HC Deb 16 June 1972 vol 838 cc2051-88
Lords Amendment: No. 1, in page 1, line 10, leave out from "amended" to end of line 19 and insert:
"by the insertion after subsection (2) of the following new subsections:—
10 '(2A) A local health authority in England or Wales may, with the approval of the Minister of Health, and to such extent as he may direct shall, make arrangements for the giving of advice on voluntary vasectomy, the medical examination of persons seeking advice on voluntary vasectomy for the purpose of determining what advice to give and for 10 treatment for voluntary vasectomy.
15 (2B) A local health authority may, with the approval of the Minister of Health, recover from persons to whom advice is given, or treatment provided, under subsection (2A) above or from such persons of any class or description 15 such charges (if any) as the authority consider reasonable, having regard to the means of those persons.' "

Read a Second time.

2.3 p.m.

Mr. Phillip Whitehead (Derby, North)

I beg to move, as an Amendment to the Lords Amendment, in line 5, leave out 'Minister of Health' and insert 'Secretary of State'.

I assume, Mr. Speaker, that it will be appropriate to discuss at the same time the second Amendment, in line 12, leave out 'Minister of Health' and insert 'Secretary of State'.

Mr. Speaker


Mr. Whitehead

It may be for the convenience of the House if I say at the outset that this is a purely technical and drafting Amendment, in that when the noble Lord, Lord Brock in another place moved his Amendment which stands on the Notice Paper as Lords Amendment No. 1 he used the words "Minister of Health" rather than "Secretary of State". I believe that legal advice taken at that time was to the effect that this was correct and satisfactory. Subsequently, further study has thrown some doubt on this. This is because the Transfer of Functions Order establishing the office of Secretary of State for Social Services assigned all functions of the Minister of Health to him and the order made no provision for assigning any future functions to the Minister of Health.

Therefore, for these technical reasons, we need to alter the reference in lines 5 and 12 from "Minister of Health" to "Secretary of State".

Amendment to the Lords Amendment agreed to.

Further Amendment to the Lords Amendment made: In line 12, leave out 'Minister of Health' and insert 'Secretary of State'.

Mr. Whitehead

I beg to move, That this House doth agree with the Lords in the said Amendment as amended.

The noble and distinguished Lord, Lord Brock, in bringing his Amendment before another place, was very concerned about the special rôle of surgeons and that the matter of the vasectomy operation should be recognised within a Statute. It was for this reason that the noble Lord introduced his Amendment by saying, in the debate in another place on Report: Even if it means making the wording longer and somewhat more elaborate, surgery should be separated from 'substances and appliances'…and I hope that your Lordships will accept it"— that is the Amendment— in the spirit in which it is intended; namely, to confer on an act of surgery the dignity and responsibility that rightly belongs to it.…"—[Official Report, House of Lords; 6th June, 1972; Vol. 331, c. 272.] It is my view that, although something might be said for the remarks of the noble Lord, Lord Gardiner in that debate that this phrasing was simply taking 115 words to do what had previously been done in 12, nevertheless if this adds to the self-respect of the profession of surgeons and draws a distinction between their rôle and that of physicians in the operations which are envisaged under the Bill, for my part, as sponsor here—I think that this was also the view of the noble Lord, Lord Amulree—I have no objection to it.

Mr. John Biggs-Davison (Chigwell)

I am very glad to hear that the hon. Member for Derby, North (Mr. Whitehead) has no objection to this Lords Amendment. He did not sound very enthusiastic about it. We had some very long debates in Standing Committee on the counselling of, and giving of advice to, those persons who wished to undergo the operation of vasectomy.

I think that the Bill, which I oppose on principle—on moral principle—is made slightly less obnoxious by the actions of the House of Lords in making this Amendment.

As my hon. Friend the Under-Secretary said in Standing Committee, counselling and the giving of advice on voluntary vasectomy are vital. Some people take the view that this is not a matter upon which anyone needs particular advice. I do not know, Mr. Speaker, whether you saw the cartoon in Private Eye and the picture of the somewhat harassed, hen-pecked husband being seen off to business by his wife on the doorstep of the family home, with the wife saying to her husband, "And remember to call in for a vasectomy on your way home". That is a slight exaggeration of the light-heartedness with which this subject is approached.

However, it is not the way in which the subject has been approached in this House, either by the hon. Member for Derby, North or by anyone else on either side of the question. This is indeed a very serious matter. As the Lord Bishop of Exeter said in the other place: My Lords, to have a vasectomy is a very serious matter."—[OFFICIAL REPORT, House of Lords, 1st May, 1972; Vol. 330, c. 607.] Therefore, my hon. Friend the Undersecretary was absolutely right when he said in Standing Committee that counselling is vital.

For one thing, whereas the operation of vasectomy is legal for therapeutic purposes, for the saving of life or health, the law as to the legality of this operation for purposes other than those is doubtful, to put it mildly. I will not go into all the arguments—what Lord Justice Denning, as he then was, and the other learned judges said in 1954, and so on. I am sure, Mr. Speaker, that you would soon call me to order if I were to embark upon any lengthy discourse on that point.

Moral questions aside, the very fact that the law on the question is shrouded in doubt adds to the point I seek to make, that vasectomy for purposes other than therapeutic purposes is a very serious matter.

It is absolutely essential that the best medical examination and advice should be available to those who wish, or who think they wish, to undergo an operation whose effects are believed to be irreversible. That is the advice which was given by the hon. Member for Derby, North. This is an irreversible operation. We had the benefit in Standing Committee of the great medical experience and wisdom of my hon. Friend the Member for Norwich, South (Dr. Stuttaford) who assured us that this is an irreversible operation. This againadds weight to what their Lordships sought to do in this Amendment which says: A local health authority in England or Wales may, with the approval of the Minister of Health,"— that has been amended to "the Secretary of State for Social Services"— and to such extent as he may direct shall, make arrangements for the giving of advice on voluntary vasectomy, the medical examination of persons seeking advice on voluntary vasectomy for the purpose of determining what advice to give and for treatment for voluntary vasectomy". That really is the argument which I seek to put before the House. This is a slight improvement on an obnoxious Bill and I have no hesitation in supporting the Amendment.

I am not sure whether the hon. Member for Derby, North will come later to the question of the reports.

Mr. Whitehead


Mr. Biggs-Davison

I do not know whether he thinks that this proposal is better than the proposal of my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg). I believe that my hon. Friend has an Amendment relating to reports.

Mr. Whitehead

The hon. Member is speaking about Amendment No. 2 which we have not yet reached. It relates to replacements for the previous Clause—

Mr. Biggs-Davison

The hon. Gentleman is absolutely right. I did not see the figure 2 in the margin. It does not look much bigger than the figures of the lines in the Amendments.

I look forward to hearing from my hon. Friend the Member for Hampstead who took a very important initiative in the Standing Committee. I support Amendment No. 1.

Mr. Anthony Fell (Yarmouth)

I am grateful to have caught your eye in time, Mr. Speaker.

This Bill has been amended by their Lordships. The Amendments are of considerable importance and I am glad to know that the hon. Member for Derby, North (Mr. Whitehead) supports them. I am not quite sure whether, if I were pressed, I should feel able literally to support them. Nevertheless, they are Amendments of great scope and importance and they raise very serious questions.

