now, that would elicit any shock from us. There is nothing worse that we could hear.

Before I go into the detail of the amendment, I shall talk about a significant and substantial shift as a result of the amendment. It has always been the tradition of the House that abortion issues have been discussed and debated in the Chamber and the media have commented on what happened, usually in a reasonable way. But the amendment has changed the game for ever. All Members in all parts of the House know, particularly from the 2008 debate, that we debate with passion. I would say that the 2008 debate was one of the best debates of the previous Parliament. However, we all remain courteous and friendly with each other following the debates. The usual parliamentary knock-about and the usual games take place—I shall say more about that in relation to the amendment in a moment—but the debate usually takes place here and the media comment on what happens here as it happens.

I have no greater opponent in the House on this issue than the right hon. and learned Member for Camberwell and Peckham (Ms Harman). In 2008 she was the whipper-in and the mover behind what happened in that debate, but I have no greater respect for almost any other woman in the House than I do for her. I hugely respect what she has achieved for women and humanity, and I know that she approaches the issue honourably, as I hope I do. It is incredibly sad, therefore, that my summer has been made so difficult not by Opposition Members, who have all been incredibly quiet, but by the nastiness and the response of the left-wing media and union-funded organisations.

The past four weeks have been incredibly difficult. The campaign against the amendment has been co-ordinated by an organisation known as Abortion Rights, which is funded by Unison and a number of other small unions. It also received membership contributions, but, as I was told in a meeting with the organisation, it is largely funded by the unions and Unison is the biggest contributor. [Interruption.] I am not saying that every penny is not accountable; I am just informing the House that the campaign has been funded by the unions. I do not think that there is a problem with that.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

Who funds yours?

[Nadine Dorries]

I will tell the hon. Lady exactly who funds my campaign—nobody. Neither I nor my office has received a single penny. Here, to me, is the disadvantage of the amendment. The unions can contact Members’ constituents and ask them to e-mail individual MPs, but I cannot afford to promote the amendment in that way. The press barons, whom the unions have fed with their response to the amendment, can pour what they want into the newspapers, but I cannot. What we have seen is an absolute divide.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Will the hon. Lady give way?

[Nadine Dorries]

I will give way, because the hon. Lady has commented previously on the press in this regard.

[Luciana Berger]

Will the hon. Lady please tell the House exactly who funds the Right to Know e-mails that many of us have received in our constituency inboxes?

[Nadine Dorries]

I will answer that question, and after I do I hope the hon. Lady will tell me who funds Labour Friends of Israel. I have no idea who funds Right to Know, as I am sure Labour Members have no idea who funds a number of campaigns that support them.

[Rachel Reeves (Leeds West) (Lab)]

At what point will the hon. Lady move on to the substance of the amendment, rather than issues such as Israel and how Unison funds political campaigning?

[Nadine Dorries]

I absolutely will—that is why I am here—but it is important to explain the context and the background to some of misinformation that Members have received in their inboxes. This is my opportunity to correct the misinformation MPs have been fed about the amendment.

The amendment has created a divide that was not present before, including in 2008. The Guardian and The Times and the union-funded Abortion Rights have mounted a campaign against the amendment. I must say that the core Conservative vote newspapers, The Daily Telegraph, the Daily Mail and so on, have been supportive, so this chasm and the politicisation of abortion has begun as a result of the amendment and as a result of the unions and the left-wing media.

[Chris Bryant (Rhondda) (Lab)]

Like The Times?

[Nadine Dorries]

There are lots of comments being made from a sedentary position, Mr Speaker, but The Times has actually fed that divide directly and repeated much of the information it has been given. I want to answer some of the accusations made about me in response to the amendment. I do not have the press barons’ money to mount and fund a campaign. I have not received a penny. In fact, I am broke. My office has not received a penny in funding.

[Lilian Greenwood (Nottingham South) (Lab)]

Will the hon. Lady give way?

[Nadine Dorries]

No.

I have also been accused of being a religious fundamentalist. Like 73% of the country, I am a member of the Church of England and have Christian beliefs, but I am not sure when that became a crime and prevented me from having an opinion. On Saturday, The Guardian printed a flow chart showing the conservative Christians who are supposed to be mounting a sphere of influence with the amendment. I did not know who 95% of the people mentioned were or the organisation they represent. If I followed Islam or Judaism, I wonder what the response would have been to such a flow chart in The Guardian. I found the chart absolutely reprehensible and disgusting.

[Chris Bryant]

Will the hon. Lady give way?

[Nadine Dorries]

I absolutely will not.

I want to mention some of the other lies that have been printed about me. I have been accused of wanting to reduce the number of abortions by introducing the amendment. That is absolutely not the objective. However, if any individual in the street was asked about the amendment and told that it might bring down the number of abortions, would they say, “Well, that’s a good thing,” or would they say, “We’re proud of the fact that 200,000 abortions a year are performed in the UK”? That is the highest number in western Europe. Would the individual in the street say that that is a good thing? No, they would say that it probably would be a good idea if something could help to bring that number down. I do not want to restrict access to abortion. The amendment is not about restricting access. I do not want to return to the days of Vera Drake-style back-street abortionists. That is not what the amendment is about. I am pro-choice, although I am presented as pro-life in every newspaper. The pro-life organisations are in fact e-mailing pro-life MPs to tell them not to vote for the amendment. I am pro-choice. Abortion is here to stay.

