HC Deb 19 April 1978 vol 948 cc628-42

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Tinn.]

11.51 p.m.

Mrs. Renée Short (Wolverhampton, North-East)

I am glad to have the opportunity to raise this subject on the Adjournment, because next week sees the tenth anniversary of the passing of the Abortion Act 1967 which made abortion legal in Britain.

Too much is heard in this House and outside of alleged scandals, abuses and harmful effects, and far too little, because on the whole it is not the stuff of headlines, of the enormous sense of well-being and relief that the 1967 Act, by its very existence, has brought to many women and their families. So now is a good time to ask whether we have the administration right. Of course, it will never be right for those who believe that all abortion is wrong, but most of us know—and I hope that my hon Friend the Minister of State will bring up to date those who do not—the measures which have been taken to control the working of the Act.

There is only one major scandal and failure of the Act, namely, the failure of the National Health Service to provide the necessary facilities for equitable treatment throughout the country, and it is a failure that needs a remedy. But it is never mentioned by those who shout most loudly about "cleaning up abuse".

Next week, those basically opposed to legal abortions and thus opposed to the concept of freedom of moral choice for individuals within a pluralistic society will be carrying wreaths from town to town, having wreaths delivered to hon. Members here, and generally attempting to continue their campaign of spreading lies, distortions and despondency, which have been their stock in trade ever since they realised that the majority of citizens did not accept their view that abortion was the same as murder from the moment of conception.

This campaign ignores the fact that more than 1¼ million safe abortions have taken place in Britain since 1967 and that almost every country in Western Europe has now followed and in many cases gone further in liberalising and humanising its laws. Only last week in Roman Catholic Italy the Chamber of Deputies passed a Bill to allow abortion on request to any woman over 18 and less than 12 weeks pregnant—something done several years earlier by France and Austria.

Next week in Britain, not only will there be emotive stories spread around, but a new political initiative will be launched called "Value your Vote", based on what has now been shown to be the completely erroneous assumption that abortion can be a major issue in election campaigns. Fortunately, the electors at Garscadden have proved the contrary to be true. So this Government or any other need no longer have any fear about introducing bold and robust measures to implement the Abortion Act and make National Health Service day-care abortions the rule rather than the exception.

In Garscadden we saw the most highly organised, spare-no-expense campaign that the anti-abortionists could organise. We had a campaign where a pressure group acted like a political party. It ran public meetings attended by the candidates, distributed leaflets to every house, had leaflet drops outside churches, plastered the constituency with emotive posters, cruised with loudspeaker vans and even provided cars to take its supporters to the polls.

It was a campaign in which the leading Roman Catholic lay organisation recommended the faithful to vote against any pro-abortion candidate and declared that the sanctity of life transcends normal political considerations. It was a campaign in which the candidate's views on abortion were canvassed and continually publicised, a campaign in which a Church of Scotland clergyman felt impelled in his parish magazine to request his flock not to be "party political meddlers"—whatever that means—and to remind them that Roman Catholic priests in another part of this constituency have advised their folk to vote SNP since it is the only party with an anti-abortion policy". It was a campaign in which Roman Catholic priests knocked on doors of houses of parishioners showing Labour Party posters and ordered them to take them down; and one in which the journal of the Roman Catholic Archdiocese of Glasgow sought the views of all candidates only on abortion.

But, despite all these massive attempts in an area with a 35 per cent. Roman Catholic population, the declared antiabortion candidates did not win, and a television programme survey of voters leaving the polling station found only 3 per cent of Roman Catholics to agree that abortion was the most important issue. It also found that 62 per cent. of them voted for the candidate who as a Member of Parliament in 1967 had voted for the Bill.

The lesson from this must be clear to all Members who have had intimidating threats made to them about future votes going against supporters of a liberal abortion law. We know that it is a hollow threat for, if it had any substance, it would have been fulfilled at Garscadden. If it failed at Garscadden, it must fail elsewhere.

As it must be clear that there are no votes to be lost on this issue, I hope that the Minister will propose immediate plans for day-care centres run by sympathetic staff in every region, regardless of the personal prejudices of senior members of the local gynaecological establishment.

These centres would save not only health and happiness by ensuring that pregnancies were terminated early but money and would release overnight hospital beds for those on gynaecological waiting lists. The money saved could be used for family planning—prevention is better than cure—through contraception and sterilisation programmes. This in the long run would reduce the numbers of abortions.