In Committee we had long debates on the subject of advice and how people would be told what would happen if they were advised to have a vasectomy operation. My hon. Friend the Member for Chigwell (Mr. Biggs-Davison), who has made a further valuable contribution to these debates, said that he would not refer at any length to what had been said by Lord Denning on the question of the legality of operations of this sort. I wish to crave the indulgence of the House in order to speak for a moment not on the legal aspects of vasectomy but to cite what Lord Denning has said on this subject. May I preface this by saying—

Mr. Laurie Pavitt (Willesden, West)

On a point of order, Mr. Speaker. I am trying to relate the question of legal advice to the Amendment. I should be grateful for your advice. This is rather a narrow Amendment.

2.15 p.m.

Mr. Speaker

I agree with the hon. Gentleman. I was in some doubt myself. We cannot have another Second Reading debate.

Mr. Fell

I think that decision is very harsh on me, Mr. Speaker. I will tell you the reason why I think it is harsh. The Amendment says: …for the giving of advice on voluntary vasectomy… In my submission, it is not possible for anybody to give the proper advice on voluntary vasectomy without the people who are advised knowing the previous legal judgments on the question whether vasectomy should be treated as legal or not. This is why I wish to cite the words of that very great judge, Lord Denning, on this subject. Of course, if you overrule me, Mr. Speaker, I shall not be able to quote those words.

Mr. Speaker

The hon. Member said that I was being harsh on him. He is sometimes harsh on me. I am never harsh on him. I was just making a cautionary noise.

Mr. Fell

I am very grateful to you, Mr. Speaker, who are always so helpful to back-bench Members.

So far as I remember, there have been about only three people who have shown any opposition at all to this Bill. It seems to have been assumed that people should be allowed to go and have themselves mutilated voluntarily without any question of the legality of such an operation arising. It is true that there was that famous case in 1954 when there was a judgment by two to one. I beg forgiveness of the Solicitor-General for going into such a matter in front of him, but I have the papers with me. The hon. Member for Derby, North looks very worried. Even if I wanted to speak for an hour and three quarters, it is extremely unlikely that I would be allowed to do so. I am sure that Mr. Speaker would quite rightly bring me to order.

Mr. Whitehead

I hesitate to raise a point of order, but I should like to intervene on a point of information. The hon. Gentleman knows that the case of Bravery v. Bravery, which he is discussing yet again, was debated in Committee.

Mr. Fell

With respect, the hon. Gentleman says this, but in fact in Committee when I attempted to raise the case of Lord Denning's judgment, I was cut short. I am simply taking advantage of this Amendment—[Interruption.] The hon. Gentleman supports these Amendments. I have read the words: …make arrangements for the giving of advice on voluntary vasectomy… That is a matter which is not likely to be gone into. The fact that a person is likely to be made infertile for ever is not likely to be gone into. Let us, therefore, see what Lord Denning did say.

I refer to the case of Bravery v. Bravery, reported in 1954 3 All England Law Reports. At page 64, the case is outlined briefly by Lord Denning in these terms: The parties married on October 25, 1934, when the husband was 25 and the wife 21 years of age. They lived happily together for two years, until a son was born to them on December 19, 1936. About 18 months later, in 1938, a shocking thing took place. These are not my words; they are the words of a great judge held in the highest repute in legal circles in this country. …a shocking thing took place. The husband underwent an operation to have himself sterilised. He was the porter at a London Hospital. One of the surgeons operated on him, and he was attended by the sister and a staff nurse. This operation provokes several questions. The first is: Why did the husband have this done? Let me give his answer in his own words"—

Mr. Pavitt


Mr. Fell

If the hon. Gentleman wishes to interrupt, I shall be delighted to give way. But I must point out that I am discussing a matter of the greatest seriousness not only to the House but to those people who may be advised by National Health Service advisers or by local health authority advisers to have such an operation because, perhaps, they are having marital trouble at the particular time, and so on.

This is how Lord Denning recounts the matter: Why did the husband have this done? Let me give his answer in his own words. Counsel asked him: 'What was the immediate cause of the operation? A.—It was because of my wife's attitude towards the boy'. As far as I remember, the boy had been born about 18 months before. The husband's answer continued: He was not a baby to be caressed and loved. He was a showpiece…Q.—Why did you agree to have an operation for sterilisation? A.—Because my wife was so installed. She was so installed with the home, and with this baby she had. Q.—You said the baby was ashowpiece?"—

Mr. Pavitt

On a point of order, Mr. Speaker. We are discussing an Amendment about whether local authorities should give advice. Is it competent and in order that we should have a case history regarding what kind of advice they should or should not have?

Mr. Speaker

I was hoping that the hon. Member for Yarmouth (Mr. Fell) would be reasonably concise in his arguments. The difficulty of the Chair is that, when it tries to restrict discussion, it frequently prolongs it. I hope that the hon. Member will be reasonably brief. As I say, this is not the occasion for another Second Reading speech.

Mr. Fell

I immediately and perfectly understand what you have said, Mr. Speaker. I am, however, in this difficulty. If I had a great legal brain and legal training, I could no doubt put the matter succinctly in my own words, and if I had the reputation of the Solicitor-General I could use words which could be used later, taken from the reports of our proceedings, by family planners in their advice to would-be vasectomisers. But I am not in that situation. I am an ordinary humble back bencher who has strong feelings on this subject and who has not been able or allowed to give the views of Lord Denning about it in any extensive way at all.

I am sure that you will recognise, Mr. Speaker, that it is not helpful to the speed with which I am able to deal with the matter if I am constantly interrupted by the promoter of the Bill and by the hon. Member for Willesden, West (Mr. Pavitt), who wants to get to Order No. 51 on the Paper.

If I may be allowed to proceed, I shall do so with all the expedition at my command, and I promise you, Mr. Speaker, that I shall not be party to an attempt to hold up the discussion. I think it vital however, that the people on the ground who will have the invidious task of advising women that they ought to persuade their husbands to become sterile should have the best advice at their disposal. The best advice that I can give, for I have no other, is the advice of that eminent Judge, Lord Denning.

Mr. Geoffrey Finsberg (Hampstead)

Will my hon. Friend make clear to the House that what he is trying to get on the record is the advice of Lord Denning on sterilisation, not vasectomy?

Mr. Fell

Perhaps somebody will come to my aid. I am beseiged from all quarters on a most important subject, a subject on which Lord Denning's views have been quoted from time to time, but only cursorily. The subject is vasectomy, which, in fact—I would be delighted if someone with experience would interrupt me and say that I am not speaking the truth—is voluntary sterilisation of the male. But I am besieged and under fire—

Mr. Biggs-Davison

My hon. Friend is not under fire from me. It was a quite outrageous interruption by my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg), because the hon. Member for Derby, North (Mr. White-head) attached importance to the majority decision in the case of Fraser v. Fraser; he did not say that it was in any way irrelevant.

Mr. Fell

I am referring to the case of Bravery v. Bravery. I am grateful to my hon. Friend for his help. Why should he not help me? He has been the only one throughout all these debates to take any notice of the dangers of vasectomy to the married men of this great country of ours. [Laughter.] It is a laughing matter, is it, that many tens of thousands of males in this country should have themselves sterilised for ever? I do not regard is as a matter for laughter. It is a matter of the greatest seriousness, and the advice referred to in the Amendment should be good advice from the highest quarter.

Mr. T. H. H. Skeet (Bedford)

I am attracted by my hon. Friend's argument that the patient or client should receive the best practical advice available, For my part, I do not see how a local authority can give this advice, as there are so many implications here. It is not simply a matter of medical advice. There is the psychological background of the marriage. The individual must live for the rest of his days with the result. Perhaps my hon. Friend would amplify that aspect of the matter.

