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Baroness Gould of Potternewton: My Lords, I rise to oppose the Prayer and to support the order which will allow emergency contraception to be sold over the counter to women who are over 16. I must, however, declare an interest as the president of the Family Planning Association.
The noble Baroness, Lady Young, concentrated some of her remarks on the need to protect young girls and to reduce the number of teenage pregnancies, which of course are important. I fully support the need to protect young girls and to reduce the number of teenage pregnancies. I shall return to that later.
The order was introduced to reduce the number of teenage pregnancies, but it is more about providing access to emergency contraception for mature and older women, and I shall concentrate my remarks on that.
There is a presumption that it is wild, immature young women who will need emergency contraception. In truth, it is mature women in stable relationships--women in their mid or late 20s--who are most likely to wish to prevent an unplanned pregnancy and who need access to the morning-after pill. All the professional bodies support the order as part of a national strategy to reduce the number of unwanted pregnancies and abortions. That view is supported by organisations that are involved with public health and family planing, by community and hospital pharmacists and by the majority of the adult public.
One might argue, as the noble Baroness did, that the fact that we can obtain emergency contraception from GPs, family planning clinics, NHS walk-in centres and some hospital and A&E departments makes its sale in chemist shops unnecessary. However, easy access is absolutely essential.
For emergency hormonal contraception to be effective, it is essential for it to be taken with some speed. It is 95 per cent effective if taken within 24 hours, 85 per cent effective if taken within 25 to 48 hours and only 58 per cent effective if taking the drug is delayed to between 49 and 72 hours.
Time and again, women call the Family Planning Association helpline saying that they have rung their doctor but cannot get an appointment within the 72-hour period, that they have not been able to get time off work to see their doctor or that they were embarrassed to discuss the reason that they needed an urgent appointment with the doctor's receptionist. Women often ring the helpline in tears of frustration and despair. A woman who has had unprotected sex, or whose regular contraception has failed, knows that
Allowing EHC to become available directly from Britain's 12,000 pharmacies has many advantages which should not be lost. Women will be able to buy it conveniently, at weekends and when GPs' surgeries are closed, and without embarrassment in an area out of earshot of other customers. Most importantly, it will increase the chance of access to advice from professional pharmacists and will limit the number of unwanted pregnancies and abortions.
I want to comment briefly on the point raised by the noble Baroness, Lady Young, in relation to teenagers. No one would deny that it would be preferable for teenagers to delay having sex. But surely it is also preferable to prevent pregnancy rather than to refuse help. We must accept the reality that one-quarter of teenagers will be sexually active before their 16th birthday. A recent survey in Scotland showed that that is true for 35 per cent of girls and 30 per cent of boys.
My view is that the social and psychological impact of an unwanted pregnancy far outweighs concerns about the morality of prescribing emergency contraception. The noble Baroness, Lady Young, also raised that point and related it to the question of abortion. I want to refer to the remarks of Dr Trevor Stammers, spokesperson for Family and Youth Concern. He made it clear that, although a school's sex education policy should have as its basis providing assistance to young people to resist the pressure to have sex, the morning-after pill is the lesser of two evils--rather the pill than the trauma of a possible abortion.
The noble Baroness, Lady Young, is wrong to believe that providing emergency contraception will tempt young people to try sex for the first time. By the time it is prescribed, sex has already taken place. Voting against the Prayer will in no way prevent teenage pregnancy; a vote in favour will.
After going through all the proper procedures, the Committee on Safety of Medicines and the Medicines Commission have advised that taking the morning-after pill is safe and effective and does not constitute an abortion. Medical care is about providing the right support and the right medication at the right time. That is exactly what emergency contraception provides. It provides a useful avenue of accessibility for women and teenagers, and its use is highly responsible in the face of a potential, unwanted pregnancy. Voting for this Prayer tonight will deny many women the right to take that responsible action. I urge noble Lords to vote against it.
Week after week, we in this House are faced with government proposals for sexual licence: Section 28, the reduction in the age of consent, and now this. Clearly, the Government are helping to create the climate of permissiveness which is bringing about the breakdown of which Mr Taylor spoke.
The selling of the morning-after pill over the counter by chemists seems to me to be a mistake. Although it may, if used soon enough, protect against pregnancy, it does not protect against sexually-transmitted diseases--genital warts, chlamydia and gonorrhoea, among others--which may lead to HIV or cervical cancer. Inevitably, it will lead to an increase in unsafe sex and will give the green light to "sleeping around", resulting in a substantial increase in the already very high level of promiscuity.
The drive to provide explicit sex education at ever-decreasing ages and the availability of the morning-after pill on prescription for the past 10 years have not succeeded in improving matters. Abortion rates have not been reduced, and teenage pregnancy rates in this country--already the highest in western Europe--continue to rise.
