HL Deb 07 March 1966 vol 273 cc910-20

3.18 p.m.

Order of the Day read for the House to be again in Committee (on Recommitment).

Moved, That the House do now resolve itself into Committee.—(Lord Silkin.)

On Question, Motion agreed to.

House in Committee accordingly.

[The EARL OF LISTOWEL in the Chair.]

Clause 1 [Medical termination of pregnancy]:

THE CHAIRMAN OF COMMITTEES (THE EARL OF LISTOWEL)

Your Lord ships will remember that at the conclusion of the proceedings in Committee on Monday last, fewer than 30 noble Lords attended in the Division on Amendment No. 11, and the Question was accordingly declared not decided and the House was resumed. The debate on the undecided Question has therefore been adjourned until to-day. The Committee now proceeds with the Amendment on which no decision was taken owing to the absence of a quorum on Monday. The Question before the Committee, therefore, is that Amendment No. 11, as an Amendment to No. 8, be agreed to.

Amendment No. 11, in the name of Lord Strange, was to add to Lord Silkin's Amendment: ( ) Where a registered medical practitioner refuses to carry out treatment for the termination of a pregnancy, he shall immediately notify a female welfare officer, appointed by the local authority, of such refusal, and it shall thereupon be the duty of the welfare officer so far as practicable to secure the physical and mental health and well-being of the pregnant woman and of the child if born.

LORD STRANGE

I now return to this Amendment, but as I have been battering away at it for so long, I shall not have to make a very long speech. As I have told your Lordships, the whole idea of this Amendment is to establish a principle which I think should be established in the Bill. I will try to explain the principle as simply as I can for those who did not hear my earlier rather long, and boring, speech on this subject.

I put it in this way. When this Bill becomes law, as I hope it will, there will be a great deal of publicity. The ordinary woman who reads the headlines in the Press and does not quite remember what it is all about, will believe that she can treat her doctor as she now treats her dentist. She will think that, just as she can go for an extraction at any time she likes, so she will be able to go and get an abortion. This is not the case. I would point out that this Bill, when it becomes law, will have been threshed out by the best legal brains in the country, the best medical brains in the country, and the best ecclesiastical brains in the country, and that it will be treated very seriously by all doctors. They will, I am sure, see that those who are entitled to it do have an abortion under this Bill, but will reject those who are not so entitled.

The figures with regard to abortion are difficult to ascertain with any certainty. We have the figures of those treated in hospitals, but we can never know the number of successful illegal abortions or the number of successful "Do-it-yourself" abortions which have taken place. The figure which was given earlier, of 100,000 abortions a year, I believe to be just about right. If this Bill is passed the doctors will be able to tell about 20,000 women, "I can do some- thing about it ", and 80,000 women will be rejected. They will go out of the doctor's house, and I presume they will seek out the nearest illegal abortionist. I need hardly tell your Lordships that the illegal abortion business is an abomination in this country. It may well be that in the higher class there are skilled men who work their trade with proper hygienic protection, but lower down the scale there are unskilled people, amateurs and charlatans, who work under dangerous conditions, without skill and with clumsiness. As a result, a great number of these unfortunate women are leaving these abortioners' dens and going to hospital, where they are very ill, and often, indeed, dying.

The principle I want to establish is that these 80,000 women who are refused an abortion by their doctors will have to be offered an alternative. They cannot be allowed to look after themselves and get what they can. The only alternative I can see to-day which could be offered to them would be to try to steer them towards adoption. It may be that the way I have suggested is clumsy. I know that many noble Lords object to the idea of introducing a female welfare officer, but I have not thought of any other means, and some better way may be found. I think it is essential that they should have an alternative, and that they should not be sent out in despair, with suicide and abortion in their minds.

The noble Lord, Lord Silkin, said something very encouraging to me when I was speaking on this subject before. He said that he had in his mind recognising this principle in later stages of the Bill. After I have sat down, if the noble Lord can give me a guarantee that he will recognise this principle, and say that there is a chance of a clause being put in the Bill which will give justice to these rejected women, then I shall be pleased to withdraw my Amendment. But before I sit down with withdrawal in my heart, I feel I cannot shut the gate, in case other noble Lords wish to contribute something on the principle I have been trying to describe. I feel that their contributions might be of value to us, and also to the noble Lord, Lord Silkin, when, as I hope he will, he frames the new clause to go into his new Bill. Therefore, I sit down awaiting your Lordships' wisdom.

3.24 p.m.

