Induced Abortion Debate
Full Debate: Read Full DebateNadine Dorries
Main Page: Nadine Dorries (Conservative - Mid Bedfordshire)Department Debates - View all Nadine Dorries's debates with the Department of Health and Social Care
(11 years, 9 months ago)
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This is the first time I have spoken under your chairmanship, Mr Crausby. As I am a Chair now, I realise the job is not always as easy as it sometimes looks. It is a pleasure to serve under your chairmanship. I have quite a long speech, which will come as no surprise to many here, and I will try, with so many people putting in to speak, to speed up my speech and shorten it as I go along.
The last time I introduced a debate on the 20-week limit was during the parliamentary stages of the Human Fertilisation and Embryology Act 2008, but my amendment was defeated. At that time, it had been 18 years since the upper limit had been debated and voted on.
Abortion law is made in Parliament, and there should be no taboo on discussing it in Parliament. Abortion law should be debated and reformed here, yet each and every time I have raised an abortion issue in the House, one MP after another has risen to comment that this is not really the place to discuss abortion and that the Bill I seek to amend should not be hijacked by discussing abortion. There are many MPs, and I think I may include the hon. Member for Hackney North and Stoke Newington (Ms Abbott), who would quite like the Abortion Act 1967 to be put into a dark cupboard and left there, never again to be brought out and discussed. If we are not to discuss abortion in this House, I am not sure who is supposed to make up the laws as they go along.
As it stands, the 1967 Act is a joke. Everyone knows that in this country abortion is obtained on demand by whoever wants it, whenever they want it. I am pro-choice, and I believe that, up until 12 weeks, that should be the case. I am delighted that more than 90% of abortions in this country take place before 12 weeks. But Parliament’s reluctance and nervousness about reforming abortion law, or even discussing it, creates an atmosphere of disrespect for Parliament among abortion providers.
I admire what my hon. Friend has done and the determination and courage that she has shown against enormous opposition.
I thank my hon. Friend for that intervention. I am very flattered.
Due to the fact that the 1967 Act is so little discussed and its format is so archaic, over the past year we have seen a number of abortion providers flout the law. One of the reasons for that is that Parliament itself shows no respect for the law. In the past year, abortion clinics have been exposed using the law creatively to offer abortion illegally and criminally based on the gender of the pregnancy. In fact, the Care Quality Commission and the General Medical Council are now investigating, I believe, 14 cases of malpractice, and arrests have been made at other clinics. The Calthorpe clinic in Birmingham has been closed down and handed over to another provider.
Those cases point to an erosion of respect for the law by abortion providers. The culture of fear in Parliament, which is held by many MPs, on discussing abortion law has contributed, or may have contributed, to the situation. That has to stop.
I admire the hon. Lady’s courage and perseverance in bringing these issues to the House.
A Marie Stopes clinic has recently opened in Northern Ireland, a province where the law is very strict on abortion and where there is no support for the extension of the 1967 Act. Does the hon. Lady share my concern that the opening of the clinic may be an attempt to stretch the law, or even to get behind it?
I am afraid that I have to disappoint the right hon. Gentleman—I discussed this with one of his colleagues yesterday—because I believe the law on abortion should be equal in all parts of the Union. Abortion law needs to be reformed in the UK, and there needs to be parity across the board. If any abortion provider is to come to Northern Ireland, Marie Stopes is probably the best bet. Marie Stopes is one of the most professional and non-advocacy-driven abortion providers. It has no political ideology and is concerned only for the health of the woman, and it operates in a professional manner. So I think that, if Northern Ireland is to have an abortion provider, Marie Stopes are the people to have. The law here needs to be reformed, and there needs to be parity on both sides of the water.
This year alone, three abortion clinics have been closed down. This is my last point: we must bring abortion law before the House because it needs to be reformed.
Following today’s debate, I have already applied to the Backbench Business Committee for a longer, dividable debate to be held next May. I am using today’s debate to give notice of that future debate. I want to give pro-choice and pro-life supporters ample time to prepare, to gather their research and to set their stall ready for a debate next May.
I join other Members in praising my hon. Friend for bringing forward this issue.
