Previous Section | Back to Table of Contents | Lords Hansard Home Page |
Lord Mackay of Clashfern: My Lords, I wonder if the noble Lord could develop that point? Can he tell the House whether the supply over the Internet of this drug by Superdrug was lawful in terms of the standing regulations?
Lord Hunt of Kings Heath: My Lords, I understand that it is lawful to supply over the Internet, but the issue is whether in so doing, the company would follow the minimum standards laid down by the Royal Pharmaceutical Society. If it did not follow those minimum standards, a pharmacist involved in Internet supply would fall foul of the regulatory provisions set by the Royal Pharmaceutical Society. On that basis, the intention to supply over the Internet has been withdrawn until discussions can take place between Superdrug and the society.
This order will be welcomed by many women. A number of noble Lords referred to the 800,000 women who were prescribed emergency contraception in 1999.
The medicine is far more effective the earlier it is taken. Waiting to see a doctor may cause delay and therefore reduce the chance of it working. Providing for direct sale through pharmacies will be an important additional route, in particular at times when traditional services may not be available. That is a very pertinent point. Huge numbers of women in this country will know the frustration of trying to track down emergency contraception over the weekend after contraception has let them down.Much of the debate has focused on under 16 year-olds and the feeling that this will encourage teenage promiscuity. I should like to place on the record the fact that the company which holds the licence for the product applied for the age limit of 16 years for pharmacy availability and that the expert advisory committees accepted that that was reasonable. This is not the only pharmacy-supply medicine that has an age restriction and I am confident that pharmacists have the experience and judgment to determine which clients should be referred to a doctor. The guidance from the Royal Pharmaceutical Society reflects that position. It states that,
The point I should like to make is that every day, pharmacists have to make judgments in their pharmaceutical outlets. The members of that profession are extremely well trained and I believe that they can be expected to operate the law effectively.
I do not believe the suggestion that this will all encourage promiscuity, for the following reasons. First, there is evidence from a study in Scotland, where women were given advance prescriptions for emergency contraception to be kept at home. It found that women did not change their sexual behaviour or their use of regular contraception. A further four-year study of 95,000 women aged 14 to 29 found that repeated use of emergency contraception was rare, and that many women used regular contraception for the first time after the use of emergency contraception. Indeed, as the noble Baroness, Lady Walmsley, suggested, we know that the regular use of emergency contraception disrupts a woman's menstrual cycle, which means that she will have irregular periods and breakthrough bleeding. This will be unacceptable to most women, and they will quickly seek medical advice.
On top of that, there is the matter of cost. I tell my noble friend Lord Rea that the cost of the product, at £19.99, is a matter for the company concerned, but, whatever one's view on the price, I think we can all agree that it will be a deterrent to regular use.
I share the view of my noble friend Lady Gould of Potternewton on the balance to be arrived at between access to emergency contraception and a potential abortion; as the right reverend Prelate the Bishop of Southwark suggested, one-off use of emergency contraception may prevent an abortion. Noble Lords
have tonight referred to the very high figures of abortions being performed in this country. They are very high, and this Government remain concerned about that. If emergency contraception can help to reduce the level of abortions, surely it is to be welcomed.The noble Baroness, Lady Young, talked about parents. Recent research among parents, commissioned by my department, found that over 80 per cent supported the provision of confidential contraceptive advice for the under-16s. Of course, I fully recognise the role that parents play in supporting their children in sex and relationship education. Indeed, it is pretty clear that the more open parents are about sexual issues with their children, the later those children become sexually active and the more likely they are to use contraception if they do become sexually active.
But we have to face the fact that not all parents manage to talk to their children. Indeed, one study showed that one third of girls had not been told about periods before they started. So there is much that we have to do in relation to health education generally. Good comprehensive sex and relationship education can help young people delay first sex and make them more likely to use contraception when they do become sexually active. Countries that report low or falling rates of teenage parenthood all include sex education as part of their overall programme. That is why the Government have issued new guidance to schools to improve the quality of sex and relationship education, to give young people the information and skills they need to resist peer pressure to have early sex and to negotiate safe and responsible relationships. As my noble friend Lady Massey of Darwen said, there is plenty of moral value to the guidance, including that pupils should be taught about the nature and importance of marriage for family life and bringing up children.
With regard to the issue of sexually transmitted infections, there is of course concern about their level in this country, and the Government are committed to doing all they can to reverse that trend. But, as the noble Baroness, Lady Walmsley, suggested, no method of contraception is 100 per cent effective, and if an accident happens emergency contraception is an effective method of preventing pregnancy. I have seen no evidence to suggest that the availability of emergency contraception would lead to a rise in sexual disease.
This has been an extremely interesting and wide-ranging debate. I share with the right reverend Prelate, the Bishop of St. Albans, a sense of the sacredness of human life and the need for us to encourage self-regard in young people. But I believe that what we are talking about tonight is a sensible and entirely justified course of action, reached after very careful consideration and after the proper processes have been gone through, the processes laid down by the party opposite in 1992. It is action endorsed by the Medicines Control Agency and the Committee on the Safety of Medicines, which advised that this product can be safely supplied under the supervision of a pharmacist for emergency
contraception; action supported by the BMA, the Royal College of General Practitioners, the RCN, the Royal Pharmaceutical Society and many other responsible bodies; and action which will encourage improved links between pharmacists and family planning services and help to ensure that under-16s and other women who need to see a doctor for contraceptive advice can be referred on quickly.Surely women have the right to take advantage of the option of rapid availability from a pharmacist without the need for attendance at the GP or family planning clinic. Surely women and their partners have the right to make responsible choices about the size of their family.