BARONESS SUMMERSKILL

I spoke fully on this Amendment before, but I should like to support the noble Lord. I would remind the Committee that the problem we are dealing with is that, so far as we can estimate, 90,000 abortions are procured every year in this country, 20,000 legally, and 70,000 illegallly. If this measure reaches the Statute Book, inevitably there will be thousands of these women, similar to those who have had illegal abortions, who will believe themselves qualified to have a legal abortion. In the first place, they will appeal to their doctors. They may well send them to the hospital to a surgeon with gynaecological experience, who may discuss the matter with a psychiatrist. But, finally, it may be that their request is rejected. What the noble Lord is asking is that some kind of welfare machinery shall be set-up for those women, who will be the end products, let us say, of this legislation, who are in desperation appealing for an abortion and are rejected, in order that they will be looked after immediately. I think this is both humane and practical, and that it is closely related to the objects of this Bill, because what we are anxious to do is to eliminate the back-street abortionist. The women about whom the noble Lord is talking now are precisely those who find themselves rejected by the hospital, and who will seek some other means to have an abortion procured. Therefore, I hope your Lordships will be sympathetic to the noble Lord's Amendment.

BARONESS GAITSKELL

With regard to the Amendment put forward so eloquently by the noble Lord, Lord Strange, and by my noble friend Lady Summerskill, of course none of us is against a welfare service for these rejected women. Nobody in this House would get up and say that. What some of us object to is the compulsory notification. When a woman goes to a doctor and asks for an abortion and is rejected, this proposed compulsory legislation will prevent her from going to somebody else who, in all good faith, may have a different opinion. That is why some of us are against this Amendment.

Practically everything to be said on this Bill has been said, but I should like to stress one or two points. As I said last time, our attitude to abortion is re- flected in our attitude to unmarried mothers and illegitimate children, which is far from forgiving and helpful. Last time I was chided by the right reverend Prelate the Bishop of Leicester for holding up Sweden as a model of tolerance and humanity in the treatment of their unmarried mothers, because the right reverend Prelate said that they had the highest suicide rate in the world. Old statistics never die or fade away, even when they are inaccurate in the first place, as these were. Switzerland, Japan, and the white male population in America have as high a rate of suicides. Perhaps it is the long hard winter which affects people in Sweden and a meterologist, not a psychiatrist, is needed to explain these figures. Even if they are high, the Swedes still show a greater humanity, though I believe they are just as strict as we are in their attitude to abortion.

I have dealt with the Amendment by the noble Lord, Lord Strange. Of course, I think something should be done about the welfare services for a woman whose request for an abortion is utterly rejected. Speaking to a distinguished physician the other day I found he was against a liberalisation of the law, because he thought it would be too permissive to the rich, irresponsible woman who regarded children as a nuisance. But are we really legislating for these women? They will always circumvent and take advantage of any law by means of their money.

Any change in the law in regard to abortion, which we hope will come about, should come within the category of a contraceptive method only to be used in the last resort, very early in pregnancy and under strict medical conditions as set out in this Bill. It seems to me that only those who believe that contraception must be left to chance or chastity have a logical case against any easing of the law to-day. Throughout the whole of this debate the male attitude has been atavistic, theological, didactic, irrational, on a subject which concerns women alone. One would think most noble Lords here believe that men and women indulged in sex only with the idea of a child, whereas I believe there are far more accidental births even in wedlock than accidental deaths in the world.

LORD SOPER

I was unfortunately prevented from being in your Lordships' House when this matter was considered on the last occasion. I want to say how much I sympathise with the intention of this Amendment, and how completely I am in agreement with the reasons for that sympathy as expressed by my noble friend Lady Summerskill. It seems to me to be obvious that if one offers to a woman in these conditions the possibility of a relief of her troubles and termination of her pregnancy, and then this offer turns out to be not viable, one may well create a sense of even greater tension and desperation than that which previously confronted her. For this reason I am sure the intention of the noble Lord, Lord Strange, to provide some aftermath to this particular experience of refusal and some, even conditioned, hope that something still may be done to alleviate the concern and trouble of the woman in question is absolutely right.

