HC Deb 07 February 1978 vol 943 cc1225-7
11. Dr. Hampson

asked the Secretary of State for Social Services how many letters and submissions he has received on the question of offering pregnant women testing facilities for spina bifida.

Mr. Ennals

Since the United Kingdom collaborative study was published in June 1977, I have received 23 letters from hon. Members and members of the public about screening for spina bifida and other neural tube defects, and have noted the Early-Day Motion signed by a large number of hon. Members.

I am anxious to establish a safe and effective screening service for neural tube defects without any unnecessary delay, and to this end I have invited the Standing Medical Advisory Committee to set up a working party to advise on what should be said on this matter to health authorities in the light of comments on the draft circular.

Dr. Hampson

Will the Secretary of State guarantee that the blood test in the sixteenth week of pregnancy will be voluntary, and that if extended nationwide the results will be closely monitored? From my discussions with the Secretary of the Royal College of Obstetricians and Gynaecologists, it would appear that if the Secretary of State were to give those two commitments it would go a long way towards enabling the Royal College to change its attitude on these tests.

Mr. Ennals

I can assure the House that it will be voluntary.

Mrs. Hayman

Does my right hon. Friend agree that whatever decision is made by parents and their doctors after the diagnosis of spina bifida, it is better that the decision should be made at the sixteenth week of pregnancy rather than after the shock of the birth of a terribly handicapped child? Does that not mean that there is an urgent need for a national screening process now?

Mr. Ennals

Yes, I am anxious to see at the earliest possible moment a national screening system, but we must get it right. We must be absolutely certain that it is safe. I cannot proceed with a national scheme until I am absolutely satisfied about points raised by the Royal College and others. I am anxious to come to a conclusion as quickly as I can.

Mrs. Knight

Has the Secretary of State seen newspaper reports that there are already several cases on record of perfect children being aborted as a result of faulty diagnosis following amniocentesis? Has he heard medical opinions that there are dangers in this procedure for the mother and the child? Is he satisfied that the risks are negligible?

Mr. Ennals

Yes, I am satisfied that the risks are very small indeed.

Mr. Wigley

Will the Secretary of State give a commitment that the screening techniques which have been developed in recent years for spina bifida and for other abnormal conditions should not only be available to but should be urged on pregnant women, to give them a total freedom of choice in this matter?

Mr. Ennals

In this connection I issued a draft circular on advice concerning the establishment of a national screening system under the health authorities. I have received comments, and I have to take them very seriously, therefore I cannot give the advice to mothers that the hon. Gentleman wants until I have a system which satisfies the doctors involved. We shall endeavour to do this as quickly as possible.

Dr. M. S. Miller

Notwithstanding any pressures that my right hon. Friend might have in this matter, will he ensure that he resists any pressure to confuse this issue with abortion and the screening tests, which his Department has agreed should go ahead, because of its value to pregnant women, in respect not only of spina bifida but of other inter-uterine deficiencies on the part of the foetus?

Mr. Ennals

Yes, but the House should not totally dissociate itself from some of the pressures on it about abortion. For the blood test to have maximum reliability, it must be taken at 16 to 18 weeks. If the test is positive, it must be followed by further tests, procedures and discussions with the patient, which may make it difficult, where an abortion is agreed upon, to ensure that the abortion takes place before 20 weeks. There is, therefore, a link between some of the pressures put before the House on abortion, and the screening procedure for neural tube defects, which may lead some mothers to decide that they wish to have an abortion.

Mrs. Chalker

In view of the fact that a great deal of research is now going on, will the right hon. Gentleman undertake to consult also the Institute of Obstetrics and Gynaecology as well as the Royal College of Obstetricians and Gynaecologists? There are vast differences of opinion about not only this screening method but other screening methods which can help valuable pregnancies to survive.

Mr. Ennals

I am sure that consultation has already taken place with the Institute. If it has not, I shall certainly ensure that it does.