Lord Weir of Ballyholme
Main Page: Lord Weir of Ballyholme (Democratic Unionist Party - Life peer)Department Debates - View all Lord Weir of Ballyholme's debates with the Northern Ireland Office
(2 days, 1 hour ago)
Lords ChamberMy Lords, first, I ought to say how I approach this debate. I had not intended to speak. The issue—passionate though people feel about it on both sides of the argument—is one that I hope I have always approached with an open mind. Abortion is a terrible thing in contemplation for anybody concerned, but it is a practical necessity for some. That is something that I have always felt strongly about.
One of the things that we could have been confused about in hearing the debate today is that the police are investigating every stillbirth and every miscarriage, which is not the case. If the death takes place or the child’s life is lost in a medical setting, usually the police are never involved. The time when the police become involved is either when there is a medical referral because there is a concern by medics or, alternatively, when there is an emergency at home or somewhere else.
I mention this because we have to be realistic, whatever the decisions made about Clause 191, about how the police respond. There are some ways the police response could be improved, but we have to give some understanding to the officers who deal with these emergencies, say, in a home or at a place of work. It could be a public toilet, or it could be that something is discovered in the middle of a field. At the beginning, the officers do not know whether they are dealing with a baby, a late-term foetus or a child who might have taken a breath or not; they have a very confused situation, and they cannot just walk away from it.
My first point is that there has to be some sensitivity. At a far earlier stage in the debate, I think the noble Baroness, Lady Lawlor, raised sudden death syndrome for babies. The police have got far better at dealing with that sort of situation, because 30 years ago we did not know that sudden death syndrome happened. Now we do, so it is dealt with in a different way from how it was 20 or 30 years ago.
The bottom line is that there is a requirement to freeze the scene in terms of evidence, because it is no good two or three weeks after the event when a judge, a coroner or someone turns around and says, “Well, you must have seen this at the scene and gained the evidence”, and they say, “Well, actually we did not seize it; we did not freeze it”. There is a difference between starting an investigation and freezing the scene and making sure you have as much evidence as is available, without too much intrusion, at that first point.
It is really important to be clear about this. If we set off and say that Clause 191 will come into effect and there will certainly not be a criminal investigation into the mother, that does not stop the need to collect evidence right at the beginning, when no one is sure. I think we have to be a little realistic about this.
On improving the police investigation process, there are two things that would be really helpful. Number one is that a senior detective with some experience attends the scene as soon as possible—I would say within an hour—to see what they are dealing with, so that if there is evidence to be seized, it is done sensitively and the family are protected as much as possible. Probably as importantly, unless there is an immediate need to start an investigation—for example, we could imagine that there might be injury to a child or a foetus that is not possible to explain by what appears to have happened to it medically, for example a knife or something else—you need to consider that set of circumstances. But generally, within a period of time—let us say 48 hours—the police must seek medical advice about how this child or foetus died and what, if anything, should happen thereafter. That starts to create a process that we could all objectively rely on.
My second point is that there has been a little confusion about the fact that, if the woman is coerced, Clause 191 does not mean that the coercer is innocent. It has nothing to do with that at all. It is only about the mother, if it is decided that that should go ahead.
I would like to make two final points. I just want to sit here and learn, but one thing I have not heard addressed in the debate—the problem, it seems to me—is that there are some women who, at 24 weeks and onward, need help. Whether the state says they can have an abortion or not, they might take that decision. Where do they go? We all agree that a back street abortionist is not a good idea. They cannot go to a medical professional, who would then be complicit in providing the abortion, perhaps, that they cannot legally have. If they end up with these online tablets designed for those under 10 weeks, that is not a good outcome. But I am not sure that what the state says—what we say—will help them in that terrible dilemma, because the need that they feel to have that abortion beyond 24 weeks has not gone away. If we abandon them to that decision alone, I do not think we help anyone. I would like to understand this myself, regardless of the decision about Clause 191: how do women in this position get some help?
With an open mind, there were three points that I do not think we have yet clarified. One thing that I was really interested to hear was that the pills designed for under 10 weeks are available online for people beyond that, and it seems as though that is not a good idea. They are designed for people under 10 weeks because that is when they work best. At 24 weeks and beyond they sound like an awful option—but what if they are your only option? How are we going to deal with control of those pills? I do not understand, from Clause 191 or the existing law, what we intend to do about that.