Is not one of the problems that—my hon. Friend alluded to this when she talked about pro-life and pro-choice Members of Parliament—this whole debate has become so unbelievably polarised? Many Members of Parliament see both sides of the argument and feel that our voice is often squeezed from the debate. It is particularly important that the voices of the vast number of legislators who, as she rightly says, should have a say on this matter are allowed to be heard, rather than the entire debate being polarised in the way that she describes.
My hon. Friend is absolutely right. It is the almost ghettoisation of pro-life and pro-choice that has over the years prevented rational and reasonable discussion of abortion.
I am attacked by both pro-life and pro-choice, because I support abortion up to a certain point but I want independent counselling to be provided to women who seek abortion and I would like the upper limit to be reduced. So I fall foul of both camps. It is important that MPs such as my hon. Friend come forward—he has views that encompass both sides of the argument—as they can be more rational in their presentation.
I have applied to the Backbench Business Committee for a debate on a votable motion next May. Of course, a Back-Bench vote does not amend legislation. If the result of the vote endorses a reduction to 20 weeks, however, it will inform the Government that perhaps it is time to bring the 1967 Act back to the House on Government time.
I too congratulate my hon. Friend on securing this debate. Does she agree that, since the 1967 Act, medical science has advanced so much that there is now a real need to reduce to 20 weeks the limit for the termination of pregnancies? I would prefer to see the limit much lower.
Later in my speech, I will address the evidence for that.
After the forthcoming debate allocated by the Backbench Business Committee, if there is a positive vote, if the debate is strongly attended and if Parliament expresses a strong feeling, that will send a strong message to the Government to bring the 1967 Act back to the House.
In 1990, the 1967 Act was amended to reduce the upper limit from 28 weeks to 24 weeks. I hope there will be a fuller debate in May, but in the meantime, following today’s debate, I will write to the Royal College of Obstetricians and Gynaecologists guideline committee, enclosing a copy of the Hansard of our speeches today, and ask it to look again. 1990 was a long time ago. As my hon. Friend the Member for Tiverton and Honiton (Neil Parish) said, things have progressed and science has moved on.
If the RCOG guidelines committee advised, based on the evidence available at the time, that the upper limit should be 24 weeks—
The hon. Lady implies—perhaps I misinterpret her—that the RCOG has not considered the guidelines since 1990. In fact, its most recent report was published in 2010, and it still says that foetal viability is very low up to 24 weeks. In fact, at 20 weeks it is 0%.
I will address that point in a moment. I will not give way any more, as I know that lots of people want to speak.
I want to make it clear that my proposal to reduce the upper limit does not include babies with foetal abnormalities or, sadly, disabilities. That is a discussion to be held, as I have said, between parents and doctors. Abortion is available up until birth for foetal abnormalities. My proposal applies to abortions for social reasons.
A study by the Centre for Sexual Health Research at the university of Southampton and the School of Social Policy, Sociology and Social Research at the university of Kent found that 41% of women who have second-trimester abortions do so because they were not sure about having an abortion and took a while to make up their mind to ask for one. I believe that one positive effect of reducing the limit to 20 weeks might be to focus the mind slightly sooner than 23 weeks. Because abortion is available until 24 weeks, there is a laxity, as people have a prolonged period to make up their mind. The research says that women took a long time to make up their mind. Maybe reducing the upper limit will help.
It is clear to me that we cannot allow the present situation in our hospitals to continue. In one room in a hospital, there might be a premature poorly baby born at 22 or 23 weeks at whom the NHS will throw everything it has to help it survive. In another room in the same hospital, a healthy baby will be aborted at 24 weeks. Dr Max Pemberton recently wrote in The Daily Telegraph that
“many doctors are uncomfortable with the current cut-off point. It is not something we openly discuss, because we know it is a highly emotive area. But privately, many doctors will express discomfort that the current legislation is inherently illogical and inconsistent. Any doctor who has found themselves in the neonatal intensive care unit of a hospital will be acutely aware of it. In the same hospital where doctors are trying to save a premature baby born at, say, 23 weeks, a woman down the corridor is legally allowed to undergo a late-stage abortion on a foetus of the same gestation. So on the one hand we throw considerable money and resources to try to save a baby’s life, while on the other we sanction its destruction.”
