Author: David Alton

Parliamentary Replies – February 2015 – Sudan; Darfur; South Kordofan; Burma; Freedom of Belief.

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Questions asked by David Alton :

Baroness Northover, the Department for International Development, has provided the following answer to your written parliamentary question (HL4385):

Question: To ask Her Majesty’s Government when officials from the Department for International Development, the European Union or United Nations agencies last had access to conflict areas of South Kordofan, Blue Nile and Darfur; how many displaced people are estimated to be located in Blue Nile and the Nuba Mountains; and how many refugees and people displaced by conflict in the Republic of Sudan and South Sudan are estimated to be in camps inside and outside these countries. (HL4385)

Tabled on: 23 January 2015

Answer: Baroness Northover:

United Nations agencies operate in all five states of Darfur and Government held areas of Blue Nile and South Kordofan. DFID and ECHO travel regularly to these states (with the exception of South Kordofan) to monitor programmes. The Government routinely denies humanitarian access to areas of active conflict where needs are often greatest. Humanitarian access from Sudan to opposition held areas of Blue Nile and South Kordofan has been blocked by the Government since 2012.

The UN High Commissioner for Refugees (UNHCR) estimates that there are 3.1 million internally displaced persons (IDPs) in Sudan, 1,470,000 of these live in IDP camps in Darfur. There are 540,000 IDPs in the Blue Nile and Nuba Mountains, with a fifth of these living in non-government controlled areas. There are an estimated 625,000 Sudanese refugees in neighbouring countries. In South Sudan, there are around 1.5 million IDPs and 500,000 South Sudanese refugees in neighbouring countries, including 120,000 in Sudan

Date and time of answer: 03 Feb 2015 at 15:27.

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Baroness Northover, the Department for International Development, has provided the following answer to your written parliamentary question (HL4386):

Question: To ask Her Majesty’s Government how many children living in Sudanese internally displaced persons (IDP) camps are estimated to be receiving education; how many schools are known to be occupied by armed militias or IDPs; what reports they have received of forced marriage, rape, and gender-based violence in camps such as Maban refugee camp; what access women in those camps have to medical services and psychosocial support; and how many pregnant women are estimated by the United Nations Population Fund to be in need of urgent care, and to be at risk of dying because of complications, respectively. (HL4386)

Tabled on: 23 January 2015

Answer: Baroness Northover:

According to OCHA, less than 60 per cent of children in almost two thirds of localities in Darfur have access to basic education. Over half of all primary school aged girls in West Darfur and 45 per cent in South Darfur do not attend school. In Sudan, the UK supports education projects through the Common Humanitarian Fund. In 2013-14, CHF funded projects reached 223,000 people across Sudan, the majority of which were children in conflict affected areas of Darfur, South Kordofan and Blue Nile.

Recent insecurity and displacement in both Sudan and South Sudan have led to a further increase in women’s vulnerability and risk of sexual and gender-based violence (SGBV) although there is a poor reporting of incidents. In Maban refugee camp in South Sudan, there were 316 SGBV incidents reported in 2014. Domestic violence remains the most widespread type of incident in the camp, accounting for 59% of all reported cases, followed by forced marriage (11%), rape (9%) and attempted rape (5%). Women in Maban refugee camp access SGBV prevention and response services including counselling, case management and psychosocial support. The UK supports the provision of these services through the UNHCR.

UNFPA estimates that around 44,211 women in IDP camps in Darfur are pregnant and in need of safe motherhood services. An estimated 6,632 pregnant women are expected to develop a potentially life-threatening complication during pregnancy or at the time of delivery, and may require a Caesarean section.

Date and time of answer: 03 Feb 2015 at 15:26.

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Baroness Northover, the Department for International Development, has provided the following answer to your written parliamentary question (HL4406):

Question: To ask Her Majesty’s Government how many (1) cases, and (2) deaths, in Sudanese refugee camps have been reported by the World Health Organisation of (a) cholera, (b) malaria, (c) malnutrition, and (d) diarrhoeal diseases; how many people have been killed by violence since December 2013 in Sudan and South Sudan; how many people living in areas of conflict in Sudan and South Sudan are projected to be in crisis or emergency phases of food insecurity; how many are estimated to be in urgent need of humanitarian assistance; and what percentage of internally displaced persons are estimated to live in flood-prone areas. (HL4406)

Tabled on: 26 January 2015

Answer: Baroness Northover:

There is no official figure for how many people have been killed by violence in Sudan and South Sudan. In South Sudan, the International Crisis Group (ICG), estimates that at least 50,000 people have been killed since conflict broke out in December 2013.

The UN currently estimates that 5.4 million people need humanitarian assistance in Sudan in 2015. In South Sudan it is projected that 2.5 million conflict affected people will be in crisis or emergency phases of food insecurity during January to March 2015.

In Sudan, 871,160 IDPs live in flood-prone areas, constituting 28% of the total IDP population.

Date and time of answer: 03 Feb 2015 at 15:25.

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Lord Bates, the Home Office, has provided the following answer to your written parliamentary question (HL4384):

Question: To ask Her Majesty’s Government, further to the reply by Baroness Northover on 13 January (HL Deb, col 652) and the Written Answer by Lord Bates on 21 January (HL4111) what is the difference between the 3,800 “Syrian nationals and their dependents” to whom they say they have given sanctuary and the 90 people whom they say were relocated to the United Kingdom under the Vulnerable Persons Relocation Scheme; what is meant by the phrase “given sanctuary”; how many of those given sanctuary were invited to the United Kingdom; how many came under their own steam; how many of the 3,800 Syrians have been given asylum or granted re-settlement; how many arrived in the United Kingdom before the present disturbances; and how many refugees in the United Kingdom are from Iraq or other parts of the Middle East region. (HL4384)

Tabled on: 23 January 2015

Answer: Lord Bates:

The latest published figures show that between April 2011 and the end of September 2014, a total of 3,468 Syrians were granted protection in the United Kingdom. This number represents those people who have claimed asylum in the United Kingdom, and includes those who have left Syria since the onset of the crisis, as well as those already residing in the United Kingdom who are unable to return safely. It is not possible to break the data down further to show how many people have arrived in the UK since the onset of the crisis, as opposed to those who were already residing in the UK.

The 90 people who were relocated under the Syrian Vulnerable Persons Relocation Scheme (VPRS) between March 2014 and end of September 2014 are in addition to the number quoted above. Potential beneficiaries of the scheme are referred to us from Lebanon, Jordan, Turkey, Iraq and Egypt by UNHCR on the basis of vulnerability.

The next set of asylum and VPRS statistics will be published on 26 February.

The phrase ‘given sanctuary’ is defined as those given protection by the United Kingdom. The table below shows the number of people from the Middle East who have been granted a form of protection or other leave after claiming asylum in the UK. It includes those granted asylum, discretionary leave, humanitarian protection, as well as other grants outside these three categories. The data also include dependents.

Q2 2011 – Q3 2014

Country Grants

Syria 3,468

Bahrain 108

Iran 4,472

Iraq 421

Israel 5

Jordan 3

Kuwait 111

Lebanon 27

Oman 0

Occupied

Palestinian

Territories 123

Qatar 1

Saudi Arabia 35

UAE 4

Yemen 72

Date and time of answer: 05 Feb 2015 at 14:08.

