4 September 2011

UK: Health ministers oppose Dorries amendment

A summary of the weekend’s news and commentary.

The Daily Mail reports on 3 September that the public health minister, Anne Milton, had written a letter to Tory MPs stating that she and ministerial colleagues would not support the Dorries amendment to the Health and Social Care Bill, which proposes to change the way that abortion counselling is provided. Milton wrote, reports the Mail:

‘We are very sympathetic to the aim of ensuring that all women requesting abortion are offered impartial, informative counselling. However, on the issue of preventing abortion services from offering counselling, we disagree with the amendment.

‘What matters is the quality and independence of view of the advice given. Counsellors should stick to the facts, not promote a particular view, and most importantly help to support women to make their own decision. It is important to be clear that the Government’s position neither represents a criticism of existing counselling services, nor hopes to create an extra hurdle for women to pass before successfully requesting an abortion.

‘We have no evidence that existing abortion counselling services are causing any harm to women. If pressed to a vote, my ministerial colleagues in the Department of Health and I will vote against the amendments. This is because the amendments exclude existing abortion services from offering counselling.’

The story was also reported by the Guardian and by BBC News Online. It was picked up by the Sunday Telegraph, which reported that ‘abortion has become a key battleground for bitter infighting within the Coalition’, and explained the government’s change of stance as a result of increasing pressure from the Liberal Democrats.

An article by Tim Montgomerie, editor of the Conservative Home blog, in the Sunday Telegraph offered a similar explanation. Montgomerie wrote:

‘The biggest ideological gaps between Tories and Lib Dems are over national sovereignty and social conservatism. Most Tories want powers back from Europe and British control of human rights laws. They also want government to encourage two-parent families and reduce the number of abortions – roughly 200,000 last year.

‘Yet in recent days, the Lib Dems have been actively undermining attempts by Tory backbencher Nadine Dorries to amend Britain’s abortion laws. Cameron and Andrew Lansley, the Health Secretary, had given private undertakings that they would support independent counselling for women considering a termination.

‘The about turn came after Nick Clegg was threatened by former MP Evan Harris (nicknamed “Dr Death” due to his support for abortion and euthanasia), who had worked with Baroness Williams to thwart the NHS reforms. Cameron was warned that Lib Dem peers would be willing to defeat the NHS Bill if it included the Dorries amendments.’

However, journalists have previously explained the government’s position as a result of its frustration at the Department of Health’s handling of the situation. 

The Sunday Telegraph also notes that a ‘compromise’ amendment option put forward by the Conservative MP Louise Mensch on Friday, ‘which suggests increasing the range of providers offering advice, but barring none - has attracted little support’.

The Mail on Sunday carries a news article under the headline ‘Cameron is branded ‘gutless’ by Tory MP after caving in to Clegg over abortion’, and an opinion piece by Nadine Dorries, under the headline ‘Why is reducing abortion rates wrong, Nick?’ Dorries argues:

‘When women have independent counselling, up to half change their mind and decide not to abort. However, when women are referred straight to the abortion clinic for counselling, that number can be as low as eight per cent… The changes would be paid for by the savings made from the reduction in the number of abortions and, as in this country we carry out almost 200,000 abortions per year, the highest number in Western Europe, surely a reduction has to be a good thing?’

The Guardian on 3 September reports that the ‘Right to Know’ campaign is coming under pressure to reveal how it is funded and name its principal figures. The Observer on 4 September reports that David Steel, the former Liberal leader and architect of the 1967 Abortion Act, ‘has lobbied ministers to vote against a bill to change the counselling system for women who want terminations.’

Steel said: ‘“Under the Abortion Act, the Department of Health has complete power over licensing and de-licensing clinics. If there were any evidence of failure to carry out proper counselling of patients, they can close clinics. More positively, there is nothing to stop them issuing guidelines on counselling if they think that necessary. There is no need to amend the health bill”’.

