The Guardian, August 2011:
The government has reversed its position on moves to strip charities and medics of their exclusive responsibility for counselling women seeking an abortion, saying it will now advise MPs to vote against proposals from a Conservative backbencher if they are put before the Commons next week.
….On Sunday, in an apparent attempt to placate [Nadine] Dorries’s growing number of backbench supporters and avoid the amendment dominating next week’s parliamentary debate, the Department of Health said it wanted to introduce an offer of independent counselling, separate from the abortion providers, promising to consult on how best to do it.
An aide to [Health Secretary] Lansley confirmed that the move was partly in response to Dorries’s proposals, triggering accusations that the government was caving in to the anti-abortion lobby, which has backed the move…
However, Lansley’s “apparent attempts to placate” Dorries seem to have continued unabated; yesterday, the Care Quality Commission made an announcement:
CQC inspects termination of pregnancy services
The Secretary of State [for Health] asked CQC, as the regulatory agency with direct powers to inspect and seize evidence across the NHS and independent sector, to conduct these inspections as a priority.
Where our inspectors discovered pre-signed forms – indicating that providers might be breaking the law – we will share this information with the police and the General Medical Council.
CQC will also be considering what regulatory action we will be taking against these providers. We will be publishing individual reports on all providers inspected shortly and cannot legally identify non-compliant services until this point.
The practice of pre-signing forms has been public knowledge since at least 2007 (see below), and so it is not immediately clear why this was suddenly ” a priority”; the prompt may have been a recent report in the Telegraph revealing that some clinics are willing to perform abortions for reasons of sex selection.
The CQC’s statement was published the day after some of its findings were reported in the same newspaper:
The Daily Telegraph understands that more than 250 private and NHS clinics were visited and more than 50 were “not in compliance” with the law or regulations.
…[Lansley] said yesterday that the regulator had found that a number of clinics may be acting beyond the “spirit and letter of the law”.
“I was appalled,” he said. “Because if it happens, it is pretty much people engaging in a culture of both ignoring the law and trying to give themselves the right to say that although Parliament may have said this, we believe in abortion on demand.”
He said it was not just a matter of enforcing the law. “There is the risk that women don’t get the appropriate level of pre-abortion support and counselling because, if your attitude is that, ‘You’ve arrived for an abortion and you should have one,’ well actually many women don’t get the degree of support they should,” said Mr Lansley.
It’s not clear whether whether this quote was given directly to the Telegraph or derived from elsewhere, but either way the “more than 50” reference is clearly a leak to the newspaper.
Concerns about how doctors handle the “HSA1” forms needed for a legal abortion to occur were discussed by the Science and Technology Select Committee in 2007. The committee’s report noted that
86. The Department of Health has ruled that both doctors are able to sign the HSA forms without seeing the patient, so long as they believe, in good faith, that the woman meets the legal grounds for abortion on the basis of the clinical notes. We have heard that the process of certifying abortions has become, in the words of the Christian Medical Fellowship, a “sham”. Dr Vincent Argent says that that the HSA1 form “is often considered to be just an administrative process where doctors make no attempt to form an opinion, in good faith, that the patient fulfils the grounds [for an abortion]”. He further claims to have witnessed HSA1 signing practices that include:
“Signing batches of forms before patients are even seen for consultation;
Signing the forms with no knowledge of the particular patient and without reading the notes;
Signing forms without seeing or examining the patients;
Signing forms after the abortion has been performed;
Faxing the forms to other locations for signature;
Use of signature stamps without consultation with the doctor.”
87. If requests for abortions are being ‘rubber stamped’ by doctors, either the requirement for two signatures does not play a meaningful role in abortion practice or the law is not being properly applied.
The committee concluded that the two-doctor requirement should be dropped rather than more rigorously enforced, although at least one member would have dissented; this would have been Nadine Dorries, who challenged Argent directly:
Dr Argent, you are claiming anecdotally that every day doctors up and down the country are breaking the law because it is a legal requirement that two doctors sign the signature, one would hope after having both seen and consulted with the patient. You are telling us that doctors every day break the law by carrying out this procedure. The reason why we have two doctors’ signatures is that this is not like going to have your appendix out or your tonsils out where you go to a doctor and you are informed of what is going to happen at the operation and then a doctor signs. This is actually taking a life. Are the two signatures not a requirement to protect the doctors also as well as the patient, given that we are talking about ending a life in abortion, not a procedure?
It should be noted that Lansley has avoided this particular line of argument, instead preferring to conflate the medical assessment with “pre-abortion support and counselling”.
Dorries has in the past few days used Twitter to publicise further the need for reform of the law; it is perhaps significant that Dorries’ first Tweet on the subject is timestamped at 8:10pm on 22 March, two hours before the Telegraph article was published:
Time to bring ’67 Abortion Act to Parliament to be debated and redrafted to deal with number of illegal abortions which take place every day (1)
Dorries loathes Furedi (“breathtakingly stupid”, according to a recent Tweet), and so we can be sure that Dorries does not wish to see the law redrafted in a liberalising direction.
Dorries, as I’ve noted previously, has positioned herself as a pro-choice reformer; she does not have the support of the Society for the Protection of Unborn Children, and she in turn has denounced SPUC’s director John Smeaton as “shameful and cowardly”. However, in 2010 she misrepresented a pro-life religious counselling charity as being “neither pro-life nor pro-choice”, and so it is difficult to take her claims at face value. She also has links with the group Christian Concern, and she has expressed enthusiasm for Rick Santorum.
Following the abortion counselling debate in Parliament in August, a committee was created to look into the issue; Diane Abbott was a member until January, when she withdrew claiming that it was “a front for driving through the anti-choice lobbyists’ preferred option”. Dorries responded that Abbott had been asleep during one of the meetings (personalised attacks on critics is a Dorries’ trademark: see here and here).
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