However, may I support him in what seems to be his conditional preparedness to withdraw this Amendment if my noble friend Lord Silk in will himself so frame an Amendment and include it in any future document that comes before us, so as to meet the demand without specifying in too great particularity the way in which that demand ought to be fulfilled. For instance, I have a good deal of suspicion that the compulsory notification of a female welfare officer might not answer the problem as it is now set forth. There are other agencies, not least of all the Church. Despite the strictures which have been put on its theological position, very often its humanitarian conditions are far better. For that reason I would confidently support the proposal that lies behind this Amendment and suggest that my noble friend Lord Silkin may well be able to tell us that in any future framing of a clause the intention of this Amendment will be met and a wider option even than that envisaged in this Amendment will be offered to those 80 or 90 per cent. of women who, in desperation, after refusal of what they think to be a right, will desperately need further counselling and further help. I believe they should get it, I believe such a clause is proper to this Bill; and I hope that my noble friend Lord Silk in will find it possible so to frame an Amendment.

LORD RAGLAN

I voted against this Amendment last time because I did not think it right that a woman, having been refused an abortion under this Bill, should be sent to a welfare officer whose job, besides being to try to comfort her, would also be, perhaps, to take her to another doctor to have the first doctor's opinion confirmed. To put a woman in the position of shopping around for an abortion, as it were, is, I feel, as degrading to her as the avuncular decision (if the noble Lord will forgive me) to send her to the welfare officer in the first place. Though I feel that the Amendment is wrong, I think the noble Lord, Lord Strange, is right. This Bill will not do enough to lessen the distress it was originally intended to lessen, even though by discussing abortion so freely in your Lordships' House it may make doctors less uneasy about performing it.

When this Amendment was put to the vote last time it was ruled that your Lordships should call the issue not decided, and by the number of noble Lords who stayed in their seats, that ruling seems to be an accurate reflection of your Lordships' opinion. The noble Lord, Lord Strange, vividly brought home, as perhaps no other speaker has done, some idea of the misery and desperation of a woman who finds herself pregnant when she does not want to be. I, for one, do not feel it is possible to legislate to meet the wretched situation that your Lordships are trying to meet while abortion remains a criminal offence. I believe that trying to amend or widen the scope of the present law is starting at the wrong end of the problem, and my conviction increases the more we discuss it.

The noble and learned Viscount, Lord Dilhorne, has repeatedly pointed out that abortion is a dangerous operation, and girls should certainly be educated to realise that it is. But its dangers under the hands of a highly qualified surgeon are as nothing when compared with the risks a woman runs when she goes for an abortion to someone who is unqualified to procure it. What ought to be done, surely, is to ensure that when a woman wants an abortion she should have it done by a skilled surgeon, and not resort to the back streets.

I entirely agree with the noble Baroness, Lady Gaitskell, that only the woman has the right to decide whether she will have a baby; and I am glad that the noble Viscount, Lord Dilhorne, agrees that this is an arguable proposition, because the vast majority of 'women I have talked to about this think so too. For a woman, sent away by a doctor, it must be small comfort to be told, even by a woman welfare officer, that she must have the baby because "doctor said you must" or, worse still, because "doctor says it will do you good". I do not know what criteria doctors will have or will find for refusing abortions. But I believe that neither this Bill, nor the noble Lord, with all his perception and deep compassion, has found a happy solution to something which touches so many women so deeply that it is sometimes hard to comprehend it.

LORD STONHAM

I want to make a few remarks on the actual Amendment moved by the noble Lord, Lord Strange, because that is in fact what we are now considering. I shall say nothing whatever about the principle which he has recommended to your Lordships should be adopted, because I am firmly convinced that every Member of your Lordships' House would agree that, under the conditions which he has envisaged, every woman is entitled to receive the maximum care, assistance and comfort. I do not think there can possibly be any quarrel about that, but with regard to the particular Amendment, and in view of the appeal which has been made to the noble Lord, Lord Silkin, as to the kind of response he should make to the invitation of the noble Lord, Lord Strange, I am bound to point out that it is at least questionable whether or not it is desirable to make a statutory provision for a matter of this kind.

I also wish to speak on the somewhat narrow point, but nevertheless it is one that is quite relevant to the facts of the Amendment—namely, that we are considering what will happen when a registered medical practitioner refuses to carry out treatment for the termination of a pregnancy. The noble Lord himself referred to four occasions out of five (because he said 80,000 out of 100.000 women would be refused abortions under this Bill), but I beg leave to say that, so far as I am aware, no foundation for those figures exists. There are estimates, without any basis on which to justify them; but even on his assumption that four out of five would be refused, it is fair to say that those refusals would be very proper medical refusals according to the provisions of this Bill. One could ask, therefore, if the noble Lord would regard that as a refusal. Again, he does not provide for any sanction in the event of non-compliance with the proposals.