The second point, from the noble and learned Baroness, Lady Butler-Sloss, was that there is this fundamental dilemma: the woman has not committed a criminal offence, but the people who enable her to do this act do commit an offence. I am not a lawyer, but that sounds like a contradiction. I think there has to be some explanation of how that gets remedied.
On the final point that was raised, I am not sure about the answers. The noble Baroness, Lady Fox, did not think it relevant, but the point about sex determination as a reason for abortion seems to me a real risk. I do not know whether Clause 191 makes it more or less likely to happen, but it is a risk and nobody should allow that. It happens now, potentially, but if Clause 191 makes it more likely, what is the mitigation of that risk? I have not heard it. That needs to be addressed if Clauses 191 is to remain.
My Lords, for the benefit of the absent noble Lord, Lord Russell, I will attempt to speak in a paperless fashion, which means that if I engage in verbal streams of consciousness I hope that the Committee will forgive me. There is a range of amendments in this group, many of which I support, a number of which I have sympathy with and a few that I oppose. That is perhaps natural, given the fact that a number of amendments in this group pull in completely opposite directions.
Of the amendments that I support, I draw particular attention to Amendment 460, which would require that before an abortion could take place there is at least a clinical appointment, that guidance is given and that it is done through that route. Noble Lords have come up with a range of solutions to what we all appreciate is a sensitive situation and have tried to square the circle. The evidence from prosecutions that have taken place, and where there have been convictions, is that in almost every case there has been an absence of clinical support and someone has, in effect, gone on a form of solo run. Albeit that it may well have been in very difficult circumstances and taken with a heavy heart, nevertheless that is the route down which they have gone.
In the limited time available, I will concentrate on supporting the Clause 191 stand part notice from the noble Baroness, Lady Monckton, because, with respect to those who drafted Clause 191, it is somewhat disingenuous, radical in its implications and dangerous, particularly for women. Let me explain why.
Mention has been made that it does not legally change the time limits. In a strict legal sense, that is true, but it does turn those time limits into a façade. If you have a situation in which an act that remains illegal can be carried out but the person who carries it out is immune and protected from prosecution in all circumstances—in blanket circumstances—you have a law that is utterly ineffective. It is the equivalent of saying that we will retain speed limits on motorways but anyone found driving on a motorway beyond that speed limit will not be prosecuted. It is somewhat disingenuous. A more honest approach would have been an amendment that simply said, “We want to move the time limit to the point of birth”. That is, in effect, what Clause 191 does, but the changes that it makes are disguised as the mirage that has been put in front of us.
This is a radical change. Within this Committee and society as a whole, there is a wide spectrum of views on the issue of abortion. Some, and I am one, would take a much more restrictive approach towards abortion and feel that with our current laws the balance is wrong. Others take a much more liberal or permissive view. The settled compromise between those positions is to say that, at present, the determining line between what is legal and what is not is whether a child can be born and viable at the point of birth. The point has been made that that line has shifted from 28 weeks to 24 weeks. There is a good argument that it should come down a little bit more. But Clause 191 will, in effect, shift the ground in some cases to a situation in which that abortion can take place up until the day of birth. That is a radical step that is out of sync with public feeling.
My Lords, we have all received briefings on this clause, telling us that, unamended, it would allow abortion up to birth. I will address that in two ways. First, Clause 191 does not fully decriminalise abortion or alter the legal time limits. The legal framework remains for medical staff, which the noble Baroness, Lady Fox, set out very clearly. It has the advantage of stopping women facing investigation after miscarriage or a stillbirth, as the noble Lord, Lord Pannick, set out, but it would also ensure that the very small number of women who have ended their own pregnancies outside the law receive healthcare, mental health support and referral to appropriate support services rather than facing year-long police investigations. That is what Clause 191 sets out to do.
Secondly, I understand that some are concerned that this change in the law may increase later-term abortions. Clearly, later-term abortions have higher rates of complications than abortions at earlier gestation, but that still remains relatively low. We can, however, look at evidence from other jurisdictions. Although the noble Lord, Lord Weir, is right to point out that there are lots of different gestation limits across Europe, bringing women into the decriminalisation zone would bring us in line with 50 other jurisdictions, including France, New Zealand, Australia and the whole of the United States, where no women can be prosecuted for having her own abortion.