I have consistently made that argument for the past seven years. The medical profession cannot make two arguments. Doctors cannot say that a poorly baby’s life is worth trying to save from 20 or 21 weeks onwards while stating at the same time that there is no chance of life up to 24 weeks, so it is okay to abort up until that point. There is an inconsistency in retaining 24 weeks. Should there be a case to say that doctors should not try to save the life of a poorly baby born before 24 weeks’ gestation? Can hon. Members imagine the uproar if we said, “Okay, the RCOG has said that viability is 24 weeks, so we really shouldn’t be saving premature babies before 24 weeks”? We should say, “No, the point of viability is 24 weeks, so we should stop. Wipe out the neonatal units, wipe out the premature units. Viability is not consistent before 24 weeks.”
Doctors cannot have it both ways. They cannot say in the NHS, “We try to save babies from 20 weeks because they are viable,” and then say, “We abort at 24 weeks because they are not.” The two arguments cannot stand. That is an anomaly, and it must end.
No. I have said that I will not give way any more. I must crack on, because lots of people want to speak.
Some people ask whether medical science in the area has moved on. Is there a difference between the science in 2008, when we had the vote, and the science today? The answer is that viability can never be proven. Until healthy women agree to allow healthy babies to be aborted at 20 weeks and we then try to save them, we can never actually know what viability is.
I thank the hon. Lady for giving way. On that point, we are not trying to save babies at 20 weeks. No babies survive at 20 weeks’ gestation. If she refers back to the British Medical Journal paper considering two periods of survival, the increase in survival of pre-term babies after the 2000 period was due entirely to babies born at 24 and 25 weeks. The absolute limit of survival is about 22 weeks; that is when we try to save them. Will she please stop suggesting that the NHS is capable of saving babies at 20 weeks? It is simply not true.
Maybe the NHS should stop trying to save babies from 20 weeks. My neighbour 10 years ago was a 22-week survivor. Although she had slight problems, they did not prevent her from going to school and living a full and wonderful life. Babies do survive from 22 weeks, which is my argument for viability. If the RCOG wants to say that viability is at 24 weeks, it must look at the living babies born at 22 weeks and say, “That’s wrong.”
The only measure of viability that we have is the premature poorly baby—the baby who arrives early for a reason. Doctors must fight to deal with two complicated situations: whatever made the baby arrive prematurely, and the fact that it has arrived prematurely, which involves lung function and other things. I am afraid that a healthy aborted baby and a premature poorly baby cannot be compared, particularly not at 23 weeks.
I have been asked in numerous interviews, and only this week by Victoria Derbyshire during the filming of a “Panorama” programme, “How do you know that aborted babies are healthy babies?” For the record, between 96 and 97 out of every 100 babies are born healthy. The viability argument needs to be discussed in the context of what we do in our neonatal and premature baby units, and what we do in terms of abortion. The two must be compared.
I want to discuss sentience, because it is an argument for life. We know that a baby can feel pain in the womb before 20 weeks. If a woman’s stomach is poked post-20 weeks or earlier, it can wake up the baby. Thanks to Professor Stuart Campbell’s amazing and pioneering work with 3D imaging, we can see how a baby in the womb responds to stimuli, and thanks to the work of Professor Sunny Anand, we know exactly how a foetus responds, due to how it reacts to anaesthetic during in-utero operations.
While a research fellow at Oxford, Dr Anand became aware that many premature and early gestation babies died during in-utero operations due to shock induced by pain during the procedure. General thinking at the time, in the 1980s, was that no baby could experience pain before birth—that until birth, a baby was not sentient. In his pioneering work, Dr Anand developed anaesthesia to be delivered to foetuses. Thanks to that work, introduced at the John Radcliffe hospital, anaesthetising babies during in-utero operations is now standard procedure, and babies now live.
Dr Anand went on to continue his work and research in America. When I sat on the Science and Technology Committee, we considered abortion, and one of the members of that Committee—Evan Harris, the former Member for Oxford West and Abingdon, who lost his seat at the last election—described Professor Anand as a little doctor from Little Rock. Dr Anand did much of his further research in America, first at the university of Arkansas and now as the St Jude chair for critical care medicine and professor of paediatrics, anaesthesiology and neurobiology at the university of Tennessee health centre in Memphis.