Perhaps my hon. Friend could confirm my view that if some of the extra money made available for day-care units in the Budget last week were used to increase the provision of early outpatient abortion, there would in a short time be an overall saving of money and further reduction in the already much reduced maternal mortality and morbidity associated more with late than with early abortion.

We have already seen a welcome move in my part of the country. Faced with an intransigent professor and gynaecological establishment who have ensured that only some 10 per cent. to 15 per cent. of West Midlands women have succeeded in getting NHS abortions the regional health authority, under pressure from the community health councils, set up a working party to consider what could be done. That working party has now produced a report with recommendations to improve the situation and to open daycare facilities.

Typically, it has been publicly attacked by Professor Scarisbrick of the anti-all-abortion "Life" organisation. In a letter to the chairman of the RHA, released to and widely reported by the local and national Press, he accuses the working party of a serious and astonishing error in stating that the NHS has a statutory responsibility to provide an abortion service.

In fact, it is the professor who is guilty of the "serious error", because his letter suggests that the working party believed this duty on the NHS sprang from the Abortion Act 1967. But nowhere in the report is this said, and clearly the duty—as detailed by the authoritative Lane Report—springs from the National Health Service Act 1946, which puts a duty on the Secretary of State, among other things, to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales … Precisely the same aims as those of the Abortion Act. Perhaps my hon. Friend can comment on this. The false premises about the 1967 Act have been enshrined in the recent series of Bills before the House which in turn were based on the report of the Select Committee of anti-abortionists.

In fact, in all those areas—except two—where concern was expressed and changes recommended, changes and controls have been introduced. The DHSS now has complete control of the private sector, and let us hope it can now devote its energies to improving the public sector. Those two areas, where little has been done, are the areas where those with detailed knowledge and objective minds know that there is no real evidence to show that change is necessary. These are reduction of the upper time limit and restrictions on the charitable services. The pressure for reduction of the upper time limit comes from repeatedly making emotive claims about live babies being killed—claims which, when exhaustively investigated, are shown to have no basis in truth.

From the evidence it appears that there was only ever one case where a child might have lived—the Stobhill case in Glasgow in 1970. Tragic and upsetting though it was, one such case in 1¼ million legal abortions cannot justify restricting the law. That there has been only one such case is shown by the fact that it is still quoted today by the anti-abortionists. If they knew of others, they would certainly not rely on evidence that is eight years out of date.

This lack of evidence has not stopped those opposed to legal abortion making unsubstantiated and extravagant claims that have understandably worried the public conscience, have been eagerly leapt upon and spread around by a Press that is hungry for sensationalism and fuelled by the hon. Member for Chelmsford (Mr. St. John-Stevas), who started this hare running in May 1970 with the rumour headlined in the Daily Express as Abortion trade in unborn babies From a whole series of unsavoury accusations I come to one of the most recent which on 8th February this year was shown in a reply to me to have no foundation in fact. On that occasion, a Mrs. Chester of Droylsden complained in a letter published in her local newspaper that a Tameside hospital had posted a notice instructing staff not to resuscitate live babies born following a certain method of abortion. Clearly, if this had been true, NHS staff would have been guilty of inciting others to break the law, so investigations were made. It was noticeable that neither Mrs. Chester nor the newspaper that printed her letter was able or willing to give the source of the information or the name of the hospital. So both DHSS time and that of the Tame-side area health authority was wasted on following up this apparently baseless accusation.

These unfounded and untrue accusations have led to a general belief that live babies are being aborted. They waste much time of the Department and AHAs in trying to follow them through—time that could have been much better spent in implementing, through the NHS, the Abortion Act in those parts of the country where abortion is not yet available.

Currently, if the "Life" newsletter is to be believed—and perhaps my hon. Friend can tell us what he knows of this—the most recent "horror" accusation is with the DPP. This story, featured again in the national Press with vast amounts of space and told to it by the "Life" organisation, concerned a child delivered by Caesarean section at Barking Hospital when, in the 29th week of pregnancy, the mother's life was in dander. According to "Life", the foetus was 25 to 26 weeks old and was thrown aside as dead and rescued only by accident while on its way to the incinerator—shades of the Stobhill story? But, according to the paediatrician concerned, the baby was in the intensive care unit within seven weeks of delivery and was thriving some weeks later when "Life" told its horror story to the Press. At the time, "Life" said that its sources were absolutely authoritative. Now its newsletter admits: We have no eye-witnesses unfortunately. It is a scandal that this sort of unauthorised and unfounded allegation can be picked up by the Press so avidly.