It is absolutely ridiculous that the amendment has been portrayed as something that would restrict access to abortion. The amendment is about medical practitioners making to a woman who presents at their surgery or organisation an offer of independent counselling, not compulsory counselling. Every single day I have read a headline stating that the amendment is intended to drive women into the arms of religious fundamentalists via compulsory counselling. That is absolutely not true. Any Member who rose and claimed that the amendment would make counselling compulsory would be being untruthful. It is nothing more than an offer. It is an offer made to some women who, when presenting at a GP’s practice, may have doubts, may be confused and may feel that they would like to accept. That is all it is—an offer. I find it very difficult to understand how anyone can object to a vulnerable woman being made an offer of counselling when she is suffering from a crisis pregnancy.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way, and I commend her courage and perseverance. Does she share the concern of many in this House and outside about the businesslike and commercial decisions that are taken in relation to abortion and feel that, because one hour of counselling a week for everyone is not enough, it is wrong that a commercial industry has been made out of abortion? Does she agree that when abortion becomes a business, the feelings of people have been lost?

[Nadine Dorries]

The hon. Gentleman makes a pertinent point about the relationship between financial incentive and abortion counselling, which I will talk about in a moment to make it quite clear how the amendment relates to the issue.

[Dr Julian Huppert (Cambridge) (LD)]

Does the hon. Lady accept the comments of the Royal College of Obstetricians and Gynaecologists, which essentially says that there is not a problem? It has commented:

“The system, as it stands, works well.”

[Nadine Dorries]

Well, that comment is probably the most fatuous we will hear in the debate, and probably the most disrespectful to women. I would like to know what the hon. Gentleman thinks about the report published last week in the British Journal of Psychiatry that women who have an abortion are twice as likely to suffer from mental health problems. Of course, I realise that the report he quotes from was probably written by men. I realise that the women who go through abortion and suffer as a result do not go back to the Royal College of Obstetricians and Gynaecologists to give feedback.

[Dr Huppert]

rose—

[Nadine Dorries]

I will not give way again to the hon. Gentleman, as I am sure that he will have an opportunity to make his point when he is called to speak later.

[Mr David Burrowes (Enfield, Southgate) (Con)]

My hon. Friend was right to introduce her remarks to the House and highlight the unacceptable personal attacks that have been made against her, which denigrate an issue of vital importance and interest to the whole House. The House needs to rise above that in today’s debate. With regard to evidence of change, could she indicate what research she has done on how much face-to-face counselling takes place in organisations such as the British Pregnancy Advisory Service, for example?

[Nadine Dorries]

I thank my hon. Friend, and in a moment I will come on to the difference between counselling and consultation, and what is available to women.

--- Later in debate ---

[Kate Green (Stretford and Urmston) (Lab)]

rose—

[Nadine Dorries]

I want to finish this point, and then I will give way.

The counsellor would be completely impartial, give no advice or direction and be entirely independent, so if the woman had been through the process and then continued to abortion, she would do so knowing that she had talked through her options with somebody.

[Rachel Reeves]

Will the hon. Lady give way?

[Nadine Dorries]

No, I have given way to the hon. Lady once. I will give way to the hon. Lady who also acts as a Whip.

[Lyn Brown]

I am listening with interest to the hon. Lady. How can she guarantee that the counselling that she proposes will not delay the abortion process?

[Nadine Dorries]

I have spoken to organisations that provide counselling and have 80,000 registered counsellors throughout the UK. [Hon. Members: “Who?”] The British Association for Counselling and Psychotherapy. I asked, “If somebody required counselling, was at a GP’s practice and a telephone call was made, how long would it take to get a counsellor to a particular woman?” The answer was that counselling could be delivered in the GP’s practice, at another venue or in the woman’s home, and that it could be anything from immediate to within 48 hours.

Registered counsellors, who have e-mailed me regularly since the amendment was tabled, say that they would love to work—counselling is a growing industry—and to have the opportunity to work with women in that situation. Unfortunately, however, counselling is available on the NHS only via the abortion provider or via the hospital.

[Mark Pritchard (The Wrekin) (Con)]

I am grateful to my courageous and honourable Friend for giving way. As 147 babies were terminated after 24 weeks in the past year—a 29% increase on the previous year—does she agree that such counselling should also include the fact that many of those terminated babies, who had minor disabilities such as cleft lips, cleft palates, half an ear or having only one ear, could have been dealt with through modern cosmetic reconstructive surgery?

[Nadine Dorries]

I thank my hon. Friend for that comment. That is a different debate, but he highlights an important issue, and it is abhorrent that 147 babies were aborted for cleft palate, hare lip and minor cosmetic issues. I have a godson who had a club foot, and he was a wonderful young boy and is a wonderful young man. I find it quite amazing that anybody would choose to abort a baby because they had a club foot, but that is an issue for another day. The amendment does not cover it, but it is an important point.

[Mr Stewart Jackson (Peterborough) (Con)]

Does my hon. Friend share my incredulity at those Opposition Members who maintain that an organisation such as BPAS—the British Pregnancy Advisory Service—can be independent in its counselling, when in its March 2011 report and financial statement it notes that

“an increase in procedures of 13 per cent against the background of falling national trends in 2010-11”

is

“a significant achievement”?

How can the opponents of the amendment maintain that there is no fiscal link and no conflict of interest?

--- Later in debate ---

[Nadine Dorries]

That is a very important point, and in a moment I will come on to the financial link and the financial incentives, with some other information that we have.

[Mrs Helen Grant (Maidstone and The Weald) (Con)]

Will my brave hon. Friend confirm her belief that existing counselling services have the capacity to deal with the level of referral?

