Lord Bishop of Leicester
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(1 day, 8 hours ago)
Lords Chamber
Baroness Hazarika (Lab)
My Lords, Amendment 423A in my name would ask the police to cease investigations into women since the other House passed this vote back in June. Since June, in a number of cases women and mothers have been investigated. At Christmas, a woman in her 40s thought she was in her early pregnancy. She delivered a foetus in its gestation sac. She was very distressed. It turned out that that was actually at 24 weeks; she had not realised. She called the ambulance, and it was made clear that she had safeguarding issues. She was a victim of domestic violence. She had children. Then the police came. Her house was searched, including the Christmas presents for the children. It was incredibly distressing. The children had to leave the house. Many noble Baronesses here have talked, rightly, about the effects on the unborn child, but what about the children of the mothers who are taken away for investigation? So this is a very important addition to the other amendments. I very much support the amendment that the noble Baroness, Lady Thornton, has tabled.
As the noble Lord, Lord Pannick said, I am sure that nobody, whatever side of this debate they sit on, thinks that anyone has a late-pregnancy abortion for the fun of it. No one is doing it to get some promotion at work or to get a late holiday—some of the excuses that we have heard suggested. This is an incredibly traumatic thing. Actually, I would say that an abortion at any time was an incredibly traumatic thing for a woman. I urge noble Lords to go, if they have not seen the Tracey Emin exhibition at the Tate; she speaks incredibly movingly but in a very harrowing way about her own lived experience of abortion. This is not something that is taken lightly.
For that small number of women who end up doing this at a late stage in their pregnancy, they are not doing it for the fun of it. They are often abused and often in situations of domestic violence; they are often from very marginalised communities, such as my own community—from the Muslim community, or from other more isolated communities. Many of them are from deprived backgrounds; they are not from nice families such as ours, where you can talk about these things. Many of them are told, by the way, that they do not know what is going on with their bodies, by their abusive partners or abusive parents, because coercive control does not just come from the husband or partner —it can come from within the family structure. They are not even told about their bodies; they are not given agency about their body—and they are told that if they dare to go to anyone for help, they will end up in prison, and here is the evidence. While I understand the concerns about coercion and care and making sure that we protect vulnerable women—it is very well intended—this could further push those very isolated women into situations that are ever more dangerous.
The final point that I want to make is that, whatever side of the divide we are on, we know that the police are really struggling with resources right now. We have had many conversations about how we do not think that police are investigating serious sexual assault against women and severe anti-social behaviour. Do we really want our police to be rifling through the bins of women who have just had a stillbirth? Do any of us think that that is a good use of time? Do we honestly want to see vulnerable women put in prison, when there are very few places in prison right now?
Finally, you cannot solve this problem by just prosecuting vulnerable women. I have had many conversations with people on the other side, and I understand that, as the Chief Whip said on our side, these views are profoundly and genuinely held by all of us. But I have heard the argument from people who say that, when the terrible thing happens and there is a late abortion, someone has to pay the price—someone has to go to prison. I would push that back. Throwing women, vulnerable women who have often been beaten and treated violently, into prison, is not the answer. Believe you me: these women need compassion, and their kids also need a mother, so that they do not fall into the patterns that lead to bad outcomes. If anyone thinks that these women need to be punished, trust me—what they will have gone through is punishment enough, which will stay with them for the rest of their lives.
The Lord Bishop of Leicester
My Lords, I shall speak to the amendment in my name, Amendment 426D. I start by thanking the Minister for meeting me a couple of weeks ago to discuss this matter—and I want to be direct at the outset about what the amendment would do and would not do.
The amendment is distinct from Amendment 425, which stands on its own merits, and which your Lordships will consider on its own terms. This amendment says nothing about adult women’s access to abortion, nothing about where medication is taken and nothing about the broader questions that have been part of our debate up till now. It rests entirely on one safeguarding principle—that when a child is the patient, a professional should meet her before prescribing. I believe that that is something that your Lordships can support, regardless of the views that you hold on everything else before the House today.