However, the really interesting thing about that story is that the child was born on 17th December and the story was not released in the Press until 21st January—in the same week that the authors of the book "Babies for Burning" were forced to make their humiliating High Court retraction and apology to the British Pregnancy Advisory Service.

Which brings us to the only other area of concern of the Select Committee whose recommendations for restrictive measures have not been implemented separation of the counselling and other functions of the charities.

It is noticeable that nobody questioned the good faith, the professional integrity or the great need for bodies such as BPAS until that disgusting little book was touted around. Could it have been that, because the charities were making the Abortion Act 1967 work as Parliament intended and driving the exploiters out of business by providing a competitive, non-profit service, they had to be discredited by the anti-abortionists who saw their supply of sensational stories disappearing and thus their hopes of appealing to the electorate?

Certainly the attacks on the charities intensified from that time, and most of them are as baseless as that book would have been shown to be had the authors not recognised that it was better to apologise quickly than to allow all the evidence of their lying, deception and duplicity to come out into the open during a trial. For not only did the authors lie in the book, they lied before a Select Committee of the House. That is my main reason for seeking this Adjournment debate.

Both Mr. Litchfield and "Mrs. Litchfield", otherwise Kentish, as she is called on the birth certificate of her and Litchfield's child, a certificate which during the course of a BBC interview Litchfield described as a fraud being investigated by Scotland Yard but which so far has never been challenged, told the Select Committee that the transcripts with which the Committee was supplied were a full, true and accurate record of the relevant tape recordings. Had the Select Committee listened to those recordings and compared them with the transcripts supplied by the authors, it would have found that they were neither full nor accurate, nor complete.

It is not surprising that the Select Committee did not make that comparison, for it took some 300 hours to do just that in preparation for the BPAS trial. Of 65 relevant conversations found on the tapes, transcripts of only 32 were given to the Committee. Among those supplied more than half differed materially from the tapes. The BPAS schedule of important differences between the tapes—that is, those that materially altered the meaning or the context of the transcripts as supplied by the authors—amounted to no fewer than 71 typed pages.

For example—this was a thread that ran throughout the deception—Mrs. Litchfield-Kentish told the Select Committee that she was not asked about her menstrual cycle on any occasion. However, in every interview recorded on the tape recordings there is lengthy and detailed investigation of her menstrual history.

In one particular interview with a Mr. Pond, whom they visited before she saw her own doctor to confirm that she was not pregnant, despite the book stating that she was confirmed as not pregnant before their investigation started, the true transcript shows six pages of conversation about her pill-taking habits and menstrual pattern, with Mr. Pond, exasperated, saying You're most unlikely to be pregnant". Before the book was published the News of the World featured that visit to Mr. Pond in its series of articles that later became the book. It not only erroneously stated that first she visited her own doctor but had Mr. Pond saying "You are 16 weeks", whereas the tape clearly has Mr. Pond saying You are 16 weeks on from your last period. That is something that Kentish herself had told him, and which could have been true as it was quite clear from the long private conversation between the authors, which is still on the tape although they did not realise that the tape was working at the time. That conversation took place while Mr. Pond was out of the room doing the urine test. At that stage they both thought that she really was pregnant and was genuinely seeking an abortion. They were arguing about the cost while Mr. Pond was outside the room.

There distorting their own situation, distorting the truth and destroying with a a tissue of lies the reputations of honest charities, doctors and others are the so-called journalists whom the hon. Member for Pontypool (Mr. Abse) described as "virginal and pristine", and who the broadsheet of the Festival of Light says it has consistently backed in bringing their book to the attention of the Christian public", going on to remark Its almost unbelievable stories of the abortion racket show the dearth of moral fibre in Britain today. Indeed they do, but not quite in the way that the Festival of Light intended.

There are 71 pages of lies, omissions and variations. It is to be hoped that soon, despite the apology being given before the evidence was out in court, it will be available for all. The DPP has requested the police to have the full tapes transcribed. I hope that they are, and I hope that my hon. Friend the Minister of State will be able to enlighten the House on this point, for Sessional Standing Orders tell us that the House will proceed with the utmost severity against any person who hath given false evidence before this House or any Committee thereof. That should interest my right hon. Friend the Leader of the House.