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Baroness Anelay of St Johns, the Foreign and Commonwealth Office, has provided the following answer to your written parliamentary question (HL4439):

Question: To ask Her Majesty’s Government what assessment they have made of the impact on human rights and religious liberties of Burma’s new Religious Conversion Bill and of other new bills in that country aimed at the protection of race and religion and which focus on restricting inter-faith marriage, monogamy and population control; and what representations they have made to the government of Burma on the matter. (HL4439)

Tabled on: 27 January 2015

Answer: Baroness Anelay of St Johns:

Restrictions on interfaith marriage, religious conversion and population growth are currently being debated in the Burmese parliament. We are concerned that, if enacted, these laws could harm religious tolerance and respect for diversity in Burma, and contravene international standards and treaties to which Burma is a signatory.

We have voiced our concerns over this proposed legislation to members of the Burmese government and to Burmese parliamentarians. Most recently, Minister of State at the Home Office, my right hon. Friend the Member for Hornsey and Wood Green (Lynne Featherstone), raised the issue when she met Deputy Foreign Minister Thant Kyaw during her visit to Burma in January. The UK also endorsed a statement issued by EU Heads of Mission in Rangoon in January reiterating those concerns and calling on the Burmese government and parliament to ensure that all new legislation is fully compliant with Burma’s international human rights obligations. We will continue to raise this issue in our dealings with the Burmese authorities, both in public and in private.

Date and time of answer: 05 Feb 2015 at 15:23.

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Baroness Anelay of St Johns, the Foreign and Commonwealth Office, has provided the following answer to your written parliamentary question (HL4407):

Question: To ask Her Majesty’s Government what assessment they have made of the report and recommendations of the All Party Group for Sudan and South Sudan, launched on 21 January, “Bridging the Gaps: Lessons from International Engagement with South Sudan 2011–2014″. (HL4407)

Tabled on: 26 January 2015

Answer: Baroness Anelay of St Johns:

We welcome the All Party Group’s report on South Sudan as a valuable and thorough contribution on an important subject. Officials are studying the detailed recommendations. Our most immediate priority remains securing peace and the formation of an inclusive transitional government that is willing to address long-term issues, and – supported by the international community – to engage widely, deeply and consistently with the people of South Sudan.

Date and time of answer: 02 Feb 2015 at 16:27.

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Baroness Anelay of St Johns, the Foreign and Commonwealth Office, has provided the following answer to your written parliamentary question (HL4408):

Question: To ask Her Majesty’s Government what is their assessment of (1) violence in Sudan and South Sudan over the past three months, (2) reports of aerial bombardment of civilian populations, (3) the provision of arms, (4) the number of children recruited into militias, (5) the report by the United Nations Security Council of crimes committed against children, and (6) the number of unaccompanied and separated children identified by UNICEF since the conflict began. (HL4408)

Tabled on: 26 January 2015

Answer: Baroness Anelay of St Johns:

Since the end of the rainy season we have noted an increase in fighting in both Sudan and South Sudan. We are deeply concerned at aerial bombings in the Two Areas (South Kordofan and Blue Nile) of Sudan, and have condemned the recent attack on a hospital run by Medecins Sans Frontieres. Recent evidence of violations of the UN arms embargo in Darfur will inform our approach to upcoming discussions on the renewal of the mandate for the sanctions regime. EU arms embargoes continue to remain in place on both countries.

Children continue to be seriously affected by the conflicts in both countries, and we are particularly concerned by the United Nations International Children’s Emergency Fund (UNICEF) estimates that since the outbreak of conflict in December 2013 almost 7,000 children have been separated from their families and 12,000 used by armed groups in South Sudan alone. South Sudan attended the UK-led roundtable on Children and Armed Conflict in New York in September 2014, and we agree with the Secretary General’s recommendation in his report of 11 December 2014 that the Government of South Sudan should develop and implement a strategy for the demobilisation, disarmament and reintegration of children. As we highlighted in last year’s Foreign and Commonwealth Office’s Human Rights Report, the Government of Sudan is also yet to fully implement their Child Act (enacted in 2010), which prohibits recruitment of children to armed groups in Darfur and the Two Areas.

Date and time of answer: 02 Feb 2015 at 16:23.

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Baroness Anelay of St Johns, the Foreign and Commonwealth Office, has provided the following answer to your written parliamentary question (HL4409):

Question: To ask Her Majesty’s Government what assessment they have made of the report of the assassination of a number of professors from the University of Mosul because of their opposition to Daash. (HL4409)

Tabled on: 26 January 2015

Answer: Baroness Anelay of St Johns:

We are aware of reports that the self-styled Islamic State of Iraq and the Levant (ISIL) has killed a number of professors from Mosul University. We are horrified by the atrocities that ISIL continues to commit and strongly condemn all abuses and human rights violations. We continue to encourage the new Iraqi government to ensure the protection of all citizens, promote human rights, reassert the rule of law and bring to justice those responsible for all violations and abuses. The UK is committed to a comprehensive, long-term strategy, as part of a global coalition, to degrade and defeat ISIL.

Date and time of answer: 02 Feb 2015 at 16:22.

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Baroness Anelay of St Johns, the Foreign and Commonwealth Office, has provided the following answer to your written parliamentary question (HL4410):

Question: To ask Her Majesty’s Government what representations they have made to the government of India about the reported killings in 2014 of Christians and reported assaults on priests, pastors and leaders of Christian communities in acts of religious hatred. (HL4410)

Tabled on: 26 January 2015

Answer: Baroness Anelay of St Johns:

We are aware of reports of attacks on Christians and churches in India. These matters are being investigated by the Indian authorities.

I also refer the noble Lord to my answer of 31 December 2014 (HL3827), which gives details of our discussions with the Indian authorities.

Date and time of answer: 02 Feb 2015 at 16:21.

House of Commons Votes For GM Babies – Will the Lords ask for safety, legal and ethical issues to be addressed? 90 Minutes for GM Babies 90 Hours for Foxhunting.

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House of Commons Votes For GM Babies – Will the Lords ask for safety, legal and ethical issues to be addressed?

gm babies

Earlier this week the House of Commons voted to permit the creation of what some MPs described as genetically modified babies. The full debate and voting list is in Hansard at:  

http://www.publications.parliament.uk/pa/cm201415/cmhansrd/cm150203/debtext/150203-0002.htm#15020348000001

Note that among those who voted against the proposals, on what was a free vote, were the two most senior law officers in the Government, the Lord Chancellor and the Attorney General. Around half the House of Commons voted against or abstained: 128 against and 350 for.

The House of Commons was given 90 minutes to consider this awesome question – a decision which will alter the genetic make-up of future generations. Just 90 minutes for GM babies – 90 hours for fox hunting. Nye Bevan once said that “politics is the religion of priorities”. What does this say about our priorities?

On February 24th the Mitochondria Regulations will now be considered in the House of Lords.