Evidence from these other jurisdictions shows that abortion law does not affect the likelihood of later-term abortions, and decriminalising abortion does not cause or correlate with any increase in third-trimester abortions. That is confirmed by the WHO and robust global evidence from countries including Canada, New Zealand and Northern Ireland, as the noble Baroness, Lady Miller, pointed out.
Looking at those in a little more detail—I am aware that it is late—in Canada, abortion was completely decriminalised in 1988. It is regulated as a health service with no criminal law or gestational limits, which goes much further that Clause 191 does. Over decades, data shows a stable pattern of early abortion and no increase in later abortion, despite that complete decriminalisation. In Northern Ireland, where abortion was decriminalised in 2019, almost nine in 10 abortions happened before 10 weeks, and there have been no reported cases of women ending their pregnancy at late gestations outside of medical frameworks.
I appreciate the point the noble Baroness is making, but would she accept that the telemedicine is illegal in Northern Ireland? Pills by post is not an option, so the only route that any woman in Northern Ireland can use is the clinical route and within the timeframe. It is pretty obvious why there have not been any prosecutions; it is because there has not been a situation arising out of that.
It is not the prosecutions that I am referring to, it is the cases themselves. I absolutely acknowledge that telemedicine is not available through medical services in Northern Ireland, but the pills are available illegally online and people are purchasing them. However, because women are decriminalised, they are never prosecuted for taking them.
The proportion of abortion procedures carried out before nine weeks’ gestation has increased in most countries with more liberal abortion laws. As explained by the noble Baroness, Lady Gerada, that is why this change is so strongly supported by the Royal College of Obstetricians and Gynaecologists, the Royal College of Nursing, the Royal College of Midwives, the Royal College of General Practitioners, and the Royal College of Psychiatrists, and many other health experts. I agree with the noble Baroness, Lady Thornton, that the meeting with these experts was really helpful. Perhaps we could do another one of those before Report so that noble Lords who have further medical questions can ask them.
Amendments 455, 456, 456B, 456C and 461F would retain the criminalisation of women in relation to abortion law, and women would still face arrest, investigation and prosecution under the law. I very much appreciate the efforts to find some compromise in Amendments 456 and 456C, and it is important to discuss whether this is possible. However, the harm that Clause 191 seeks to address would remain if those amendments were to be included in the Bill, as investigations would still be ongoing and we would still see women being pulled into the criminal justice system, as the noble Lord, Lord Pannick, set out.
I will briefly touch on vulnerable women. It is important to consider how this clause and the amendments would impact those women, who could be in a situation of abuse or coercion. Noble Lords have rightly raised concerns around this. Importantly, non-consensual abortion would remain a crime under Clause 191, including in the terrible case that the noble Baroness, Lady Falkner, referred to.
Experts in this area have been really clear that the clause will be beneficial to women in this situation. The threat of criminal sanctioning can dissuade women from seeking help or even telling anybody what has happened to them. That is why it is supported by so many violence against women and girls groups, including the End Violence Against Women Coalition, Refuge, Rape Crisis, Karma Nirvana and many more. These groups came and did a very helpful briefing to noble Lords; perhaps we could replicate that again before Report. I understand noble Lords’ concern around coercion, but we should listen carefully to the experts in this area.
I will address telemedicine and Amendment 460, which would repeal its provision. Like other noble Lords, I was here for the legislation on its introduction, and I will present what has happened since. A large national cohort study undertaken in England and Wales published in the International Journal of Gynaecology & Obstetrics found that telemedical abortion is
“safe, effective and improves care”,
and is preferred by women. Full telemedicine is now essential for abortion provision and is being used by over 100,000 women every year in England and Wales. It has meant that once a woman decides she wants an abortion, she is able to access it more quickly and, therefore, more safely. Since the introduction of telemedicine, as the noble Baroness said, we have seen the average gestation at treatment for abortion falling substantially, with more than half of all abortions now taking place before seven weeks’ gestation. As we know, it is much safer to have an abortion as early as possible.
Telemedicine also provides a safe and confidential way for women in abusive and controlling relationships to receive abortion care. Safeguarding is an essential part of abortion care provision. Any patient that causes professional concern is provided with a full safeguarding assessment, and pre- and post-abortion support and counselling is available to all patients. Abortion providers are regulated by the Care Quality Commission, NHS England commissioners and the Department of Health and Social Care, which all have regulatory oversight.
