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"The Government places great importance on raising consumer awareness and understanding, of what constitutes good general practice and on increasing consumer influence in developing services to meet patients' needs".

The paper goes on to say that general practitioners should publicise the services that they offer.

As that is not yet in place, we want general practitioners who are not willing to perform abortions or to refer a woman for an abortion to sign a register so that a woman knows that a particular general practitioner would not help her if she went to see him or her. That would ensure that patients have access to the necessary information about their general practitioners, and would allow patients to make an informed choice before approaching a doctor.

As I understand it, general practitioners who offer contraception do so by saying that they have a certificate from the joint committee on contraception from their area health authority. The register is just another way of doctors making a statement to say, "I am sorry, there is nothing wrong with it, but I have an objection to carrying out abortions, and it is better that you know now, rather than come to me, when I will have to tell you and refer you to someone else, and you may find that the same thing happens again."

I hope that right hon. and hon. Members will consider the new clause in the light of my remarks. It is not in any way intended to hound general practitioners, but to relieve them of unnecessary visits from women they cannot help and whom they would have to tell, perhaps with some embarrassment, that they could not help. One in five women who have abortions between 20 weeks and 23 weeks approached a doctor before the 12th week of pregnancy. Surely all hon. Members agree that no abortion should be later than necessary. The new clause is a modest proposal, and it would in no way prevent doctors from exercising their right conscientiously to object to abortion. However, it would help women to get access to the services they need as quickly as possible. That is why we tabled the new clause.

6.30 pm

The Minister for Health (Mrs. Virginia Bottomley) : The House is well aware that Ministers remain neutral on matters concerning abortion, which are issues for right hon. and hon. Members to exercise their conscience and use their own judgment. Traditionally, Ministers advise the House on details of administrative, medical or legal issues. I shall follow that tradition in seeking to comment on the amendments and new clauses.

Certainly Health Ministers have no particular expertise in advising other hon. Members how best they should make a moral or ethical judgment. Hon. Members will recall that, during the lengthy debate on the abortion clauses in the Bill in a Committee of the whole House, I agreed that we would come back if the House had voted for particular measures which would lead to an incoherent or inconsistent Bill. I assure the House that, having studied the results of the Committee stage, that is not the case, except for matters concerning Northern Ireland. In deciding whether to support the amendments, we believe that right hon. and hon. Members should exercise their own judgment, except that we believe that it would be right to leave existing arrangements for Northern Ireland unchanged.

My hon. Friend the Member for Torridge and Devon, West (Miss Nicholson) tabled amendment No. 31, on

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which my hon. Friend the Member for Eastleigh (Sir D. Price) and the hon. Member for Peckham (Ms. Harman) spoke. The House will be aware that at present, in ordinary circumstances, a pregnancy may be terminated only if two doctors are of the opinion, formed in good faith, that an abortion is justified under one or more of the grounds specified in the Abortion Act 1967. The opinion of a single doctor is sufficient in cases where that doctor is of the opinion that abortion is immediately necessary to save the life of or to prevent grave permanent injury to the woman's health.

Amendment No. 31 enables the House to modify that position for pregnancies of 12 weeks or under. My hon. Friend referred to it as a limited, modest and useful measure. Some hon. Members may take that view, but during the debate it has become clear that my hon. Friends the Members for Castle Point (Sir B. Braine) and for Gainsborough and Horncastle (Mr. Leigh) and the hon. Members for Liverpool, Mossley Hill (Mr. Alton) and for Sheffield, Attercliffe (Mr. Duffy) do not regard it in that light.

New clause 1 appears to be intended to allow a woman the right to have an abortion on request up to the 12th week of gestation, regardless of the grounds specified in the 1967 Act, if one registered medical practitioner certifies that the pregnancy has not exceeded that period. New clause 6 and amendment No. 31 do not go as far as new clause 1. They relax the two- doctor requirement and allow the termination of a pregnancy with the consent of one doctor, provided that the requirements of the Act are met and the doctor is of the opinion that the pregnancy has not exceeded 12 weeks. I am advised that, of the two proposals, amendment No. 31 is technically superior to new clause 6 and would achieve its purpose without further amendments to the Act being required.

In considering the new clauses and amendment No. 31, the House has agreed that, when an abortion is carried out--every case is clearly an individual tragedy--it is much better that it takes place early. Although 84 per cent. of abortions were carried out before 12 weeks' gestation in 1988, and in 1989 that figure had increased to 86 per cent., in 1988 some 30,000 abortions took place after the 12th week of pregnancy.