My only point in relation to Evan Harris’s comments about Professor Anand is that Dr Anand is a gentle, polite academic who is well renowned and respected and has a successful career. To describe such a man as a little man from Little Rock, and to have binned and not considered the evidence on abortion that he presented to the Science and Technology Committee, was a travesty. I complained about it to the Clerks at the time, and I will continue to complain about it, as it tainted the report. If a foetus can feel pain stimuli, it is a sentient being. Anyone who feels, is. They exist. If one feels, one is a human being.
I move to the feminist argument. As the mother of three young adult daughters, I am a strong believer in a woman’s right to choose. Never, ever would I want to see a return to the bad old days of backstreet abortionists, or restricted access to early abortion. Do I champion this issue from the perspective of religion? No, I do not. I do not come to this from a religious perspective. I champion this from the perspective of compassion, humanity and civility. I believe in the right to choose, but, provocatively, I would like to throw this in: what about the female baby, post-20 weeks? I often hear the argument, “It is a woman’s right to choose.” What about healthy female babies who are aborted at 24 weeks?
I champion this issue because I believe passionately in the reduction of the upper limit. When I visit pregnancy crisis centres, I hear women who are undergoing counselling. Some actually say, “I would have preferred an option other than ending my baby’s life.” Well, there are other options. That is one of the reasons why I tabled the counselling amendment—there are always other options.
I would like to talk about the truth about abortion. It is not just articulate, clever women who abort; vulnerable women are coerced. They are the women who are seen by pregnancy crisis centres. Not every woman who has a late-term abortion for social reasons actually wants one. I was staggered to hear what one MP who came up to me the other day said. Her actual words were, “Every woman who wants an abortion knows exactly what she is doing.” Well, in her rather slick, well-educated Oxbridge world and her leafy shires I am sure they do, but what about the young Asian girl who was recently marched into a clinic in floods of tears by two family members? No one knew her age, but she was marched in by two family members for an abortion. Is that a one-off story? No. Speaking to abortion providers, that happens on a regular basis.
What about the young women who have waited to have their abortion because they did not want to have it, and who then found themselves being coerced by partners or others? One woman at a pregnancy crisis centre that I went to aborted at 24 weeks because she had been told by her partner and other family members that it would be beaten out of her if she did not. Not every women makes the decision because she went to university and marched up and down streets in Oxford and chanted about women’s rights. Lots of women are actually incredibly vulnerable. It seems to me as though many of the women who make the feminist “women’s right to choose” argument have no regard whatever for those women. In pushing one particular mantra and ideology, no consideration is taken of those women at all.
It is assumed, and I am told, that it is a woman’s right to choose, and that by wanting to limit from 24 weeks and by wanting to introduce counselling, what I am trying to do is limit a woman’s right to choose. Well, let me inform everybody that a woman’s right to choose is limited because the upper limit is at 24 weeks. To say that a woman’s right to choose is being limited is nonsense—it is already limited. It is limited because at 24 weeks it is felt that a baby is viable. I argue this: a baby’s life is viable before 24 weeks, so it is time to reduce the limit, because this is 2012, not 1990. I hope we live in a society that is civilised and compassionate, and which cares for vulnerable women who do not want to have abortions and are forced to do so. I hope that we would give as much consideration to those women as we do to the Oxbridge-educated, articulate women who change their job and want to have an abortion.
Some of the women who end up at pregnancy crisis centres do so because they are scarred and need counselling, which is not available to them, because they aborted at a very late stage. Those women are more likely to suffer mental health consequences than those who abort at an early stage. If we do not go for the viability argument; if we do not look at sentience and all the other arguments I have made; if we just decide to disregard the fact that in one hospital, there might be two babies, one being aborted at 23 weeks and another having her life saved at 20 and if we choose to ignore all that, let us just decide that we should be a little more considerate to the women who find themselves forced into a situation in which they have a late-term abortion.