The former Cabinet Minister and Chairman of the Conservative Party Chairman, Lord Deben (John Gummer), with all-party support, has laid a Motion before the Lords urging Peers to consider more carefully, and with much more detailed parliamentary scrutiny,  the safety and legal implications of this decision. He has called on the public to write to Members of the House of Lords asking them to vote for the Motion, which reads as follows:

  Lord Deben to move that this House declines to approve the draft Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015 laid before the House on 17 December 2014 and calls on Her Majesty’s Government not to lay new draft regulations until a joint committee of both Houses has been established and has reported on (1) the safety of the procedures permitted by the draft regulations, (2) the compliance of the draft regulations with European Union and domestic law, and (3) the key definitions used in the draft regulations.  

The Regulations contain two distinct methods of altering germ line genetic identity – spindle transfer and pro-nuclear transfer.

They both raise questions of legality in international law and both raise safety concerns.

The second (but not the former) also involves the destruction of at least two and, in some cases as many as ten, human embryos to create the new modified human embryo.

gm babies3

During the Commons debate, the Minister, Jane Ellison, was keen to combat the slippery slope argument with the following rejoinder:

“I looked back at the debates in the House on IVF all those years ago, when some were worried about a slippery slope, and all the safeguards are still in place more than two decades later.”

Those who used the slippery slope argument back in 1990 did so on the grounds that allowing for the destruction of human embryos in IVF was likely to lead to the commodification of the human embryo, and further abuses to human life.

Two decades later, around 2 million embryos have been experimented on, destroyed, or otherwise discarded. The 1990 legislation paved the way for the dignity of the human embryo to be defiled with the addition of gametes from other species. And this week, Parliament allowed for the genetic modification of human embryos. If that isn’t evidence of having fallen down a slippery slope, I don’t know what is.

We have been here before. In 2007, prior to the legalisation of human/animal hybrids, disabled people were told that without that provision, those of us who opposed it, were condemning them to years of suffering. It was a lie. The disabled people who were brought in wheelchairs to lobby Parliament in favour of animal human hybrids were shamelessly manipulated and exploited, cruelly raising false hopes.  Funding agencies subsequently refused to finance the procedure which Parliament was stampeded into authorising. It was bad science and bad ethics. 

The Warnock Report, which led to the 1990 legislation and paved the way for animal-human embryos, said that “the human embryo should be treated with respect”. Baroness Warnock subsequently said it was hard to see how you were showing respect as you flushed the human embryos down the drain. Welcome to Dystopia.

gm baby

As we now consider crossing another red line note that the Human Fertilisation and Embryology Authority has admitted “pro nuclear transfer involves genetically modifying a human embryo”. The Department of Health says it doesn’t but there is no consensus on the science, the definitions or the law. What is clear is that using unamendable Regulations, hurried through Parliament we cross yet another red line

The procedure raises profound questions.

No other country in the world has sanctioned it. Most are signed up to Protocols banning it. Other Parliamentarians are askance that Britain is sullying its reputation by doing it. Even the People’s Republic of China – after using pro-nuclear transfer, and after the death of all three babies conceived, has banned it (the reasons for the three foetal deaths are unknown because the data has been withheld). Other countries which have banned it include the United        States. So has the Council of Europe.

It would be callous not to recognise the deep desire of women whose children may be affected by mitochondrial diseases to bear healthy children of their own. However the issues of safety and legality still remain outstanding whatever view one takes of the ethics of one or both of these procedures.

How can it be right to push ahead with a procedure which, one world authority, Professor Stuart Newman, has described as “inherently unsafe?”. Another warned that “the UK is one the verge of an historic mistake.” The Chief Medical Officer, Dame Sally Davies, who supports the proposals, told Peers this week: “no-one will guarantee that it is safe”;

The Human Fertilisation and Embryology Expert Panel, in three reports, recommended a number of preclinical experiments. Yet the majority of these have not yet been conducted, written up, or peer-reviewed. This will surely leave the NHS open to the charge of negligence if babies are subsequently born with disabilities. Last month the NHS was required to pay compensation of £10 million to a girl of seven because of disabilities which occurred though their negligence when she was born. If there are unforeseen outcomes in any of these pregnancies won’t the failure to carry out proper clinical trials lead to similar litigation in the courts?

One scientist, who supports these procedures, rightly asks the question “how many abnormalities need to be seen before the programme is stopped.”  That’s a central question – yet the Government’s advisers dismiss it saying it is “purely rhetorical.”

In a back-to-front process, and in the absence of pre-clinical trials and results, Parliament is being asked to give the last word on public safety to the Human Fertilisation and Embryology Authority. But they are a regulator, not a legislator. It is Parliament’s duty to protect the public.

I was particularly struck by the representations which have been made to British Parliamentarians by European Parliamentarians. 43 of them (including Greens, Socialists, Christian Democrats and Conservatives), wrote to the Secretary of State, Jeremy Hunt warning him of “the enormous safety consequences for the children created and their offspring.”  They warned that the UK may be in breach of the European Union Clinical Trials Directive – which says that no procedure “used in clinical practice” may be authorised “without any investigation or trials first having taken place.”

The Attorney general in Northern Ireland concurs with that view, as does Lord Brennan QC who sent the Government Counsel’s Opinion that they are acting illegally. He cited Article 9(6) of the Directive (2001/20/EC) which states that “No gene therapy trials may be carried out which result in modifications to the subject’s germ line genetic identity.”

gmbabies 4

Much of the debate revolves around the key definitions which are used in the Regulations. The debate in the Commons found no settled view on whether the technology constitutes ‘genetic modification’; whether ‘mitochondrial donation’ is an accurate way to describe the processes involved;  whether the procedures can be said to involve ‘three parents’ (and the implications for children born there from who will be denied knowledge of their true biological identity); and whether or not manipulating mitochondrial DNA will affect the characteristics of the children who result from these techniques. Some say it’s just like a blood-transfusion: but no blood transfusion brings a new human being into the world.

The one thing which is clear though this fog is that key questions of safety, legality, definitions and ethics cannot be treated in this cavalier way. Lord Deben is right to ask that a Joint committee of both Houses now goes away and considers these questions properly, separating and examining the two techniques involved, and allow Parliament to take a considered and informed view before further undermining its reputation and turning Britain into a rogue State.

If you wish to write to Peers you can do so by email  http://www.parliament.uk/get-involved/contact-a-lord/lord/  or write to the House of Lords, London SW1 A OAA. 

House of Commons Amendment To Safeguard The Lives of Unborn Girls Defeated – 201 votes to 292 votes – Full debate follows

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The unborn child at 18 weeks gestation. 600 babies are aborted daily in the UK - some, up to and even during birth, with the full force of British law. 7 million have been aborted since abortion was made legal and some have had up to 8 legal abortions. sex selective abortions

 

House of Commons Amendment To Safeguard The Lives of Unborn Girls Defeated – 201 votes to 292 votes – Full debate and the Division List of how MPs voted follows:

 

The Background:

On January 22nd, 73 Members of the House of Commons signed an amendment to the Serious Crime Bill based upon the Abortion (Sex-Selection) Ten Minute Rule Bill.

