A and E Departments

Sarah Wollaston Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

I agree that there have been teething problems with 111 and we are addressing those problems. [Hon. Members: “ Teething problems?”] There is laughter on the Opposition Benches. We are hitting our A and E targets at the moment, and 111 is available in more than 90% of the country. We are dealing with those teething issues, but I take on board the right hon. Gentleman’s point. The 111 service needs to be quicker at getting advice to people from a GP or a nurse. The fundamental issue with 111 is that giving the public an easy number to remember has highlighted how inaccessible GP out-of-hours services have become. We have to address that if we are to restore public confidence in 111.

[Dr Sarah Wollaston (Totnes) (Con)]

If someone cannot get an appointment with their family doctor, they are undoubtedly more likely to end up in A and E, but does the Secretary of State agree that we will not increase capacity in primary care unless we address the work force shortage in general practice and broaden the skill mix of those who can see people in primary care?

[Mr Hunt]

I agree with my hon. Friend. Under this Government, we have 6,000 more doctors than we had under Labour, but we need more people going into general practice as well. [Interruption.] Yes, the training might have started under the Labour Government, but the funding happened under this Government, and it would not be possible if we cut the budget, which is what the Labour party still wants to do. She is right to point out those issues, however. One way of making general practice more attractive is to restore the personal link between GPs and the people on their list and a sense of personal responsibility and accountability. We need to find the right way of doing that, given the pressures on general practice at the moment, and I hope to work with her and many others to do that.

Mental Health

Sarah Wollaston Excerpts

Thursday 16th May 2013 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

It is a pleasure to follow the hon. Member for Islington North (Jeremy Corbyn), who made some powerful points. Perhaps I might add to what he said about the appalling difference in respect of the use of compulsory detention under the Mental Health Act 1983 for those from black and ethnic minorities. We heard in evidence that the fear of this among some communities is acting as a deterrent to seeking early help. We must address that, making sure that people do have that access and that that fear is removed from communities in order to improve health for everybody.

I wish to begin by stating for the record that I am married to a consultant NHS psychiatrist who is also chair of the Westminster liaison committee for the Royal College of Psychiatrists, which provides impartial advice to all political parties on psychiatry. He is also now a clinical director of NHS England’s mental health and dementia network in the south-west.

The corresponding debate last year focused importantly on the issue of stigma in mental health, and I congratulate the ongoing work of Time to Change in reducing stigma. The other issue that was raised, which many Members have focused on today, was parity of esteem. It is wonderful that that important principle is established within the Health and Social Care Act 2012, but we now need to ensure that that translates into action and practice on the ground. As we have heard, 23% of the overall disease burden lies in mental health, but we all recognise from stories that we hear in our constituency surgeries, and from clear evidence, that that does not translate into either funding or our constituents’ experiences of services. How are we going to see that translated into action? We need to look at the evidence of what works and to focus on the outcomes.

We know that 30% to 65% of hospital in-patients have a mental health condition and that mental health and physical health are inextricably linked. Not only is someone more likely to suffer from a mental illness if they have a chronic long-term condition, but someone who has a mental illness will find that there is an impact on their physical health. We have heard again about the scandal that the life expectancy of people with a serious mental illness will be shortened by between 20 and 25 years.

[Anna Soubry]

My hon. Friend is picking up on the point made by the hon. Member for Islington North (Jeremy Corbyn) about there being a real link between public health issues such as smoking and alcohol, and mental health issues. Does my hon. Friend agree that we can do great work in this area at a local level, especially under the new arrangements whereby public health is devolved back down to local authorities, where it used to be and always should have been?

