Conscientious Objection (Medical Activities) Bill [HL]

Baroness Barker Excerpts

2nd reading (Hansard): House of Lords
Friday 26th January 2018 Lords Chamber

[Baroness Barker (LD)]

My Lords, I declare an interest as the new chair of the All-Party Parliamentary Group on Sexual and Reproductive Health in the UK, a position that I have taken over from the noble Baroness, Lady Gould. I place on record my thanks to her for all the work that she has done during her time in that position.

In that capacity, I have had the great privilege of talking to my noble friend Lord Steel. He could not be here today but if he were then, like me, he would seek to vigorously oppose the Bill from the noble Baroness, Lady O’Loan. He would also have picked up the noble Lord, Lord Alton, on his partial quotation from 1967: what my noble friend went on to say was that conscientious objection was written into his Bill but with the proviso that no woman would be denied access to the services that would then become legal. He wanted to say to noble Lords today, had he been present: do not be fooled by this Bill. It would take us straight back to the period of the early 1960s, when practitioners such as the senior registrar in the West Midlands effectively denied women their legal rights.

I often talk to students about the contrasting systems of the US and this country when it comes to discussing and legislating on matters of morality and conscience. I draw a contrast with the US where, such is the level of religiosity in debate that no elected politician can go against the prevailing religious orthodoxy and therefore they do not, and matters of conscience and morality are litigated in the courts. We in the House of Lords do things rather differently: we bring in all shades of religious opinion and debate these matters extensively. I ask them to compare and contrast the two.

I think it is right that we have our system and that we engage in debates such as these. I therefore agree with the right reverend Prelate that it is important that we look at these matters in very informed and deliberative ways. I agree with him that it is perhaps time that we reviewed the 1967 Act; it was written 50 years ago and times have changed. Unlike him, I believe it is now too restrictive and wish to see it liberalised.

I want to address the issue of conscience. I listened very carefully to the speeches by the noble Baroness, Lady Eaton, and the noble Lord, Lord Elton. Someone reading our debate today might come away believing that it is only those who object to abortion who are holders of conscience and morality. I do not believe for a moment that is true. I remember talking to Lord Winstanley, a young doctor who helped my noble friend Lord Steel to take—

[Lord Elton]

Would the noble Baroness give way? I made it clear at the beginning that the question of whether you believe an act is right or wrong is absolutely immaterial; what matters is the effect on the person. I attribute no beliefs to anyone.

[Baroness Barker]

The point that I wish to make stems from exactly that. Noble Lords will remember that during the passage of the Marriage (Same Sex Couples) Act there was a proposal that registrars, who are public servants, should, according to their conscience, be permitted to deny services to people who would be married under that Act. The effect of that would have been that were people like me, and in this case the noble Lord, Lord Cashman, to turn up to a register office to register the death of our loved one, we would not be accorded the same treatment and dignity as any other person.

The noble Baroness, Lady Young, talked about the United States of America. The Bill is one example of a much larger movement in which people who oppose certain legislation on matters of what I would consider to be social progress use the issue of conscience as a proxy by which to undermine laws which are democratically passed. That is a serious and insidious development, and one that we in this House should strongly resist. This is not about the clarification of conscience, it is about the extension of people’s rights to opt out of provisions of laws which have been carefully considered and agreed in great detail in our democratic institutions.

The impact of the Bill is exactly what the noble Baroness, Lady O’Loan, sought to deny. She said that this is not about restricting access to services. It absolutely is. We already have examples of that. We have examples in the NHS of GPs who refuse to provide access to contraceptive services. There are boroughs in London where there is no provision. What happens in those circumstances? It is poor women and women who do not have the freedom or wherewithal to travel elsewhere to get those services who suffer.

This is a deeply pernicious Bill. I hope that, when we get the opportunity to do so, we will vote against it in such overwhelming numbers that we put an end to the arguments that lie behind it, which I believe are thoroughly disingenuous.

[Lord Elton]

Before the noble Baroness sits down at the end of a powerful and lucid speech, as she is sitting on the Front Bench, is she delivering the line of her party on the Bill or is she speaking personally?

[Baroness Barker]

I make it absolutely clear. As on all other Benches, we have a variety of beliefs on this subject, but what I can say in all clear conscience is that I represent the majority of my colleagues on these Benches.