At the conclusion of its Committee Stage , Fiona Bruce laid an amendment to Section 65 of the Serious Crime Bill 2014, clarifying that the Abortion Act 1967 does not permit a pregnancy to be terminated on the grounds of the sex of the unborn child.

Fiona Bruce MP
Fiona Bruce MP

The amendment was selected by Mr.Speaker for debate at Report Stage and was voted upon. If it had succeeded it would have become law when the Serious Crime Bill receives Royal Assent.

This short amendment would have gone into Part 5 of the Bill which deals with crimes which have a disproportionate effect on girls, including female genital mutilation. Together with clause 74(2), which deals with how the Bill’s provisions can be followed-up, the amendment achieves the same effect as the 10 minute Rule Bill, which received near unanimity in a vote on the 4th November in the House of Commons where a motion approving the Abortion (Sex-Selection) Bill was passed 181:1.

sex selection abortions

Speaking about the amendment, Fiona Bruce MP said:

“The amendment has two aims. First to oblige the Government to think of ways to support women who are under pressure to abort on grounds of the sex of their baby. Second, to consolidate current law, which is necessary to prevent false information being distributed to women. Still today, BPAS, Britain’s biggest abortion provider, insists that sex-selective abortion is not illegal. We must battle the prejudices which give rise to the abhorrent practice of sex-selective abortion. It would be wrong to look the other way as women and girls continue to suffer.” *

Mary Glindon MP said:

“If opposing the abortion of baby girls – often under coercion – makes me anti-choice, then I will wear the label with pride.”

JasvinderSanghera CBE, founder and CEO of Karma Nirvana and spokeswoman for www.stopgendercide.org said:

“Sex-selective abortion is a reality in the UK. This is widely known in diaspora communities and beyond. The Government has a responsibility both to women suffering under cultural pressures and to their baby girls.”

Rani Bilkhu, founder of Jeena International, and spokeswoman for www.stopgendercide.org said:

“The Government has been clear that sex-selective abortion is illegal. But the UK’s biggest abortion provider BPAS continues to contradict them. It has been very upsetting to see some people claim that there is no evidence of sex-selective abortion in the UK. We know it is happening because we have been continually supporting women for nearly a decade who have had them or are being forced or coerced in having them. In their desperation to oppose this initiative, some radical commentators have said that there is no way to help women like those we deal with except through racial profiling. This is nonsense, and if the same argument were made about FGM and forced marriages, people would run a mile. We know sex-selective abortions are happening in the UK and the time has come to face up to it. People speak about choice. The women who we deal with rarely have a choice. Many are forced or coerced to abort simply because they are girls, this is the first act of violence against women and girls. We are supporting Fiona Bruce and her colleagues because it is the right approach, making a clear statement about the law, and providing the means for the Government to take practical action and to send a clear message to all stakeholders including communities that practice sex selection abortions is not only acceptable but against the law.”

sex-selection-ad-2

For questions regarding www.stopgendercide.org email info@stopgendercide.org

For interviews, phone www.stopgendercide.org spokeswomen:

A full media kit including video feature, images and further information is available here: http://www.stopgendercide.org/media/

A feature video on the campaign including interviews with Jasvinder Sanghera, Rani Bilku and Fiona Bruce MP is available here: http://youtu.be/nJCMkb8R1Rw

Also, see:

http://www.telegraph.co.uk/women/womens-life/11362298/Gender-abortions-could-be-outlawed-within-months.html

http://www.telegraph.co.uk/women/womens-life/11362379/Gender-abortion-Its-time-for-urgent-action.html

SEX-SELECTIVE ABORTION AMENDMENT TO THE SERIOUS CRIME BILL

Short briefing

What does the amendment say?

“Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the unborn child.”

What would this achieve?

The amendment has two aims.

  1. To oblige the Government to think creatively about ways to help women who are under pressure to have sex-selective abortions.
  2. To clarify that sex-selective abortion is impermissible in UK law.

How would this amendment oblige the Government?

Clause 74(2) of the Serious Crime Bill provides that “the Secretary of State may by regulations make provision that is consequential on any provision of this Act”. Regulations would be an opportunity for the Government to consider and implement measures offering concrete help these women.

Why does the law need clarification?

While the Prime Minister and Department of Health are clear that ‘abortion on the grounds of gender alone is illegal’[1], they are flatly contradicted by the British Medical Association[2] and the British Pregnancy Advisory Service[3], who between them represent those who vast majority of the sector. This is despite numerous clear ministerial statements and new Government guidance reiterating the illegality of the practice. The Government’s view is therefore reduced to an interpretation.

The ‘Sex-Selection’ amendment clarifies existing abortion law in line with the Government’s interpretation.

Would this require singling out a particular community or racial profiling?

No. As with FGM and forced marriage, the problem does seem to be prevalent in some minority communities. Like FGM and forced marriage, the Government has a duty to work out a way to help those affected with sensitivity. Mandating changes to doctors’ and counsellors’ guidance does not require racial profiling, and is just one idea.

Is sex-selective abortion an issue in the UK?

Yes, but on a very minor scale when compared with China or the Indian subcontinent. In 2012, the Telegraph ran investigations proving that it was possible to get doctors to refer for a gender abortion in the UK[1]. Researchers from Oxford and Imperial College have found that gender selective abortion could be detected from birth and census data[2]. In May 2014, the Department of Health produced an in-depth breakdown of birth data statistics, showing that there was no statistically significant gender ratio imbalance in the UK across ethnicities.[3] However, there is a growing body of anecdotal research comprising the experiences of a number of women have spoken about their experiences of UK residents having sex-selective abortions in the UK as well as abroad.[4] Rani Bilkhu, director of Jeena International which works with women who have had sex-selective abortions said “Saying that there is no evidence is tantamount to saying that these women are lying and that our organisation is making things up.”

Notes:

[1] Prime Minister, Oral Answers to Questions 19 March 2014, c780 (Official Report)

[2] British Medical Association Press Release ‘Abortion guidance Ignores Gender Complexity, Say BMA’ 27th May, 2014 http://bma.org.uk/news-views-analysis/news/2014/may/abortion-guidance-ignores-gender-complexity-says-bma,

[3] British Pregnancy Advisory (BPAS) ‘Britain’s Abortion Law’ poses the question. ‘Is abortion for reasons of fetal sex illegal under the Abortion Act?’ They answer ‘No. The law is silent on the matter’ http://www.bpasresources.org/product_info.php?ID=11244 (registration necessary)

[1] Newell, C and Watt, H Abortion Investigation: Doctors Filmed Agreeing Illegal Abortions, No Questions Asked, Telegraph, 22nd Feb 2012

[2] See https://www.spi.ox.ac.uk/fileadmin/documents/PDF/WP35__Sex-ratio_of_births_to_India-born_mothers.pdf and http://www.independent.co.uk/news/science/the-lost-girls-illegal-abortion-widely-used-by-some-uk-ethnic-groups-to-avoid-daughters-has-reduced-female-population-by-between-1500-and-4700-9059790.html

[3] See Department of Health Birth Ratios in England and Wales, May 2014

[4] See for example Connor, S: ‘I had to terminate my pregnancies because I was carrying girls’ The Independent, 14th March 2014.