[Nadine Dorries]

That is precisely the next point in my speech; my hon. Friend must have been looking over my shoulder!

I now turn to the counselling provision available to women today. Many women do not want or need counselling. They find out that they are pregnant and know exactly what they want to do, but those are frequently the women who are supported—who have partners, family and friends who will support them through that awful situation. No woman wants to have an abortion, but many know that they have to, for various reasons, and this amendment is not about them. A mystery shopper, however, recently approached several abortion clinics posing as a young woman who was pregnant and unsure of what to do. Every time I mention BPAS there is a howl from Opposition Members, but I am going to mention it in this instance, because this is irrefutable evidence.

The individual posed at a central London clinic as a 26-year-old pregnant woman who did not know what to do, and she asked for counselling. I shall come on to the difference between counselling and consultation, but she said that she did not know what to do, because she had been given the immediate consultation, was not sure whether to go through with the pregnancy, and therefore wanted an abortion. She was told that, at that very busy clinic in central London, one hour of counselling was available at one set time per week. I believe that when she revealed her identity she was offered another hour.

In fairness to BPAS, it says that it has flexibility in the system and can offer more hours. Why did it not do so? If it has flexibility, how much is there?

[Chris Bryant]

I am very grateful—[Interruption.] The hon. Lady says something from a sedentary position. I wholly deprecate the fact that she has had threats made, but it is inappropriate to bring forward this amendment to this Bill, because if we are going to consider abortion we should be considering the whole issue in the round, not just appending something to this kind of Bill. As she knows, I disagree with her, but she will also know that the whole point of counselling, in any circumstance, is to allow a person to come to the right decision for themselves. That is precisely what BPAS, Marie Stopes and others provide, because any counsellor who does not do that is not worth their salt.

[Nadine Dorries]

I would love to hear how the hon. Gentleman knows that that is what happens in Marie Stopes and BPAS. He always speaks on such issues as someone with huge experience, but I am highlighting at this moment what happens. If he thinks that one hour per week, at a set time at a busy London clinic, for the entire throughput of women having abortions, is enough counselling, so be it; that is his opinion.

--- Later in debate ---

[Mr Chuka Umunna (Streatham) (Lab)]

rose—

[Nadine Dorries]

I should like to make this point before I take any more interventions, because I also want to defend BPAS. I do not want it to look as if I am attacking the organisation, because it and, probably more so, Marie Stopes, do what they do—the clinical procedure of carrying out abortion—incredibly well. The service that they provide for the NHS is absolutely vital, and I do not want to see Marie Stopes or BPAS disappear or to diminish their roles. They have a job to do, and they do it well. Their job is the provision of clinical abortions, and I want that to continue.

[Louise Mensch (Corby) (Con)]

Will my hon. Friend confirm that it is still safe for those of us who do not have concerns about the counselling that BPAS and Marie Stopes offer to support her amendment, because it does not prevent BPAS and Marie Stopes from offering counselling? I, for one, have no such concerns, yet I am prepared to vote for her amendment, because it does not prevent those organisations from offering advice. Will she confirm that?

[Nadine Dorries]

My hon. Friend is not totally correct, because the whole purpose of the amendment is to separate out the financial situation. I shall come on to that in a moment. I disagree with my hon. Friend, and if she listens to the rest of the debate she will understand why. I do not believe that the place where an abortion was carried out is the right place for someone suffering from post-abortion distress to receive their counselling—a situation that many women suffering from post-abortion distress have told me about.

[Andrew Selous (South West Bedfordshire) (Con)]

I am grateful to my hon. Friend and parliamentary neighbour. May I for a second take the debate from the general to the particular? I think that she is on to something. I mentioned a 23-year-old constituent of mine who, having been to an abortion clinic, then went to a clinic such as my hon. Friend advocates. It was then her decision: she decided to change her mind, and today has a beautiful three-month-old daughter. She is pleased that she had the opportunity for that counselling, which no one forced her to take. That is why I think my hon. Friend is on to something.

[Nadine Dorries]

I hope that my hon. Friend is talking about the Crisis pregnancy centre in Dunstable, which I have visited along with many others. It does amazing work with young women.

[Craig Whittaker (Calder Valley) (Con)]

Marie Stopes International said in the briefing that it sent to all MPs that only 2% to 2.5% of women who go through the abortion counselling process opt to keep the child. Does my hon. Friend agree that that may indicate an incredibly poor success rate among counselling services?

[Nadine Dorries]

I thank my hon. Friend for that intervention, because I am coming to another interesting statistic that I have not yet included in my speech.

[Gavin Shuker (Luton South) (Lab/Co-op)]

rose—

--- Later in debate ---

[Nadine Dorries]

I will give way in a minute.

There is a huge disparity between the figures that show both where a woman received her counselling and her decision. In 2008, BPAS announced that the proportion of women who came to it and decided not to proceed with an abortion was as high as 20%. Unfortunately, freedom of information requests asking for the figures and the contracts with PCTs show that that is not true: the real figure is 8%, and sometimes even lower in some PCTs. I am not sure why an abortion organisation would say that its figures for women who do not proceed to an abortion are higher than they actually are.

[Gavin Shuker]

rose—

[Kate Green]

rose—

[Nadine Dorries]

I want to finish this point, and then I will give way. I know that the hon. Member for Stretford and Urmston (Kate Green) wants to intervene, and I will take an intervention from the hon. Member for Luton South (Gavin Shuker) first, in a moment.

