AMENDMENT OF SECTION 1 OF PRINCIPAL ACT (Hansard, 8 February 1980)

§ Miss Richardson
I beg to move amendment No. 3, in page 1, line 8, leave out "less than 20 weeks" and insert "27 weeks or less".

Mr. Deputy Speaker
With this it will be convenient to take the following amendments:
No. 2, in page 1, line 8, leave out "less than 20 weeks" and insert "24 weeks or less".
No. 48, in page 1, line 8, leave out "less than 20 weeks" and insert "20 weeks or less".

§ Miss Richardson
My amendment seeks to fix the upper time limit in the Bill at 27 weeks. There is a principal amendment dealing with a 24-week limit which we shall come to in a moment. Naturally, if it were a choice between 24 weeks, 22 weeks and 20 weeks, I would support 24 weeks.
I want briefly to argue the case for leaving the upper limit as it is at present. For that reason, I have tabled an amendment setting the time limit as near as possible to the present limit. I accept that there is a large body of opinion in this country—medical and otherwise—which accepts 24 weeks, and we have had assurances of that.
Recently I received an answer to a question which 1 had addressed to the Minister of State, Department of Health and Social Security which stated that a foetus can be, and has been, viable in a small number of cases after 24 weeks. But there is still room for a margin of error, and for that reason I believe that the Act should be left as it is.
I am glad to see that I am not alone in this. As I said earlier, I am a lay person; I am not medically or legally qualified. I have here a letter from the British Medical Association dated 5 February which was addressed to most hon. Members. In it the BMA said: The Representative Body of the British Medical Association has decided that it cannot support any amendment to the 1967 Act. If the Representative Body of the BMA, which we know has looked at the Act over many months, can decide that 1006 no amendment is required, that satisfies me. Such a distinguished body of medical opinion should be listened to carefully by the House. We lay great stress on the fact that we are the supreme law-making body. However, we should listen to expert opinion from outside before coming to conclusions. Doctors ought to know, and we have always regarded the BMA as an authoritative body.
I think that to make the period 20 weeks would be appalling. In Committee, the Minister of State, referring to 20 or 22 weeks, said that 22 weeks would be the worst of all possible worlds. I hope that the House will decisively reject the 20 weeks and the 22 weeks and will seriously consider my proposition to insert 27 weeks in place of the existing 28 weeks. In that way the law would remain almost as it is now.
Men and women in the House know that an error of timing can be made. It is easy for both the woman concerned and her doctor to make an error of two weeks or even four weeks when calculating the gestational age of the foetus. Even if the House comes to the conclusion that 24 weeks is the right period, there will still be problems for women because they may be considered to be 24 weeks pregnant when they are not.

§ Mrs. Dunwoody
No one has yet made the vital point that doctors, rather than make a mistake, will not go beyond a limit which is well within the present 28 weeks. The lower the limit, the more doctors will shorten the time. That is a great danger.

§ Miss Richardson
My hon. Friend is absolutely right. I was going to make that point. If we put in the Bill 24 weeks, the majority of doctors will calculate on the basis of 22 weeks or in some cases 20 weeks. That is why 20 weeks is ludicrous. In that event, the effective upper limit would be not 20 weeks but 16 or 18 weeks, and that would remove from many women the right to have a proper abortion.
What numbers of people are we talking about? The arguments have been rehearsed before. A tiny fraction of women have abortions after 20 weeks. An even tinier, minute fraction have abortions after 24 weeks. There is a fail-safe mechanism, as it were, in having an upper time limit, 1007 because that will enable some women to be helped who otherwise would not be helped. We are talking about the less than 1 per cent. of women who have abortions at over 20 weeks—a small minority.
If a woman is the partner of a man in a very good job—a banker or perhaps a well-off consultant—and she wants an abortion at 24 weeks, 28 weeks, or even later, she will be able to get one, as she always could, in the private sector. If she has £250 or whatever it costs—I do not know what it costs at present, but certainly more than is within the purse of most of my constituents, for example—she will be able to get an abortion. Rich women will be able to go on having abortions and the time limit will be for them to decide, as long as those abortions are in the private sector. Poor women will not be able to do so. We should leave the Act virtually as it is, although we should perhaps lower the period by one week.
We hear a lot about sex education in schools. However, it is surprising how many young girls who are still pupils at school do not know about sex. They may find themselves pregnant without realising it. They then become extremely frightened. They do not want to tell their parents and they are frightened to tell their friends. Often, a girl is frightened to go to the nearest family doctor, although he may have brought her into the world and may know all about her. Indeed, the doctor may be shocked that his little patient is about to have a baby. A very young girl may therefore leave her pregnancy too long, as a result of ignorance or of fear.
At the other end of the age scale there are women who are experiencing the menopause. They may have a second family and grown-up children. They think that they are past the age of child-bearing, but to their horror they find that they are pregnant. At first they may not realise it. Such women are also part of the handful of those who need to be protected by a reasonable upper time limit. The mentally and physically handicapped may be unable to get an abortion within the time limit of 20 or 24 weeks because of their particular difficulties.
Most important of all are perhaps those who know and understand about their 1008 pregnancy and who go about it in a sensible and responsible manner. However, they find that they are shunted from one doctor to another, one hospital to another and one area to another. They are unable to get an abortion under the National Health Service. It is not their fault that no decision has been made about the termination of pregnancy. We do not have a decent spread of abortion facilities under the National Health Service. As other hon. Members and I have already said, we would welcome an amendment to the 1967 Act that provided proper day-care abortion units that would be freely available all over the country.
We wish to obviate the obstructions that the Bill will cause. I realise that there are temptations and that there is a great deal of prestigious support for the limit to be set at 24 weeks. However, I beg the House to consider whether it would not be better to leave the upper time limit as it is. The issue should be allowed to rest on the good sense of the doctor, of the woman concerned and of her family. The present upper time limit should therefore be left. The majority of the population want that time limit to remain. They do not want a new upper time limit as it might only cause confusion.