[Dr Wollaston]

I am grateful to the Minister for that intervention. There has been a consistent tendency to ignore physical health problems in those who have severe mental health illness. She is right to say that putting in primary prevention work locally is important, but the Government could perhaps do more on primary prevention, through having a relentless focus. I am grateful to her for the personal support she has given to addressing issues such as alcohol pricing and the availability of ultra-cheap alcohol. Such issues are very important, and the Government need to deal with them to support the work that is being done. Minimum pricing is, of course, not a magic bullet, but unless we address the issue of ultra-cheap alcohol all the other measures that public health directors wish to take within local communities risk being undermined.

[Anna Soubry]

Does my hon. Friend agree that we can do great work on the minimum pricing of alcohol at local level? I urge her to examine the work being done in Newcastle and, in particular, in Ipswich, where all the agencies are coming together. We have seen supermarkets and many off licences agreeing not to sell cheap beer and lager. Does she agree that such an approach has the potential to be a better way—I think it is one—of dealing with this issue than minimum unit pricing?

[Dr Wollaston]

Although I absolutely agree that those projects in Newcastle and Ipswich are impressive, there will, unfortunately, always be ways in which they can be undermined. In my area we can find an example of maximum alcohol pricing, whereby white cider is being sold at a maximum price of 23p a unit, and that is destroying areas. There will always be a way for people to get around a minimum pricing level and, although we can see real benefits from these projects, particularly for street drinkers in isolated pockets, I feel overall that minimum pricing would be a good way of addressing this issue on a wider level. But I will not focus on that today.

I want to draw attention to the evidence on providing integrated services. Mental health and physical health services should be much better integrated. Is the Minister aware of the recent report by the Centre for Mental Health and the London School of Economics, which evaluated the use in Birmingham city hospital of the RAID service—the rapid assessment interface and discharge psychiatric liaison service? Is the Minister aware of the role that liaison psychiatry plays? Such services are greatly appreciated by patients and provide an excellent way for them to receive services; moreover, they are incredibly cost-effective. By providing rapid access to a professional service, not only for in-patients but for people who attend accident and emergency services and those who are seen by the poisons unit, it reduces re-admission rates, provides better care and far better outcomes, and saves money. The pressure on A and E services has been much in the news in recent weeks. Liaison psychiatry reduces re-attendance at minor injury units and A and E departments, so such services are vital. It would be really helpful to know whether the Minister is aware of the evidence base and will be promoting liaison psychiatry services.

I want to talk about social exclusion and the role of mental health services in social exclusion. If a person is homeless, they are far more likely to suffer from mental health problems. Equally, if a person has mental health problems, they are very much more likely to end up homeless and on the streets. In my area of Totnes, we tragically have suffered some deaths among our homeless population. We know from those who provide help to the homeless in south Devon the level of dual diagnosis—the number of people who have both mental illness and, for example, addiction problems. I would very much like to hear from the Minister in her summing up what work will be done to improve access to dual diagnosis. I pay tribute to Mark Hatch and the work that he has been doing, alongside very many dedicated volunteers, with the Revival Life Ministries and with Shekinah, providing an outstanding service to our local community.

I want to raise a point about access to GP services for the socially excluded and homeless. In coming months, there will be much focus on how we reduce health tourism. If, in reducing health tourism, we require people to bring a passport to their GP in order to be registered, very many people who are socially excluded will not be registered because they simply do not have access to identification. I ask the Minister, in addressing an important problem of great concern, to be particularly careful to avoid making it even harder for the socially excluded to obtain help with their problems. That would be a real avoidable tragedy.

Prior to the debate, a constituent wrote to me most movingly about the Cinderella service around autism, and lack of access to mental health services for those who suffer from autism, which has a knock-on effect on their carers. Listening to accounts from parents, who have been struggling for so long to obtain the help that their children need, and their description of what happens as their children move into adult services, it becomes clear that that is an area where services genuinely need to be improved. I look forward to hearing from the Minister what more can be done.

Finally, I return to the Health Committee’s review of the Mental Health Act. Would the Minister look at the evidence on the variation in the use of community treatment orders around the country, and tackle that variation? It cannot be right that in some parts of the country they are not used at all, while in others they are heavily used. The evidence base on their effectiveness is very poor. Should the Government lead on that, or should the royal colleges take a lead, so that we have a system that is transparent and used equally around the country?