Also see:

http://davidalton.net/2012/03/02/infanticide-gender-abortions-subversion-of-conscience-wake-up-britain-before-its-too-late/

 http://davidalton.net/2013/06/22/gender-based-abortions-question-if-its-illegal-and-immoral-andrew-lansley-in-these-cases-why-is-it-legal-and-ok-in-other-cases-i-thought-it-was-all-just-a-matter-of-choice-june-2013-d/

http://davidalton.net/2012/10/31/its-a-girl-premiered-at-the-british-parliament-exposing-the-scandal-of-gendercide/

 

 

Scroll down for 1. Division List. 2. Some Media Comment. 3. Full Debate

 

Some Cabinet Ministers who voted for the Bruce Amendment:

 

 

Theresa May

Jeremy Hunt

Iain Duncan-Smith

Patrick McG

Oliver Letwin

David Cameron abstained, Nick Clegg and Ed Miliband voted against..

Those in favour:

Tellers for the Ayes:

and

Those against:

NOES

Tellers for the Noes:

and

Question accordingly negatived.

Some media comment:

The Times: 

Tim Montgomerie comment piece:

http://www.thetimes.co.uk/tto/opinion/columnists/article4362098.ece

 

The Telegraph:

Dominic Grieve debunking legal myths about amendment:

http://www.telegraph.co.uk/women/womens-politics/11428460/Why-we-need-to-clarify-our-abortion-laws.html

 

Steven Swinford

http://www.telegraph.co.uk/news/politics/labour/11427987/Labour-torpedoes-attempt-to-outlaw-same-sex-abortions.html

 

Daily Mail:

Asian communities hit out at those who whipped against the amendment.

http://dailym.ai/1DIfaQi

http://www.dailymail.co.uk/debate/article-2964610/DAILY-MAIL-COMMENT-Union-meddling-question-morality.html

 

The House of Commons Debate:

New Clause 1

Termination of pregnancy on the grounds of the sex of the unborn child

‘Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the unborn child.’—(Fiona Bruce.)

Brought up, and read the First time.

Fiona Bruce (Congleton) (Con): I beg to move, That the clause be read a Second time.

Madam Deputy Speaker (Dame Dawn Primarolo): With this it will be convenient to discuss New clause 25 —Termination of pregnancy on grounds of sex of foetus—

‘(1) The Secretary of State shall arrange for an assessment to be made of the evidence of termination of pregnancy on the grounds of the sex of the foetus in England, Wales and Scotland.

(2) The arrangements made under subsection (1) shall be such as to enable publication of the assessment by the Secretary of State within 6 months of the date of Royal Assent to this Act.

(3) The Secretary of State shall consider the assessment made under subsection (1) and—

(a) determine and publish a strategic plan to tackle substantiated concerns identified in the assessment made under subsection (1); or

(b) publish a statement and explanation in relation to why a plan under subsection (3)(a) is not required.

(4) Any strategic plan under subsection (3)(a) must include, but need not be limited to, steps—

(a) to promote change in the social and cultural patterns of behaviour with a view to eradicating prejudices, customs, traditions and all other practices which are based on the idea of the inferiority of women and which may amount to pressure to seek a termination on the grounds of the sex of the foetus;

(b) to ensure best practice exists in identifying women being coerced or pressured into seeking a termination on the grounds of the sex of the foetus, or at risk of being so, and in the provision of protection and support to potential victims; and

(c) to promote guidance to service providers, health professionals and other stakeholders.

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(5) The Secretary of State must lay a copy of the plan, determined under subsection (3)(a), before each House of Parliament within 6 months of the publication date of the assessment under subsection (2).’

Fiona Bruce: New clause 1, which I wish to be put to a vote, is supported by more than 100 MPs. The arguments for it are straightforward. First, it is to clarify beyond doubt, in statute, that sex-selective abortion is illegal in UK law. This new clause is not seeking to change the law on abortion as some have said, but to confirm and clarify it. It also provides the Government with an opportunity to address the problem by bringing forward best practice regulations and guidance to support and protect women at risk.

New clause 1 is necessary because there is no explicit statement about gender selective abortion in UK law. The law is being interpreted in different ways because when the Abortion Act 1967 was passed, scans to determine the sex of the foetus were not available. That has led to a huge amount of confusion and mixed messages. That is despite the fact that the Government have repeatedly said that abortion on the grounds of gender alone is illegal. Health Ministers have said so; the Prime Minister has said so; the Department of Health has published guidance to that effect; and the chief medical officer has written to doctors about it. Despite all of that, abortion providers and others, staggeringly, are still refusing to accept the Government’s interpretation of the law.

Only last week, the country’s largest abortion provider, the British Pregnancy Advisory Service, republished its controversial guidance in a booklet entitled, “Britain’s abortion law: what it says and why”. The following question is posed: is abortion for reasons of foetal sex illegal under the Abortion Act? To this, it answers, “No, the law is silent on the matter.” The former Director of Public Prosecutions, Keir Starmer, has said:

“The law does not in terms expressly prohibit gender-specific abortions.”

Sir Edward Leigh (Gainsborough) (Con): All we are trying to do is simply clarify what everyone in the House of Commons wants to be the law: we should not have abortion on the basis of gender. That is the reply to the DPP. We just want the law to be made absolutely clear.

Fiona Bruce: Absolutely right. That is the purpose of new clause 1. I will come on to explain why it is so important to many of the women who are suffering as a result of the lack of clarity in the law.

This House must make the matter clear. If we cannot get a consistent line from abortion providers on whether or not it is illegal to abort a girl—it is usually girls but not always—for the sole reason that she is a girl, then the law is not fit for purpose. To do so constitutes a gross form of sex discrimination. Indeed it is the first and most fundamental form of violence against women and girls. Surely no one can object to a clause that simply states that that is wrong.

New clause 1 will do more than that, because if it is passed, by virtue of clause 79 (2) the Government will be able to issue guidance to help address this abuse and support affected women. That is why new clause 25 is inadequate when taken alone. What it is proposing is a

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Department of Health assessment or review of the issue. The Department can already do that. Without new clause 1, it is inadequate, because it fails to go to the heart of the issue and to clear up the very real confusion that exists. It fails to clarify the law, as new clause 1 does, that sex election abortion is illegal in this country.

Let me turn now to some of the objections to new clause 1. Much of them have misrepresented its impact and some have been plain scaremongering. First, it is said that it will criminalise women. That is flatly untrue. The clause applies only to authorising doctors; it does not affect an expectant mother’s standing in law. We have also heard that it will stop abortion for disability where there is a sex-linked condition. That is also totally incorrect. I can reassure colleagues that there is nothing in this new clause to prevent a doctor from diagnosing substantial risk of serious handicap via the sex of the baby. In such cases, the ground for the abortion is the risk of the disability, not the sex of the baby. New clause 1 will not change that, and I have been careful to obtain expert legal opinion to that effect.

Kate Green (Stretford and Urmston) (Lab): The hon. Lady spoke rightly a few moments ago about the importance of clarity in law. Does she not agree that there would be reluctance and confusion when the grounds for a termination were the genetic disorder, but the only way in which that genetic order could arise is in relation to the gender of the foetus?