[Lord Swinfen (Con)]

Perhaps the noble Baroness will answer one simple question to clarify what I think she said. Am I right in thinking that she said that a medical practitioner who had a conscientious objection to helping with an abortion would still have to help with an abortion if it was necessary? That is what I understood that she said.

[Baroness Barker]

For the avoidance of doubt, I agree with the statements made in the court judgment of 2016: that no practitioner should be compelled to take part in the hands-on offering of a procedure, but they cannot indirectly deny women access to treatment to which they are legally entitled.

Conscientious Objection (Medical Activities) Bill [HL]

Baroness Barker Excerpts

Committee: 1st sitting (Hansard): House of Lords
Friday 23rd March 2018 Lords Chamber

In concluding, I urge those who have tabled these amendments to talk to us so that we can discuss a way forward that would meet their concerns As tabled, these amendments would not enhance the situation of all those who are regulated by the organisations in Clause 1(2)—we will come back to that important part of the Bill—nor would they enhance the experience of patients. Patients would still be able to accept the same services. It is possible to provide autonomy for patients and protect the conscientious objection of medical practitioners. They are not mutually exclusive—a recognition, perhaps, of the human rights of which the noble Lord, Lord Brennan, so eloquently spoke.

[Baroness Barker (LD)]

My Lords, time is against us. For me, that is deeply frustrating because I have listened with great care to a number of very important points as well as a number of somewhat contentious allegations and assertions being made throughout the debate, each and every one of which should be subject to a great deal of scrutiny in your Lordships’ House.

In the short time available to me, I wish simply to say this. The noble and learned Lord, Lord Mackay, as ever, gave one of the most interesting and thought-provoking speeches. He talked about the nature of conscientious objection, and I think that issue needs further examination. It is important to look not only at the nature of conscientious objection—some such objections are absolute, others are not—but at the context in which it is exercised. If there has been a fundamental flaw in this debate, it is that we have not debated those two things together. That has enabled claims to be made on either side that I believe are not fully justified.

From where I am sitting and from the briefings I have had, I would say that conscientious objection must seek to balance the rights of healthcare professionals to act within their own ethical principles with the rights of patients to access medical care. The noble Baroness, Lady O’Loan, was half-right when she said her Bill as drafted would not remove the necessity for the NHS to provide access to abortion care. No, it would not; it would simply frustrate it. In practice, that would mean the denial of service to a woman. The exercise of conscience is not without effect.

The noble and learned Lord, Lord Mackay, said he is relieved that he is not a medical professional. So am I, but I do pay great attention to those who are. In this case, notwithstanding the point rightly drawn to our attention by the noble Lord, Lord Winston—that there is not total agreement among members of the professional bodies—those bodies have considered this issue over the last 60 years. They were involved in the discussions before my noble friend came forward with his landmark legislation, and over time came to conclusions that their members in the NHS—all 1 million of them—have to accept. They are the people for whom this is not a theoretical debating point; it is the exercise of life-and-death judgment.

Medical ethics are not the preserve only of those who have conscientious objection. Healthcare professionals who provide these services do so for the good of their patients, and this Bill, as currently drafted, threatens that. Therefore, at this late stage, I have to say to the noble Baroness, Lady O’Loan, that I welcome her invitation to talk, although I do not hold out much prospect of agreement because I think that we come from fundamentally different places.

The House should think long and hard about the words of the noble Lord, Lord Turnberg, regarding what the Bill might mean. In doing so, it is incumbent on all of us to consider whether this is an improvement on the point that my noble friend Lord Steel reached 50 years ago in anticipation of the problems that we now seek to address. I support the amendment.

[Baroness Thornton]

I just want to add two words to that. The noble Baroness, Lady Barker, is completely correct. The noble and learned Lord, Lord Brown, and my noble friends Lord Turnberg and Lord Cashman have summarised the situation. I think that the noble Baroness, Lady Barker, is right: the Bill does not improve the position that the noble Lord, Lord Steel, came to all those years ago.

I say to the noble Baroness, Lady O’Loan, that assertion is not evidence. I read her speech at Second Reading in which she used the word “evidence” but did not give us any evidence. Assertion is not evidence. In this Chamber, when you want to make a case and prove it to noble Lords under the scrutiny system, the evidence has to be evidence and not assertion.