Mr. Fell

With great respect, I shall resist the temptation to answer my hon. Friend because I want to get on with what Mr. Speaker has kindly allowed me to adduce—at least, until the sundry interruptions which I have had—namely, the views of Lord Denning in the case of Bravery v. Bravery. I take up Lord Denning's account of the matter again: Q.—Why did you agree to have an operation for sterilisation? A.—Because my wife was so installed"— The word "installed" may be understood by the Front Bench, but it is not readily understood by me. She was so installed with the home"— [Laughter.] I am sorry, but I am reading from the account of the matter in the law report, which I presume to be correct. I have no reason to doubt that that word, which is repeated, is wrongly quoted. However, I do not know its meaning. If anyone is able to say what the word "installed" means in this sense, it may help the House, because there are one or two hon. Members on the Opposition benches whose faces are wreathed in mirth, and I fear they may do themselves an injury, though certainly not so serious an injury as vasectomy.

Seriously, I want to get on. I hope, Mr. Speaker, that you will have noticed that the only reason why I am not getting on faster has been the sundry operations in the middle of almost every sentence which I try to read. Q.—You said the baby was a show-piece? A.—Yes. Q.—In what way? A.—She wanted to have him perfectly dressed, and when he was tiny, if there was the least thing missing, she would be absolutely beside herself.

2.30 p.m.

I presume that, as Lord Denning quoted all this in his judgment, it was highly relevant, and that is why I am quoting it. Lord Denning goes on to say: Those answers throw a flood of light on the husband's mentality. Why did he object to the wife treating the baby as a showpiece? Although he did not realise it, he must in some strange way have been jealous of the place which the child had in the wife's affections, and his jealously found expression in a determination not to give her any more children, seeing that was the way she treated this baby. But it may well be asked why go to the length of sterilisation? Why not use contraceptives? Both agreed that ever since the birth of the child they had been having intercourse using contraceptives. He was the one who used them, not she. And yet he went and had himself sterilised. It is, as the commissioner said, 'an amazing story', and it was done simply because he was jealous of the baby. He did it so as to 'pay her out' for making so much of it. That seems to me to be cruelty in itself. That last remark, one presumes, is part of the reason for finally granting or not granting the divorce. Lord Denning goes on: The second question is: Did the wife consent to it? The husband says she did. She says she did not.

Will somebody tell me what will happen in the centres to be set up where the same questions will be asked? One hopes that warnings will be given of cases of this sort which lead to the destruction of a marriage. This fear has never seriously been put forward by any supporter of the Bill except the hon. Member for Pontypool (Mr. Abse) who, although he dilated at great length in Committee, is unfortunately unable to be with us today on the final curtain of this dreadful Bill.

I will not read the whole of what Lord Denning said in case it might appear that I am trying to hold up the proceedings, which I am not. If any hon. Member feels that I am being cursory or unfair to Lord Denning and will tell me so I will read out the rest of his remarks.

The view of Lord Denning was the minority view of three judges, but I have an enormous admiration for Lord Denning and it so happens that I know nothing of the other two judges. Lord Denning's judgment was that this type of operation was not legal in certain circumstances. No doubt it is legal for medical reasons but not merely to make one's life simpler and to enable one to have intercourse without fear. That is what it amounts to, is it not? Most of the operations for vasectomy will be carried out not for medical reasons but simply on the advice of one of these bodies—I do not even know what they will be—which will come under very little supervision from the Department. We have already been told that the Department could not itself set up such a body and that it will have to come under the local authority.

Does anyone in the House genuinely and honestly believe that every local authority is fitted to run an establishment to advise husbands and wives whether they should or should not restrict the possibility of having further children? Can anyone say that with clean hands? Of course not. It is impossible, and everyone knows it. That is why the whole question of the advice is of such enormous importance to the lives of the people who will be affected by the Bill.

Throughout the proceedings on the Bill my hon. Friend the Under-Secretary of State and I have had discussions from time to time on what advice he will give to the people who will have to advise. I have had no answer. My hon. Friend has been courteous and helpful and has never refused to give way to anybody, but he has never told us what sort of Circular he will send out to local authorities, what interest he will take and what controls there will be on the people who will give advice.

What sort of people will they be? Are we to have a new type of policeman, as we had for parking meters, to take the place of doctors? Are we to have an inferior doctor to advise these people? There are plenty of advisers, people called social welfare workers, and so on. What qualifications will they be required to have to do this job?

I will cite a typical case of the sort of advice they will be asked for. Let us imagine a local authority with a first-rate medical adviser and a first-rate social service department which tries to do everything it can to look after the people who come within its orbit. Someone hears that a family is having dreadful trouble. The husband and wife are throwing pots and pans at each other as hard as they can. Perhaps a health visitor is sent to see them, or they may go to the council to have a talk. Perhaps they are behind with the payment of rent because they do not get on—[Laughter.]—the hon. and learned Member for Barons Court (Mr. Richard) is laughing about this. If he would like to intervene and tell me why I will willingly give way to him. I do not think it is particularly funny. Tragedy families are not funny.

There may be an advisory clinic under the control of the local authority. The people employed by the local authority to give advice to problem families such as I have instanced are people of personality, experience of life and, perhaps, strong character. My problem family cannot get on, they are behind with the rent and have enormous bills which they cannot settle. They may be in a terrible advisory clinic. They will be in a terrible state because of the rows they are having and all they will be thinking of, naturally, is how they can make up their differences. They will want to know how they can get back on to an even tenor of married life and will not be interested in anything else. The hon. and learned Gentleman might easily have been a social worker. There are many Labour Members who have been social workers, and some Conservative Members. There is nothing wrong with that. If the hon. and learned Gentleman had been a social worker in the local authority's clinic, everything would have been all right, because he would be very careful to see that his personality did not impinge on that of the man and wife he was advising. But I envisage the case where the adviser sees as a short cut to the healing of marital breaches the permanent sterilisation of one or other of the partners. He might say, "They already have two children. Why do they want more in this over-populated world? It is better for the husband to have a vasectomy than for them to go on having babies or having abortions", which is murder. Naturally enough, if advisers think in that way they tell the wife that there is an easy way out of the difficulties. They say, "You don't have to go through an awful operation and you no longer have to take the pill".

Mr. Whitehead

On a point of order, Mr. Deputy Speaker. The hon. Gentleman has been speaking half an hour on what I stressed was a drafting Amendment, which simply spells out in more detail precisely the same procedures as were to be followed when the Bill left this House.

Mr. Deputy Speaker (Miss Harvie Anderson)

I appreciate the hon. Gentleman's concern, but the Chair must have regard to what is on the printed Amendment paper. I would join the hon. Gentleman in hoping that the hon. Member for Yarmouth (Mr. Fell) will not unduly prolong his remarks in view of the business before us.

Mr. Fell

You are kindness itself, Mr. Deputy Speaker, in that you have been careful about the matter the hon. Gentleman has just raised with you, careful in view of the fact that it was not possible for you to hear what I have been subjected to during the past 25 minutes or half an hour. Until the last five minutes there has been a succession of interruptions of almost every sentence I have said. Had there not been these continual interruptions, my speech would almost certainly have been finished by now.

There is a very small number of hon. Members who have shown any opposition to the Bill. It would be a disgrace to the House if the reasonable arguments about the Amendment were not put, if they went by default and the case for the British people was not even allowed to be heard in the House.

When I was interrupted again by the hon. Gentleman, who is making life very difficult not only for me but for himself, to say nothing of the Chair, which fortunately has infinite patience and is always so ready to help, was instancing the case of a married couple who went to a local authority for help in their marital troubles. I had got as far as speaking of the hon. and learned Member for Barons Court as their adviser as an illustration. I had said how spendid the advice would be if he were able to give it, and how happy the couple would probably be for ever after.