Oral Answers to Questions

Sarah Wollaston Excerpts

Tuesday 16th April 2013 Commons Chamber

[Mr Hunt]

It is an additional 4 million since the disastrous changes to the GP contract and an additional 1 million since the last election.

[Dr Sarah Wollaston (Totnes) (Con)]

In Brixham in my constituency, 94% of five-year-olds are protected against measles. Just up the road in Totnes the figure is only 70%. There are many reasons for the variation, but does the Secretary of State share my concern that if parents believe they are protected by, for example, homeopathy products, they might be less likely to use an evidence-based treatment? Will he make an unequivocal statement that such products will not give any protection?

[Mr Hunt]

I am happy to do so and thank my hon. Friend for bringing up the issue. There is no scientific evidence whatsoever that homeopathic products can provide protection against measles. The right thing to do is to get two doses of the MMR jab. As I said earlier, anyone whose children, whatever their age, have not had those two doses should contact their GP.

Immigrants (NHS Treatment)

Sarah Wollaston Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

The Government are not going to take any lessons in overblown rhetoric when Labour Members talked about this problem for 13 years and did absolutely nothing about it. What was missing from the right hon. Gentleman’s remarks was a proper apology for Labour’s total failure to control our borders during a period in office that saw a quadrupling of net migration. We do not know how many people are residing in this country illegally, but in January the London School of Economics published a report stating that it could be nearly 900,000 people, in which case the cost will not be a few millions but many, many times that. In 13 years, Labour did not change eligibility for access to free NHS services and did nothing to improve the collection of proper dues from people coming from outside the European Union.

The £20 million figure that the Prime Minister’s spokesman used this morning is the amount of uncollected debt that is owed to the NHS by foreign nationals. If the right hon. Gentleman had listened to my response, he would know that we believe—of course it is impossible to get exact figures on this because of the total mess that the previous Government created—that we identify less than half the people who should be paying for NHS care and collect less than half the money that should be collected.

Of course we will work with very closely with Scotland, Wales and Northern Ireland to ensure a co-ordinated approach. If the right hon. Gentleman had listened to what I said, he would have heard that the exemption for emergency care and for public health issues will remain in place, which is extremely important.

Let me finish by talking about A and E issues. The reality is that the LSE estimates that about 70% of those living illegally in the UK live in London, where A and Es happen to face some of the biggest pressures. University College London Hospitals NHS Foundation Trust opened a new A and E only in the past few years and it was built for a capacity of 65,000 people a year, but it is now seeing 120,000 a year. If the right hon. Gentleman’s Government had done something about this rather than talk about it, A and Es across London would not be facing the pressure they are now facing.

[Dr Sarah Wollaston (Totnes) (Con)]

Will the Secretary of State publish the names of those trusts that are abjectly failing to identify and recover charges from those who are not entitled to free care?

[Mr Hunt]

My hon. Friend makes a reasonable point. Part of the problem is that when we should be identifying someone as a foreign national who should pay for their NHS care, that does not happen a lot of the time because of the incentives in the system. Under the NHS improvement initiative, which is taking place in London at present—it is worth looking at that closely, because it has a lot of promise—there is a centralised collection of debt from foreign nationals who owe the NHS so that that does not become the responsibility of individual hospitals, which is something that is putting them off registering people as eligible for their NHS care.

Accountability and Transparency in the NHS

Sarah Wollaston Excerpts

Thursday 14th March 2013 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

I want to start by thanking the vast majority of staff in the NHS, who go to work every day motivated to serve their patients and deliver world-class care.