The right hon. Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel) and the hon. Member for Peckham mentioned the Royal College of Obstetricians and Gynaecologists report which showed that 20 per cent. of abortions done between 20 and 23 weeks' gestation had been referred to a doctor earlier and had then been referred for a second opinion.

Delay can occur at various stages in considering a woman's request for an abortion, and the need to obtain the consent of two doctors can be a contributory factor. Many hon. Members have spelt out the importance of trying to ensure that, when an abortion needs to be carried out, it should happen swiftly and without undue delay. The right hon. Member for Tweeddale, Ettrick and Lauderdale also made the useful point that a greater public consciousness of the need to take necessary steps before 12 weeks should be encouraged. I can also pass on the medical advice that those terminations that take place after 12 weeks are much more likely to lead to complications, quite apart from the additional stress to the woman.

I shall briefly comment on new clause 5, to which the hon. Member for Barking (Ms. Richardson) referred.

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Again the Government remain formally neutral, although it is important to make it clear that we would anticipate a number of difficulties should such a clause gain support.

Hon. Members will know that section 4 of the Abortion Act 1967 already provides that, except where treatment is necessary to save the life of or prevent grave permanent injury to the pregnant woman, "no person shall be under any duty whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection". If medical or nursing staff have strong ethical or moral objections to abortion work, they should not be obliged to take it on. Their conscientious objections should not be detrimental to their careers and appointments.

New clause 5 seeks to introduce a statutory notification system. Apart from a number of technical faults, with which I shall not trouble the hon. Lady, it would require very demanding administrative arrangements. Perhaps more important are the implications of making public people's views on a matter on which there are such strongly held feelings. In addition, we have received correspondence from the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, expressing grave reservations about the implications of such a system. As the hon. Lady said, although the new clause refers to medical practitioners and not to nurses, it is important to make it clear that they anticipate difficulties with such a system. Similarly, the Royal College of Midwives has informed us that it might well lead to considerable difficulties of recruitment and retention.

Conscientious objection has been considered by the Social Services Select Committee. There are strong views and, of course, the Government will consider the Select Committee report carefully. I turn now to a subject which has been the source of considerable concern to many hon. Members representing Northern Ireland constituencies. The hon. Member for Antrim, North (Rev. Ian Paisley) spoke forcefully and was supported by his hon. Friends. The 1967 Act, which legalised abortion under certain circumstances, does not extend to Northern Ireland. The provisions of that Act were not originally introduced in Northern Ireland because the Government considered that the reform of social law in the Province was a matter for the Northern Ireland Government. It has been the policy of successive Governments throughout direct rule that Northern Ireland's unique position makes it desirable to re-establish a devolved Administration there.

The Northern Ireland Constitution Act 1973 provides for a Northern Ireland Assembly to determine its own policy and pass its own legislation on certain matters. The amendment falls clearly within that legislation. Parliament may of course legislate in such matters, but we have always been at pains to tailor such legislation to the particular circumstances of Northern Ireland, especially in social legislation, where the values of the people of Northern Ireland may differ from those of people living in England, Wales and Scotland. To the best of my knowledge, no Northern Ireland Member of Parliament has ever called for changes in the Northern Ireland abortion laws. Similarly, all the soundings of opinion have made it very clear that there is no will in Northern Ireland for such a change. I am

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informed that my noble Friend Lord Skelmersdale and my right hon. Friend the Secretary of State for Northern Ireland have received more than 2,000 letters on the subject, urging them robustly to resist such a new clause. I strongly urge the House to reject new clause 7, which would be offensive to the overwhelming majority of people in the Province.

I urge the House to support Government amendment No. 54, which is a tidying amendment. There is a contradiction within clause 34, and amendment No. 54 simply excludes clause 34 as it applies to Northern Ireland.

Many hon. Members are seeking to catch your eye, Mr. Deputy Speaker, who all have strongly held and sincere views on these difficult and sensitive matters. I have sought to confine my remarks to the medical, administrative and legal issues that affect these concerns. My having made the point about not altering the position on Northern Ireland, it is for hon. Members to weigh up the merits of the new clauses and amendments and to exercise their judgment on behalf of their constituents.