But I was going on to say that the danger arises on how the Ministry is to suggest dealing with the matter and how local authorities are to train and take on advisers for such services. Of the essence of the first part of the Amendment is the advice to be given. The Amendment says: A local health authority in England or Wales may, with the approval of the Minister of Health, and to such extent as he may direct shall, make arrangements for the giving of advice on voluntary vasectomy… The advisers are people of considerable personality. They are overwhelmed with people who have marital troubles and with the social service they are trying to help to run for the local authority. Their life is no easier than that of the doctor in his surgery who has 10 people in the waiting room and 15 minutes in which to deal with them. We cannot imagine that little palaces will be set up in local authority areas, palaces with limitless facilities, with lots of social service officers ready to advise all the people who are in difficulties. We know that my hon. Friend the Minister, with his great responsibilities, will do everything he can to help, but we cannot imagine that he will be able to conjure up the services and advice that are essential if the system is not to go wrong, if countless wrong decisions are not to be made and countless men are not, under advice, to have the vasectomy operation with no chance of their ever having children again.

But the situation is worse than that when the personality of the adviser is stronger than that of the couple, who will be a bit off balance anyway because they are having battles. This will apply to many thousands of couples. The adviser may well tell the wife, "All you have to do is sign a form. Your husband also has to sign, but you can get him to do that. It is painless and there is no difficulty. It is irreversible". The husband may not care very much about that in the difficulties of his married life. The adviser says, "The doctor will sign it, and away your husband goes for a vasectomy. It will take 10 minutes, and probably there will be no cost to you." We are not sure about that, but the hon. Member for Derby, North (Mr. White-head) is urging a free service paid for by the local authority to stop the birth of children.

Mr. Pavitt

On a point of order, Mr. Deputy Speaker. The hon. Gentleman has spoken about the cost. We are speaking about a very narrow Amendment on advice from local authorities.

Mr. Deputy Speaker

The hon. Member for Yarmouth (Mr. Fell) must have heard the Chair, before the present occupant took over and since, make it clear that it would not be in the interests of the House to elongate his remarks on the Amendment unduly.

Mr. Fell

What I should love to say, Mr. Deputy Speaker, is that of course I absolutely sense what you are saying, agree without a word, and will now sit down. But how is it possible for me to be fair to my case, to myself or to the Chair, and do that, when throughout my speech I have been interrupted by several Labour hon. Members and various others, one of whom, my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg) has gone? By the process of exhaustion, it could well happen that within a short time there will be no more interruptions, because the interrupters will all have gone.

Mr. Geoffrey Finsberg

Unfortunately I have not gone, and I have had to listen to this.

Mr. Fell

That is a very good illustration that my interrupters will not leave, so interesting is the case I am trying to put to the Committee concerning what would happen to the country.

Mr. Deputy Speaker

Order. The hon. Gentleman must be aware that he is stretching this Amendment into a very wide debate. I hope he will not continue to do it or seek to do it.

Mr. Fell

I will finalise my illustration, Mr. Deputy Speaker, because I am sure that what you are quite rightly telling me to do is not to be diverted by questioners, wherever they come from. I will abide by what I imagine to be what you are telling me. I will not take any more interruptions. I will continue with my speech and finish it as fast as I am able. However, I will take one more intervention, because I was about to do so before you rose.

Mr. Skeet

I merely want to tell my hon. Friend that I wish to speak briefly about this matter after he has finished.

Mr. Fell

That encourages me even more, knowing my hon. Friend's facility in speech. It encourages me to get on with my own speech and try, in spite of the interruptions, to come to some sort of conclusion.

We are discussing a series of words. The hon. Member for Derby, North (Mr. Whitehead), although he did not read them to the House, counted 101. I will finish this story of the married couple, if I may. They have got to the stage of agreeing that the husband shall have a voluntary vasectomy operation. In the case I am talking about, the man has the operation and—fortunately, this is only an imaginary couple—a week later the wife is killed and a year later the man, who has two children on his hands and no mother to look after them, meets a girl whom he thinks would be an admirable wife to him and an admirable mother for the children. But he has to say to her, of course, "I cannot have any more children if we should get married". Of course, to many young women that would be an insuperable objection to getting married.

You will now, Mr. Deputy Speaker, see the drift of my remarks—the dangers inherent in the sort of advice that will be given to the married couples that local authorities are doing their level best to look after and help. But there can be so many slips in attempting to look after other people's business. I suppose that the most relevant thing which could be said about the Bill is that it takes away from people their own responsibilities, because the advice we are talking about is the sort of advice that most couples should be able and must be able to give to themselves instead of relying always on other people to do their job for them.

The horror of this sort of legislation is the attitude "Let the State do everything and pay for everything, and let the taxpayer pay the bill for everything." That is the horror of the Bill, which is not disguised by glib talk about Amendments which come from the other place, about how those Amendments have been discussed there and the suggestion that we should simply accept them. The hon. Member for Derby, North is a deeply thoughtful man. He has shown himself to be a model of courtesy and kindness throughout the proceedings, but even he has become so tired of the Bill that he wants it to go through on the nod.

Mr. Deputy Speaker

Order. I think it would be unwise to try to make comparisons of that kind. I have said to the hon. Gentleman twice that it is not in the interests of the House if his speech is unduly long.

Mr. Fell

I am, of course, again in difficulty, Mr. Deputy Speaker, although I have craved your indulgence before. All I can say at this stage is that I will abide by what you say. Nevertheless, I think I must be allowed to come to a conclusion. [Interruption.] The hon. Member for Derby, North cannot help interrupting me from a sitting position. If he were able to interrupt me from a standing position, he might get on better. I do not intend to be interrupted anyway because of your ruling, Mr. Deputy Speaker, and therefore I must be allowed to conclude my remarks.

I wish the hon. Member for Pontypool (Mr. Abse) were here, for he it was who in earlier discussions of the Bill—which I cannot discuss except in so far as they are related to the Lords Amendment—spoke at great length and, if I may say so, at far greater length than I am doing this afternoon.

Mr. Deputy Speaker

Order. The hon. Gentleman will be aware that the proceedings at earlier stages cannot be referred to in this way.

Mr. Fell

Yes, Mr. Deputy Speaker. I said as I was going along that I would be out of order if I discussed them. Of course, I take your correction immediately. I want to refer not so much to those proceedings as to the advice given here, which is very much in line with what the hon. Member for Pontypool stressed in earlier discussions.

With that short interjection, I think it unnecessary for me to speak any more on this. I hope I have not offended the Chair in any way, and I hope you will realise that if any offence has been given to the Chair it has been only because of the vast importance which a very few of us attach to the other side of the argument on the Bill. This is almost our last chance to put the argument before the Bill comes into law, which I hope it will not.

Mr. Pavitt

I rise briefly to support the Lords Amendment. The principle has been agreed to. The Amendment is mainly a drafting one and I think that those hon. Members who sat for many long hours in the Standing Committee will agree with that. The problem of how advice is to be given is not for us. It can be tackled in a number of different ways. But, of course, a lot of responsibility rests upon the persons concerned and therefore the community, through the local authority, is the right channel. We are members one of another. No unloved or unwanted child should be born into the world, and the responsibility rests far beyond the immediate parents to the community at large. Their Lordships have shown their regard for ensuring necessary safeguards and have passed this very small but important piece of legislation through their House. I hope that this House will agree with them.

Mr. Ray Mawby (Totnes)

My hon. Friend the Member for Yarmouth (Mr. Fell) has made the same point as the hon. Member for Derby, North (Mr. Whitehead)—that this is purely a drafting Amendment and that the whole principle has been previously discussed. I beg to differ. My reading of the Lords Amendment suggests that it specifically spells out something not spelled out in the original Bill. I ask all hon. Members to look closely at the Amendment and not to be beguiled by the words of the two hon. Members who suggest that it is purely drafting.