We should not think that we can just return to the halcyon, storm-free days of the 1970s, when NHS care was perfect. Before I started medical school, I worked as a nursing auxiliary, which would now be called a health care assistant, in what was then known as a geriatric hospital. I have no wish to return to the days of vast, mixed wards and a rather authoritarian approach to care. I would far rather the NHS of today than that of the 1970s.

However, the mantra that the NHS is the envy of the world sometimes gets in the way of providing decent feedback and criticism when things go wrong—and after listening to the words of the right hon. Member for Cynon Valley (Ann Clwyd), who could say that things do not go wrong? The failures at Mid Staffs, and the fact that more than 1,000 people died in a single hospital, are truly shocking. Robert Francis told the Health Committee that he had spent three years of his life “listening in horror”—how shocking! It is hard to imagine any other institution or organisation where death on that scale would not have led to prosecutions, yet too often in the NHS it is not prosecutions that follow but promotions, just as it was in this case.

It has, unfortunately, become something of a heresy to criticise the NHS, and my comments are not to be interpreted as criticising the vast majority of staff, but rather as a means of considering how we can help those staff and their patients. It is vital that NHS staff are free and feel safe to raise concerns. This week, at a meeting in the House that I was chairing, Robert Francis spoke about “complaints being a gift”, but that is not the experience of staff or patients within the NHS.

The Health Committee conducted an inquiry into complaints and litigation in the NHS that reported in June 2011, and I wish to read from the chilling evidence that we heard from Nicola Monte. She spoke of her experience of being barrier-nursed in Stafford, and said that a nurse came into her room and berated her saying, “I have been off sick because of you complaining about me. Do you realise the suffering you have caused me?” Too often, staff end up feeling that they are victims because—as they know—they are often scapegoated for what are system failures, often by management. That runs throughout the NHS; the response to complaints is defensive and dismissive and that must change if we are to implement what Robert Francis rightly recommends as a new culture change of openness, transparency and candour within the NHS.

I hope, however, that no one will think that introducing a statutory duty of candour can be a single approach. That will not work without a culture change that supports and welcomes complaints as a “gift” to identify problems and improve care. I hope the Government will implement in full the recommendations made by Robert Francis so that complainants are regarded not as the problem but as part of the solution.

I particularly welcome the Secretary of State’s announcement that gagging clauses are to be outlawed with immediate effect throughout the NHS but—I hope he will not mind my saying this—that must extend to the top of the system. Would the Secretary of State feel it appropriate for David Nicholson’s secretary to have the following clause in his or her contract:

“That they should avoid associating themselves with recommendations critical or embarrassing to the NHS commissioning board”?

I think we would find that wholly unacceptable, yet, if I may refer Members to the ministerial code of conduct, the Secretary of State’s Parliamentary Private Secretary, who is not a member of the Government, has exactly that clause within his contract. That is something we have to change because the culture of the NHS must extend from the Department of Health to the nursing auxiliary—or health care assistant—at the bedside, and to patients so that they and those around them feel safe and able to raise complaints.

[Mr Cash]

Is my hon. Friend aware that Public Concern at Work, to which I referred in my witness statement on Stafford hospital, has played a big role in highlighting whistleblowing and has set up a commission to look at that issue? The outlawing of gagging clauses should apply not only on severance, but also—emphatically—when people are in post so that they can be properly protected when acting in the public interest.

[Dr Wollaston]

I absolutely agree. This is about starting to identify the culture and values of the people we employ in the NHS, and making it clear that not only does everyone in the NHS have a duty to bring forward concerns, but that those concerns will be welcomed and acted on. I would like everyone in the NHS to have an individual to whom they can go and feel safe in raising their concerns. I thank my hon. Friend for raising that point.

My hon. Friend the Member for Reading East (Mr Wilson) has told me that he does not feel that he has been gagged, which is great, but there is still an important point of principle: as a PPS, he is not able to speak in this debate. We want everyone, from the very top of the NHS and the Department of Health, right through to the bottom of the system, to feel that they are fully free to raise any concerns they have, wherever they may be.