There is a huge disparity in the figures, and the freedom of information request shows an even bigger disparity. Marie Stopes had told me—I hope I get this right—that the proportion of women who go to the organisation and do not proceed to termination is about 15%, although I do not know what freedom of information requests would show about those figures. The fact is that abortion providers are saying that 20% or 15% of women do not proceed to abortion, although freedom of information requests show that the figure is 8%, as was shown in the press this week. I have no idea why there is that disparity, or why they would say that the figure is 20% when it is not.

[Several hon. Members]

rose—

[Nadine Dorries]

I give way to the hon. Member for Luton South.

[Gavin Shuker]

The hon. Lady has rightly probed the relationship between counselling and abortion on behalf of those of us who feel uncomfortable about that relationship. However, does she agree that 90 minutes does not seem like a long time for us to debate the implications of what is going on? The Bill is substantively about the nature of the NHS, and not about abortion provision. In that light, I urge her to consider whether it is appropriate to divide the House on this issue.

[Nadine Dorries]

I do feel that it is appropriate to divide the House on this issue, because I would like the amendment to be part of the Bill.

[Several hon. Members]

rose—

[Nadine Dorries]

I am not going to take any interventions for a few minutes. I would like to go back to the fact that only one hour of counselling is available in a busy London clinic. I ask Members, just for a moment, to put themselves in the shoes of a 16-year-old girl who turns up at that clinic and does not know what to do. She is pregnant and panicking. Some of her friends tell her to have an abortion and some tell her not to. She does not want to tell her parents because she is scared of doing so. Her boyfriend is saying to her, “You’ve got to have an abortion and get rid of it.” That is a mish-mash of the four or five stories a day that we hear in my office.

--- Later in debate ---

[Several hon. Members]

rose—

[Nadine Dorries]

I know that others want to speak. I have been speaking for a while and I want to get to the end, so I will keep going for a bit longer. I will take interventions in a minute. [Interruption.]

[Mark Pritchard]

Soubry, zip it! [Interruption.] Sorry, Mr Speaker.

--- Later in debate ---

[Mr Speaker]

I am grateful to the hon. Gentleman. Let us try to maintain proceedings on an even keel. The hon. Gentleman has said that he is sorry, and that is fine.

[Nadine Dorries]

As I said, I do not want to look as if I am knocking abortion providers. As a nurse, I assisted with many terminations. I do not want to look as if I feel that there is no place for abortion provision. I am pro-choice and do not want to return to those other days.

[Jim Shannon]

rose—

[Mr Umunna]

rose—

[Nadine Dorries]

I give way.

[Jim Shannon]

rose—

[Mr Speaker]

Order. It is important that the hon. Lady makes it clear to whom she is giving way.

[Nadine Dorries]

I give way to the hon. Member for Streatham (Mr Umunna).

[Mr Umunna]

The central point of disagreement for many people is the implication in the amendment that the abortion providers—BPAS has a presence in my constituency—are incapable of providing impartial independent counselling to those who come to them. The manager and staff at the centre in my constituency have said that they find insulting the idea that when they are giving counselling they are somehow seeking to persuade those who come to them to have an abortion, when that is not the case. In fact, when I visited BPAS recently a couple of young ladies had come to the centre intending to go through with an abortion but subsequently decided not to because of the counselling that they received.

[Nadine Dorries]

All I can say is that we will look at the freedom of information figures that have come from the clinic in the hon. Gentleman’s constituency. If what he says is the case, that must have been the year’s allocation for that clinic, because the FOI request information that we have received does not show that.

[Several hon. Members]

rose—

[Nadine Dorries]

No, I will carry on for a bit longer.

I want to talk about the difference between consultation and counselling. I doubt very much whether the constituents of the hon. Member for Streatham had counselling; I think they probably had consultation. There is a big difference. Every woman who turns up at an abortion clinic has a consultation, but that is about the medical process—the side effects and what is going to happen. Every e-mail that we receive from women on this subject involves a consultation. This is how the law stands today; my hon. Friend the Member for Broxtowe (Anna Soubry) might want to listen to this, as most of the way through she has been nodding in agreement with the adverse comments.

When a woman turns up at an abortion clinic, the clinic does not offer counselling. It does offer consultation, but the woman has to ask for counselling; it is not offered. She has to ask—or the doctor in the clinic has to see that a woman is in a particular position, or be alarmed enough by her state to offer counselling. I want to make the point very clear: counselling is not offered, but has to be asked for. [Interruption.] Someone says from a sedentary position that it is, but if it is, the centre is operating outside the guidelines, because counselling is not offered.

[Mr Edward Leigh (Gainsborough) (Con)]

I am sure that many abortion providers do their level best to give advice, but that is not the point being made. Surely in any field of endeavour it is not appropriate for the provider of a service to give the so-called independent advice. That is the key point—and, frankly, the only point.

[Nadine Dorries]

As I have said to many people, I will come on to the financial situation and the reasons for it.

To recap, the amendment proposes that abortion clinics make an offer of counselling, which they do not make because under the guidelines they have no provision to make it—the woman has to ask for it.

Last week, The British Journal of Psychiatry reported that women who abort are twice as likely to suffer from mental health problems.

[Dr Huppert]

Will the hon. Lady give way on that point?

--- Later in debate ---

[Nadine Dorries]

No.

I do not want to ban abortion—I want it to continue—but should we not be taking better care of our young girls and women? Should we not be offering them something better? How do women get to the position of suffering mental health problems as a result of abortion?