Mr. Pavitt

Has the hon. Member for Totnes (Mr. Mawby) addressed himself to the debate in Committee on precisely this subject?

Mr. Mawby

The hon. Gentleman will know that we cannot all sit on every Standing Committee, and we are forced, therefore, to read reports of debates. Clearly, the hon. Gentleman will have more intimate knowledge of that Committee than I can ever have.

I am concerned with what the courts are always concerned with—not what was said in Standing Committee, but what the Bill says. The Bill will not be altered in just a drafting sense if the Lords Amendment is accepted.

The last thing I want to do is to rehearse all the arguments of the past about the sittings of the House. The hon. Gentleman correctly said that it would not be for the House to decide the way in which the advice was given, or the sort of experts who would be recruited to give advice, but that it would be a subject for the advice and consent of the Secretary of State. That is right and proper.

On the other hand, we have to ask ourselves one or two questions. Unlike normal contraception, this would be an irreversible decision, and we have to ask what will be the width of the considerations that will be taken into account by the experts giving advice. One only has to take into consideration the discussions which I have had with various gynaecologists about their differing attitudes, whether they should advice or undertakean operation for abortion for social reasons, to discover that this matter raises all sorts of problems. I do not intend to deal with them now, as they have little to do with the Amendment. Nevertheless, it is true to say that there are gynaecologists who are in great difficulty from time to time in deciding priorities in the advice they give and, at the end of the day, whether they are prepared to undertake an abortion.

A local authority is to be given the power to advise on vasectomy. We must take into account how wide the consideration should be. It is obvious that if there is genuine medical need those concerned will not go to the local authority for advice, but to their own local doctor, who will send them to a consultant. The consultant will say that it should be done for strictly medical reasons.

But what about the young couple who enter marriage and find that a building society is not prepared to give them a mortgage because the wife is still of child bearing age? Will the advice point out that if they could prove that there was no prospect of the girl bearing a child, they might be able to move into decent living conditions from possibly dreadful conditions? Would the consideration upon which the advice was based be as narrow as that? I hope not.

A young couple faced with that situation may often be prepared to get married forgetting that they may want to start a family later. They may take that irrevocable decision, voluntarily, of course, but nevertheless acting upon advice which appears to have come from experts who have been appointed by the local authority with the express consent of the Secretary of State. It is important that we should take these matters into consideration.

There are other local authorities which have a direct incentive, if not to reduce the population, at least to keep it at its present level. Would those advisers be so overwhelmed by the desperate need to keep the population at its present level as to say to anyone who came for advice "For goodness sake, either have a vasectomy or move to Birmingham"? This has to be given serious consideration. I would be happy to think that my misgivings will turn out to be ill-founded in practice. Nevertheless, they are serious misgivings which must be taken seriously.

If this advice is to be given it is right that it should be from the local authority. There will be the direct contact of welfare visitors with problem families. There ought to be full advice available to such couples at the earliest possible moment about the kind of voluntary action they can take. We could quickly reach the position that the welfare worker is seen not as someone who is ready to help but as someone who has become nothing more than a nosey parker because certain advice may be given which does not take account of wider considerations.

It is all very well to say that every person has a right to have the operation or not. The important thing is that there are particular cases in which it appears that the man did not take completely voluntary action, where there is evidence that it was decided to some extent either by the other partner of the marriage or some other consideration. There is also the question of a man who becomes a widower. A new situation might arise. The man has to take his own decision.

Where advice is to be given under the terms of the Amendment it ought to be the best possible advice in the interests of the man and his family, without taking into consideration such matters as the population explosion and the fact that there are too many people living in the towns. Far from being a drafting Amendment, the Amendment raises matters of principle. I hope that if it is passed my right hon. Friend will pay particular attention to any representations made to him and that before granting permission he will satisfy himself that the standards of the advisers and the type of advice given are the highest possible.

Mr. Skeet

You can always rely upon me to make a very brief contribution and one that is to the point, Mr. Deputy Speaker. I only regret that on this occasion the Minister will not answer my remarks but I feel that they should be made. A decision has to be taken by the man in question. Under the Amendment he can take the decision only by seeking advice and it is right that he should take advice. He can take the best advice from a man in Harley Street or he can take advice from the local authority. What I am concerned about in dealing with local authorities throughout the country is whether there will be consistency in the advice that is given.

The legislation on abortion has gone wildly wrong. In certain parts of the country the advice which is given is "You can have abortion whenever you want it". In other parts, abortion is not given lightly because people realise the problems involved. Therefore, it is most important that, whether it be in Birmingham, Glasgow, or anywhere else, the best advice should be given and there should be consistency in it. That presupposes that there would be a course of instruction which the Minister would have to arrange through the Ministry. In that event, what will be the criteria? Will they be based specifically on medical grounds, or will it be said "This is partly a medical and partly a psychological matter", the psychological part revolving round the question of how the man concerned, his wife and family will be affected in the years ahead?

We must consider these matters. I accept that advice must be given; and if it is the will of the House that it should be local authority advice, I regret it but I am prepared to accept it.

Under subsection (2B), the local authority can, with the approval of the Minister of Health, recoup all the money expended. I know that the Labour Party is against means tests. We on this side of the House realise that there can be reasons for them. It is necessary in such an important matter as vasectomy that the best advice should be given. If a man has to pay for it, he will think twice about having the operation. On the other hand, if it is possible that he will not have to pay, he may consider the matter lightly and afterwards severely regret his decision to have the operation. It is open to any man to go to any doctor and seek advice on vasectomy. He might be able to pay for the operation. It would be inexpensive if it is short, but it would be certain.

I thought it only right to express these points of anxiety. I should be grateful to the Minister if he could clear up the points I have raised. It should not be left entirely to local authorities to give whatever advice they have in mind. There should be advice from the Ministry as to the criteria to be adopted and the factors which must be taken into account.

Mr. Biggs-Davison

My hon. Friend has made the important point that there should be uniformity in advice. He then turned to the question of subsection (2B). Does my hon. Friend think that there should be uniformity about whether people should be charged for the operation? I should have thought that the argument for uniformity in this respect was even more important, otherwise there would be a great sense of injustice.

Mr. Skeet

There must be uniformity in the advice given by local authorities. It would be absurd if one set of criteria operated in the North of England and entirely different criteria operated in Wales. I am not responsible for the Lords Amendment, but if anybody wants to have the vasectomy operation, as it is a short operation replete with so many consequences for the family concerned, it should be paid for. It would therefore be unnecessary to put it under the National Health Service. But if the Lords are prepared to go to the limit and say "You can have it on the Health Service", although it is possible for the Minister to give a dispensation and to say that the moneys may be recouped, we come back to the original point. There should be uniformity in the sense of paying for whatever happens.

3.15 p.m.

Mr. Biggs-Davison

Is my hon. Friend aware that although it was said by hon. Gentlemen on the Opposition side that this was a drafting Amendment, in fact it introduces a new principle? This was not agreed in Committee, and it is surprising that the Amendment should be treated so lightly by hon. Gentlemen opposite. We shall require an explanation why the hon. Member for Derby, North (Mr. Whitehead) is now accepting the novel principle of charges to be imposed by the local health authority with the approval of the Department. This is something new. We did not discuss it in Committee, and yet we are told that this is largely a drafting Amendment, as if to say that we should disregard this important matter of principle.