Mr. Campbell-Savours : I oppose new clause 5. The Minister inaccurately referred to midwives being affected by it. It does not refer to midwives, and the Royal College of Midwives Trusts was inaccurate in the brief that it circulated to hon. Members. I appeal to my hon. Friend the Member for Barking (Ms. Richardson) not to press new clause 5, to which many hon. Members are deeply hostile, and I shall explain why. An organisation called the Economic League registers people who take a principled position in conscience on political issues. My hon. Friend said that the new clause is supported by "we on this side", whereas it is supported by some Labour Members but not by me. The new clause sets up a register exactly the same as that organised by the Economic League. Instead of people being registered for their political conscience, they would be listed because of their opinion on abortion. That is quite unacceptable and is against all the traditions of the Labour party, which for decades has prided itself on the libertarian position that it generally takes on all issues.

We are deeply hostile to the new clause. It will lead to the targeting of doctors by minority groups, who will not want certain doctors to be allowed to practise in certain hospitals. Furthermore, it will lead to the emigration of many doctors who will feel, having been placed on the register, that no one will be willing to give them an appointment or interview anywhere in the United Kingdom. I say to my hon. Friends on the Front Bench--I ask them to listen to what I am saying--please do not press the new clause. It is appalling, it is immoral and it is wrong.

Dame Jill Knight (Birmingham, Edgbaston) : I rise briefly to support the hon. Member for Workington (Mr. Campbell-Savours). I can never recall a public register being drawn up to pillory people who hold certain opinions.

Mr. Campbell-Savours : The Economic League.

Dame Jill Knight : As far as I am aware, the Economic League does not produce a register that is available to the public. The new clause says that the public register should be available for anyone to read.

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6.45 pm

Hon. Members have a right to whatever opinion they hold. There are sinister groups, as my right hon. Friend the Member for Castle Point (Sir B. Braine) and I have good reason to know, who physically attack those who oppose abortion. I have been the victim of an attack and my right hon. Friend the Member for Castle Point has also been attacked. If the new clause is passed, those vicious people will be able to obtain a list of doctors who have a professional job to do but have a right to their own opinion on how they do their job. Doctors who do not agree with abortion will be targeted mercilessly. It is not only a question of them not being able to get a job in a practice or a hospital because, without question, they would be targeted in a most vicious, wicked and un-British way. The House cannot allow this sinister new clause to be passed.

Dr. Moonie : In the few minutes that I have, I shall give my reasons for supporting several of the new clauses and amendments. I support new clause 1 for the simple reason that a balance should be struck in the law between the rights of women and the potential rights of the unborn foetus. The later parts of the Bill provides a reasonable balance between those rights. They recognise that as the pregnancy proceeds the rights of the foetus become paramount. They do not recognise that the rights of the woman should be paramount early on. It is a matter of civil liberties as much as medical reason, and I believe profoundly that a woman should have the right, up to 12 weeks into her pregnancy, to decide whether she wishes to proceed with it.

New clause 6 and amendment No. 31 are almost identical. They provide for a single signature rather than the two signatures that are necessary at present. An argument that has not been advanced thus far should be recognised. When the Abortion Act was passed in 1967, there were disparities in the training of medical practitioners, general practitioners and consultant practitioners in hospitals. That was recognised by the fact that two signatures were required--that of the GP for the initial referral and that of the consultant to signify that he agreed. Medical practice has moved on since that Act was passed and general practitioners are given full and rigorous training before being allowed to take up their position. They are adequately trained and informed to make that judgment without it being subjected to that of a second party. If new clause 1 is not passed, new clause 6 or amendment No. 31 would recognise that fact.

I support new clause 5, and I gave it considerable thought before adding my name to it. The NHS is an expensive resource and it is paid for from my taxes and those of others. People are entitled to receive a full service, but they are also entitled to know who will not provide it so that they may find out who will.

The rights of women have not been mentioned by Conservative Members, but they never are ; all they talk about are the rights of unborn children. They do not care about the rights of women, and I certainly will not listen to the hon. Member for Birmingham, Edgbaston (Dame J. Knight), who gave us her bigoted views, having attended for only five minutes while other hon. Members who had been present longer waited to speak.

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I support new clause 7, which deals with the rights of women in Northern Ireland. Women in Northern Ireland who wish to have an abortion should have the same rights as other women in the United Kingdom.