Fiona Bruce: Not at all. We can trust our medical practitioners to be professional in that respect. It is quite clear that the ground for the abortion in such cases would be the genetic condition and not the sex of the child.

Glenda Jackson (Hampstead and Kilburn) (Lab): Will the hon. Lady give way on that point?

Fiona Bruce: I will, but then I need to make progress.

Glenda Jackson: There are certain genetic diseases that are transmitted by the mother to a male foetus. They are not passed on to a female foetus. So the hon. Lady’s argument is invalid.

Fiona Bruce: That is exactly the point that I am making. If the handicap, or the condition, is diagnosed via the sex of the baby, in such cases the grounds for the abortion, through that diagnosis, is the risk of serious handicap, and on that ground the abortion can be legitimately carried out.

Mr Dominic Grieve (Beaconsfield) (Con): Perhaps I can help my hon. Friend, although I do not think that she needs assistance. Of all the arguments that have been put forward on this matter, the one that has no traction at all is the suggestion that enacting this new clause would lead to the confusion that the hon. Member for Hampstead and Kilburn (Glenda Jackson) fears. It plainly would not. There might be other arguments that can be advanced and of course there will be different views across the House, but that could not possibly happen if the new clause were enacted.

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Fiona Bruce rose—

Glenda Jackson: Will the hon. Lady give way?

Fiona Bruce: No, I am going to continue. I thank the former Attorney-General for making that point so lucidly.

We have also heard that the new clause could introduce racial profiling of expectant mothers, but has anyone argued that for female genital mutilation? The term “family balancing” goes wider than any one particular community.

Then there is the argument that the new clause will do nothing to help abused women. It will indeed. It will clarify the law and as Polly Harrar of Jeena International powerfully told me:

“What we’ve found with the Forced Marriage Act 2007 was that we were able to use that piece of legislation as a bargaining tool to negotiate with parents, so a young woman could say, ‘You do realise this is a criminal offence?’”

In the same way, Polly says,

“with sex-selective abortion: having clarity in the law means that women could use this clarification to protect themselves against pressure to have a sex-selection abortion.”

She continues that

“as with FGM having a higher profile, legislation does effect a step change in cultural attitudes. So while legislation alone is not enough, it has real power to change behaviour, and that’s what is needed.”

That addresses clearly the Royal College of Midwives’ objection that new clause 1 will do little to alleviate the external pressures or coercion that these women face. As Mandy Sanghera said:

“We also we hope this will act as a deterrent—it will enable women to have more control over their own decisions.”

Is that not what many objecting to the clause want?

What does not help women under pressure to have an abortion simply because they are carrying a girl or a boy, whether that pressure comes from violence or coercion or is more subtle, is allowing that abortion to take place and sending the woman back to an abusive situation. To do so is to condone the very culture behind the pressure for such abortions and to exacerbate such abuse. The new clause does nothing to diminish services for those suffering abuse. Indeed, if it is followed by sensitively crafted regulations it should certainly improve them.

Then the quite offensive point is made that there is no evidence for sex-selective abortions in the UK. That is offensive as it is insulting to women such as those I have mentioned who have been campaigning for many years to stop this practice. Yes, the numbers are small compared with those in China or India, but they are real. Should we have to wait until those numbers grow before we take action? Rani Bilkhu, who, incidentally, is pro-choice, says:

“I have been supporting women dealing with sex-selective abortions…for almost a decade. Saying that there is no evidence is tantamount to saying that the women we work with are lying and that my organisation”—

Jeena International—

“is making things up.”

Interestingly, Rani also says that “nobody is collecting data”, so it is no wonder that opponents of the new clause say that there is none.

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I know of many examples of women who have suffered. One had one daughter, conceived a second girl, had an abortion and then could not conceive again. Another had three abortions on the basis of gender, including of twins. Another’s husband punched and kicked her in the stomach when he discovered she was having a girl. Yet another says that

“women suffer depression after these abortions. What is not always considered is the emotional and psychological impact.”

These women deserve our support in the manner that they say will really help—through legislation and by clarifying the law. That does not stop a review, but it is essential that we clear up the confusion, support these women and pass new clause 1. In doing so, we would reflect the overwhelming public mood. A recent ComRes poll showed that 84% of the public agree that aborting babies because of their gender should be explicitly banned by law. More than that, we should support new clause 1 because it is, quite simply, the right thing to do.

 

Ann Coffey: I am grateful for the opportunity to speak in support of new clause 25, tabled by me, the right hon. Member for Cardiff Central (Jenny Willott), my right hon. Friend the Member for Dulwich and West Norwood (Dame Tessa Jowell), my hon. Friend the Member for Walsall South (Valerie Vaz) and the hon. Members for Truro and Falmouth (Sarah Newton) and for Totnes (Dr Wollaston). I will seek to test the opinion of the House on the new clause.

The Offences Against the Person Act 1861 makes it a criminal offence intentionally to unlawfully procure a miscarriage, including for a woman to procure her own miscarriage. The Infant Life (Preservation) Act 1929 makes it a criminal offence intentionally to kill a child capable of being born alive before it has a life independent of its mother. The Abortion Act 1967 creates exceptions to those offences in limited circumstances and abortion on the grounds of gender is not one of those exceptions. It is therefore illegal and subject to criminal prosecution. Indeed, guidance was reissued as recently as May 2014 by the Department of Health that said again categorically that abortion on the grounds of sex was illegal. I am therefore not quite sure why the new clause proposed by the hon. Member for Congleton (Fiona Bruce) is needed or how inserting it into the 1967 Act would address her concerns.

8.15 pm

Sir Edward Leigh: If the hon. Lady thinks that such abortions are illegal under the 1967 Act, what possible objection could there be to making that explicit in law?

Ann Coffey: If the hon. Gentleman will wait, I am coming to that point.

The statement the hon. Member for Congleton proposes would sit alongside the existing seven grounds for termination in the 1967 Act, but of course the sex of the foetus can be a factor in causing so much distress for the woman that she meets the existing medical criteria for a termination. The British Medical Association supplied two case studies that demonstrated how that can occur. In both cases, gender was a key factor in affecting the state of mind of the pregnant woman and her wish not to continue the pregnancy. It is not clear how new clause 1, if added to the Bill, would affect the decision

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of doctors on the legal grounds on which they might agree a termination, if at all. It would inevitably be subject to legal challenges that would, I believe, dilute the clarity of the 1967 Act. As far as I am aware, there is no evidence that doctors are granting terminations to women who do not meet the medical grounds laid down in the Abortion Act 1967.

Mr Burrowes: Does the hon. Lady agree with the TUC interpretation of the law, which is that it would be right in some circumstances for a doctor to approve an abortion if, for example, a woman did not want to have a girl for cultural reasons?

Ann Coffey: I repeat that as far as I am aware there is no evidence that doctors are granting terminations to women who do not meet the medical grounds laid down in the Abortion Act 1967. That would be a criminal offence.

Duncan Hames (Chippenham) (LD): I am sure that the hon. Lady is right about there not being evidence for that. Is she aware of whether there is evidence of doctors refusing permission for a termination on the grounds of one of those criteria? Are there statistics to demonstrate that that happens?