Mr. Skeet

I appreciate that. As the hon. Gentleman knows, I am a great believer in Private Members' Bills and I wish him well with this Measure, but as well as being a matter of judgment it is up to the Minister to answer the points I have raised. They are important and I believe that many people will share this view. I shall be much obliged if my hon. Friend will deal with them now.

The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)

Such was the eloquence of my hon. Friend the Member for Yarmouth (Mr. Fell) that I hesitated to disturb that impression of eloquence and charm which he displayed to the House by introducing a coarser note such as is introduced when a person like myself speaks from the Dispatch Box. However, at the invitation of my hon. Friend the Member for Bedford (Mr. Skeet) I think that I must speak briefly to reassure the House, and, having listened to their speeches, my hon. Friends the Members for Totnes (Mr. Mawby) and Bedford, that no change of substance is effected by the Lords Amendments which we are considering.

May I assure the House, my hon. Friends and any hon. Gentlemen opposite who may have misgivings about it that the changes effected by the Lords Amendments which we are discussing have no practical effect upon the character of the Bill which the House finally passed and sent through to the other place. The reason for the Amendments was that in terms of intra-professional standards Lord Brock, who is a surgeon, thought it proper that the operation of vasectomy, which is a surgical operation, should not be tacked onto the end of the activities of local authorities in the matter of providing pills and other contraceptive substances which are available for prescription by general physicians. He wanted to make certain that anything that fell within the remit of surgeons was spelled out in a separate subsection, but I repeat that the effect of the Bill is unchanged in any substance.

My hon. Friend the Member for Bedford raised the question of advice to local authorities. I think that if he checks our earlier debates he will realise that I was able to give the House a considerable assurance that my right hon. Friend is proposing to dispatch to local authorities a carefully worded circular of advice in the matter of the operation of the Bill.

The Measure will operate for only a year because in 1974 local authorities lose their health powers. The Chief Medical Officer of my Department, Sir George Godber, will communicate with medical officers of health in local authorities on what I might call the professional network to elaborate his professional misgivings.

The House will have noted that charges are to be made with the approval of the Secretary of State". I think that I can leave the House in no doubt that we should probably hesitate long and earnestly before we ever thought of giving approval for charges to be made in this matter. Local authorities having, therefore, to meet the cost of this through the rates, are not likely to give it a major priority for the short period for which the Bill will operate.

I assure the House that the points made by my hon. Friend the Member for Totnes, my hon. Friend the Member for Yarmouth and my hon. Friend the Member for Bedford all provide grist to the mill for the circular we shall have to devise to send to local authorities when and if the House passes the Bill.

Mr. Fell

My hon. Friend, as usual, is courteous and helpful. But we have asked about this before. May we ask again? Can my hon. Friend give us any sort of time when we are likely to see the circular? What will be in it? When he says, "But this is only for a year", I cannot help but feel that my hon. Friend is not as naive as that. In spite of his earlier blandishments to me about the beautiful, friendly, nice and pretty speech I made, I made nothing of the sort; nor did I intend to. Does the Under-Secretary realise that it is naivete in itself to think that this does not establish a principle? It is not a question of lasting for only a year. Once the principle is established, it will probably exist for ever.

Mr. Alison

In so far as the principle relates to the operation of vasectomy, my hon. Friend knows that that is available widely under the National Health Service at present. So far as the principle of local authorities continuing to have health powers—perhaps the principle to which my hon. Friend was referring—it is now accepted on both sides of the House that local authorities should lose health powers in any reorganisation that operates. So in matters of principle my hon. Friend can be reassured.

Mr. Fell

If vasectomy, only for health reasons, is available now, why on earth are we passing the Bill?

Mr. Alison

The decisions of surgeons in general hospitals at present may, in certain cases, allow for very severe social considerations. So the whole gamut of service we are discussing is already available in the hospital service. But it would be out of order for me to get drawn into this matter because it is not one to which the Amendment relates.

The last point made by my hon. Friend the Member for Yarmouth was whether the House would have a chance to see the circular. The difficulty here is that we cannot dispatch the circular—which becomes, when dispatched, a public document—until the House has authorised us, through the Bill, to put the machinery in operation. When the House has done that and when the circular becomes a public document, my hon. Friend will have access to it.

Mr. Biggs-Davison

Perhaps I would be pressing this matter beyond the bounds of order if I were to ask my hon. Friend to pursue the question whether surgeons who perform the operation of vasectomy at present for other than health reasons are acting within the law. But why does my hon. Friend set his face against charges in a rather casual way? This is an operation which is once-and-for-all. I should have thought that some charge would go some way towards concentrating the mind of those who come forward for this sort of operation. Why does he set his face against charges in this way?

Mr. Alison

That is a fine point and a number of factors are involved. It may be that if charges were available to local authorities, because they would not have to bear the expense through their ratepayers, they might go in for the operation on a very much bigger scale. I am sure that my hon. Friend would not want that to occur. That is one side of the coin.

The other side of the coin is the need for uniformity of some sort when local authorities lose their health powers and the whole thing passes into the hands of the hospital service. That is the sort of consideration we have to weigh. I cannot commit my right hon. Friend, but the chances are that he would be disinclined to authorise charges to be made under the Bill when it becomes an Act.

With those reassurances about the basically drafting character of these Amendments, and my attempt to meet the point made by my hon. Friend the Member for Bedford, I hope that the House will agree that this is a harmless and desirable Amendment.

Mr. Martin Maddan (Hove)

The Amendment is not harmless. I did not quite catch my hon. Friend's final words as he sat down but I think they were to the effect, perhaps, that the Amendment was trivial and insubstantial and did not really matter. I cannot agree with that.

In dealing with a topic of this sort, we must realise that we are dealing with a deep social question. When it comes to giving advice, it underlines the fact that we are not dealing with a medical question per se. Although I am the first to say that doctors, in the discharge of their duty, are conscious of their social obligations, if Parliament passes Statutes which have the effect of laying a duty—or, if not laying a duty, at least providing an opportunity which it is thought may be taken advantage of—on authorities to give advice on voluntary vasectomy, it will not be long before they are advocating that very course. That is what especially worries me about the Amendment.

It is a very serious matter to suggest to anybody that he should undergo such an operation, having regard to the effect that that will have on his whole future life within his present or future family. The State must tread much more carefully and slowly, if at all, and with much more consideration beyond medical considerations.

My hon. Friend the Under-Secretary has mentioned the advice of his Principal Medical Officer. That is very serious and weighty medical advice; nobody would deny that. Much more than that is involved in this issue, and what I hope—

Mr. Deputy Speaker

Order. The hon. Member may be perfectly right, but I hope that he will confine his remarks to the Amendment.

Mr. Maddan

I will confine my remarks to the making of arrangements under the Amendment, to the giving of advice on voluntary vasectomy. This is a new principle which has been introduced into the Bill at this late stage. In giving such advice, we are embarked upon something far more important than a mere medical matter. It might be assumed from the title "National Health Service (Family Planning Service) Amendment Bill" that it is all a rather innocent matter. We are saying that we can visualise circumstances in which the provision of such an advice service will lead to the State—not private people, not doctors, not mum and dad, not friends—giving advice to people to secure a voluntary vasectomy.

I do not believe that the State is not regarded by ordinary men and women as having a sort of wisdom which individual people do not have. I think that people believe that the State has extra wisdom. Perhaps the reason people believe that the State has extra wisdom is because of the debates we have and the care we take in Parliament in discussing these matters before enacting them. Therefore, any advice given through a State agency is regarded as more weighty and as more setting the seal of approval upon the course of action than advice given through a private quarter, even a medical quarter.