[Jim Shannon]

The hon. Lady will be aware of facts and figures that indicate that a number of people who have had abortions regret it afterwards. Does she feel that if the consultation process is done correctly and the information is shown to the person who wishes to have the abortion, they would perhaps then decide that the child they are carrying could develop into a young lady and have life? Does she feel that the consultation process is clearly where the issue has to be addressed and that the emphasis has to be on the counselling, not on the abortion?

[Nadine Dorries]

The hon. Gentleman makes a point that is pertinent to his own beliefs. What I believe about counselling is that no advice should be given, that there should be no direction, and that it should be completely impartial. It should be an influence-free zone—a bubble—where a woman can sit and talk through the issues with somebody who is not guiding her. That is what counselling should be.

Every single day I receive e-mails from women who do not want other women to experience what they have experienced—who do not want their daughters to go through what they have gone through. I receive e-mails from staff who are working in, or have worked in, abortion clinics. I am in dialogue with some very senior members of staff of a number of organisations and abortion clinics across the UK—

[Luciana Berger]

Will the hon. Lady give way?

[Nadine Dorries]

No, I will not give way again.

Those members of staff are themselves not necessarily happy with the guidelines and the way in which they are forced to operate. I speak to people at abortion clinics across the UK who would like the guidelines to change because they do not necessarily feel that women receive the counselling that they should receive because it is not offered but has to be asked for.

[Kate Green]

rose—

[Nadine Dorries]

I give way to the hon. Lady, who has tried to intervene several times.

[Kate Green]

Where in the hon. Lady’s amendment is there a guarantee of the quality of counselling that women would receive from such organisations?

[Nadine Dorries]

I hope that the quality of counselling is determined by the professional bodies by which the counsellor is accredited—they determine the standard of counselling. It does not matter whether counselling is for an abortion, for cosmetic surgery, or for anything else—it has a defined manner in which it is delivered, which is that advice is not given, that influence is not asserted, and that it is totally impartial. Any counsellor who is trained as such and accredited by a professional body delivers counselling in that manner.

Let me return to the mental health issue and the e-mails that I receive on a daily basis. One of the problems—

[Dr Sarah Wollaston (Totnes) (Con)]

Will my hon. Friend give way?

[Nadine Dorries]

No, I should like to continue. [Hon. Members: “Give way!”] I will give way once more and then not until I have finished the next section.

[Dr Wollaston]

My hon. Friend has twice quoted the Royal College of Psychiatrists and asserted that there is a much higher rate of mental illness after termination of pregnancy, but the RCP has made it clear—any Member can look online at the draft of its very comprehensive evidence review—that we have to compare like with like. In other words, we have to make a comparison with rates of mental illness after unwanted pregnancy. Looking at the rates after unwanted pregnancy, we see that there is no difference between the rate of mental illness after termination of pregnancy and live birth. Indeed, the biggest predictor of mental ill health after a termination of pregnancy is whether somebody was suffering with problems beforehand.

[Nadine Dorries]

The hon. Lady makes the assumption that I want women to continue with unwanted pregnancies. That is not the case. I have made the point that abortion is here to stay for any woman who wants an abortion. The amendment simply proposes that any woman who feels that she wants or needs counselling can be offered it—that is all. I find it very difficult to understand why the hon. Lady would feel that anybody in a crisis pregnancy should not be offered counselling. Why should they not?

[Mr Stewart Jackson]

The hon. Member for Cambridge (Dr Huppert), who is currently fulfilling his role as Dr Evan Harris’s vicar on earth, expressed the view that everything is fine at the moment. Does my hon. Friend share my concern that it is routine for primary care trusts absolutely to refuse to reveal the financial relationship they have—for instance, with Marie Stopes or BPAS—on the basis of commercial confidence, and that it takes freedom of information requests to get that information? The system is clearly not working, and if we want transparency and openness, things have to change.

[Nadine Dorries]

My hon. Friend is absolutely right. Not only that, but the accounts of BPAS and Marie Stopes, which are revealed via the Charity Commission, can sometimes be three years out of date—we do not get to see them until three years later. That is amazing when one considers that the Charity Commission is paid £60 million of taxpayers’ money each year.

This, for me, is about the women who have contacted me and asked me to propose this amendment on their behalf, and I have to dedicate some of this speech to them. Every day I receive e-mails and speak to people—

[Luciana Berger]

Will the hon. Lady give way on that point?

[Nadine Dorries]

No.

I constantly speak to people at a high level across the abortion industry, and they always tell me that no woman goes through those doors wanting to be there. All women’s stories are the same; there is a theme that runs through every single one. The individual circumstances may be different, but the stories all start in the same way and with the same questions: “Will I lose my job or won’t I lose my job?”; “Will he leave me or won’t he leave me?”; “Will my parents kick me out or won’t they kick me out?” The questions are all the same; there are no surprises. Many women say that once they are referred—

[Dr William McCrea (South Antrim) (DUP)]

Perhaps this is not about this particular debate on the amendment, but I have to say that some of us in this House have the conviction that the emphasis seems to be on the right of the woman and that it is about time we spoke about the right of the unborn child. They have rights too.

[Nadine Dorries]

The hon. Gentleman is a man of great conviction and, I think, a lay preacher, and we all respect and honour his views. However, the amendment is not about the unborn child; it is about the woman accessing counselling.

[Margaret Hodge (Barking) (Lab)]

Will the hon. Lady give way?