I will address the medical complications point, which a number of noble Lords have raised. There have been 54,000 complications to medical abortion over the past five years, but that covers all gestations for all forms of medical abortion—in clinic, at home, telemedical or in person, scan or no scan, and at any gestation. Those complications are not reflective of pre 10-week medical abortion and are not exclusive to telemedical abortion care. No information has been included before 2021, when telemedicine was launched, so there is no analysis to see what has happened since then.
This also looks at the basic numbers of complications rather than rate, so it is an incomplete picture. As noble Lords have mentioned, over 1 million abortions have taken place in that five-year period. The number of abortions has gone up, which means the number of medical abortions has gone up. Therefore, sadly, the number of complications has gone up. But rather than looking just at the total figures, when you look at the rates shown by the latest abortion statistics and the hospital episode statistics, the rate of complications for medical abortion has fallen by 25% since telemedicine was introduced. That is why telemedicine is supported so strongly by medical professionals. Put simply, it is better care for women.
Telemedicine is a choice for clinically eligible women, not a requirement. A woman can always choose—
My Lords, the noble Lord, Lord Jackson, has been around this circuit before, I think on a Private Member’s Bill proposed by one of his noble friends, about collecting the statistics. It shows that he does not actually seem to have checked what statistics are already collected before deciding that these things need to be done. I thought that it might be useful for the Committee to know that the annual abortion statistics already include the ethnicity of the woman and medical complications as part of the treatment. The noble Lord will also be aware that it is incredibly rare that the sex of the foetus is known, because the vast majority of abortions are carried out or happen before 10 or 12 weeks—so that is simply not known or collectable.
Complications from abortion care are extremely rare and are already reported. Abortion care providers are regulated and scrutinised through long-established accountability mechanisms, including published safe- guarding reports and Care Quality Commission inspections. These are on the public record; I am not sure why the noble Lord has decided that these things are not. Doctors are already legally required to provide information about abortions to the Chief Medical Officer, including gestation complications and grounds for an abortion.
The noble Lord is bringing forward amendments that would cause a huge amount of bureaucracy and might risk leaving medical professionals permanently unsure of the status of abortion law. I am sure that we would wish to avoid that happening. I shall be very interested to hear from my noble friend the Minister what the Government have to say about the implications of all these amendments.
My Lords, I support the amendments in the name of the noble Lord, Lord Jackson. We live in what a lot of us would describe as a post-truth world, in which facts are often passed off as opinions or, worse, that terrible phrase “fake news”. Sometimes opinions are passed off as being completely truthful facts, and sometimes we have misinformation going around the globe that comes not simply from conspiracy theorists on the internet but, sadly, sometimes from world leaders.
Given that context, it is important that when this House resolves on any legislation, looking into the future, that it should be on the basis of evidence, truth and facts. That is particularly true when it comes to abortion. It is an issue, irrespective of your views on it, which is deeply sensitive, and on which raw emotions are often provoked. To some extent we saw that earlier when, at times, the atmosphere of the Committee got a little bit tense. People have genuinely conflicting views on this, so the more we can try to base this on evidence, the better.
That is particularly true for the proposed changes that are being made in Clause 191, for two main reasons. First, although there has been some mention that this has been in the ether for a number of years, the specifics of this legislation came about by way of a Back-Bench amendment to a different piece of legislation, with a limited amount of debate on it. It was not part of a government programme or manifesto commitment. Any Back-Bench Member is perfectly entitled to bring forward an amendment; that is the normal procedure. The downside of that is that there has not been a direct level of consultation on this specific proposal.
Secondly, despite what has been said, there are some concerns about the quality of the data that we have on a range of issues. I listened carefully to what the noble Baroness said, and it seemed that she was putting forward two somewhat contradictory positions. You can either make the argument that all this data is already there and already gathered, and therefore these amendments are unnecessary, or, alternatively, you can make the argument that this would involve so much gathering of data that it would be a bureaucratic nightmare. You can argue either of those propositions, but the two are somewhat mutually exclusive in that regard. It strikes me that when we take decisions on this, it is important to get the data.