If we were to pass the Amendment, we would be envisaging the setting of the seal of approval by the State in certain circumstances—social, not medical—of voluntary vasectomy. When the Bill was introduced, that was not what was intended. The Amendment is embarking upon entirely new terrain, and terrain which I believe is very dangerous.

I understand entirely the difference between morality and people's responsibility for their moral actions, and the need for the State to intervene in the law. This issue has been brought to our attention in recent Measures concerning homosexuality. What we are doing here, it seems to me, is turning the same coin upside down. We are saying that the State can move in and give approval to courses of action which individually we might hesitate to give, or that if we gave the advice as individuals, people might hesitate to accept it.

3.30 p.m.

There can be no doubt that if the State, after deliberation in Parliament, sets up a service of this sort, what will be thought by the general public is that Parliament, as a sort of guardian of the national conscience and morality, has said, "This is all right" not only on medical and social grounds, but that it may actually be positively encouraged.

It is for that reason that I am very perturbed about this Amendment. If I have arrived late on the scene it only emphasises my concern about this Measure. I hope we shall hear something about the social consequences and the moral status of the State if we were to accept this Amendment.

Question put and agreed to.

Lords Amendment, as amended, agreed to.

Lords Amendment No. 2: in page 1, line 19, at end insert: (2) It shall be the duty of any local health authority providing voluntary vasectomy services by virtue of this section to make to the Secretary of State, at such times as he may require, periodical reports as to those services, and the report for any period—

  1. (a) shall show how many patients received treatment in the period, and categorise them by age; and
  2. (b) shall state the expenditure of public money incurred by the authority in the provision of those services during the period; and
  3. (c) shall give such other information possessed by or available to the authority as the Secretary of State may request with respect to those services or to the persons who have at any time applied for or received treatment;
and for that purpose a local health authority shall keep such records as the Secretary of State may from time to time direct.

Mr. Whitehead

I beg to move, That this House doth agree with the Lords in the said Amendment.

Mr. Deputy Speaker (Miss Harvie Anderson)

I suggest that it will be convenient if at the same time we discuss Lords Amendment No. 3, in page 2, line 1, leave out Clause 2.

Mr. Whitehead

We have had an interesting debate. I hope to set some kind of model to the House in the debate on this Amendment by being brief, if nothing else. Amendment No. 2 replaces Clause 2 as it was when it left this House. It proposes an addendum to Clause 1 which was agreed to after wide discussion between the noble lord, Lord Amulree who took the Bill through another place. Lord Aberdare and the Minister.

I should like on this occasion, since this is my last opportunity to do so, to pay a formal tribute to them for the great assistance they have rendered throughout the passage of the Bill. In both Houses it has enjoyed overwhelming support—in this House in Committee, on Report and Third Reading, and unanimous support in another place.

Amendment No. 2 deals with Clause 2 which was originally introduced into the Bill by the hon. Member for Hampstead (Mr. Geoffrey Finsberg). Clause 2 was concerned with the keeping of records, and it was divided roughly into three subsections. The first laid upon local health authorities the duty to make reports, and in the Amendment this is retained. In another place Lord Aberdare said that he could give an assurance that a summary of the reports received from local health authorities would be made available and circulated.

Subsection (2) as it left this House placed a duty on local health authorities to keep records concerning ages of rejected applicants—those under the age of 30 who wished to have vasectomy operations and had been turned down—and to keep trace of those places where they might turn up and ask for the operation again. In another place Lord Aberdare said that this would entail elaborate and costly administrative machinery out of proportion to any benefits that it might bring. We are not all agreed with him on that.

Subsection (3) as it left this House suggested that there should be an annual follow-up into the social circumstances, and any changes therein, of men who had undergone the vasectomy operation. It was quite new to the procedure of local health authorities—something which we do not do with any other operation known to medicine or surgery, and I think quite rightly.

hen the matter was considered more widely, the view was expressed in another place that this provision would involve an unacceptable intrusion into the lives of families where the husband had had a vasectomy operation, and that it might deter people from having the operation.

It is my view, having been as brief as I can, that Clause 1, revised as it will be by this Amendment, is a great improvement to the Bill. It ought to find wide approval and I hope it will be accepted.

Mr. Biggs-Davison

Lords Amendment No. 3 arises from the excellent initiative taken by my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg). We are very much indebted to him for introducing in Committee a new Clause providing for reports to be made and records to be kept. I am glad to be able to agree with the hon. Member for Derby. North (Mr. Whitehead) on the desirability of follow-up.

Vasectomy is a novel form of contraception. It must be taken for granted that it is irreversible, although my hon. Friend the Member for Hampstead in Committee referred to certain American experiments in reversal operations. We learned much in Committee about the unknown quantity that this operation represents, about the work done by Dr. Roberts and the rather gloomy evidence that was included in the report of the Family Service Organisation in Massachusetts. We learnt that vasectomy represents a threat to marriage and sometimes leads to divorce, sometimes to emotional disturbances and in most cases to less effective handling of personal problems. That is a serious report. We do not yet know much about this operation. We certainly do not know about its possible side effects and psychological and emotional consequences, and I am glad that the other place has produced this Amendment.

Mr. Fell

As I understand, Amendment No. 3 gets rid of Clause 2 which is replaced by Subsection (2) in Amendment No. 2, which requires any local health authority providing voluntary vasectomy services to make to the Secretary of State periodical reports as to those services. The subsection goes on to detail what information shall be given in the report.

The Amendment does not harm the Bill and I do not object to the Amendment which their Lordships, in their wisdom and after discussion, have suggested. It requires that the reports shall show how many patients received treatment in the period, and categorise them by age". One might have been happier if it had called for fuller categories in that section instead of simply by age.

Paragraph (b) requires that the report, shall state the expenditure of public money incurred by the authority in the provision of those services during the period". I presume that this part of the report would include an account not only of the expenditure of public money but of what money is to be set against that in respect of income received from those who have paid to have a voluntary vasectomy operation. I must not refer to matters which have gone before, but the Bill now includes a way by which a payment for these operations could be required, as I understand it, by direction from the Ministry.

Further, paragraph (c) requires that the report, shall give such other information possessed by or available to the authority as the Secretary of State may request with respect to those services or to the persons who have at any time applied for or received treatment. I regard this as the most important part of the Amendment, for it enables the Secretary of State to ask for any information he requires in connection with the carrying out of the operation. My hon. Friend will correct me if I am wrong, but I see it as enabling the Secretary of State to have a report at any time of the year, or at any time he wishes, of the number of operations performed, what had happened to the people on whom the operations had been performed, and what had happened to the families involved.

The most useful information of all for which the Secretary of State could ask would be information concerning the progress of the family life of those concerned. In line with what I said earlier, I hope to hear from the Minister a definite statement that he will require the most detailed information regarding the families in which the male has had this very final operation performed.

I fully understand when my hon. Friend the Under-Secretary of State is unable to tell us what the circular will contain, for he has not drafted it yet, and I understand his difficulty in not being able to say anything about the details of what he will require until the Bill has become law, if it does. But will he tell us the sort of information which he will require? For instance, will he require information concerning the sort of people whom each local authority uses to give this advice?

3.45 p.m.

In an earlier intervention, my hon. Friend the Under-Secretary said that vasectomy operations at present available under the health service are available under expert medical guidance and in the course of care of the health of a patient. That is all right so far as it goes but it will not be the case when and if the amended Bill comes into force, because while the Minister will have to ask for information on various matters the amended Measure will not lay down for what information the Minister must be required to ask.