§ Mr. Charles Morrison
Amendment No. 2 sets out to increase the time limit from 20 to 24 weeks. It is pleasant to be connected with an amendment that has already received a considerable amount of support. I do not imagine that it will be supported by the whole House, but it is gratifying to know that it is supported by my hon. Friend the Minister for Health and the right hon. Member for Salford, West (Mr. Orme).
It is a great pity that the Bill did not deal only with the time limit. The vast majority of people in this country are more concerned about the time limit than about any other part of the Bill. A large proportion of letters that we receive in support of the Bill are more concerned about the time limit than about any other aspect. It is a pity that my hon. Friend the Member for Bute and North Ayrshire (Mr. Corrie) did not limit the Bill to the time limit. Should the Bill not complete all its stages, I hope 1009 that the Government will consider the suggestion of the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel) that they should introduce a short Bill to cover the time limit.
In today's first debate, my hon. Friend the Member for Essex, South-East (Sir B. Braille) referred to flouting of the law as it exists. I wish the law to be upheld. However, I cannot understand how the law is less likely to be flouted if it is changed.

§ Sir Bernard Braine
First, the case that I cited this morning showed that the law was clearly being flouted by a doctor, and it is my charge that it is being flouted by others. My hon. Friend is on another point. He says that if the law is being flouted he does not see that it can be improved by changing it. When the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel) introduced his Bill in 1966, he told us that in no circumstances would it be used for abortion on demand. Because of the drafting of the Act, the intentions of Parliament are being flouted every day of the week. There is the well-known statistical argument. The amendments that the Bill makes will change that. The Bill will prevent the flouting of the intentions of Parliament in 1967.

§ Mr. Morrison
My hon. Friend is extremely optimistic. I t may well be that if there is a new law it will not be flouted in the same manner. However, in my judgment—and this is one of the reasons why I support the existing legislation—if it is amended as suggested it is much more likely that there will be more flouting of the law in future than there has been up to now. I emphasise again that it is my desire that the law should be upheld, preferably the law as it is now, but, if not, the law according to what the House decides.
It is important to keep the question of the time limit in perspective. We know that the vast majority of abortions are carried out before 16 weeks. Fewer than 1 per cent. are performed after 20 weeks. Therefore, we are talking about a very small proportion at the upper margin. One must ask to whom the 1 per cent. relates—[Interruption.]

Mr. Deputy Speaker
Order. Other speakers have had a careful hearing. I 1010 think that the hon. Member for Devizes (Mr. Morrison) is entitled to the same.

§ Mr. Morrison
I apologise, Mr. Deputy Speaker, for not being able to shout down the background noise.
The 1 per cent. of abortions refers particularly to the very young who have concealed their pregnancies, to older women who thought that they were menopausal rather than pregnant, and to disadvantaged women who are unskilled at taking part in what has been termed "the abortion hurdle race."
I direct my attention particularly to young people because the matter has great relevance to that. The 1976 figures show that 522 teenage girls had abortions at 17 weeks or later. Of these, 387 had pregnancies of more than 20 weeks. Also in 1976, 10 per cent. of late abortions at over 20 weeks were carried out on girls of 15 or under. In 1977, 3.57 per cent. of all abortions to those under 15 and 1.74 per cent. of those to 15-year-olds were carried out at 20 weeks or later.
The important point is that these rates for teenagers are the highest among all groups of women except those aged 45 or over. It seems to me that these young people are those whom we should particularly consider. I have no doubt that many abortions would take place earlier if there were better counselling and better National Health Service provision. Also, I have no doubt that many of them would take place earlier among teenagers if the young girls themselves were prepared to face their parents earlier with their problems.