So far this pair have got off scot-free. They have deluded the public and deluded a Select Committee into producing a report that has resulted in two Bills coming before the House, each of which has attacked and sought to destroy the work that the two major abortion charities undertake to make good the lack of NHS provision.

I hope that my hon. Friend, 10 years after the enlightened legislation that the House enacted with the liars publicly exposed and the electorate's views on the anti-abortion lobby made clear at Garscadden, will be able to get on with the task and that the House will provide the resources for him to do so.

12.10 a.m.

The Minister of State, Department of Health and Social Security (Mr. Roland Moyle)

I shall try to deal with the questions affecting my responsibilities as one of the Ministers responsible for the administration of the Abortion Act. First, however, I must remind the House that the Government take no collective view on the moral questions of abortion in the belief that individual Members should make their own judgments on these matters.

My hon. Friend the Member for Wolverhampton, North-East (Mrs. Short) invited me to remind the House of the measures taken by my Department to control the private sector of abortion and to comment on whether I agreed that these measures are effective. It might help if I indicate to the House the range of undertakings which private nursing home proprietors must give my right hon. Friend as a condition of his approval under the Abortion Act.

Briefly, they provide for the maintenance of detailed records, the inspection of premises and records by the Department's officers at any time without notice, the giving of receipts to patients and the retention of copies for inspection, the acceptance of fees only after two doctors have certified that the Act's criteria are met in each case, the number of patients per 24 hours not to exceed the number of beds approved, and for the examination of patients by a doctor before discharge.

The nursing home must also undertake not to advertise abroad, either directly or indirectly, employ touts, or to accept patients who have been diverted from their intended destinations or touted for. The proprietors must have no connection with agencies or persons known to advertise abroad, or to tout for or divert patients.

Proprietors must also, in applying for approval, provide the Department with detailed information about the business arrangements of the companies and individuals involved in the application, all of which is carefully inquired into by the Department's investigators. Medical and nursing arrangements, including staffing, equipment, procedures and accommodation, are checked by the Department's medical and nursing teams.

Nursing homes which concentrate on abortions have had to satisfy my right hon. Friend that the total costs charged to abortion patients treated on their premises are not unreasonable, and must not increase these costs without prior approval. All financial arrangements between nursing homes and doctors, other than payment of fees, and pregnancy advice bureaux must be reported to the Department.

I think that it will also be worth while on this occasion, having dealt with nursing homes, to focus on the arrangements for registration of approved advice bureaux, as this register was established only early last year.

The background to the register is that, under the Abortion Act 1967, only places which carry out termination of pregnancy are required to be approved for that purpose by the Secretary of State. This means that nursing homes that carry out abortions, in addition to being registered with the local health authority, also have to satisfy the Secretary of State that they should be approved for carrying out abortion, whereas the bureaux which advise and refer women for abortion neither require approval under the 1967 Act nor need to be registered with the local health authority.

In the early years, following the implementation of the Act, and in the absence of control of any kind, a large number of small referral agencies mushroomed, mainly in London. It was these agencies that saw some of the most blatant abuses of the Abortion Act and caused public concern—such practices as touting for patients, employing persons to divert patients from their intended destinations, and canvassing abroad for patients. This led the Lane Committee to recommend that, whilst the existing control over nursing homes appeared to work very satisfactorily, there ought to be a system of licensing pregnancy advice bureaux.

Even while the Committee was sitting, my Department had adopted a system of blacklisting undesirable agencies. Approved nursing homes were warned that if they accepted referrals from such agencies they would risk losing the Secretary of State's approval. As a result of the blacklisting of 23 agencies, these abuses were eliminated and most of the people concerned put out of business. In 1975 the then Secretary of State accepted a recommendation by the Select Committee on the Abortion (Amendment) Bill, based on the conclusions of the Lane Committee, that this form of control should be extended by requiring approved nursing homes to give an assurance that they would accept only patients referred from pregnancy advice bureaux who were on a register approved by the Secretary of State. The first register was published on 10th February 1977 and there are now 35 registered bureaux; nine applications have been refused. Registration will be reviewed and, as appropriate, renewed on 1st October this year.

Before registration, each bureau is inspected to ensure that the accommodation and facilities for counselling and medical assessment on the premises are of reasonable standard; counsellors are interviewed and counselling notes inspected to assess, as far as it is possible to do so, the standard of counselling to be provided to clients and the business arrangements inquired into to ensure that undesirable persons are not involved and that all is above board.