[Nadine Dorries]

No, I want to continue for a bit longer.

The diagnosis of pregnancy happens very quickly. One can buy a pregnancy testing kit for £1. It is possible that the reason some women suffer distress following an abortion is that they can be tested before they have even missed their first period. For some women, that is fantastic and they go straight for an abortion when they find out. For others, however, it all happens so quickly that they can be aborted by the time they are seven or eight weeks pregnant, and then afterwards, when the pressure has gone and the coercion has disappeared, they realise—

[Dr Phillip Lee (Bracknell) (Con)]

Will my hon. Friend give way?

[Nadine Dorries]

May I just finish this point? When those women would have been 10 weeks pregnant, two or three weeks after the abortion, they realise that they could have worked it out and that they could have got there somehow. That is when the problems are beginning to kick in. That is why an increasing number of women are becoming very anxious about the fact that they do not receive pre-abortion counselling. That is why I receive so many e-mails and why other organisations receive them.

--- Later in debate ---

[Nadine Dorries]

I thank my hon. Friend for his candour. However, I inform him that opportunities to debate abortion in this House do not come very often. In fact, the last time it happened was in 2008 when I had to table an amendment to another Bill, which was controversial. The same criticism was made that the amendment should not have been tabled to that Bill. The fact is that the Government do not make provision for abortion to be discussed in this House. Therefore, it either has to be attached to a Bill like this or it does not happen at all, unless one is drawn first in the ballot for private Members’ Bills.

[Dr Lee]

Yes, but my point is that this is such an emotive subject—we can tell from the responses on both sides of the House that people feel passionately about this—that the debate needs to be calm and considered and the language both here and in the media must not be inflammatory or incendiary, because if it is, it polarises the debate and those of us who want to see progress towards abortion not being so prevalent in society get terribly frustrated.

[Nadine Dorries]

Well, I hope that the unions and the left-wing media will take my hon. Friend’s comments on board.

[Andrew Selous]

I wonder whether my hon. Friend will clarify something. It is my understanding that if she chooses to press any of her amendments to the vote, it will be amendment 1221. I wonder if that might be more acceptable to my hon. Friend the Member for Bracknell (Dr Lee) than amendment 1, which he may have been speaking about.

[Nadine Dorries]

The amendments are grouped, but when I spoke to the Table Office last night, I was told that I would speak to amendment 1 and that amendment 1 would be pressed to the vote. I hope that the Clerks will clarify that. [Interruption.] I will take advice from the Clerks, but when I spoke to the Clerk last night, I was told that it was amendment 1. [Interruption.] My hon. Friend the Member for South West Bedfordshire (Andrew Selous) is going to find out for me now.

On the offer, the amendment would provide space and time to talk and think for women who are feeling confused—that is all.

I now come to the financial arrangements between abortion clinics and counselling providers. If anybody in this House were to take out a mortgage today, the person who sold them the mortgage would have to refer them elsewhere for independent advice. If it was a husband and a wife, I believe that they would have to go to separate advisers, because they cannot both take advice about taking out the mortgage from the same person. I wonder why we feel it is appropriate that organisations that take £60 million a year of taxpayers’ money and are paid to carry out abortions give advice on the procedure.

[Penny Mordaunt (Portsmouth North) (Con)]

I am a former director of the largest patient organisation in Europe, which provides services on the commissioning side and the provider side through advice and support. It is a charity that deals with long-term conditions. We had to follow extremely strict rules to ensure that there was no conflict of interests and we could not provide commissioning services to an area of the country if we were also on the provider side. Why does she think that that situation has not existed for this particular area of health care?

[Nadine Dorries]

Because, unfortunately, abortion provision and counselling is never scrutinised thoroughly or legislated on. No legislation happens in this place to deal with abortion. It is an issue that can never be debated. People shy away from debating abortion because of the uproar that results so things do not happen that perhaps should happen. If one is to have cosmetic surgery and it is deemed that it might have a psychological effect, one would be offered independent counselling. That does not happen with abortion.

[Mr Umunna]

Will the hon. Lady give way?

[Nadine Dorries]

No, I would like to continue on the financial incentives.

BPAS and other organisations would say that they do not have to meet targets and that they have no financial concerns. However, BPAS has advertised for business development managers, whose primary function is to increase its market share—those are its own words in the advert. If an organisation advertises that it wants to increase the number of abortions, can we trust it to provide vulnerable women who walk through the door with the counselling that they need? On pensions mis-selling, this place has separated by law the people who provide and sell pensions from the people who advise on pensions.

[Mr Frank Field (Birkenhead) (Lab)]

Does the hon. Lady accept that she might further her case if she concluded her contribution soon?

[Nadine Dorries]

Sorry?

[Mr Field]

My advice was that the hon. Lady might further her case if she concluded her remarks shortly.

[Nadine Dorries]

Yes, I will.

I will come to a conclusion now, as time is whizzing away because of the interventions. I thought long and hard before tabling this amendment. Like so many issues—

[Angie Bray (Ealing Central and Acton) (Con)]

Will my hon. Friend give way?

[Nadine Dorries]

No, I am going to close. I thought long and hard about tabling this amendment. Like so many issues concerning abortion, it is a highly emotive area. There are those who believe that the right to an abortion is so sacred that, no matter what, it should never be touched, debated or reformed. There is not a single MP in this House who has not been asked by a constituent about their beliefs on this issue. I am sure that many prefer, understandably, to fudge a response, particularly when the reaction to discussing abortion can be so aggressive, as I have found to my cost.