After the Bristol heart scandal, whistleblower Stephen Bolsin was asked how we could prevent this from ever happening again. He said:

“Never lose sight of the patient.”

His whistleblowing cost him his career. He first raised the alarm in 1989. His work over six years to raise his concerns remains one of the single most important improvements in clinical outcomes in the NHS—that is how important whistleblowers are to our system. Yet the scandals keep happening. Would it not be a tragedy if, five years from now, we were still saying, “We need to put patients at the heart of everything we do in the NHS”? It is time to make that happen.

Social Care Funding

Sarah Wollaston Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

I am afraid that what the hon. Lady says sums up the attitude of the Opposition; they thought it was wishful thinking to try to solve this problem, whereas we are getting on with a solution. We do not have those financial products available at the moment, but the whole point of these structures is that we will help to create a market in which it is possible to have them. The point of the cap is to allow the hon. Lady’s constituents, even people on lower incomes, to plan and make provision, not only for costs of more than £75,000, but for any costs they have up to £75,000. In combination with that, we are increasing the threshold for Government support from £23,000 to £123,000.

[Dr Sarah Wollaston (Totnes) (Con)]

I warmly welcome today’s statement, particularly the rise in the asset threshold, as I well remember my former patients’ shock when they realised that for anything over £23,250 they would have to meet their entire costs. However, may I ask the Secretary of State to look again at the impact there will be on rural local authorities, for example, Devon’s, which has the fifth oldest population in England?

[Mr Hunt]

I will certainly do that, and I am grateful for my hon. Friend’s comments. I would just say that it is in some of those areas with the highest proportion of older people that the impact of the current lottery in care provision is so dramatic and needs addressing so quickly. I therefore hope that her constituents will welcome the certainty in these proposals, but I will certainly look at and identify whether any particular issues are raised in rural areas.

NHS Funding

Sarah Wollaston Excerpts

Wednesday 12th December 2012 Commons Chamber

[Andy Burnham]

I hear reports from ambulance services all over the country that they simply cannot hand over patients at the door of A and E departments and are having to queue outside. Consequently, large swathes of the country are being left without adequate ambulance cover. That is unacceptable, especially as we go into winter and temperatures drop. We need to see some evidence that the Government have a grip on these things. I have been told that large parts of my constituency have occasionally been left without adequate ambulance cover. We must have answers on these matters today.

[Dr Sarah Wollaston (Totnes) (Con)]

I am very disappointed to hear the right hon. Gentleman talk down the NHS. As he has just acknowledged, before the election the NHS knew that it was facing an unprecedented efficiency challenge. He will also know that under Labour productivity in the NHS fell continuously. I wonder whether—[Interruption.] Okay, but for almost every year—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The hon. Lady needs to ask a sharp and punchy question as an intervention, and very quickly.

[Dr Wollaston]

Will the right hon. Gentleman acknowledge the NHS’s achievement in making a productivity gain?

[Andy Burnham]

The hon. Lady just made another untrue statement. She talks about talking down the NHS, but productivity has not fallen. I am sorry, but let us have some honesty. We are not just going to sit here and take one statement after another—

NHS Commissioning Board (Mandate)

Sarah Wollaston Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

Let me say to the hon. Gentleman that we have 17,000 fewer managers than when his party was in power. We also have 3,500 more doctors and there are more clinical staff in the NHS today than when his party left office, so I think the record speaks for itself. There is not a climate of fear—I reject that. There is an understanding that the NHS is under a lot of pressure, with an ageing population and more people using and needing its services every year. That is why today’s package is so important to support the NHS in delivering what the public need.

[Dr Sarah Wollaston (Totnes) (Con)]

At long last, the NHS will be operationally independent, and genuinely clinically led. I welcome the mandate: it is an excellent and ambitious target for the NHS. Will the Secretary of State reassure the House that, in these challenging times, efficiencies made in the NHS will be genuinely reinvested in patient services?