It has been highlighted—I think it was mentioned in a Private Member’s Bill that the noble Lord, Lord Moylan, proposed—that there are sometimes concerns over the quality of the data. Perhaps not unsurprisingly—it is not unique to this particular debate—we have heard different people on different sides of this argument quote sometimes contradictory data as to where we are.
It strikes me that there are one or two solutions to these problems, neither of which is mutually exclusive. The noble Lord, Lord Jackson, in the next group of amendments, proposes, apart from anything else, that we pause things until there is a proper consultation period. These amendments then look towards the idea of producing data and a report, and gathering evidence so that there can be a review of the procedures and how things work out. They highlight the range of issues that formed a number of the concerns in the previous debate. These are issues around the level of coercion, the medical complications that arise as a result of changes, whether it leads to a driver on sex selection, and, as mentioned, the incidence of late abortion, which then leads to a live birth. This range of issues highlights a lot of the concerns that were raised in the last group.
I appreciate that we have had this debate today, and that the proponents of Clause 191 will say that the concerns that have been raised—although I am sure they will accept they are genuine—are, in their view, misplaced or perhaps exaggerated, and that we have nothing to fear from Clause 191. Various incidents of what has happened in other parts of the world have been quoted. It is important, therefore, that we test that out. These amendments would gather that data and allow us to assess that. If we are dealing with false fears then, for the proponents of Clause 191, this will strengthen their argument in a year or two years’ time, whenever these things are reviewed. If the fears are genuine and are realised, however, then it is important, as the noble Lord, Lord Jackson, says, that if we gather evidence, it is not some sort of desktop exercise where we simply look at figures. If we gather evidence then it should be on the basis of having the opportunity, if it shows that there are increased dangers, for instance, to women or concerns over any other categories, to take a level of corrective action. That seems a very sensible course of action. I do not think there is anything that anybody should have to fear in these amendments, so I commend them to the Committee.
My Lords, I listened to the noble Lord, Lord Weir of Ballyholme, and what he said sounds eminently sensible, but the problem is this: the noble Baroness, Lady Thornton, has set out the level of detail that is already gathered. The noble Lord, among other Members of your Lordships’ House, have gone on all day about telemedicine and coercion, yet when the royal colleges set up the evaluation of telemedicine, when it came in during Covid, they took particular care to examine issues such as that. They came up with data that showed that telemedicine was safe. Actually, it not only discovered women who were being coerced; it discovered women who were being trafficked. Yet Members of your Lordships’ House still trot out the same argument time and again. I listened to the noble Lord, Lord Weir of Ballyholme, and the arguments of the noble Lord, Lord Jackson, and I am afraid I rather think that it does not matter what data we collect: they will make the same arguments over and again.
My noble friend Lady Brinton cannot be here this evening, but she particularly wanted to say this: the detail of these amendments is designed to confuse and delay the safe and effective legal rules of abortion. They would also take abortion out of the clinical sphere, trying to exceptionalise it and create an environment so hostile that it would deter women and, equally important, clinicians and medical staff, as the rules become more and more complex; and it would also be at the whim of the Secretary of State to amend details or to report at various times. It is a worrying idea to use secondary legislation to make everything more complex, because it gives Ministers the powers to change things and causes confusion and distress.
I have listened to what has been said. Initially, I was not quite clear whether it was an intervention or not, but I appreciate that it is actually a speech. I think comparisons with America are somewhat facile, because if we were gathering data, it would be on an NHS-wide basis in that regard. The idea of anybody, as you would have in the United States—where an individual county will take a particular view—imposing different decisions or requiring different things is not something that could happen in this country. By all means, criticise the amendments and try to take them apart, but let us not make false comparisons based upon the very different federal system they have in the United States compared with what happens here.
I do not think that it is a false comparison. What we are saying is that, instead of having a system that is democratically decided openly and in Parliament, we will leave it to regulation and officials. I think that is wrong.
The other thing that my noble friend Lady Brinton wanted to say relates to proposed new subsection (3) in Amendment 457. Imagine a woman who is, in the words of the amendment,
“acting in relation to their own pregnancy”,
having to identify and report medical complications. What does that mean? I do not think that that is intended to make it any easier for a woman in need to access the care she needs. I think it is intended to frustrate and, therefore, I hope that these amendments will not be passed.