Health and Care Bill

Jess Phillips Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jess Phillips (Birmingham, Yardley) (Lab)]

Will the hon. Lady give way?

--- Later in debate ---

[Jess Phillips]

I had not intended to be here at all today. Sadly, my mother-in-law died of a heart attack very suddenly on Friday, so women’s health and how we treat it is at the very top of how I am feeling at the moment. My mother-in-law, much like my own mother, who sadly died as well, sent her children to women’s liberation playgroup. She would not have forgiven me for not turning up for the opportunity of a free vote, so here I stand. Her name was Diana, and I feel that days like this are often dedicated to the Dianas of this world.

I want to respond to some of what has been said about coercion and control. I respect the hon. Member for Congleton (Fiona Bruce) and her firmly held views, and I would go down fighting for her right to hold those views. Had she allowed me to intervene on her earlier, I would have asked her whether she could tell me which expert agency that deals with violence against women and girls agrees with her. I represent the entirely alternative view. Maybe she and I could just both be honest and say that, largely, the detail in front of us does not necessarily matter: she thinks one way and I think another, and we should just be honest about the reality of that situation.

There is no evidence that coercion will be a concern any more than it already is. That is not my experience, from years of working with victims of sexual violence, sexual exploitation and abuse. The problem is not usually that they are forced to have abortions but the alternative: they are forced to go to term. They are scared. I worked with a beautiful woman called Natasha who was killed when her violent ex-partner found out that she had had an abortion. He murdered her. That is the normal pattern.

[Sir Peter Bottomley]

The evidence that has been given to me is that virtually every group concerned with violence against women and girls supports the use of telemedicine, as do Dame Clare Gerada and Dame Lesley Regan, who are leading doctors, gynaecologists and obstetricians. Lastly, with telemedicine consultations, the period of time before an abortion has been halved, not increased.

[Jess Phillips]

I agree 100% with every word that the Father of the House has just said. There is no expert opinion group that agrees with the view put forward by the hon. Member for Congleton, who cited the secretariat of a pro-life group. By the way, I am pro-life: I am pro the people who live being able to make choices. I am incredibly pro-life—I am just also pro-choice. I hate the terminology that suggests somehow one side is pro-life; what is the alternative?

[Alec Shelbrooke]

First, may I offer my condolences for what must be a very difficult time for the hon. Lady and her family?

There has been a lot of conversation in which people have said, “You’ve got no way of knowing that it is going to be less than nine weeks and six days.” Will the hon. Lady address that particular point, which is very important to how people have been trying to frame the debate?

[Jess Phillips]

I have heard similar framing, with some saying people will take the pills after 10 weeks. If we look at the actual data, we see it shows that the change increased from 25% to 40% the proportion of abortions happening before six weeks. Telemedicine has dramatically reduced the gestational period, making it much less. I am afraid to say that these are not a good faith arguments. They are based not on fact, but on the idea that women will lie. Women are concerned about their health. They are frightened about their health. We do not make decisions about our health in the hope that we will be harmed; we do what is best. We should not be treated like children; we should be treated like adults.

[Mrs Maria Miller (Basingstoke) (Con)]

I thank the hon. Lady for giving way and add my condolences to those of others for her sad loss.

The hon. Lady is right when she says that these issues can be entrenched and people have entrenched points of view. When we have that situation as a House, we look at the facts and at what the experts say. The experts who support Government amendment (a) in lieu of Baroness Sugg’s Lords amendment 92 include the vast majority of professionals: the Royal College of General Practitioners, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the British Medical Association; and the Academy of Medical Royal Colleges. Does the hon. Lady agree that, when it comes to trying to find a way forward through entrenched views, we should look at the experts, and the experts are giving us a very clear way forward, followed by my hon. Friend the Minister?

[Jess Phillips]

I absolutely agree. It is difficult to be dispassionate. I have never been accused of being dispassionate about anything. I am passionate about what I eat for my breakfast. I am just not a dispassionate sort, but the right hon. Lady is absolutely right that we must look at column A and column B in this instance. Column A is full of experts—medical experts, women’s rights experts, and women themselves—and a huge amount of evidence.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I just wanted to add to the list that the right hon. Member for Basingstoke (Mrs Miller) just read out the World Health Organisation, which also says that telemedicine is safe, and the National Institute for Health and Care Excellence, based in the United Kingdom, which made a recommendation in 2019 about the safety of telemedicine for abortion.

[Jess Phillips]

I totally agree with my right hon. Friend. Actually, if people are against telemedicine for abortion, they might have very strongly held views about not liking telemedicine for anything. By that virtue, they should be against it for everything. For all the people who are desperately worried about vulnerable women—victims of domestic abuse and victims of sexual violence—not being able to access healthcare, I say come on and join me. They are absolutely right: there is zero availability of most mental health support. There is zero chance of getting a GP appointment any time soon, but somehow, people are against telemedicine only on this issue.

Often in debates, we do not stand up to seek to convince others. That only happens when there is a free vote—when actually the debate is really important. To people who are unsure, I say that I understand it—I totally get it—especially if they do not necessarily have so much skin in the game have but a huge load of emails in their inbox. The reality is that if they are not sure, they should either try to be convinced by the debate and the evidence, or they should simply abstain on the issue.