The Observer further reports that ‘there is unease among pro-choice campaigners that a US-style anti-abortion agenda is starting to take root in the UK, supported by American Christian evangelical movements’, and quotes Ann Furedi, chief executive of BPAS:

‘“Over the past couple of decades, anti-choice organisations in the US have moved away from arguing about the morality of abortion, towards presenting their cause in the language of women’s health. This often leads them to promote misinformation – for example, that abortion causes breast cancer, infertility or mental illness – as a means of scaring women about abortion, or encouraging legislators to restrict access to abortions. There are important moral and political arguments that should be had about abortion; hiding behind non-evidence based, pseudo-scientific health claims reveals the moral bankruptcy of some anti-abortion campaigns today…

‘“The Dorries amendment – tagged on to a bill which has nothing to do with abortion – seems to be an example of using legislation to interfere with women’s access to a legal abortion service, with the goal of making the experience more unpleasant.”’

The Observer reports that the Royal College of GPs and the BMA have said they do not see any reason for the amendment: ‘Any GP who has an ethical or religious object to abortion is allowed to “conscientiously object” and take no part in referring or treating a woman with an unplanned pregnancy. But Dr Peter Saunders, of the Christian Medical fellowship…said GPs were the right people to give independent counselling. “They would not need to state their own ethical position until it gets to the point that the woman says she would like an abortion and then the doctor can explain to her that they are not able to help,” said Saunders, who has advised Dorries’.

On 4 September, PA reports that Dr Liam Fox, the Conservative Party Defence Secretary, said: ‘“I would certainly want to support any amendments that saw the number of abortions fall in the UK. I think the level is far too high. I would certainly welcome any restrictions which enable people to think twice and get objective advice. I would actually want to see what the amendments specifically are but I’m in favour of something that sees the high level of abortions in the UK reduced.”’

The Dorries amendment has also attracted more commentary high-profile columnists. In a column (un-ironically) titled ‘Abortion reform: a modest proposal gone awry’, the Sunday Telegraph’s Christina Odone writes:

‘Given that 60 per cent of Britons are pro-choice, the panicky insecurity of the pro-choice faction seems odd. Given that that there is not the slightest prospect of abortion being criminalised – or even seriously restricted – why do its supporters show all the tolerance, nuance and perspective of Animal Liberation fanatics besieging a research laboratory?

‘What fuels their sense of urgency that leads to such personal venom directed against the likes of Nadine Dorries. The polarisation is manifest. The pro-choicers divide the public arena into “us” (for whom abortion is always a right, end of story) and “them” (everyone else). They have accused the MP and former nurse of manipulating statistics, lying about findings, self-promotion and even (oozing sisterly sympathy) of letting herself go and having “a rumpled face”. She has been compared to an annoying insect and a Sarah Palin-style Mama Grizzly. She has received abusive phone calls, green-ink letters, and enough death threats to suggest that American-style violence risks engulfing the debate.

‘Now, she is under pressure to reveal how her campaign is funded: pro-choicers suspect her of being in bed with the religious Right. Dorries denies the allegations: “I have not received a single penny from anyone. In fact, I’m broke!” She admits to being “shocked by the animosity – it is beyond reason and acceptability.”’

On the other hand Matt Chorley, the Independent on Sunday’s diarist, points out some of the personal attacks that Nadine Dorries has delivered at her critics, most recently Alice Thomson of the Times (London):

‘Don’t cross Nadine Dorries, the forthright Scouse nurse turned Tory MP, who has been calling for a tougher abortion regime. She was profiled in Friday’s edition of The Times by Alice Thomson, who sharpened her pencil and made plain her disdain for the 54-year-old parliamentarian. Note: “Her face is as crumpled as her shirt”.

‘In response, Dorries fired off a withering character assassination on her blog. After noting that Thomson is “award-winning” in a comment dripping with sarcasm, she reels off a string of put-downs. There are claims of being misquoted: “You would think it wouldn’t be too difficult for a journalist who knows her Vera Wang to listen to a tape.” There are catty remarks about Thomson’s outfit: “I waited with anticipation for haute couture to waft through my door, instead I greeted emaciated Gap.” And there is a devastating swipe at Thomson’s shoulder-length mousey-blonde hair. “Oh, and Alice, darling, there comes an age where it’s just not OK to wear your hair long and in the style of a 16-year-old and you, sweetie, passed it some time ago.” It is worth remembering that Dorries once admitted her blog is “70 per cent fiction”, so Thomson needn’t go to the hairdressers just yet.’