[Mr Hunt]

My hon. Friend, as a GP, will recognise from the mandate that a lot of the improvements that we need in the NHS are in primary care. The budget for the NHS is protected, but demand for services is going up, so we need to make these changes. I will give her one example where I think that this is particularly important. The number of hours it will save GPs if the majority of prescriptions are ordered online, which does not happen at the moment, could transform life for more than 8,000 GP surgeries up and down the country.

Regional Pay (NHS)

Sarah Wollaston Excerpts

Wednesday 7th November 2012 Commons Chamber

[John Pugh]

I do not think that that is the case, or that the right hon. Gentleman thinks so, but he ruined my punchline, which goes like this: if the South West consortium is even more schizophrenic than the Government on this, it must be made to come to its senses.

[Dr Sarah Wollaston (Totnes) (Con)]

I ask the hon. Gentleman please to withdraw his comment about this being a schizophrenic response. It is really unfortunate when people use the term “schizophrenic” to refer to very important decisions, because it minimises the impact of schizophrenia on sufferers. May I ask him to rephrase his comment?

[John Pugh]

I cannot take it off the record, but I do take the point that the hon. Lady has made.

--- Later in debate ---

[Alison Seabeck (Plymouth, Moor View) (Lab)]

It is a pleasure to follow the hon. Member for Aberconwy (Guto Bebb), who very openly mulled over some of the problems posed by regional pay.

The unfairness, irrationality and economic illiteracy of the proposal made by the south-west cartel, as highlighted by the hon. Member for Southport (John Pugh), who is no longer in his place, are stunning. The upshot of the documents that have been leaked to the public has been an outcry in my region. I, too, have received hundreds of e-mails and letters from local people who are concerned about what they see as an unfounded and unfair attack on hard-working Plymouth families.

The south-west proposals are tacitly supported by the Government. When questioned in the House, they washed their hands of any responsibility for the action being taken by the 20 trusts in my region. Why is that? Is there something about the south-west? Did the Government believe that the south-west would be supine because there are lots of Government MPs in the region? Did they think they would try regional pay in the south-west and put their toe in the water and perhaps that nobody would notice—after all, it is a long way from London? Did they think, “We now have regional pay in the south-west. It’s a good idea, so we’ll roll it out in the rest of the country”? The response from people across the party divide in the south-west, including those working in the NHS, has put the proposal firmly in its place. We will not accept it or take it lying down.

[Dr Wollaston]

Does the hon. Lady agree that there are concerns in the south-west that regional pay will impact on the ability to recruit in certain key specialties?

[Alison Seabeck]

The hon. Lady speaks from a wealth of experience of working in the NHS. She is absolutely right on that point, which I will make more of later in my speech.

The public have a right to know what the Government’s position is, but as with so much else, confusion reigns. The Deputy Prime Minister has said at times that he is not in favour of regional pay, but it will be interesting to see how he votes today. The Chancellor of the Exchequer is clearly in favour, but the Prime Minister says nothing. The Secretary of State for Health has not helped to clarify matters today. The amendment, which is in the name of the Chief Secretary to the Treasury, is interesting. It states that the Government will not go down the route of regional pay

“unless there is strong evidence and a rational case for proceeding”.

How will the Government consult and gather the evidence to decide whether there is a rational case for regional pay? When will the Minister make the evidence available to Members of the House?

The Government must understand that the proposal is causing huge concern. The debate is not just about public sector pay restraint. Labour Members have accepted that there needs to be restraint in the public sector. We are not saying that that should not happen in times of austerity, but there is a need for equal pay for equal work. It is wrong if a nurse in Plymouth, working the same hours, doing the same job and providing the same high-quality care, is paid less than her counterpart in a hospital in Peterborough or Preston.

Induced Abortion

Sarah Wollaston Excerpts

Wednesday 31st October 2012 Westminster Hall

[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.