In addition, registered bureaux must subscribe to various requirements governing their conduct. Amongst other things, these prohibit advertising abroad and association with touts and require the maintenance of proper records, the giving of receipts, and consultation with my Department about the methods of advertising in this country. All registered bureaux have received a copy of my Department's counselling circular, and they are expected to provide counselling in accordance with its central requirement that women should make up their minds in the light of all the relevant facts about their situation and about the alternatives to abortion which are open to them. The register appears to be working well.

As with approved nursing homes, all registered bureaux are subject to unannounced visits by my Department's inspecting officers. One of these officers is always a doctor, authorised to inspect counselling notes and medical records and to discuss counselling and medical procedures at the bureaux with the counsellors and doctors concerned. The other member of the team, an administrative officer, checks facilities, staffing and accommodation and general records and receipts. A full report is made on every unannounced visit.

Bureaux may also be visited by the Department's special investigators, who are ex-police officers, either at random or as part of wider inquiries, and the opportunity is taken to check records—other than patient records—staffing and procedures at the premises. So far it has not been necessary to remove any bureau from the register for failing to comply with the requirements of registration. My right hon. Friend, however, will not hesitate to do this, if necessary; nor will he hesitate to take firm measures against any approved nursing home which he finds has acted contrary to assurances given to him. I am of the opinion that the present system of administrative control, including as it does now the registration of pregnancy advice bureaux, is effective in preventing abuse and flexible enough to react quickly to any change in circumstances.

The second main issue which has been raised with me concerns the effects of the 1967 Act over the first 10 years of its operation and, in particular, the extent to which the NHS has provided facilities for abortion. The statistics published regularly by the Office of Population Censuses and Surveys show that the number of abortions performed under the Act increased steadily up to 1973 when there were 167,149 abortions performed in England and Wales of which 110,563 were performed on women resident in England and Wales. The number of abortions notified in 1977 was 132,999 of which 102,237 were notified as being performed on resident women. The rate of abortions per 1,000 women aged Is to 45 years also increased up to 1974, but decreased after that, and appears to be significantly lower than the rate in countries with similar legislation.

It is difficult to establish what the long term pattern will be, but, for those of us who lay emphasis on prevention, there are encouraging signs that the free family planning services are helping to reduce the number of unplanned pregnancies. A survey of family planning use between 1970 and 1975 published yesterday demonstrates the growing use of more effective birth control methods particularly amongst those groups which previously seemed least inclined to use the family planning services. The most recent figures on births and abortions show that the rate of extramarital conception, measured approximately by adding figures of illegitimacy, pre-nuptial conception and legal abortion amongst the young, is decreasing. For example, the rate of extramarital conceptions per 1,000 women in the age group 16 to 19 fell from 60.4 per 1,000 women in 1972 to 45.8 per 1,000 women in 1976—a fall of 24 per cent. A similar decline occurred in the 20 to 24 year age group. Even in the under-16 age group, where the numbers are small but of considerable concern to us, the figures, which showed a rise up to two per 1,000 in 1973, remained steady thereafter.

On the question of NHS abortion facilities, I fully accept that provision varies considerably among different parts of England, and overall the NHS performs only just over half of all abortions on women resident in England and Wales. But we are determined to improve NHS facilities. The letter of guidance which went out with the £50 million announced by my right hon. Friend the Chancellor in the Budget Statement last week in fact states that some of the money could be spent on day-care termination facilities.

As a result of recent activities, I am happy to say that my Department has had discussions with two regions about improving abortion facilities—namely, Wessex and the West Midlands. I have noted that the West Midlands Regional Health Authority has accepted its working party's report on abortion facilities in that region, which proposed the provision of day-care facilities for abortion supported by arrangements for counselling. I am sure that my hon. Friend will regard that as a considerable advance.

On the question of the Barking case, I understand that papers relating to the incident at Barking Hospital were referred to the Director of Public Prosecutions, who considered them and con- cluded that there was no evidence of a criminal offence.

My hon. Friend also raised the question of the Droylesden case. Mrs. Chester, the lady who made the accusation, refused to be interviewed or to give any further information about the allegation, other than what she had been told about the notice by a staff nurse. The editor—

The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at twenty-one minutes past Twelve o'clock.