The amendment is about one thing and one thing only: providing women with more choice. It would allow women who are at their most vulnerable greater access to support. It must be wrong that the abortion provider that is paid £60 million to carry out terminations also provides the counselling when a woman feels strong or brave enough to ask for it. If an organisation is paid that much for abortions, where is the incentive to reduce them?

I will move on to the tactics that have been used in this House to thwart the amendment. I wish to be very clear and will take no more interventions. I went to see the Prime Minister regarding this amendment and he was very encouraging. In fact, it was at the Prime Minister’s insistence that I inserted the word “independent”. I have attended a meeting at the Department of Health at which it was decided what process would be implemented to make this a reality.

Last weekend, the former MP for Oxford West and Abingdon, Evan Harris, who has spent most of the day in the office of the hon. Member for Cambridge (Dr Huppert)—he is still here, tabling his amendments—turned up on the airwaves expounding the theory that there is no evidence of a problem, that the amendment is unnecessary as nothing needs to be fixed, that the status quo should remain and that the abortion industry should be allowed to continue under the veil of secrecy that it has.

I received a message informing me that the former Member for Oxford West and Abingdon had approached the Deputy Prime Minister’s office and exerted pressure. In fact, he tweeted exactly that, saying that he had applied pressure on the Deputy Prime Minister, who had now forced the Prime Minister to make a climbdown. Basically, a Liberal Democrat—in fact, a former MP who lost his seat in this place—is blackmailing our Prime Minister and our Government. Our Prime Minister is being put in an impossible position regarding this amendment. Our health Bill has been held to ransom by a former Liberal Democrat MP, who has focused on this amendment.

The interesting thing is that ComRes polling shows that 78% of the public support the amendment.

[Martin Horwood (Cheltenham) (LD)]

On a point of order, Mr Speaker.

[Simon Hughes (Bermondsey and Old Southwark) (LD)]

rose—

[Nadine Dorries]

I will not give way. The right hon. Gentleman may be interested to know—

[Mr Speaker]

Order. I apologise for interrupting the hon. Lady, but there is so much noise in the House that it is sometimes difficult to know whether somebody is seeking to intervene or standing for another purpose. Point of order, Mr Martin Horwood.

--- Later in debate ---

[Nadine Dorries]

Thank you, Mr Speaker.

I think our Prime Minister has been put in an impossible position. I want every Liberal Democrat Member to know that in the polling that was done, support for the amendment was 78% among the public, but it was highest among those who voted Liberal Democrat in the 2010 election, at 84%.

[Dr Huppert]

Will the hon. Lady give way?

[Nadine Dorries]

No, no, no.

I think that is because Liberal Democrats traditionally support choice. Is it any wonder that the person in question is now the former Member for Oxford West and Abingdon?

[Andrew Percy (Brigg and Goole) (Con)]

Will my hon. Friend give way?

[Nadine Dorries]

It is time to make a decision not informed by the Liberal Democrats, and without being blackmailed by a Liberal Democrat or held to ransom by the Liberal Democrats. It is time to make a decision based on our conscience. I say to hon. Members: be prepared to stand by your view today for a long time, as it will be on everyone’s parliamentary record. In weighing up whether to support the amendment, Members should bear in mind the fact that 78% of the public support it. This is why we are here as Members of Parliament—to make difficult decisions such as this, not to be blackmailed or held to ransom. This is why we are MPs—because our constituents expect us to be brave. They expect us to stand up in the face of blackmail and be accountable.

[Andrew Percy]

Will my hon. Friend give way?

[Nadine Dorries]

It does not happen very often in the House, but we have a conscience vote. It hardly ever happens, but we are all personally answerable for the decisions that we take. This decision is about nothing more than supporting an offer of counselling to vulnerable women who may need it and who may use it as a lifeline.

[Andrew Percy]

Will my hon. Friend give way?

[Nadine Dorries]

How many times do I have to say no to my hon. Friend?

This is about being accountable for our views, which is what Parliament is all about. I do not see why we should shy away from putting our positions on the record. If Members want to stand in the way of a woman’s basic right to independent counselling, then they should vote against this proposal. However, if they want to ensure that a woman can have access to very basic support, they should vote for the amendment. It is up to them—support these reasonable measures to provide all women with independent counselling, or stand in the way of that basic support.

This vote is about women. I want every woman in this country to be able to look every MP in the eye and ask, “How did you vote for me and my daughters? What was the decision that you took?” Every MP will be accountable for that vote and that decision today.

--- Later in debate ---

[Dr Huppert]

I am delighted to have a chance to speak in the debate. It is tempting to respond to all the comments made by the hon. Member for Mid Bedfordshire (Nadine Dorries), but I shall avoid doing so. Instead, I shall make just two points.

First, let me quote something that was said by the right hon. Member for Bristol South (Dawn Primarolo) before she became Deputy Speaker. She said of the hon. Member for Mid Bedfordshire:

“The hon. Lady has asserted many things to be facts that are not… Some of the things that she is saying are not borne out by the evidence.”—[Official Report, 20 May 2008; Vol. 476, c. 263.]

I think that that is extremely true.

[Nadine Dorries]

Will the hon. Gentleman give way?

[Dr Huppert]

Unfortunately there is not much time, but I will give way once.

[Nadine Dorries]

Would the hon. Gentleman care to be absolutely specific? Will he focus on what he thinks those facts are and then give me a chance to respond?