Ann Coffey: As the hon. Gentleman will be aware, part of the new clause proposes a proper assessment of some of the issues surrounding this question. I hope that during the assessment we would get much better facts about what is and what is not happening.

Women are pregnant in very different circumstances, subject to different pressures—economic, familial and community—that can all influence a pregnant woman’s state of mind and her attitude to continuing her pregnancy. If there is no substantiated evidence that doctors are granting abortions on the grounds of gender alone, we might be dealing with a more complex issue, which is how wider community and cultural attitudes to girls and women affect the physical and mental health of the pregnant woman.

Therefore, before legislating we should examine the facts relating to this complex issue, because I am concerned that the insertion of the proposed statement might have the unwanted consequence of women who might otherwise have access to an abortion on the grounds of physical and mental welfare being denied a termination. New clause 25 would arrange for an assessment of the evidence of termination of pregnancy on the grounds of the sex of the foetus in England, Wales and Scotland to be published within six months of Royal Assent. Of course, included in that assessment should be the experiences of women who feel that they have been pressured to have their pregnancies terminated.

Like other hon. Members, I have received briefings from many organisations and groups on the issue, and they demonstrate its complexity. One group that is in favour of new clause 1 talked about a growing body of research comprising the experiences of women who have talked about having sex-selective abortions in the UK as well as abroad. It states:

“We know from experience that women are having sex-selective abortions in the UK, and we feel their experiences—which reflect a much wider problem—should be taken seriously before the situation worsens.”

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Another group that is opposed to new clause 1 has said that it would

“have far reaching and unintended consequences for the very women it purports to protect.”

It talked about the need to locate the protection of women from sex-selective abortion within a safeguarding framework. It states:

“There is a need to examine the issue alongside other forms of gender discrimination that impact on the practice, including the practice of dowry, domestic violence and honour based violence.”

It therefore calls for a wide-ranging inquiry, including on available support services.

Sir Edward Garnier: The arguments that the hon. Lady is making are those that I have read and that have persuaded me against supporting new clause 1, which I had originally intended to do when it was first mooted. I am persuaded that the real difficulty we face is getting evidence to court, and nothing that my hon. Friend the Member for Congleton (Fiona Bruce) has said will improve the quality of the evidence. I horribly disapprove—

Madam Deputy Speaker (Dame Dawn Primarolo): Order. This is not an opportunity for the hon. and learned Gentleman to make a speech. This debate must end at 9 o’clock and many Members wish to speak, so interventions must be brief. I think that we have the gist of what he was saying—

Sir Edward Garnier rose—

Madam Deputy Speaker: No, I think that we have the gist. Thank you.

Ann Coffey: I think that the hon. and learned Gentleman has made his point.

I agree that the connection between cultural preferences for one sex and the factors that might then lead to a state of inconsolable distress for the pregnant woman needs to be better understood to enable us to protect women from coercion and to support them in their pregnancies. We should certainly look at the facts before agreeing to any change in the wording of the 1967 Act, because we must be careful not to worsen the situation for already vulnerable women.

New clause 1 assumes that restating that sex-selective abortion is illegal will offer women protection from pressure to terminate their pregnancies, but women subject to intolerable pressure to abort will continue to be subject to coercion. My concern is about how women would interpret the inclusion of the new clause. They might feel that Parliament has legislated that if the sex of the child is at all an issue, irrespective of their mental distress, they will not have access to a termination. Sometimes it is not what legislation says that has a powerful effect on behaviour, but what people believe it says. That might lead them to pursue alternative routes as a first resort, rather than a last one. We do not want to go back to the days of the botched backstreet abortions that took place prior to the 1967 Act, which throughout the ages have been the resort of desperate women. I remember the lengths to which women would go to terminate their pregnancies prior to that Act, in spite of the risks to their own health.

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If the assessment that we propose uncovers substantiated concerns that there is pressure to seek terminations on the grounds of gender, we need to put in place a plan to deal with what is giving rise to those pressures and how we can better support women who might be being coerced. That is the proposal in the second part of new clause 25. I hope that in bringing forward those proposals there would be extensive consultation with women from all cultural backgrounds.

Finally, I would like to share a story with Members. On a recent train journey I started talking with an Asian woman who was originally from Bangladesh. In the course of the conversation she showed me a photo of her three daughters, who are now grown up. I said that they were beautiful and how lucky she was to have three daughters, at which point she looked very distressed. She then told me that she had never enjoyed any of her pregnancies because she knew that she was carrying a girl and that her then husband saw girls as being of no value and, in turn, viewed her as having no value as a wife because she had not produced a son. He eventually abandoned her. However, I am happy to report that my travelling companion went on to have her own career and that her girls are confident young women who are finding their own ways in life.

When I asked her what she thought could be done about those attitudes to girls, she said that the answer was education, education, education. She of course is right. We understand that from our own history of fighting for women’s equality—a fight that many of us still feel is a work in progress. I hope that this cross-party amendment will be supported by the House and that it will mean that when the Secretary of State reports back in six months’ time on her assessment, with accompanying proposals, we will be better informed about a way forward in addressing concerns that I agree we should not ignore. No woman should feel pressured into seeking a termination for any reason, including gender.

The Parliamentary Under-Secretary of State for Health (Jane Ellison): I welcome the opportunity to speak in this debate, and I will try to do so relatively briefly in order to allow more Back-Bench contributions. New clause 1, which stands in the name of my hon. Friend the Member for Congleton (Fiona Bruce), and new clause 25, which stands in the name of the hon. Member for Stockport (Ann Coffey), both relate to the very important matter of addressing the abhorrent practice of sex-selective abortion.

The Government have been consistently clear that abortion on the grounds of gender alone is already illegal. The Department of Health repeated that in guidance issued in May 2014, and it is important to stress that all independent sector providers have agreed to comply with, and operate on the basis of, the Department’s guidance and that they must do so as part of their licensing conditions. The Care Quality Commission monitors compliance with that, including through its inspection visits.

Mr Burrowes: On the welcome guidance that was published, I understand from freedom of information requests, and from an e-mail sent on 21 January, that there was a request for joint badging of that guidance to ensure that all the stakeholders signed up to it. Why did that not happen? Why was it left only to the Department to publish it?

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Jane Ellison: It was the Department’s own guidance, which is why the Department published it. In the course of forming the guidance, we spoke with all the people we would be expected to speak to.

The chief medical officer for England has written twice to all doctors—in February 2012 and November 2013—reminding them of their responsibilities under the 1967 Act and reiterating the Government’s position on gender-selective abortion, and that was reiterated by professional bodies.

The Department has also undertaken detailed analysis to investigate whether the gender birth ratio in the UK varies by the mother’s country of birth beyond the range that might be expected to occur naturally. The analysis, first published in May 2013 and updated in 2014, concluded that, when broken down by the mother’s country of birth, no group was statistically different from the range we would expect to see naturally occurring. The Department has quite rightly committed to repeat that analysis annually when new birth data become available. However, I stress that the Government will remain vigilant, will continue to monitor data and will be fully open to any other evidence that comes to light.