I hope that the Backbench Business Committee grants the next debate on this issue next May. I hope that there will be a vote. I hope that, by then, enough information will have been put before hon. Members for them to decide that what they want to do is what the public want to do. I finish on this note: I am overwhelmed by the amount of support that I have received from members of the public in wanting to reduce the limit. The more this is debated, as it should be, the more public opinion will become informed, and the more MPs will realise that what they need to do in this place is carry out the will of their constituents, not follow their own political ideology.
Such debates in this place—I have attended a few—are deeply polarised, and often quite unpleasant, between those who assert the right to life and those who equally emphatically assert the right to choose, which is strange because both rights are then usually qualified by those who uphold them. I think all hon. Members would agree that there are circumstances where either right can be overridden and I know no one who does not believe this. The dividing issue between hon. Members in this Chamber is the limits of abortion, and such a debate is necessarily about how much or how little abortion is permissible. To be honest, those who argue for limits often favour much less abortion, or rare abortion, and constrained choice for the woman. That by itself is not an argument against discussing the limits rationally.
We are not helped much by the fact that two sorts of argument are given for abortion in law: one is about the preferences or the good of the woman, where her mental health, usually, and sometimes her physical health is the issue; the other is about the hypothetical preferences of the foetus, in cases of severe abnormality, where gross deformity or suffering is in prospect. There are, therefore, two different sorts of abortion, and it is not obvious to me that the same limits should apply to both types. A problem in discussing the current limits is that the cases that would immediately be affected by a small reduction would disproportionately fall into the latter category—deformity and so on. Such cases are rare and untypical, and that slightly skews our debate. It is a mistake, in this debate, to confound the two types of abortion.
Much, perhaps most, current debate has been centred on the viability of the foetus at certain stages—its ability to survive with or without medical assistance outside the womb. Of course, that varies depending upon the quality of that medical assistance, which we would all agree has improved enormously. On my way here, I read a story in Metro of a baby who survived being born below the abortion limit and was looking happily out of the pages of the paper. This kind of evidence is often cited as new scientific evidence about what we can achieve. We may achieve still more in future.
Some argue that we should not think simply of the survival of the foetus, but of its ability to thrive, lead a quality life, have full use of mental faculties and so on. It is legitimate to say that mortality and impairment is high among babies born prematurely.
On the important matter of viability, the hon. Gentleman will be aware that, post-20 weeks, the method of aborting a baby is to administer a lethal injection into the baby’s heart via the mother’s abdomen, to ensure that the baby is delivered dead, not alive. That is why that procedure was invented, created and introduced. That in itself is an argument for viability below 24 weeks, because if there was no chance of viability below 24 weeks, there would be no need to introduce a lethal injection procedure.
I accept that point, but we must be aware that there is an argument that the abortion limit should be set at a point where a statistically significant number of foetuses can be shown not just to have survived, but to have thrived. That position is somewhat arbitrary. I see no obvious reason why obstetrics should not continue to improve and the issue continue to haunt us.
I find all this talk about survivability somewhat confusing, because at no stage is the human infant capable of independent survival. Some societies, and indeed some philosophers, have argued that a severely deformed infant born at full term, incapable naturally of living without abnormal intervention and presenting all those features that would have justified abortion should be allowed to perish or may be killed. I do not accept that view, but I recognise that it has been put.
What scientific evidence shows about survival prospects strikes me as relevant but not crucially so. Survivability is only relevant because it stands proxy for something else. No one argues that a baby that can survive and show all the signs of conscious, individual life was not conscious from the moment of its birth and capable of wilful behaviour, having feelings, sentience and so on. Equally, it is hard to argue that were they in the womb that would not also be exactly the case. To kill such a baby, or a baby of such an age, while it is in the womb is thus, logically, to kill a sentient, conscious, wilful and, indeed, innocent human being, and one needs a good reason to justify that type of behaviour. The paramount wishes of the mother simply do not seem to be a good enough reason.
Where consciousness can be presumed, or to put it more strongly, where complete unconsciousness cannot be assumed, the rights of the child in my view would ordinarily trump the rights of the mother. A precautionary principle should kick in, but it clearly does not do so within the existing framework. That is why it is important that we have this debate.