In the Daily Telegraph on 2 September, Graeme Alan writes under the headline ‘Abortion reform: listen to your prejudices’: ‘Just as no man is an island, neither is the NHS, British Pregnancy Advisory Service, a church, an atheist collective, the BMA ethics committee, or any other provider of information and counselling. All of us bring our lifetime of experience – that which we oddly term disparagingly as “prejudice” – to any evidence presented to us. What matters to users of counselling is that a transparent explanation is provided about the opinions of our counsellor; only then can we judge the advice they give us.’

A column by Susie Orbach in the Guardian on 3 September argued that the Dorries amendment ‘is an attempt to situate women’s sexuality in the marketplace’. Suzanne Moore’s column in the Guardian talks about her mother’s experience of abortion in the 1950s, and argues:

‘I know what having an abortion is like myself so I could make a terrible joke about it running in the family. Actually, my point is that abortion is a very common experience. Nor am I trying to suggest that the proposed amendments to the Health and Social Care Bill concerning counselling mean a return to these dark old days. The reason I am telling you all this is because I admired my mother’s refusal to be ashamed of her own experience. Now this new breed of anti-abortionists snip round the edges of the process with their strategies of delay ... er, sorry, “independent counselling”. But beware their language of care. This is not about care but about control. This control absolutely depends on shame: sexual shame. This shame keeps us quiet. Shame keeps us locked into individual guilt. Shame even makes us stupidly grateful that we are allowed to have any choice at all.

‘This whole debate around counselling pivots on the idea of deep and private shame, positing the idea of counselling being used to sell an evil procedure. Women are always “vulnerable” dupes, never simply adults who have made decisions.’

Janice Turner, in Saturday’s Times, writes: ‘What Ms Dorries and Louise Mensch, MP — who, smelling a media picnic, has buzzed right over with her own amendment — do not grasp is that being “pro-choice” means just that. Marie Stopes and BPAS are not “pro-abortion”. If women had been pressured to terminate, would newspapers not have resounded with such scandals? If these charities have any financial incentive at all, it is in a woman leaving their clinics satisfied with her own choice. Marie Stopes wishes to show Ms Dorries case studies of women counselled by it who do not terminate pregnancies, including a 16-year-old girl who it discovered was being coerced by her family. Ann Furedi, the head of BPAS, has invited the Labour MP Frank Field, co-sponsor of the amendments, to meet and hear about their work: he has not replied.

‘Because the object here is not medical best practice, it is only to make noise…’

Turner also notes that ‘the aggregate of voters who have been grateful for such services must be legion. Though Ms Dorries suggests that she speaks for a groundswell of socially conservative opinion, there is nothing to suggest that abortion is starting to define our political landscape as in the United States, where legal abortion is under grave threat. The British position remains that of tolerant distaste: it is a grave, unpleasant provision, but a necessary one.’

Minette Marrin’s Sunday Times column argues that Nadine Dorries’s attack on the Royal College of Obstetricians and Gynaecologists’ ethics committee ‘undermined her own credibility and that of her campaign’, and writes of the Dorries amendment:

‘It makes no sense. At least, it makes sense only if one regards the whole thing as having a hidden agenda — more than a hint of a covert anti-abortion lobby. The point, I imagine, is to silence counsellors who are not necessarily anti-abortion, and replace them with purportedly “independent” ones who always are against it, thereby reducing the number of abortions in the UK, which is Dorries’s stated aim. She claims her amendments could reduce abortions by a third. If this is an American-style pro-life political stance that is an underhand attempt to restrict women’s choice, I suppose we should all be grateful that it is so inept — so inept that the prime minister, who originally supported it, has been forced to do a U-turn and say he and other senior ministers would not vote for it.’