[Dr Huppert]

I am afraid that there will not be time to go through all that. The hon. Lady challenged me to comment on some evidence that she had provided, and then would not allow me to do so. The hon. Member for Totnes (Dr Wollaston) remarked on that.

The Royal College of Psychiatrists has clearly done a much better systematic review than the one the hon. Member for Mid Bedfordshire looked at. It shows:

“Where studies control for whether or not the pregnancy was planned or wanted, there is no evidence of elevated risk of mental health problems.”

As I have said, that is a much more detailed review.

Unfortunately, there is not sufficient time to cover all the other topics the hon. Lady would like to talk about. I congratulate her, however, as it takes a lot to unite Abortion Rights with the Society for the Protection of Unborn Children, both of which oppose her amendments. The SPUC has been very clear that it cannot ask MPs to support the amendments.

Let me move on, however, and ask whether there is actually a problem that we need to address: are there too many abortions? The best way to reduce the number of abortions is by empowering individuals, by providing better access to contraception and by providing better sex and relationships education at school to both boys and girls. Are there areas where we need better advice and counselling? Absolutely there are. People who have had a miscarriage do not get the counselling support that they desperately need. We should focus attention on that. For all the reasons that have been discussed, I urge the House to reject these amendments.

I want to speak in favour of my amendment 1252, which proposes that evidence-based advice should be given. Although the Government will not support the amendment if it is put to a vote, I was pleased to hear that they accept the principle behind it, which is that we want that expert advice. I am not a medical doctor—I am not an obstetrician or gynaecologist—but they have clearly stated what they think the best advice is, and it should be followed. We should expect all groups giving advice to live up to this high standard. Women—all people—should get proper medical advice, and it should be the best advice available. They should not be misled, and they should not have made-up risks told to them. The Royal College of Obstetricians and Gynaecologists has excellent guidance from 2004, and all organisations should stick to it. I confirm that the British Pregnancy Advisory Service and Marie Stopes stick to that guidance, and so should all other groups.

I trust the Government when they say that they will stick to that advice—the best medical advice. I have some concerns about some of the Government’s other comments however, and I hope to have a chance to talk to the Minister in greater detail, although this debate has not been the forum in which to do that. I urge the House to stand up for what it believes in, to reject the presentation we heard earlier and to reject the amendments.

[Nadine Dorries]

First, I should point out that the hon. Member for Cambridge (Dr Huppert) was referring to an older study.

We have heard a number of points of view. I take on board the comments of the right hon. Member for Birkenhead (Mr Field) and I appreciate the response from the Minister. She is my friend, and she has gone out of her way to understand the issue and to bring this debate to a calm and reasoned conclusion.

This debate is not just about my amendment. There are many people who support it, as I have frequently stated. [Interruption.] I have no idea why whenever I stand the hon. Member for Rhondda (Chris Bryant) always feels the need to continue chatting; he should just be quiet.

I heard what the right hon. Member for Birkenhead said, and I have listened to the Minister. Unfortunately, I am being urged by many other people, not least those who have told their stories, to go to a vote, because there are people who want a line drawn in the sand here. I shall therefore press amendment 1221 to a Division.

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 14

Other Services Etc. Provided As Part Of The Health Service

Amendment proposed: 1221, page 9, line 37, at end insert—

‘( ) After paragraph 8 insert—

“Provision of independent information, advice and counselling services for women requesting a termination of pregnancy

8A (1) A local authority must make available to women requesting termination of pregnancy from any clinical commissioning group the option of receiving independent information, advice and counselling.

(2) In this paragraph, information, advice and counselling are independent where they are provided by either—

(a) a private body that does not itself refer, provide or have any financial interest in providing for the termination of pregnancies; or

(b) a statutory body.’.—(Nadine Dorries.)

Question put, That the amendment be made.

Future of the NHS

Nadine Dorries Excerpts

Monday 9th May 2011 Commons Chamber

[Mr Lansley]

I suppose the one thing the right hon. Gentleman has learned about being in opposition is that it is best for a party to try to forget everything that it did in government, because it will not be held to account for it. He has also recognised that the best thing is to have no ideas of his own. He does not even seem to know whether he agrees with our ideas or opposes them. We do not have any answers from him. The right hon. Gentleman’s quotation was from the former, not current, chair of Monitor, who knows perfectly well that these measures were in our respective manifestos and were brought together in the coalition agreement. They have a mandate. From my point of view, this is not just about the electoral mandate but about how we can deliver the best care for patients and see through principles that I thought the right hon. Gentleman’s party, as well as ours, believed were right.

Let me make it clear that the challenges in the NHS are about more than just clearing up Labour’s mess. We must recognise that there are now more pensioners than children under 16, alcohol-related admissions to hospital have doubled and emergency admissions have risen by 12% in just four years. Obesity in this country has doubled in the last 25 years. Under Labour, the demand for health care was rising while productivity was falling. The only way that Labour could cover those risks was by massively increasing the budget and that is no longer an option. Mounting pressure on the NHS is inevitable and the status quo, as Labour recognises, is not an option. The NHS needs modernisation.

[Nadine Dorries (Mid Bedfordshire) (Con)]

Will the Secretary of State give us an update on the tally of the number of GPs who have signed up to the new consortia to support the NHS reforms?

[Mr Lansley]

Yes, I will. Some 220 pathfinder consortia have come forward, representing the equivalent of 45 million patients across England—that is, 90% of the population. They are not obliged to do so. They have volunteered to come forward to demonstrate that they can deliver better services for patients.