This is not particularly difficult for me. As I have said, I am not a dispassionate sort. I have stood in this House before and said that I have had an abortion. I do not feel devastated by that fact. I think we need to be clear about this. In this place, we only deal in hard cases, because they tell the argument much better. One thing I would say about when I had an abortion is that the worst process of having an abortion is the waiting. I had made the decision about what I was going to do with my body. I had made it the second that I saw I was pregnant on a pregnancy test, because I am an adult woman, completely capable of handling my own body and knowing my own mind, and that is how we should treat every woman in this country.

[Fiona Bruce]

On that point about adult women, and the point about the number of professional organisations that have been quoted, as if there were universal support for the continuation of telemedicine, I will mention two organisations, with particular reference to young people. The National Network of Designated Healthcare Professionals for Children, NHS doctors and nurses who work in the area of children’s safeguarding, has welcomed the Government’s decision to end the provision, and the Royal College of Paediatrics and Child Health recently released a statement:

“Children and young people under the age of 18 and Looked after Children up to the age of 25 must be offered and actively encouraged to take up a face-to-face appointment to assess gestation, support their holistic needs and assess any safeguarding issues as part of the pathway for early medical abortions.”

[Jess Phillips]

I could not agree more. People should absolutely be able to access a face-to-face appointment where they want and need one, and there is not a single thing in the legislation that would prevent that. I go back to this idea: “If you don’t like abortion, don’t have one. No one’s forcing you.” This is exactly the same. No one is forcing anybody to take through the procedure at home; it is a choice that we should allow adult women to make.

When I made that choice, after I made it I had to wait another eight weeks. It was some time ago, long before the pill was even necessarily widely available. I had made the decision, and I did not feel sad about it. I did not feel bad about it. I had made the decision on behalf of my son, who had only just been born—although, actually, I do not even need an excuse. I did not want to have a baby, having just had one, and it is perfectly well within my gift to make that decision. The argument is often made about all the children who have been lost because of women like me, but my younger son, Danny, would not exist if that baby had been born, so we end up equal, and he is a cracker of a kid.

The reality is that I had to wait, and I started to feel pregnant. I started to feel unwell, I started to feel tired and it started to affect my work. That was horrendous for me, knowing that I was not going to go ahead with it—not horrendous because of guilt, but because it made me feel sick and it made me feel that people had expectations of me. I had to hide it. I could not tell people I was pregnant; I had to hide that fact from people at work and other places, because I had to wait. Had I been able, at the four-week point when I found out I was pregnant, to just stay in my house and ring up, it would have been a far better situation for me.

People do not want to think about me, but rather obsess about the difficult cases, not the vast majority who are adult women and should be trusted to take medication in their own homes. We are treating those women as if they are going to get a methadone allowance from a surgery, as if they cannot be trusted when they say, “Actually, I’d prefer to stay at home and not maybe have a miscarriage on the bus on the way home because I live in a rural community.”

If people want to hear about the hard cases, I am currently handling one. It is the case of a young woman who has been sexually exploited since she was 13 years old. She is 23 now. She has had 10 years of being raped repeatedly, pretty much every weekend of her life, by multiple men, and it continues. Obviously, she falls pregnant—well, she does not fall pregnant; she is raped and then she gets pregnant. She has very little trust in agencies and in the police, and she is right to have so little trust. She has been failed time and again. Without the opportunity of telemedical abortion, I have no idea how she would cope. It is a vital service for people who really need it.

I ask hon. Members to vote Aye on Government amendment (a) in lieu of Lords amendment 92, or, if they are not sure, to abstain. Adult women can be trusted to decide what they want to do with their health, and any other vote would suggest otherwise.

--- Later in debate ---

[Dr Johnson]

With respect, the right hon. Lady makes my point for me, because that is right: there is nothing to stop that happening, and it may be that the doctor would say that they wanted to see the patient, but they do not have to do so. We know that abortions are being prescribed by telemedicine to children under the age of 18. If this measure had been looked at properly by the House as a single issue, rather than as this amendment to something else, we would have stipulated that children under the age of 18 should not be receiving abortions over the telephone without proper appointments, as I think they should and as the right hon. Lady, if I understand her correctly, also seems to be saying that they should.

We know that sometimes women and girls can be coerced into having abortions that they do not want, perhaps because the baby is of a gender or sex that the father does not want, perhaps because they are being abused, or perhaps they are being trafficked or sexually assaulted. It is very difficult for a woman to tell someone about that over the telephone, whereas if a woman is seen in clinic, she has that one-to-one opportunity.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

I am going to finish my point. In person, the woman has a one-to-one opportunity with that clinician and a chance to say, “Please can you help me?” Clinicians are alert to that opportunity to provide that help. It is true that if the woman receives the abortion by post, the problem of her being pregnant is solved, but the problem of her being abused is not. That is what can continue.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

No, I am going to continue. The other problem with giving tablets—[Interruption.] The hon. Lady spoke for 16 minutes, which is considerably more than a fair share, given the number of Members who want to speak, so I will keep going.

The other problem is who will take the tablets. If someone is prescribed something of such severity over the telephone, the clinician does not know who will take the tablets. Will they be taken by the woman speaking to the clinician on the telephone? Will they be given to somebody else? Are they going to be sold to somebody else? Is somebody else going to be forced to take them? The reality is that we do not know and we cannot know, and that is another safety issue.

I will summarise my concern by saying, as a woman— I have not had an abortion, but I guess in the future I could become pregnant and not want to be—if I were having an abortion, I would rather have the inconvenience of having to go to a clinic than the worry of knowing that some women are having abortions without going to a clinic. Essentially, for me this is an issue of whether we want to make things more convenient for the majority of women, or we want to protect the women who are the most vulnerable, the most marginalised and the most at risk.