§ Mr. Richard Needham (Chippenham)
If that is so, and the percentages are so small, why would it not be possible to leave the discretion in the hands of the doctors concerned? Why should it be necessary to alter existing legislation? Not only are those concerned small in number, but they are a very small number who must be of particular concern and at particular risk.

§ Mr. Morrison
I was about to come to that matter. There is a question of the balance of interest between the pregnant woman and the unborn child.
I want to emphasise that in relation to the time limit we are considering a very small number of people who have 1011 not obtained a legal abortion, more often than not because of fear, inadequacy or perhaps stupidity and sometimes because of lack of opportunity. We must balance their interests and those of the unborn child.
That is the dilemma that must be faced in fixing the limit. That is why there should be a limit and why we are considering the matter now. The limit that was acceptable in 1967 is no longer acceptable in the light of new knowledge, advances in medical science, and so on.
There is an argument for leaving the limit at 28 weeks, given the existence of section 1 of the Infant Life (Preservation) Act 1929, which provides: Subject as hereinafter in this subsection provided, any person who, with intent to destroy the life of a child capable of being born alive, by any wilful act causes a child to die before it has an existence independent of its mother, shall be guilty of felony, to wit, of child destruction, and shall be liable on conviction thereof on indictment to penal servitude for life". Therefore, the legislation already covers a child capable of being born, or any wilful act causing a child to die before it has an existence independent of its mother.
Nevertheless, I think that the vast majority of people now believe that the upper limit should be reduced. The question is to what figure it should be reduced. Should it be 27 weeks, 24 weeks, 22 weeks or 20 weeks? If it were reduced to 20, as the Bill proposes, there is no doubt that in practice many doctors would work to a time limit of considerably less—probably 17 or 18 weeks—simply because of their understandable and justifiable fear of breaking the law.
In my opinion, the certain consequence would be a growth in illegal abortions—and that just at the time when a pregnant woman was entering the most difficult period of the pregnancy. Therefore, it would be bound to increase suffering and perhaps mortalities.

§ Sir Bernard Braine
Does my hon. Friend realise that his argument applies equally to 24 weeks, and that many babies aborted at 24 weeks may have a 26-week gestation age? As we now know for certain that above 24 weeks 50 per cent. of such babies have a chance not 1012 simply of life but of survival, does not he think that he is running a bit of a risk with life? [Interruption.]

§ Mr. Morrison
I shall make my speech in my own way and, as far as possible, in my own time, despite that interruption from the Strangers' Gallery.
Regarding the question of 24 weeks, I am particularly impressed by the letter written by Dr. Pembrey, senior lecturer at the Institute of Child Health, to the Minister on 23 November 1979. He said: Before 24 weeks there is no evidence to support the view (reported of Professor Reynolds) that improvements in neonatal intensive care will make such foetuses independently viable. May 1 remind you, as others have done for other reasons, that whilst estimation of gestational age is generally fairly reliable, in an individual case the age may not be certain. The extremely rare cases that survive after being born at say '24–25 weeks gestation' have probably survived because in fact the gestational dating was not precisely correct. On that basis, Dr. Pembrey strongly urged the Committee to reject any time below 24 weeks as the legal limit. Against that view is that of Professor Reynolds, who says that, because of possible improvements in neonatal intensive care, the limit should be set at 22 weeks.
I believe that we should legislate on the basis of what we know end of what is possible now, not on what may or may not happen at some time in the future. I do not know what will happen in the future. I do not know what advances may be made. Therefore, I am prepared to keep an open mind. I wish to ensure that at this juncture we legislate on the basis of the best available knowledge.

§ Mr. Douglas Hogg
The effect of my amendment No. 48 would be to reduce the period to 22 weeks. The practical effect would be to increase the period within which the operation may lawfully be performed by three weeks over that contemplated under the terms of the Bill.
Hon. Members have dwelt on the 20-week period. If they look at the Bill carefully, they will see that the limitation is effectively one of 19 weeks. The Bill clearly provides that the operation shall not generally be performed if the pregnancy has lasted for fewer than 20 weeks. In other words, the limit is up to and including 19 weeks. In my amendment I voice the views of many hon. 1013 Members and probably the views of most of my constituents. I shall not support the attempts to redraw the statutory criteria. Such an attempt is wholly wrong and I shall oppose it. However, on the narrow question of time the House must be very careful indeed.
The objectionable feature of the present law is not that it allows late abortions in exceptional cases. That itself is not objectionable. The objectionable feature of the present law is, that, theoretically at least, it applies the 28-week limit to the generality of cases. The House should understand what that means. It means that the House is proposing a statute for the generality of cases, which permits the abortion of a foetus which, in the majority of cases, is capable of a viable existence. That is the evidence. At 28 weeks most foetuses are capable of pursuing a separate and independent existence.