Miss Ann Widdecombe (Maidstone) : I shall speak to new clauses 1 and 6 and amendment No. 31. I am grateful to the Minister for her comments on the conscience clause and the difficulties that it will cause. I am also grateful for her comments on Northern Ireland. I bear in mind three points in my opposition to new clauses 1 and 6 and amendment No. 31. If we passed new clause 1, we should be saying that for the first trimester of pregnancy there would no longer be any reason to produce medical grounds for abortion. Whatever may be the failings of the Abortion Act 1967, at least it requires good reasons to be given for abortion. It provides some, albeit paltry, recognition of the fact that the unborn child is special and that abortion is special and cannot be equated with a simple operation, such as having a tooth out. If we remove the medical grounds, we remove that minimum recognition of the difference between such operations.

I am also concerned about those women who have been neglected in the arguments advanced by the Opposition. I refer to those who receive inadequate counselling and who consequently suffer from post-abortion syndrome. If the signature of only one doctor is needed and abortion becomes immediately and readily available, those women will be less likely to receive good counselling and to be given sufficient time to consider what they are doing.

The argument that has been deployed by the Opposition today is bogus. They argue that if we make early abortion easier, we shall reduce the number of late abortions. I refer not to a pro-life document but to a study published by the Royal College of Obstetricians and Gynaecologists--no friend, in recent years, of the pro-life movement. When the RCOG investigated the causes of late abortion it found that

"in 30 per cent. of second trimester abortions"--

that is the period immediately following the 12 weeks--

"the major cause of the abortion was not that it had been earlier requested and that there were NHS delays but that in fact there was, very simply, a failure in those early stages to recognise pregnancy. Of the further 50 per cent."--

that takes us up to 80 per cent.--

"personal factors were the major cause."

They include prolonged indecision, apprehension and, above all, changes in relationships and changes in circumstances.

The report also referred to the large number of foreign women entering the country and inflating the late abortion figures. Perhaps--most sinister of all--the major reason for delay, according to the RCOG, between the 15th and 19th week was the wait for a prostaglandin abortion because the unborn baby must be of a particular size for prostaglandins to be effective. Does that mean that a child should be allowed to grow until it is ready to be aborted? The figures show that the major reason for late abortions is not NHS delays.

As for the figures quoted by my hon. Friend the Member for Eastleigh (Sir D. Price), for whom I have great respect and with whom I work on many issues, he said that where there is abortion on demand or request up to 12 weeks, a larger number of abortions are performed during those 12 weeks, but he failed to examine the effect on those percentages of the regulations that govern abortions after the 12th week. The tougher the regulations that govern

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abortions after the 12th week, the more abortions are carried out during the first 12 weeks. The figures for the Netherlands and Britain are close, compared with France, because it is still so easy after the 12th week to obtain abortions in both countries. It is not true that if we make abortion easier in the first trimester we shall reduce late abortions. That is not the governing principle. We have been told that an overwhelming majority of people believe in abortion on demand in the early stages of pregnancy. A recent Gallup survey--many hon. Members invoke Gallup surveys, so I hope that we shall not hear that there is anything wrong with this one--asked a representative sample of the population a simple question : "Do you think that abortion should be made available on demand in some circumstances, or never?"

Only 24 per cent. of those who were asked that question said that abortion should be available on demand. There is no majority for it. We fly in the face of public opinion. I urge hon. Members not to be misled by claims that easy early abortions mean fewer late abortions. It does not. Many other factors govern late abortions. We must not further devalue the life of the unborn child, the need for proper counselling and the recognition, paltry though it is in the Act, of the fact that the decision to have an abortion is serious.

Mr. Frank Field (Birkenhead) : This is the first occasion on which I have spoken in a debate on abortion. I do so in consequence of a recent important decision by the House. It has changed my stance. I am not vain enough to think that the House may be interested in the reasons for my change of stance, but I represent a constituency in which the religious groupings make it necessary for me to spell out why I shall vote in a different Lobby tonight.

My hon. Friend the Member for Sheffield, Attercliffe (Mr. Duffy) captured yesterday what was rightly called the high moral ground when he referred to the rights of the unborn child. The debate can be polarised in that way. However, we should examine our moral actions from a different standpoint. Sometimes it helps to stand back from the issue that we are discussing and consider another one on which people, faced with a difficult issue, had to come to a moral decision.

Bishop Bell of Chichester adopted the absolutist stance that to bomb Germany was wrong, and he deployed his argument powerfully. In a sense, a similar argument has been deployed tonight. At that time, the pilots, and the men and women who had to service the aircraft, had to take a moral decision. According to the records, we now know that many of those people were immensely troubled. They did not regard it in absolutist terms but as a choice between two evils : letting the Nazis win or taking part in an activity that they did not like. They carried out their duty.