These points are, of course, nothing to do with the principle which he has at heart, which I believe we all have at heart, but it is right for me to sound this warning because, although I am quite sure that my noble friend will wish to give the kind of assurance that the noble Lord has asked for on the matter of principle, I am bound to say that it is going to be very difficult to implement this in a Statute. Therefore, I would hope that any assurance that is given would be given in the broadest possible terms, and that the noble Lord would understand the difficulty and accept it as such.

3.41 p.m.

LORD SILKIN

As my noble friend has just said, everyone who has spoken, and I believe everyone who has listened to the discussion, will have the very greatest sympathy for what the noble Lord, Lord Strange, wishes to achieve. My difficulty is that he does not achieve it by his proposed subsection. Even if we accepted the Amendment, it just would not work. As my noble friend said, there is no obligation on the woman herself to take any notice of the welfare officer, or even to go near her. The patient herself will be informed—she must be informed—by the doctor, but she need take no notice whatever. There is no sanction against a doctor who does not inform the welfare officer, and I am not at all sure that at the present time the number of welfare officers available could meet the need. Therefore, whatever one may feel about the desirability of something of this kind, I do not think any of us could support this particular Amendment. It just cannot stand.

The noble Lord asked whether I was prepared to give any guarantee that in the Bill which I hope to introduce in the next Parliament I would provide in the proper form for what he wants. I am sorry I cannot give him that guarantee. I should like to make some kind of provision and I hope it will be possible. I am prepared to go as far as this: that I will certainly discuss it with the powers that be, with the Ministry of Health and the Home Office, and see whether something of this kind can be provided in a Bill. I am pretty sure I could promise him that instructions would be given by the Ministry of Health, if a Bill of this kind were passed, under which they would recommend very strongly that in every case the noble Lord has in mind there should be available a welfare officer to assist the unfortunate woman. Whether that goes as far as the noble Lord would wish I do not know, but I think it is something which I could persuade the Minister of Health to agree to. But I should not like to give the noble Lord a firm guarantee that I would find in a new Bill a form of words which would exactly meet what he wishes. In fact I am not sure what he does wish at the present stage. I hope, therefore, that on the very narrow ground that this Amendment is unsuitable he will be content to withdraw it, with such assurance as I have been able to give him, and certainly an assurance of my good will in the matter and my desire to meet his wishes so far as possible in a measure of this kind.

LORD AMULREE

May I say one word which may have some bearing on what the noble Lord, Lord Strange, and the noble Lord, Lord Silkin, have just said? I think it is a fact that most of the big gynecological departments in the country now have a medical social worker attached to them, and that is a practice which we trust will spread to the not-so-big ones and finally to the small ones. They would certainly be people to whom doctors could refer those women who they thought, for one reason or another, possibly were not fit persons for abortion. That would really solve the problem the noble Lord, Lord Strange, is talking about, without putting into a Bill rather complicated wording which would be very difficult and not very proper, I think, to enforce.

LORD STRANGE

I thank your Lordships very much for being so kind to me and listening and giving such encouragement that the principle I was fighting for has been recognised. Even the noble Lord, Lord Raglan, in his brilliant speeech, may not quite recognise all the parts, but he does know, after some generations, the reasons why. I would thank especially the noble Lord, Lord Silkin. I know this Bill is brought in with humanity. I am certain he will do what he can to preserve the principle I have striven for. I have pleasure in withdrawing the Amendment.

Amendment to Amendment, by leave, withdrawn.

LORD CONESFORD

May I ask the noble Lord, Lord Silkin, whether there is possibly a misprint in paragraph (c), which does not appear to make sense as it stands? It says: the opinion mentioned in subsection (1) of this section must be certified in writing by the practitioner who carried out the treatment before the treatment is begun". I have struggled to attach a meaning to those words and I am not sure I have succeeded, but I think the whole thing could probably be put right if instead of the word "carried" there were the word "carries", which is the expression found in the following paragraph (d). I think if it said "the practitioner who carries out the treatment ", it would probably be all right, but it seems to me wrong as it stands.

LORD SILKIN

I am not going to chop words with the noble Lord. I think it makes sense, but you have to read it several times. I think it ought to be quite clear and unambiguous, and what I promise the noble Lord is that when I come to redraft the Bill I will have another look at paragraph (c) and make it clear beyond a peradventure.

Amendment (No. 8), as amended, agreed to.

Clause 1, as amended, agreed to.

LORD CHAMPION

For the purpose of the Statements, I beg to move that the House be now resumed.

Moved, That the House be now resumed.—(Lord Champion.)

On Question, Motion agreed to, and House resumed accordingly.