Examination of Witnesses (Questions 304-319)|
MP, DR FIONA
24 OCTOBER 2007
Q304 Chairman: Good morning. Welcome
to the last oral evidence session of our Science and Technology
Select Committee's inquiry into the scientific developments relating
to the Abortion Act 1967. Could we welcome the Rt Hon Dawn Primarolo,
MP, Minister of State. We understand you are under the weather,
but thank you very, very much for coming. There is a lot of interest
obviously in this session. Could we also welcome Dr Fiona Adshead,
the Deputy Chief Medical Officer, and Paula Cohen, the Assistant
Director of Legal Services. We are delighted you are able to join
us because I think you have some interesting questions to answer
this morning. Minister, before we start, could I say that this
has been an interesting inquiry, ahead of what we expect will
be very hotly contested amendments to the Tissues and Embryos
Bill. We have taken a vast amount of evidence from sources here,
on the Continent and in the United States. This Act was first
passed in 1967 and amended in 1990. Is it fair to say that the
1967 Act needs major revision because it is out of date?
Dawn Primarolo: Good morning,
Mr Willis. I hope that my voice will hold up this morning. I have
a bad cold and I feel like I am the public health minister for
coughs and diseases spread diseases! With regard to the 1967 Act
and answering questions on that, I am going to confine myself
entirely to what Parliament has decided in changes to the 1967
Act and whether or not that currently works. There have been suggestions,
particularly from other organisations, that the Act could be improved
around a number of points. There is discussion around the time
limitsit is a matter for the House and I know this Committee
is considering itand there are also issues with regard
Q305 Chairman: I am coming to all
those matters, but, briefly, do you feel that the Act as it currently
stands does not need amending?
Dawn Primarolo: The Act as it
currently stands works as Parliament intended and it works well
within those guidelines, yes. It is of course for Parliament to
decide, Mr Willisit is not for mewhether or not
they want to make further changes.
Q306 Chairman: Do you think Parliament
should in fact have a view on this, given that it was 1990 when
it was last debated? It is such an important issue. It creates
an enormous amount of interest on all sides of the argument.
Dawn Primarolo: It is an important
issue and there are views expressed by a wide range of views and
very passionately. The Department of Health's view and the advice
to meand that is why there are no proposals from the Government
to amend the Actis that the Act works as intended and does
not require further amendment at the present time. But, because
of the existence of a free vote on these matters, there have been
a number of attempts to change the 1967 Act which have not succeeded,
apart from the 1990 amendment, and there are opportunities again.
Q307 Chairman: Let us get down to
some of the detail now. In terms of collecting data on abortion,
how does the Department do that so that we know the data is accurate
and informs not only the professions and the interest groups but
Dawn Primarolo: Are you talking
about the number of abortions, age, all of the data I give in
PQs? The Chief Medical Officer has a notification system that
comes through the Healthcare Commission.
Dr Adshead: Essentially, as you
will be aware, we collect information as part of the Act. There
are notifications to the Chief Medical officer. We rigorously
scrutinise those and we send back, on average, about 5% of the
forms that we receive in order to get further information, where
information is necessary, and we use that to monitor the Act.
Q308 Chairman: What worries me, Dr
Adshead, is that the information you are collecting does not in
fact deal with, for instance, mental health.
Dr Adshead: The notification form
has information on why the doctors feel that the termination is
necessary and it does allow us to distinguish between physical
health and mental health reasons. The form of opinion (as I believe
it is called) does not distinguish between the two. So there are
two notifications systems: one which is submitted to us by the
practitioner who performs the termination and the other which
gives the opinionwhich is the two doctors' signatures.
That is the one which does not distinguish between the two forms.
The practitioner who performs the termination does distinguish.
Q309 Mr Flello: Good morning. Do
you see a standard response on these forms? Do the same sorts
of words get put on the forms, which might suggest that somebody
has not thought about it but has just put the phrase they always
Dr Adshead: The Act requires that
doctors who both sign the opinion form and obviously fill in the
notification form need to do so in good faith. As you will be
aware, the General Medical Council has a code of practice around
this. Clearly, the form, by its very nature, is standardised because
it has different data items on it, but it would be outside the
terms of the Act if the doctors were not acting in good faith
and had seriously considered this.
Q310 Mr Flello: With the greatest
of respect, that was not my question. My question is: What do
you see coming back?
Dr Adshead: We obviously see,
at an aggregate level, and we publish statistics that come from
the notification forms. If we had any sense that we did not feel
the Act was being carried out in the form in which Parliament
intended, then obviously we would investigate that.
Q311 Dr Spink: Has there ever been
any instance of you feeling thatever, in the thousands
and thousands of abortions that take place every year, one instance?