The Minister for Health said that there is an element of tragedy in every abortion. That starting point unites the whole House. On earlier occasions we have debated means by which the number of tragedies can be reduced. Some people believe that we should make it more difficult for women to have abortions. It is clear from the way that the House speaks and votes that that is not an option. In the messy area of not being absolutist but of having to choose between alternatives, I believe it to be right to go

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for earlier rather than for late abortion. We should make it harder for late abortions to take place, but that option is not before the House tonight.

We must link family planning to the debate about abortion. We all know in our hearts that if we had a fraction of the campaign and the lobbying force that has rightly supported the issue of abortion behind the issue of family planning, things would be very different. If we could move on the family planning front as well, the tragedies to which the Minister for Health referred--tragedies which unite the House--could be reduced. The number of women coming forward for abortions could be significantly reduced.

Dame Elaine Kellett-Bowman (Lancaster) rose--

It being Seven o'clock, Mr. Deputy Speaker-- proceeded, pursuant to the Order [2 April] and the Resolution [20 June], to put forthwith the Question already proposed from the Chair.

The House divided : Ayes 159, Noes 264.

Division No. 250] [7 pm

AYES

Abbott, Ms Diane

Adley, Robert

Allen, Graham

Archer, Rt Hon Peter

Armstrong, Hilary

Ashton, Joe

Banks, Tony (Newham NW)

Barnes, Harry (Derbyshire NE)

Barnes, Mrs Rosie (Greenwich)

Barron, Kevin

Beckett, Margaret

Blunkett, David

Boateng, Paul

Boyes, Roland

Bradley, Keith

Brown, Gordon (D'mline E)

Brown, Michael (Brigg & Cl't's)

Brown, Nicholas (Newcastle E)

Brown, Ron (Edinburgh Leith)

Bruce, Malcolm (Gordon)

Buck, Sir Antony

Caborn, Richard

Callaghan, Jim

Campbell, Ron (Blyth Valley)

Carr, Michael

Cartwright, John

Clark, Dr David (S Shields)

Clay, Bob

Clelland, David

Clwyd, Mrs Ann

Cohen, Harry

Coleman, Donald

Colvin, Michael

Cook, Frank (Stockton N)

Cousins, Jim

Cox, Tom

Dalyell, Tam

Darling, Alistair

Davies, Ron (Caerphilly)

Davis, Terry (B'ham Hodge H'l)

Dobson, Frank

Doran, Frank

Dunwoody, Hon Mrs Gwyneth

Eastham, Ken

Fairbairn, Sir Nicholas

Fatchett, Derek

Field, Frank (Birkenhead)

Fields, Terry (L'pool B G'n)

Fisher, Mark

Flannery, Martin

Flynn, Paul

Foot, Rt Hon Michael

Forth, Eric

Foster, Derek

Foulkes, George

Fraser, John

Fyfe, Maria

Garrett, John (Norwich South)

George, Bruce

Gill, Christopher

Gilmour, Rt Hon Sir Ian

Glyn, Dr Sir Alan

Golding, Mrs Llin

Gould, Bryan

Hamilton, Hon Archie (Epsom)

Harman, Ms Harriet

Haselhurst, Alan

Hattersley, Rt Hon Roy

Haynes, Frank

Heal, Mrs Sylvia

Hicks, Robert (Cornwall SE)

Hogg, Hon Douglas (Gr'th'm)

Hood, Jimmy

Howarth, George (Knowsley N)

Howells, Geraint

Howells, Dr. Kim (Pontypridd)

Hoyle, Doug

Hughes, Robert (Aberdeen N)

Hughes, Roy (Newport E)

Hunt, Sir John (Ravensbourne)

Illsley, Eric

Ingram, Adam

Janner, Greville

Jones, Martyn (Clwyd SW)

Kinnock, Rt Hon Neil

Lambie, David

Leadbitter, Ted

Leighton, Ron

Lestor, Joan (Eccles)

Litherland, Robert

Livingstone, Ken

Lloyd, Tony (Stretford)

Loyden, Eddie

McAllion, John

MacKay, Andrew (E Berkshire)

McKelvey, William

McLeish, Henry

Madden, Max

Mahon, Mrs Alice

Marek, Dr John

Marland, Paul

Marshall, Jim (Leicester S)

Maxton, John

Meacher, Michael

Michie, Bill (Sheffield Heeley)

Miscampbell, Norman

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