It would be wrong to tie down the Minister to ask for definite kinds of information, but things will be made very difficult for him because, with respect, at present all that the Minister knows of vasectomy under the present service—except for one or two items that he may hear from one of the bodies that may from time to time advise him—comes from his own medical authorities. Under the Bill as enacted he will be getting reports from local authorities which may or may not be prepared for him by the local medical officers. The reports may be sent to him by anyone.

One would like to know what sort of reports they will be and what reliance the Minister will be able to place upon them. They will be concerned with all manner of things. There must be reliable lines of communication between the Minister and the local authorities, and proper lines of communication with the advisers or whatever they are to be called and with the centres or whatever they are to be called which will advise people who in desperation, and only in desperation, could have this terrible and final operation.

Many things are not yet settled. The hon. Member for Derby, North (Mr. Whitehead) is worried about Lords Amendments Nos. 2 and 3. He has spoken on them, and has kindly given us the benefit of his views on them. He thought that they were all right but I do not think they are, because they do not put the Minister in a position in which he will be able to furnish the House with the precise information necessary for the House to know the progress of this revolutionary Measure which will allow people to have this terrible operation at the expense of the taxpayer. How can one with an easy mind pass much a Measure?

Mr. Deputy Speaker

Order. I hope that the hon. Member will stick to discussion of the Amendment under discussion.

Mr. Fell

I have been doing my best, Mr. Deputy Speaker. I perhaps strayed for a moment in order to try to save time, but at that moment I also sought to retrieve myself. I shall keep strictly to the Amendments, as I have done so far.

I was saying that the hon. Member for Derby, North has kept us informed of his view of these Amendments. We have therefore been invited to look at them. I have done so, and I am not happy about them.

Mr. Peter Rost (Derbyshire, South-East)

I accept that my hon. Friend is not happy about them, but does he not agree that the Bill has substantial majority support on both sides and that it would be a great pity if because of a procedural manœuvre it were not now allowed to go through?

Mr. Fell

My hon. Friend is entitled to ask me any question he likes. I seek your protection in this matter, Mr. Deputy Speaker. An hon. Member can be accused of all manner of things. I do not think that the allegation that he is indulging in a party manœuvre should weigh with him in a matter on which he feels as deeply and as strongly as I do about this terrible Bill. I should be ruled out of order if I said any more about that, but I was led into it by my hon. Friend.

It is true that if there were more Amendments it would be easier to talk about this matter with my hon. Friend the Minister. The paucity of Amendments is dreadful. The Amendments do nothing to require the Minister to do the things that are absolutely necessary. Lords Amendment No. 2 says: shall give such other information possessed by or available to the authority as the Secretary of State may request with respect to those services or to the persons who have at any time qualified for or received treatment". We are in the most frightful dilemma. We have a series of Amendments which have been discussed today for a few hours. With respect to the hon. Member for Derby, North, who has fought so gallantly to get the Bill through the House, we are now blessed with no very strong support from him for Amendments from the other place which do not serve the purpose.

It is true that there are procedures in the House, which it would be wrong for me to mention, in spite of my hon. Friend's intervention. But it is also true, Mr. Deputy Speaker, that you were kind enough to call me to speak to the Amendments, and I cannot with any conscience lend my support to them. I may be told to vote against them. But, with great respect, no one in the House is stupid enough to believe that if I and one or two others voted against the Amendments it would make any difference. Therefore, who shall criticise me if I use the normal procedures of the House to vote against the Amendments in the other and only way open to me?

Mr. Deputy Speaker

Order. We are discussing the content of the Amendments not the procedures of the House.

Mr. Fell

Indeed, Mr. Deputy Speaker, and of course I apologise for having been sidetracked by an interjection from the hon. Member for Derby, South-East (Mr. Rost), who at other times today, to which I must not refer except in passing, has interrupted me, thus burning the minutes away until we are in this position.

We are faced with a dreadful dilemma over these Amendments, are we not? We have had them sent to us by their Lordships. It could be said that if they had used self-denial to a greater extent than they have, the situation here would not have arisen. But they did not and my hon. Friend the Under-Secretary of State, instead of trying to persuade their Lordships not to send the Amendments to this House, has welcomed them. I am in the position of trying to talk about them. Here we have this last set of Amendments which we are talking about and they make no impression on me as Amendments which can truly serve the purpose of keeping the Bill going.

Mr. Geoffrey Finsberg

Does my hon. Friend recall that in Standing Committee he was kind enough to put his name to a new Clause in similar terms? Will he accept from me, as the sponsor of that new Clause, which was accepted, that I am perfectly satisfied that what has come from the other place makes no material alteration? If my hon. Friend put his name to the new Clause moved in Committee, will he now explain why he did so?

Mr. Fell

My hon. Friend's appeal does not fall on deaf ears. I have great regard for him and in order to help him in Standing Committee—which I will not talk about—I supported the new Clause which he put down. But that was only because it was a slight help and not a hindrance. That is all. Now we have these Amendments. What can I do?

Mr. David Crouch (Canterbury)

Sit down as a service to the House.

Mr. Fell

I understand the urgency felt by a few of my hon. Friends and hon. Members opposite. I may not understand all that much about this place, but I do understand the protections that are open to us. One of the protections I have is that these Amendments have been sent down from the other place for discussion, and I am discussing the last two of them. If Amendments are drafted by their Lordships and sent down to this honourable House, it would be churlish in the extreme of me not to give them my full attention. That is precisely what I am attempting to do today, through the interruptions of my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg), the hon. Member for Derby, North and others.

I will try to bring myself to a conclusion as quickly as possible. I want the House to realise how short of what is necessary these Amendments are. As anyone who served in the Committee or who has had time to read the proceedings knows, I have repeatedly asked my hon. Friend the Under-Secretary of State for assurances about the matters contained in these Amendments. He has been unable to give those assurances. [Laughter.] With the greatest respect to my hon. Friend, this is not a laughing matter. I see that my hon. Friend is pointing to the clock and it is suggested that we have some sort of moral victory. But how empty are moral victories when one compares them with this immoral Bill.

Mr. Whitehead rose in his place and claimed to move, That the Question be now put.

Question, That the Question be now put, put and agreed to.

Question, That this House doth agree with the Lords in the said Amendment, put accordingly:

The House proceeded to a Division. Mr. TERRY DAVIS and Mr. John Roper were appointed Tellers for the Ayes but, no Member being willing to act as Teller for the Noes, Mr.DEPUTY SPEAKER declared that the Ayes had it.

Question accordingly agreed to.

It being after Four o'clock, further consideration of the Lords Amendments stood adjourned.

Mr. Deputy Speaker

Lords Amendments to be further considered what day?

Hon. Members


Mr. Deputy Speaker

No, I cannot have that. It is after four o'clock.

Mr. Ivor Richard (Barons Court)

On a point of order. As I understood it, Mr. Deputy Speaker, both Amendments were taken together and the whole discussion was on that basis. I thought they had been put together.

Mr. Deputy Speaker

I am grateful to the hon. and learned Member for raising that matter so that I may make it clear that, although they were taken together for discussion, it was necessary to put them separately to the House.

Mr. Richard

Further to the point of order. Does that mean that although the hon. Member for Yarmouth (Mr. Fell) sat down before four o'clock, for which we were extremely grateful in view of his strong feelings on this matter, and although the House agreed without a Division that we should move to a Division on the Amendments, and although one of the Amendments was agreed, the second Lords Amendment cannot be put to the House? If that is so, is it not utterly ludicrous and an absolute farce of parliamentary procedure?

Mr. Deputy Speaker

The procedure must be followed as I have stated it.

Mr. Richard

Is that so?

Mr. Deputy Speaker

Yes, that is so.

Lords Amendments to be further considered upon Monday next.

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