Dr Adshead: A previous secretary
of state asked the Chief Medical Officer to carry out a review
based on concerns that appeared in the press about late abortions
and that report was published. If there are any concerns that
are brought to the Department, then we would act on that information.
Q312 Chairman: We are coming back
to this, because we really need to ask the lawyers a little bit
about it. Minister, before I pass you on to Dr Spink, the Committee
were concerned that on Sunday an article appeared in a newspaper
which was giving your views about what this Committee was going
to ask you. Do you feel that was a discourtesy to this Committee?
Dawn Primarolo: I did not see
the article. I do not know what the Committee is going to ask
me, so I could not speculate. My evidence was published and the
evidence is public, but I am here and I will do my best to answer
your questions. Unfortunately, it is not always possible. There
are lots of things that have been attributed to me on a whole
range of things over the last two weeks.
Q313 Chairman: These were direct
quotes which you made to The Independent, which
we had a concern about because it seemed to be prejudging what
in fact the Committee would be asking you and the responses you
would make. But you did not regard that as a discourtesy?
Dawn Primarolo: No. If that is
a discourtesyit was in the evidenceobviously I would
apologise to the Committee, but I have not speculated at all what
the Committee might ask me because I do not know what the Committee
might ask me.
Q314 Dr Spink: You know about this
issue because I emailed you about it on Monday before raising
it on the floor of House as a point of order with the Speaker.
The Independent quoted that: "On Wednesday, Dawn Primarolo,
Public Health Minster will tell the Commons Committee ... "
and it went on to say what you would tell us, and it said "
... said one official ahead of the Human Tissue and Embryos Bill's
long passage through Parliament." Do you know who that official
Dawn Primarolo: I am afraid I
do not. Clearly, I had notice of the point of order that you raised
and, as the Speaker said, with regards specifically to the question
of the timing, that is in the evidence. I do not have that, and
I would say that I do not feel that is any more information than
was in the written submission, but, Dr Spink, if that has offended
you or others
Chairman: I think we have made the point.
Dr Spink: Could I follow that up.
Chairman: No, I do not want to pursue
Dr Spink: I do want to pursue it, Chairman.
Chairman: I do not.
Q315 Dr Spink: Very briefly. Should
you know who the official was?
Dawn Primarolo: I do not
Chairman: Minister, I do not want you
to respond because we have far too many things to get through.
We have made the point.
Dr Spink: Chairman, the official was
not saying what the evidence said; the official was saying what
the Minister was going to say, not what had been said in the evidence,
so it was a discourtesy.
Chairman: Dr Spink, please. We will ask
the Minister, if she wishes to clarify that further, to do so
outside this meeting. I really want to get on to the evidence
now of our report. I have raised the issue which you asked me
to do, and we now need to move on.
Dr Spink: Chairman, you volunteered to
raise the issue. I did not ask you to raise the issue, I think
you will recall.
Q316 Mrs Dorries: Minister, your
records say that you are committed to the liberalisation of the
abortion law. Do you think, given your opinion and the statements
you have made or that your official has made this week, you are
the right minister for the job, or that maybe somebody with a
fairer viewpoint on this issue should be in your place?
Dawn Primarolo: I am not here
to discuss my personal views. I am here, as the Minister, to answer
questions that the Committee puts to me about the information
that the Department has. I am perfectly capable of giving that
information, where I have it, to this Committee, and I will do
so quite clearly.
Q317 Mrs Dorries: Despite the fact
that you have said you are committed to the liberalisation of
the abortion law.
Dawn Primarolo: With respect,
this Committee is not about what I do or do not think as an individual
Member of Parliament.
Q318 Mrs Dorries: Minister, the decisions
will ultimately be based around that.
Dawn Primarolo: It is about my
role as a minister in giving the evidence on the information that
the Department has to this Committee so that this Committee can
come to a conclusion. People may interpret that evidence differently.
That is not for me. I am here only to give the Committee the information
the Department has on the subjects that you have requested me
to do so.
Q319 Chairman: Perhaps I could raise
a specific question from your evidence, minister. The Department's
evidence noted that the Government is committed to increasing
the ratio of early to late abortions. That is clearly what was
stated. Will the Government take responsibility to make legislative
changes that would make access to earlier abortion easier? Because
that is a logical extension to what you have said.
Dawn Primarolo: The Government
has been pursuing that for some time. Eighty-nine per cent of
abortions are carried out under 13 weeks now; 68% under ten weeks.
In agreement with all those with whom we would discuss this in
the medical profession, it is agreed that the strategy should
be to ensurebecause that is safestthat abortions
are conducted as quickly as possible. Indeed, that seems to be
very much the views expressed in the House when it has been debated.
In that sense, the Department is committed and has ensured, through
the Health Service, that wherever possible that early access is