§ 2.58 p.m.
§ Lord Renton asked Her Majesty's Government:
§ Whether some health authorities, contrary to Section 4 of the National Health Service Reorganisation Act 1973, are closing down or reducing the services provided by NHS family planning clinics; and if so what steps they will take to reopen such clinics and restore such services.
§ Lord HeskethMy Lords, the local provision of family planning services like other health provision is for individual health authorities to decide.
§ Lord RentonMy Lords, I thank my noble friend for that reply, but is he aware that it is more than marginally unsatisfactory? Does he accept that the action of district health authorities in cutting family planning services in recent years is contrary to statute and is causing unwanted pregnancies and more abortions? When will the Government face up to their responsibilities for ensuring that that section of the law is complied with?
§ Lord HeskethMy Lords, I am very much aware of the concerns of the Family Planning Association about the closure of family planning clinics. However, I understand that proposals for the closure of clinics and reductions in services are not being taken forward in the form originally proposed once they have been fully debated and discussed locally. I think it is significant that no closures have been so contentious that the full consultation process involving referral to Ministers has been brought into play to date.
§ Lord Hatch of LusbyMy Lords, is it not the case that the Minister's first reply was misleading? When he said that it was up to local authorities, was he not contradicted by the noble Lord, Lord Renton, who quoted correctly the statute that is being broken as these clinics are closed down? Will the Minister not now rescind his original answer to the noble Lord, Lord Renton, and admit that this is a government responsibility under statute?
§ Lord HeskethMy Lords, I think the noble Lord, Lord Hatch, will find that the statute says:
The Secretary of State's duty to arrange to such extent as he considers necessary to meet".That, combined with the second answer I gave to my noble friend Lord Renton, provides, I believe, a satisfactory answer.
§ Lord EnnalsMy Lords, bearing in mind that up to 25 per cent. of district health authorities have either cut, or are proposing to cut, their family planning services, and bearing in mind the point made by the noble Lord, Lord Renton, that there has been a 5 per cent., or rather 12 per cent., increase in abortions over the last five years, apart from the increase in teenage conceptions, was the Minister saying in his earlier reply that the department and therefore Ministers are turning down these proposals for a reduction? If so, will he accept from me our grateful thanks? Will he go further and ensure that the family planning services are not reduced as it is now proposed they should be? Will he take a firm stand, not just on behalf of the Family Planning Association and its requests but of all of us who are concerned about this issue?
§ Lord HeskethMy Lords, I have indicated that the Department of Health has made clear that it expects health authorities to make full use of their family planning services. I again draw the attention of the noble Lord, Lord Ennals, to the point I made concerning my second answer to my noble friend, Lord Renton. As to the increase in abortions, I have to say that we cannot state that the closure of family planning clinics has a direct effect on the abortion rate because there is no basis on which the detail of the reasons for the increase in the abortion rate could be satisfactorily compiled.
§ Lord Henderson of BromptonMy Lords, is not the Minister's reply a trifle disappointing in view of the recent most welcome emphasis by the Prime Minister on the importance of family planning and containment of the world population in the context of environmental pollution? In particular, will the noble Lord kindly say whether he can give any information on the progress of the three family planning and pregnancy counselling projects for young people set up by the Department of Health and Social Security in 1986?
§ Lord HeskethMy Lords, with regard to the question of the noble Lord, Lord Henderson of Brompton, concerning the three research projects which are going on at the moment, I believe I am correct in saying that the results will be available at the end of 1989.
§ The Countess of MarMy Lords, will the noble Lord agree that closures have taken place because the district health authorities have had to make economies? Does he consider it right merely to pass the costs from one National Health Service budget to another possibly at greater expense, because the Family Planning Association considers that its provision of family planning services is cheaper than if the patient were to go to a GP? Also, can the Minister say what has happened to the Government's banner of freedom of choice and explain why women cannot choose to go to a family planning clinic if they wish rather than to their GP?
§ Lord HeskethMy Lords, I am sure that the noble Countess is aware that there is a certain level of disagreement concerning the cost effectiveness of the two alternatives, certainly as concerns the department. I must once again draw her attention to my earlier remark which is that a great number of the closures which were proposed have not in many cases taken place after further consultation.