Pregnancy Counselling

Gavin Shuker Excerpts

Monday 12th December 2011 Commons Chamber

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

I am extremely grateful to you, Mr Speaker, for granting this Adjournment debate. Three months ago, during our debates on the Health and Social Care Bill, an amendment upholding a notion supported by 78% of the British public, that

“a woman should have a right to independent counselling when considering having an abortion, from a source that has no financial interest in her decision”

was put to the vote. It was voted down by a majority of three to one. I know this all too well because I intervened in the debate to say why I hoped it would not go to a Division. It felt misplaced in the legislation and followed a fractious debate that had been conducted in the papers and the media. It descended, as all such debates seem to, into a political bun fight. Indeed, one of the few voices of moderation—hon. Members might be surprised to hear me say this—was the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), who is in her place tonight.

The Government are rightly engaging in a consultation process to see how best to improve pregnancy counselling services. It is in that context that I sought this Adjournment debate. I hope that we can show, as a House, that we have the maturity to ask a simple question without descending into accusations either of betrayal or of compromise. The question we must ask is this: do the present arrangements for pregnancy counselling, when a woman is deciding whether to undergo a termination procedure or to make arrangements for seeing her pregnancy through, serve us well?

I should like to quote a few women who have spoken about their experiences of the pregnancy counselling system as it is currently constituted. All these women received taxpayer-funded counselling; they really are the most important voices we could hear from this evening. A woman called Jennie had a bad experience. She said,

“I felt this counsellor was disinterested. I actually told her to pay attention because this was important to me that I had this counselling. It was like she was thinking about her shopping and I was just choosing a handbag.”

Emma said:

“I felt irritated with the counsellor because she presented my abortion options like it was a sweet shop; ‘So what would you prefer? The pills that will do this, this and this or you could have a surgical procedure.’ I was so angry; I just told her I didn’t care.”

Other women have reported that they felt pregnancy option counselling simply was not made available to them. A woman called Kerry said:

“They did not offer me counselling. I was crying and screaming as I went for the abortion but they still went through with it. I was pressurised by my boyfriend. It is the first thing I think about in the morning and the last thing at night.”

Patricia was not offered counselling either. She said:

“I was never given any options. When I took the second pill I was sent home to have the abortion. I have not stopped crying ever since.”

It is tempting to dismiss these experiences, but they are real. Any mature debate will, I hope, avoid the accusation that these women are in some way rewriting their own history. Surely we should do all we can as a society to ensure that women, regardless of their choice in such circumstances, do not have to live with regret, in many cases for the rest of their lives.

At the heart of the proposal that all women should access independent counselling where the source of that counselling does not have a financial interest in their decision is a concern about the current arrangements. At present the only available taxpayer- funded pregnancy counselling is given by those working for abortion providers. Some have suggested that this means that counsellors will act unprofessionally, in a directive fashion. I do not suggest that, but I do have a concern.

When a pregnancy counsellor also works for an organisation that provides abortions, there is an underlying direction of travel. The expectation, for both the organisation and the woman accessing the service, is that the normal process will conclude in the termination of a pregnancy.

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

Given that the law gives a woman the right to choose, does the hon. Gentleman agree that a woman should also have the right to choose from where she gets her counselling? I have a wonderful lady in my constituency, Sarah Richards, who receives no funding for the women who come to her. She does not badger them in any direction. Would the hon. Gentleman like to see a woman such as Sarah Richards who provides such a service receiving the same payment as the British Pregnancy Advisory Service receives for the women it counsels?

[Gavin Shuker]

The hon. Gentleman makes an extremely good point about the experiences in his constituency. I will go on to talk about the system that I think might be able to facilitate something along those lines and address some of the concerns that, quite understandably, many people will have when they hear about those who are currently outside the system coming in as well.

It is reasonable to expect that women are offered, should they want it, counselling that does not have a connection and an underlying association with only one outcome.

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

My hon. Friend is making a very thoughtful case. Does he agree that we particularly want to avoid late terminations? They are stressful for women and they are obviously a cause of great concern. How would he be sure that directing women to sources of counselling outwith abortion providers would not cause delay?

[Gavin Shuker]

My hon. Friend makes an extremely good point. Where terminations are to occur, they should happen early. There is a concern that women who desire the kind of context in which they can make their own decision are provided for as well. There will always have to be a balance in any system, but there is an inherent risk in the system as it is currently constituted that women are not able to access that counselling.

It is reasonable that independent pregnancy counselling should be made available to all women who are considering their options. It might surprise the House to know that there is no legal guarantee that such counselling is available.

[Fiona Bruce (Congleton) (Con)]

I commend the hon. Gentleman for introducing this important debate. Does he also agree that where such counselling is offered, it should be provided by counsellors who have specialist training and experience in advising those who are in the situation he describes?