The amendment is brought on behalf of the National Network of Designated Healthcare Professionals for Children—NHS doctors and nurses who carry statutory safeguarding responsibilities for children across every local safeguarding partnership in England. Its concern is that the needs of children, particularly looked-after children who become pregnant, are not sufficiently accounted for in this clause. Since 2022, a girl of 14 can telephone an abortion service, receive medication by post, take it at home, and no clinician will ever meet her. How does that give confidence that safeguarding risks are being properly assessed? How does the provider of medication know whether there is someone else in the room when they speak to the child on the phone? How do they know whether someone else has suggested that the child should make the phone call? Surely the only safe way to assess risk is to meet in person.
The noble Baroness, Lady Blackstone, says that telemedicine is safe. I fully respect her experience in this field and, in many situations, I would agree, but in the case of children, of which I note she made no mention in her speech, I believe she is wrong. Telemedicine is not safe for children.
Baroness Gerada (CB)
Is the right reverend Prelate aware that coercion can also occur in the consultation room, as I have seen many times? It may actually be safer for the girl—or the child, as he is calling her—to be able to choose the place and the time where she has that consultation.
The Lord Bishop of Leicester
I am very aware that there are risks to all forms of consultation. My argument is simply that the risks are minimised by in-person consultation.
The considered view of safeguarding professionals in the NNDHP is that the current guidance put in place by the Royal College of Paediatrics and Child Health in 2022 is simply not robust enough. That guidance, I note, requires an in-person meeting for children under 13. Children under 16 are,
“normally … required to complete their consultation in-person, unless there is a compelling indication to do otherwise”.
Evidence, however, suggests that most providers of abortion care are arguing that the option of telemedicine itself is a compelling indication that an in-person consultation is not required. For those aged 16 or 17, the guidance says only that children—and, of course, 16 and 17-year-olds are still children under the Children Act—should “be encouraged” to attend in person. More fundamentally, guidance can currently be changed unilaterally, without parliamentary scrutiny or public consultation, at the discretion of the body that issued it. I believe, therefore, that legislation is required. What Parliament enacts, only Parliament can remove.
The case for this amendment, however, does not rest on my view or the NNDHP’s alone. The Government’s own consultation found that safeguarding organisations specifically identified under-18s as the group for whom in-person assessment was most critical to reduce the risk from those who sexually exploit children, manipulate the system or force their victims to obtain abortion. Indeed, MSI Reproductive Choices has documented that face-to-face appointments are associated with a significant increase in domestic abuse disclosures compared with telemedicine. This is especially significant given that girls and young women face a higher risk of coercive or abusive relationships than those aged over 24, and are often less equipped to ask for help.
The clinical risks compound this. Beyond 11 weeks’ gestation, home management is not appropriate and the risks to the patient increase significantly. As has been mentioned, accurate gestational age assessment is the foundation on which safe prescribing depends, and it cannot be done reliably by telephone. These are not theoretical risks. We have heard stories already. I would simply add that of a 16 year-old who was estimated by the clinic to be under eight weeks pregnant, but the baby she delivered was in fact 20 weeks. She later said, “If they had scanned me and I knew that I was that far gone, I would have had him”. An in-person appointment would have changed everything for that young woman. This amendment would require such an appointment.
I echo the concerns of the noble Baroness, Lady Stroud, in her amendment. Without an in-person consultation, it is unclear how we will ensure that early medical abortions take place within the law. Indeed, challenges around vulnerability and correct gestational assessment apply to adulthood as well, which is why I fully support Amendment 425.
The Lord Bishop of Leicester
I realise that I am going to make myself very unpopular at this hour, but I will make a very brief comment on the couple of comments that were made regarding the amendment in the course of the debate. I remind noble Lords that this is about children who become pregnant and it is about safeguarding risks. Therefore, I was not entirely happy that it should be contrasted between evidence and anecdote. There is plenty of evidence to support the need for this from professionals in the field. Similarly, to those saying that professionals say that children will not come, I am afraid that the professionals that have advised me on this are very clear that children will come when it is necessary. I therefore invite the House to support the amendment and ask for a Division.