It is surely very unwise to allow pharmacists to sell this pill to women. They are not allowed to consult the doctor concerned; they have no access to medical records; nor can they check the age of girls who seek to buy the pill. I gather that the pill should not be taken by women who are or may be pregnant, have high blood pressure or heart disease, or have had a stroke or breast cancer. Pharmacists often cannot know whether those who come to them fall into any of those categories. Therefore, risks to health will multiply. Meanwhile, doctors cannot know how often their women patients have used the pill. That can seriously affect decisions about medical treatment and be dangerous to the women concerned.
The selling of the morning-after pill over the counter gives the green light to "sleeping around" and will result in a substantial increase in the current level of promiscuity. For those reasons, I support the Prayer introduced by the noble Baroness, Lady Young. I am sure that she is right.
Baroness Walmsley: My Lords, I must confess that the speech of the noble Baroness, Lady Young, leaves me somewhat puzzled. I believe that I live in the real world. In the world where I live, people of all ages have sexual relationships. In the world where I live, these days most couples take responsibility for their own fertility. They take advantage of the fabulous advances which have occurred in medical science over the past 50 years and use the hormonal and barrier products which ensure that, when they have a child, it is a
However, in the real world where I live, things sometimes go wrong with the normal methods of contraception used by responsible people. Condoms split or come off; women forget to take their pills; or they may be sick and lose the pill. Human beings are not perfect. In those situations, surely a responsible, mature woman must not be condemned to bear a child which she does not want simply because she cannot obtain the help that she wants easily and readily. Of course not.
In the real world where I live, young people are very street-wise. Although there are shortcomings in our provision of sex education, most young people know that if they have unprotected sex they are in danger of pregnancy and infection--dangerous infections which can kill. Fortunately, every woman who is in a sexual relationship today can readily obtain contraceptive advice and treatment without undue cost.
But--and this is a big "but"--people sometimes behave under the influence of powerful chemicals which can interfere with their normal good judgment. No, I do not mean alcohol, Ecstasy or any similar drug; I refer to testosterone and oestrogen. Those chemicals are incredibly powerful and are particularly plentiful when young people may not yet be used to their effect. Therefore, should we be trying to punish women of all ages who suspend their normal good judgment or have an accident by forcing them to bear children they do not want by taking away the help that they need? That would be the effect of the proposal of the noble Baroness, Lady Young, if it were carried today.
We have heard that we in this country have the highest rate of teenage pregnancy in Europe. How can that be when we have sex education and free family planning facilities? We seem to have done everything to inform, advise and supply treatment, yet still these tragedies happen. Well, we have not done quite everything. One thing we have not done is to make provision for the accidents, the unplanned errors of judgment and the coercion and abuse situation--until now. Now we have a weapon which should help so long as it is made easily available at no undue cost.
In doing so, we may also be able to reduce the number of abortions. Recently, evidence has been published showing that 90 per cent of pregnancies that were terminated could have been prevented by emergency contraception, and 70 per cent of women seeking abortion would have used emergency contraception if they had known about it and known where to obtain it quickly.
Some people who oppose the availability of this medicine over the counter believe that it may lead to irresponsible attitudes to sex. This is nonsense. Those who say so have not done their homework. Recent studies have shown that only four per cent of users wanted the product more than twice a year.
It is obvious to any woman why that is. Frequent use will disrupt the normal pattern of periods and there is nothing women hate more than periods that have gone haywire. It drives them mad; it cramps their style. If we do not know that, the advertisers of sanitary protection certainly do because they base their advertisements on the fact. Women who acknowledge they are at risk of an unwanted pregnancy and take action are to be commended, not stigmatised. They deserve the safeguards which have been put in place by the Government.
There is one more thing we could do, and I wish we would. We could stop talking about sex as if it were some terrible immoral activity that causes untold harm to society and start accepting it as normal human behaviour, We should learn to discuss it with our children openly, frankly and without embarrassment. As long as it is something hidden and "naughty", children will want to do it. And they may want to do it before they are ready for it, understand it or are prepared to deal with its consequences. What we should be doing today is saying to the Government, "Well done, keep going, extend the arrangements that make the product free to those for whom cost might be a barrier to getting help."
I welcome the checks on pharmacies carried out recently by some members of the press to ensure that pharmacists are following the guidelines. But I have to say that it is much more of a tragedy for a 15 year-old girl to have a baby than to have a pill that she should not have had. These tests, one hopes, will put pharmacists on their mettle and ensure that they follow the guidelines conscientiously. None of them wants to be exposed by the Daily Mail. I also welcome the fact that Superdrug has shelved the idea of selling the product over the Internet. The safeguards and advice available through this method are just not good enough.
One of the most important aspects of advice given by pharmacists and nurses is that unprotected sex can lead to dangerous infections as well as pregnancy. Most young people know this very well and take appropriate precautions. However, there is no evidence that the availability of this product will make women so careless of their own health that they will take dangerous risks.
What is important now is that the properties and availability of this product are made part of an integrated sex education programme for both adults and schoolchildren which informs but does not judge, which protects but does not control, which understands but does not patronise.
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