HL Deb 23 February 1971 vol 315 cc956-60

4.15 p.m.

THE MINISTER OF STATE, DEPARTMENT OF HEALTH AND SOCIAL SECURITY (LORD ABERDARE)

My Lords, I apologise for interrupting this interesting debate, but with your Lordships' permission I should like now to repeat a Statement which my right honourable friend the Secretary of State for Social Services has made in another place. It is as follows:

"The Government have now studied the working of the 1967 Abortion Act. Our conclusion is that while the Act has operated to the benefit of many people there is cause for real concern about the way in which certain of its provisions are working in practice. We therefore propose to appoint a Committee of Inquiry to review the operation of the Act, on the basis that the main conditions for legal abortion remain unaltered. I will if I may circulate the full terms of reference in the OFFICIAL REPORT. The essential point is that the Inquiry will be concerned with the way the Act is working and not with the principles that underlie it. It will be open to the Committee not only to recommend changes in the law but also to suggest interim changes in the regulations under the present Act, should they find this necessary. The honourable Mrs. Justice Lane has accepted our invitation to preside over the Inquiry, and in choosing other members we shall be looking for people with the right kind of knowledge and experience who are not already committed on the subject.

"The Government believe that family planning can often improve the quality of domestic life: it can prevent the unhappiness that unwanted pregnancies can cause and reduce the need for abortion. The Government propose to encourage the growth of local authority family planning, including domiciliary, services, particularly in areas of special need. Provision has therefore been made in the rate-support grant for expenditure in England and Wales to treble by 1972–73. The rate of growth in subsequent years has yet to be settled. Advice will remain free to all, and so will equipment to those requiring it on medical grounds. Local authorities may waive charges for equipment in other cases. Hospital authorities are also being asked to increase provision for family planning. No change is proposed in the arrangements for the provision of family planning and advice and equipment by general practitioners."

The Committee's full terms of reference are:

"To review the operation of the Abortion Act 1967, and, on the basis that the conditions for legal abortion contained in paragraphs (a) and (b) of subsection (1) and in subsections (2), (3) and (4) of Section 1 of the Act remain unaltered, to make recommendations."

BARONESS SEROTA

My Lords, may I first of all thank the noble Lord, Lord Aberdare, for repeating this long-awaited Statement. I am glad that the announcement to set up an Inquiry to review the workings of the Abortion Act has been linked to that of the development of family planning services for it is now widely recognised on all sides that the problems of unwanted pregnancies can be properly dealt with only by a comprehensive birth control service within the National Health Service. As I understood the Statement—and I should be grateful if the noble Lord could confirm this—this is to be a genuinely independent fact-finding Inquiry which will make any recommendations needed to correct the present weaknesses, failures or abuses in the Act, rather than an Inquiry concerned with its fundamental principles. I also welcome that part of the Statement which indicates that, under the chairmanship of Mrs. Justice Lane, the Committee of Inquiry will consist of people who have not been publicly associated with the abortion controversy.

I welcome, too, the decision of the Government to expand the family planning services, but regret that this appears to be confined only to the local authority services, and then only on medical grounds rather than on medical and social grounds. All noble Lords would agree, I think, that the old distinction between medical and social grounds is now becoming increasingly blurred. I particularly regret the decision of the Government to limit the increase solely to the local authority services, in view of the report of the Central Health Services Council's Advisory Sub-Committee on the Development of the Maternity Services, which, as the noble Lord, Lord Aberdare, will remember, recommended quite recently that a free family planning service should be an integral part of our maternity services throughout the country.

Just one last question, my Lords, if I may. I see that hospital authorities are also being asked to increase their provision for family planning. May I also ask the noble Lord, Lord Aberdare, whether additional resources are to be made available for this service, particularly as the Sub-Committee on the Development of Maternity Services, under the chairmanship of no less a distinguished member of the medical profession than Sir John Peel, recommended that the hospitals should be the focal point of our family planning services of the future in view of the increasing number of births that are now taking place in them?

BARONESS SUMMERSKILL

My Lords, while welcoming the noble Lord's Statement, may I ask him whether he will bear this point in mind? He mentioned the importance of providing more equipment. I believe that the provision of equipment and new clinics should be accompanied by widespread propaganda. The highly intelligent family, of course, know or learn about birth control quite easily. The ones we wish to reach are those people who, because they are shy, or for cultural reasons, or even for religious reasons, are reluctant to go to a birth control clinic. What needs doing, I think, is to condition these people into the right way of thinking. Then, of course, the equipment will be used. There are family planning clinics and other places where birth control is taught which at present are under-used, and the Government are not going to succeed if they simply say, "We will provide equipment and clinics", without also arranging lectures of all kinds in the most appropriate places by people who are carefully chosen and who will be able to persuade families to use the equipment mentioned by the Minister.

BARONESS GAITSKELL

My Lords, may I ask the Minister to consider one point? Could not family planning—I prefer to use the words "birth control"—be part of the medical students' curriculum? That would mean that all doctors would know about it and would be able to tell their patients about it.

LORD ABERDARE

My Lords, I am grateful to the three noble Baronesses who have commented on this Statement and for the way in which it has been generally received. May I first confirm to the noble Baroness, Lady Serota, that the abortion inquiry is indeed an independent fact-finding inquiry into the working of the Act and not into the principles which underlie it. It is true that we are hoping to develop the local authority services by the additional money to be given under the rate-support grant; but this is not purely for a family planning on medical grounds only; it is also for family planning on social grounds. The local authorities are able to give advice and provide equipment on social grounds and the only distinction is that when they are given on social grounds the person concerned is expected to pay for the equipment but not for the advice. As the Statement mentioned, we are also encouraging hospital authorities to give more family planning advice. We have already made extra funds available to them for general purposes, and we should expect them to find the necessary funds from that.

May I say to the noble Baroness, Lady Summerskill, how very much we agree with what she has said? We do not expect to confine ourselves only to local authority clinics as the answer to this problem. A circular will be sent to local authorities, and we hope that they will pay great attention to increasing their domiciliary services for the people such as those she had in mind in order to persuade them to make use of the facilities that exist. We shall also work through the urban programme which should give extra money—a 75 per cent. grant—in those areas where perhaps this sort of advice is very much needed. May I say to the noble Baroness, Lady Gaitskell, that I will certainly bear in mind the very important point that she made.

THE EARL OF LAUDERDALE

My Lords, may I ask three questions arising from the Statement? First, can the noble Lord give us an assurance that the selection of Committee members will be based on the widest possible spectrum without discrimination against any section of medical or ethical opinion? Secondly, will the Committee be willing and able to take evidence from all quarters without any kind of discrimination? Thirdly, will it be able to recommend any amendment of the Abortion Act?

LORD ABERDARE

My Lords, those selected as members of the Committee will be completely independent: the whole object is to get people who are not committed one way or the other. They will be completely free to take what evidence they want. They will be able to recommend alterations to the Act but not to those parts of the Act which contain the underlying principles. If I might quickly read the Committee's terms of reference, they are: To review the operation of the Abortion Act 1967, and, on the basis that the conditions for legal abortion contained in naragranhs (a) and (b) of subsection (1) and in subsections (2), (3) and (4) of Section 1 of the Act remain unaltered, to make recommendations. The subsections referred to are those that contain the principles behind the Act. If there are any legislative changes which the Committee think should be made, they can make recommendations.