I hope that the House will reject the Prayer.
Lord Monson: My Lords, the noble Lord the Minister has said nothing about the Northern Ireland anomaly, although the noble Baroness, Lady Young, raised the point. The age of consent in Northern Ireland is 17, not 16. Is it not therefore the case that a chemist in the Province who supplies the pill to a 16-year-old may be guilty of aiding and abetting a criminal offence?
Lord Hunt of Kings Heath: My Lords, that clearly is a matter for the Northern Ireland Assembly and the Northern Ireland Health Department. But I can tell the noble Lord that the decision has the full support of the Northern Ireland Health Department, and, as the noble Baroness, Lady Young, suggested, was signed by the Northern Ireland Health Minister. That Minister raised no objections, and I do not believe that that point impacts on the decision made in the order.
Baroness Young: My Lords, I should first like to thank very much those who have supported me this evening, and, as always, to thank the noble Earl, Lord Longford, who speaks with great moral authority. I only wish that I were as good a Christian as he is. We should all take note of his courage and sincerity. I also thank my noble friend Lord Elton for what he said. He was the one speaker who drew attention to the importance in all this discussion of love, commitment, responsibility and marriage. It is extraordinary how those four words are left out of every debate.
The two right reverend Prelates who have spoken will not be surprised to hear that I am very disappointed by what they said. I am bound to say to the right reverend Prelate the Bishop of Southwark that to argue that the best can be the enemy of the good, and that therefore we should not have the best, seems to me an extraordinary moral argument. But I am not here to discuss that.
I was even more surprised to hear that the theological position of supporting the lesser of two evils is a good one to take up. When the Pope went to Ireland he was told that the IRA was protecting the Roman Catholic population against Protestant oppression, and his reply was quite simply "Murder is murder". We need to keep a firm hold on moral principles when we are talking about these matters.
We have had a very full debate. I started my remarks by saying that I thought there had been a great deal of misunderstanding about the issue. As I listened to the debate, I realised that those words were rather truer than I thought when I wrote them.
We have heard a great deal, at great length, with great emphasis and great force, about the importance of contraceptives, about a woman's right to choose and that every baby should be a wanted baby. It was as though somehow I was arguing against any of these principles. As I made abundantly clear at the beginning of my remarks, I am well aware that the morning-after pill has been available since 1985; that emergency contraception has been available to women since 1985. It is not new. I made it perfectly clear that if my Prayer against the order carries this evening, that situation will be the same; nothing will change. Listening to many of the speeches today, one would think that I was saying that emergency contraception would never be available again. I have not said that; I do not think it; it is simply not the case.
We are talking about whether or not these emergency contraceptive pills should be available across the chemist's counter. At this point I remind your Lordships of what my noble friend Lord Howe said about the role of pharmacists. Of course I recognise that the Royal Pharmaceutical Society has laid down good guidelines--I would expect it to. I would expect pharmacists to do their best. But, as my noble friend Lord Howe pointed out, the reality is that we have all seen the queues in the chemist's shop. I do not know where all this consultation will take place. I looked into my local chemist in preparation for this debate to see where it might take place. There did not seem to be anywhere but the most public place, in front of the counter. Perhaps other chemists are different.
The questions that the chemist should ask are very important. We are putting at risk the health of young girls. I do not want that responsibility. We need to take these matters very seriously. The guidelines are correct but, as we all know, guidelines are not always adhered to, especially in a busy chemist's shop late in the evening. I ask the House to recall, very clearly, what my noble friend Lord Howe said.
Perhaps I may conclude by answering two or three points, which I believe to be important. I was very sorry that the noble Lord, Lord Hunt, kept referring to 16 year-olds and under as women. This illustrates the attitude of the Government. In law, they are not women, they are children--and we should recognise what we are talking about.
I am sorry that he thought there would be no increase necessarily in sexually transmitted diseases as a result of increased use of the morning-after pill. Of course the morning-after pill encourages unprotected sex--that is one of its purposes. That is one of the reasons why young people look to it.
Finally, I should like to make a point about parents. Some of the talk about parents has been rather casual. One of the reasons--not the only reason--that we have one of the highest rates of teenage pregnancies in
this country is, of course, the high rate of marriage breakdown and the undermining of family life. Taking steps which undermine family life is very serious. I shall be perfectly frank, I do not like the fact that school nurses can provide the pill without parents knowing.What is being said to parents is a kind of general, blanket question: "Would you like your children to be helped to understand sex, contraception and all the difficulties of growing up"? Most parents think it is a good idea. What they do not know is that the result of all this is that somebody, without telling them, is giving their child the morning-after pill and contraceptive advice.
We are contriving and conniving at undermining parents. Whatever I may think about it--and I have been a parent--I know that I would never want for other people's children what I would not want for my own. One thing we should have learnt is the importance of keeping teachers, parents and doctors all speaking with one voice to their children. One of the troubles that we have today is that they do not do so.
There are a lot of people in the country--I mention, once again, representatives of the Muslim community, who have been to see me on more than one occasion--who are very concerned about this matter. I would not have taken up the time of your Lordships' House today, or, indeed, on any other occasion, if I did not believe that in this world today--which, the debate has shown, is immensely confusing and uncertain for young people, with terrible tragedies waiting to happen, with the teenage pregnancy rate and so on--this move to give the right to chemists to supply the pill over the counter is an opportunity for one more ratcheting up of society. I do not believe it will help people. Women need the help; they have got the help. We should pray against this order today in the interests of young people.
On Question, Whether the said Motion shall be agreed to?
Their Lordships divided: Contents, 95; Not-Contents, 177.
Next Section
Back to Table of Contents
Lords Hansard Home Page