I accept that there is a different argument to be had about the destruction in the womb of human life that we would all agree not to be conscious, and that falls back upon religious views about respect for individual human life, including the potentially, but not actually, conscious. The mediaeval Church made that distinction. But the argument that we must take sentience seriously rests upon our ordinary moral intuitions about the value of individual existence. The debate simply will not go away until we align the law with our basic moral intuitions. I applaud those, including the Secretary of State for Culture, Media and Sport, who simply alerted us to this fact and indicated that we really must have this debate.
It is a pleasure to serve under your chairmanship, Mr Crausby. I congratulate my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) on securing this debate on a subject in which she has a long-standing interest. I have listened to the views expressed by Members, and I acknowledge that many of them are deeply and strongly held. The nub of both sides of the debate is best encapsulated by the speeches of the hon. Member for Feltham and Heston (Seema Malhotra) and my hon. Friend the Member for Congleton (Fiona Bruce). They gave speeches based on their beliefs, knowledge and sound arguments.
Forgive me, but I want to make progress, because the clock is against me. I will give way when I have made some points. In the short time available, it is important that I make some of the main points in my speech.
It is right that abortion is a matter of conscience. It is important to respect the views of all individuals and accept that we have different views, whichever side of the political fence we sit on. My hon. Friend the Member for Southend West (Mr Amess) reminded us that certain Cabinet members have expressed their own views on the upper limit for legal abortions. They all made it clear that those are their own personally expressed views. I want to make it quite clear that, notwithstanding the fact that some Cabinet members may want a reduction in the upper limit, the Government have no plans to bring about a change to the time at which an abortion can be carried out. I want to stress that point again, so I repeat: we have no plans to review the Abortion Act 1967.
We are by no means complacent. When I was fortunate enough to be made a Minister, I made it clear that in the time I am in office I want a reduction in the number of abortions. We all want that, but there is a debate about how we best achieve it. I take the view that we best achieve it through better contraception and by empowering our young men and women to make the choices that they want to make, if they have a sexual relationship.
I will, but I want to make these points because they are important. I want better counselling services—
I will. I also want more work done on why so many women have more than one abortion, which is of great concern to people on both sides of the argument. There is a lot of work to be done.
I want to say something on counselling that may interest my hon. Friend the Member for Mid Bedfordshire in particular. As the new Minister with responsibility for this matter, I have carefully considered how we move forward on abortion counselling. I believe that the best way forward is about contraception, how we reduce the repeat abortion rate, how we empower young men and women and how we improve abortion counselling services for women generally. A committee was formed as a result of the measures that my hon. Friend tried to introduce. There is also a cross-party inquiry into unwanted pregnancy, led by my hon. Friend the Member for Hastings and Rye (Amber Rudd). I commend that. They will do important work and hear important evidence, but the simple reality is that we therefore no longer plan to undertake a separate consultation on abortion counselling. I am sorry if that disappoints members of the committee.
For the purposes of transparency, I will today place in the Library a short document on abortion counselling, representing the great work done by my predecessor, my hon. Friend the Member for Guildford (Anne Milton). I pay tribute to the work she did when she was Minister for Public Health, and to the cross-party committee, which looked at counselling arrangements for women requesting an abortion. I am extremely grateful for the work it did, and I thank its members for their efforts. I am sorry if there is disappointment, but we do not intend to change the law, so a separate consultation would be an otiose exercise.
It is not a case of changing the law, but changing the Government’s commitment. The Government made an absolute commitment to consult. In fact, the British Medical Association moved a motion in agreement. Why have the Government changed their mind about the consultation on non-compulsory independent counselling?
The committee has done some good work. I do not think that it would be right to take the matter any further. I am sorry if that disappoints people, but that is my view. I can see no purpose in a consultation, because we do not intend to change either the law or the guidelines.
As the committee identified, counselling services throughout the NHS are patchy. That is not acceptable. It also decided that it is of primary importance that there are no delays when a woman seeks a termination of her pregnancy. That is why it is important that if a woman is going to have a termination, she does it as quickly as possible. The group was in unanimous agreement on that, which I welcome. There is other work to be done on counselling, but I take the view that that is not the primary issue that we should address, which is why I made the decision I did.