§ Mrs. Dunwoody
Certain tests to establish whether a foetus is likely to be born handicapped can be carried out only after the sixteenth week and such tests must be done at least twice. We are talking about less than 1 per cent. of pregnancies and of women who are likely to give birth to handicapped children.

§ Mr. Hogg
I am surprised, because I do not believe that the hon. Member for Crewe (Mrs. Dunwoody) has looked at her Bill closely.

§ Mrs. Dunwoody
It is not my Bill.

§ Mr. Hogg
The situation is covered by clause 1(b). I do the hon. Lady for Crewe an injustice. She takes the view, understandably, that the Bill is objectionable. However, the Bill covers the risk of malformation and handicap.
When a statute permits abortion at 28 weeks in the generality of cases, it permits what is offensive to many. The objections to late abortions are grave and numerous. The moral objections are considerable. They have been voiced by other hon. Members and I shall not repeat them. There is no doubt that late abortions are profoundly distressing and distasteful to those involved in them.
A statute that offends the moral sense of many and is deeply offensive to the common sense of most tends to bring the whole corpus of law into disrepute. If I am right, the House should be trying 1014 to determine what is the latest possible date for an abortion which does not involve the risk of a viable foetus being aborted. The House should be doing that. That is not a matter of opinion, conjecture or speculation. It is a matter which is clearly covered by the best medical evidence available. [HON. MEMBERS: "That varies."] It does not vary. On certain points it is absolutely plain.
My hon. Friend the Minister read out a letter to the Committee from Professor Reynolds on 29 November. I am not going to read it at length because time is short, but it is important to summarise the conclusions. They go to the root of the debate. The conclusions are that between 28 and 29 weeks there is an 85 per cent. chance of survival, between 26 and 27 weeks approximately a 50 per cent. chance of survival, and between 24 and 25 weeks, according to the professor, not many, but a few. I take up the point made by the Minister in Committee. To his own knowledge, there is one authentic case of a viable foetus being aborted at 24 weeks. Below that, at 23 weeks, no case is known. It is likely to occur in the foreseeable future. At 22 weeks, no case is known. There is no prospect of such a birth in the foreseeable future. I suggest, therefore, that the best evidence points to 22 weeks. Atlhough other doctors differ about the conclusions to which Professor Reynolds came in his letter, I am not aware that any of the doctors challenge the statistical data on which his conclusions were founded. The conclusions are a matter for this House. But we must consider the statistical data. If we accept it, we must act on it.

§ Sir Bernard Braine
rose—

§ Mr. Hogg
I have only four minutes.

§ Sir B. Braine
My hon. Friend is wrong.

§ Mr. Hogg
The point made by my hon. Friend the Member for Devizes (Mr. Morrison) is that we should accept 24 weeks. But the objection to accepting 24 weeks is simply this. In a small minority of cases, a viable foetus will be aborted. I suspect that the evidence underestimates the potential risk of survival. The number of abortions performed after 20 weeks is very small. The 1015 number of abortions performed at 24 weeks is even smaller. The statistical data from which people draw the conclusion that only a small number of foetuses is capable of viable existence at 24 weeks is very narrowly based.
I ask the House not to support any proposition which in the generality of cases legalises the abortion of viable foetuses or even admits of the possibility of that effect. At the same time, I ask the House not to accept a proposition that imposes too low a figure. I agree with what has been said about the great evils that flow from too low a figure. If I am right about the first point and 24 weeks is too high, and if I am right about the second point and 20 weeks is too low, the House has no real alternative. It is a matter of opinion. Fortunately, it is a matter for the House. I believe, personally, that 22 weeks is the period that would be most acceptable to most people in this country. That is the amendment I propose.

§ Mr. Abse
The contribution made by the hon. Member for Grantham (Mr. Hogg) should be considered with great care by the House. The reason why I have put my name to his amendment and support him is that I have come to similar conclusions. The hon. Gentleman is correct that no one could possibly believe that we should have a law under which it is possible, unless there are overriding circumstances, for an abortion to take place when it is known or believed probable that a child could be born alive.
There are two aspects to this matter, the political and the moral. I believe that the House is weary of the abortion debate. It will never be—