[Gavin Shuker]

The hon. Lady makes an extremely good point. I agree, and I will go on to say a few words about some of the criteria that we should look for in people providing such counselling in future.

I believe it is perfectly reasonable, in a debate as complex and fractious as this, to suggest that given the issues we have talked about, the most sensible thing the Government could do is take out of the equation the financial link between counselling and the procedure. I accept that there are opinions in all parts of the House, but one simple principle to enact—and one potentially complex thing to do—would be to take the financial link out of the process. Many would see it as wrong that pregnancy counselling is currently monopolised by those who are pro-choice. There is an imbalance in the system which means that, by and large, counselling is provided only by private abortion clinics. I encourage hon. Members, whatever their perspective on the issue, to consider this simple question: can it really be right that the only taxpayer-funded pregnancy counselling available is currently given by those working for abortion providers?

Counselling in this context should always be non-directive, client-centred and universally available, and the right to it should be legally protected, but I do not believe that it should be subject to a duopoly, as it is at present. If a provider can produce genuinely client-centred and non-directive counselling that is free from a financial link to any given procedure, I believe that the NHS should fund it. There are more than two such providers in the UK today.

In that light, I very much welcome the commitment that the Minister gave the House in September. She said:

“Whether women want to take up the offer of independent counselling will be a matter for them, but we are clear that the offer should be made.”—[Official Report, 7 September 2011; Vol. 532, c. 384.]

She also spoke of the difficulty in defining what was meant by “independent” in this context. For some it simply means non-directive, but for others it means independence from finance or independence of the organisational structure from the abortion provider. As I understand it, her Department has not yet given any assurance that the offer of independent counselling would by definition mean counselling by persons or bodies without any kind of vested interest in abortion provision. I ask her to reflect on this and reiterate her commitment that women will be offered independent counselling and that the way to ensure that is by creating a regulatory framework that recognises the provision of alternative sources of pregnancy counselling to those offered by the big two.

In this country we have more than 40,000 trained counsellors who are members of either the British Association for Counselling and Psychotherapy or the UK Council for Psychotherapy. I hope that the Department will liaise with both organisations and the Royal College of Psychiatrists in developing an entirely new approach to how pregnancy counselling is provided in this country.

I know I speak for many, both in the Chamber and outside, when I say that my preference would be for abortion clinics not to be provided in pregnancy options counselling, ensuring that every woman seeking such counselling would know that there is no financial relationship between counselling and the provision of a termination. However, I accept the Government’s position that the right way forward on this issue is through consultation that allows all parties to express their views. It seems entirely practical and plausible for the Government, using the resources currently available, to develop a system in which every woman considering her pregnancy is offered counselling, should she wish to have it.

Non-directive pregnancy options counsellors, who are excluded from the present state settlement, can offer practical advice and help for women who choose to take their pregnancy to full term and often an ongoing support relationship. The focus of existing providers, understandably, is whether to abort or not. Just as choices are wider than simply whether or not to have an abortion, so counselling should give recognition to and advice on adoption and fostering when a woman considers continuing with her pregnancy.

Let me turn to the inevitable charge that allowing counsellors who are pro-life in their personal lives into the system would be inherently damaging to women. It starts with an assumption that the present system is both neutral and independent and hinges on a prejudice about those who hold such convictions. Allow me humbly to disagree with this notion. First, if the debate this autumn taught us anything, it is that no one is neutral. On an issue of conscience, right-minded and well-meaning people will rightly disagree and end up on different sides of the debate, but they will hold a position of conscience that they feel strongly about, hence my suggestion that we do what we can do now, hence my call to break the financial link between counselling and the termination procedure, and hence my desire to ensure that there is no nagging doubt at the back of any woman’s mind about who is looking out for their interests.

Secondly, there is an assumption that people cannot park their personal convictions at the door. Every counsellor knows that pressure in any direction is counter-productive for a woman who wants to continue her pregnancy but needs the space to reach that conclusion herself. In a new system, every counsellor should know that, whether they are personally pro-choice or pro-life, any moves that depart from non-directive principles should endanger their ability to do such work in future.

Equally, I hope that being pro-choice would mean being pro-all-the-choices available to women and that some providers are more expert at providing additional choices to those currently available and funded within the present system. That is why I hope that providers who, as many Members have mentioned, are doing amazing work to support women who would otherwise have felt no option but to undergo an abortion will be welcomed into our present system.

As a House, we have always had the ability to bridge divides, overcome prejudices we see in one another and together find a better arrangement for those we are here to serve. I feel certain that there are women who are let down by the current arrangements. The right response for us is to come together in a spirit of respect, excluding no one or their views. The ongoing consultation by the Government is an opportunity for us to do so, and I hope that we will not be found lacking.