On the British Medical Journal blog Marge Berer, editor of Reproductive Health Matters, provides a critique of the (lack of) evidence behind the public health minister’s sympathy for Dorries’s proposals, and writes that the MP’s amendments ‘would have provided an inflammatory and unwelcome distraction from the debate on the NHS Bill and the ills that Bill is set to bring us. The Speaker of the House might not have selected the amendments anyway, given that the DoH is (or was) on the case, in pursuit of a problem created out of thin air.’

In a twist that the mainstream media have not yet reported, the anti-abortion campaign SPUC has issued a briefing urging its supporters to oppose the Dorries amendment. One of the reasons it gives for this is that: ‘There is a particular danger that if the whole field became subject to DoH regulations, pro-life agencies could be banned from offering pregnancy counselling. There is a particular danger that if the whole field became subject to DoH regulations, pro-life agencies could be banned from offering pregnancy counselling.’

Also read:

Health ministers vow a united front against plans to tighten up abortion laws
By Daniel Martin, Daily Mail, 3 September 2011

Anti-abortion bid in disarray as critics rally
MPs back compromise amendment as Nadine Dorries comes under pressure to reveal allies
Ben Quinn, Polly Curtis and Allegra Stratton, Guardian, 2 September 2011

Health ministers ‘oppose abortion advice changes’
The government has written to all MPs to tell them health ministers will vote against a proposal to change the advice given to women seeking an abortion.
BBC News Online, 3 September 2011

How the row over abortion advice for women led to bitter political infighting
By Laura Donnelly and Ben Leapman, Sunday Telegraph, 4 September 2011

Why power is shifting to the Lib Dems
Nick Clegg has worked out how to use the Government machine - and that’s bad news for the Right.
By Tim Montgomerie, Sunday Telegraph, 3 September 2011

Cameron is branded ‘gutless’ by Tory MP after caving in to Clegg over abortion
By Simon Walters, Mail on Sunday, 4 September 2011

Abortion debate: Dorries campaign urged to reveal how it is funded
Pro-choice groups opposing Tory MP’s move to tighten law fear faith-based crisis centres could fill counselling role
Polly Curtis and Ben Quinn, Guardian, 2 September 2011 20.37 BST

Abortion law pioneer David Steel asks MPs to reject change
Former Liberal leader and architect of 1967 act speaks out amid fears of an American-style anti-termination agenda
By Tracy McVeigh, Observer, 4 September 2011

Abortion level ‘far too high’ - Fox
UKPA, 4 September 2011

It’s the same old game. Get your rosaries off my ovaries, as we used to say
For all the liberal language, independent counselling is just an underhanded anti-abortion tactic
By Suzanne Moore, Guardian, 2 September 2011

Abortion reform: a modest proposal gone awry
A modest proposal by MP Nadine Dorries to offer independent advice to women seeking an abortion has led to angry protests, death threats – and the stifling of a once-in-a-generation debate. How did it come to this?
By Cristina Odone, Sunday Telegraph, 3 September 2011

Matt Chorley: The IoS Diary Independent on Sunday, 4 September 2011
Independent on Sunday, 4 September 2011

Abortion reform: listen to your prejudices
Parliamentarians should be proud of the efforts of Nadine Dorries and Frank Field.
By Graeme Archer, Daily Telegraph, 3 September 2011

Abortion services aren’t about selling soap powder or shoes
Nadine Dorries’s amendment to the health and social care bill is an attempt to situate women’s sexuality in the marketplace
By Susie Orbach, Guardian, 3 September 2011

Britain doesn’t want a Mama Grizzly, Nadine
How dare you reduce the abortion debate to conspiracy theories and phoney concern. You just want to cut the numbers
By Janice Turner, The Times (London), 3 September 2011

Beware this MP’s senseless and sinister bid to curb abortions
With her remarkable comments, Nadine Dorries undermined her own credibility and that of her campaign on abortion counselling
Minette Marrin, Sunday Times, 4 September 2011

Marge Berer: Independent abortion counselling? Whose problem?
BMJ blog, 1 September 2011

Questions and answers briefing on the Dorries/Field counselling amendment
SPUC, 1 September 2011