My hon. Friend the Member for Congleton cited poignant anecdotal reports of sex-selective abortion, as she did on her ten-minute rule Bill. As I said to her at the end of that debate, I urge her and anyone with evidence of individual cases to report this to the police to investigate. I invite her once again to come to the Department with such evidence.

Considerable concern has been expressed about the impact of new clause 1 and it is right that we touch on that. The Government consider that the new clause would restate our long-standing position on the issue—that abortion on the ground of gender alone is illegal. However, hon. Members will have heard the concerns expressed by a number of groups about the practical implications of new clause 1. Although the Government do not consider on balance that ground E would be affected by the new clause, it is naturally worrying for me as a Health Minister to hear from the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives about the concerns that new clause 1 has caused among health professionals providing termination of pregnancy services to women.

Mr Grieve: I am very grateful to hear from my hon. Friend that ground E would not be jeopardised. The Government have access to good legal advice—[Interruption.] I trust that they have access to good legal advice, and it must be the case that the Government have a position on the matter. I am grateful to hear from my hon. Friend that that particular anxiety is completely misplaced.

Jane Ellison: I am concerned about the fears that some people have about the practical implications of the new clause, and I think others share that concern. I hope to come on to that

The Royal College of Obstetricians and Gynaecologists highlighted the potential impact on abortions for foetal abnormality—I hear the point that was made on that in two interventions—where an inherited gender-related condition may be indicated, and the possibility that the new clause, if passed, may result in further concerns. The RCOG says:

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“Parents with a family history of such a condition may not have the option of Ground E.”

The RCOG also says, in relation to how doctors might feel about the practical implications, that “doctors deciding not to provide this aspect of gynaecological care”

might do so

“because it is deemed to be too ‘risky’ to them professionally.”

The House will want to be aware of these and other concerns regarding the practical implications of the new clause from the body that represents the doctors who provide these services and whom we entrust with the training, support and education of our future work force.

Dr Sarah Wollaston (Totnes) (Con): Does the Minister agree that one of the issues is that there are some types of X-linked genetic disorders affecting only one sex that cannot be detected by genetic testing for the specific condition in question, and that that is where the uncertainty arises? In other words, it would be entirely on the basis of the sex of the child. That is why the concern and uncertainty would be increased by the new clause.

Jane Ellison: My hon. Friend exactly describes the concerns as they have been expressed to me by the RCOG.

It may be helpful for me to give the House some figures on abortions in our country. The House is aware that the vast majority of abortions—91%—are carried out at under 13 weeks’ gestation. This is before the gestational age at which the sex of the foetus is routinely identified at the second scan, at around 18 to 21 weeks’ gestation. Disclosing the sex of the foetus is a local decision and is based on clinical judgment about the certainty of the assessment and the individual circumstances of each case. Some 98% of all abortions were carried out at under 18 weeks’ gestation in England and Wales in 2013. It is also the case that 98% of abortions performed in the independent sector in 2013 were carried out at under 18 weeks. By contrast, in 2013, 94% of reported abortions for foetal abnormality were performed in NHS hospitals. In the light of this, the House would want to consider that the new clause could be thought likely to have greatest potential impact on those health professionals working in our NHS, rather than on independent sector providers.

As the hon. Member for Stockport explained, new clause 25 would require a further assessment of the evidence that terminations are taking place on the ground of the sex of the foetus alone. I have already outlined the analysis that the Department of Health is undertaking on an annual basis in this area. We will also take into consideration any other evidence that comes to light. I stress to the House that we take the issue of coercion and abuse very seriously. Women who present for an abortion will always have the opportunity to speak to a health professional on their own at some point during the consultation. From my perspective as public health Minister, this is the sort of issue that would sensibly be considered as part of any further review, and the Department of Health is already considering what further sources of evidence can contribute to our knowledge on this important issue.

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Fiona Mactaggart (Slough) (Lab): Does the Minister accept that clauses 73 and 74 of this Bill precisely help to protect women from family coercion to have an abortion?

Jane Ellison: That is a useful point to draw out about other parts of this important Bill.

It is for the House to decide whether it wants to place the commitment to a further review on a statutory footing by supporting new clause 25.

As is the convention with such issues of conscience, as a Government we do not take a position either for or against new clauses 1 and 25. If the matter is pressed to a Division, Government Members will have a free vote. However, I hope that it has been helpful to hon. Members in forming their own opinion on these two new clauses for me to set out the Government’s actions to date in this area, the facts in relation to the gestations at which most abortions are performed, and the concerns raised by professional bodies. As I have said, it is for the House to decide whether it wants to support either of the new clauses, or indeed both or neither of them, but I reiterate that abortion of a foetus on the grounds of gender alone is already illegal.

Luciana Berger (Liverpool, Wavertree) (Lab/Co-op): The impassioned speeches that we have heard in this debate are testament to what a sensitive and complex matter this is. New clause 1 would amend the Abortion Act 1967 and proposes that a pregnancy could not

“be terminated on the grounds of the sex of the unborn child.”

New clause 25 would require a review of the evidence relating to abortion on the grounds of gender alone and for this to be followed by a strategic Government plan that addresses concerns about the prevalence of termination on the grounds of the sex of the foetus in England, Scotland and Wales.

I am in favour of new clause 25 as the best way to address concerns about sex-selective abortions. Outwardly, the intentions behind new clause 1 might seem reasonable. However, a wide range of well-respected organisations and experts have raised concerns, pointing out a number of unintended and troubling consequences. The organisations include the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, the British Medical Association, the TUC, the End Violence Against Women Coalition, Genetic Alliance UK, Imkaan and the Southall Black Sisters, among many others.

Sir Edward Leigh: Will the hon. Lady give way?

Luciana Berger: I am going to continue because we have a lot to get through and many Members wish to speak.

New clause 1 represents a significant departure from the current principles on which abortion law in this country is based. Given that this is a matter of huge significance, the new clause deserves fuller debate and scrutiny than we have the opportunity for in the remaining 24 minutes of this debate.

Choosing to terminate a pregnancy simply because the foetus one is carrying is not the sex one wishes for is a notion that most people find abhorrent. As the hon.

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Member for Congleton (Fiona Bruce) confirmed, sex-selective abortion is already illegal under the Abortion Act 1967.

Sir Edward Leigh: Will the hon. Lady give way on that point?

Luciana Berger: If the hon. Gentleman will forgive me, I am not going to take his intervention.

The Government, along with the chief medical officer, the Royal College of Obstetricians and Gynaecologists, and the Royal College of Midwives, have said that abortions carried out on the sole premise of foetal sex are illegal. As we have heard, updated guidance and instructions to doctors published within the past 12 months have clarified this. All independent sector providers have also agreed to follow the revised guidance as part of their licensing agreements. Let me be clear: we do not need new clause 1 to make sex-selective abortion illegal. However, it is right that we should send a strong message from this Parliament that gender-selective abortions are wrong. We can do that today by requiring the Government to carry out a thorough assessment and produce an action plan to address the root causes of this practice. That is what new clause 25 would do.

The change to the law proposed in new clause 1 would not only fail to address the root issues that lie behind the problem but have serious unintended consequences. I listened closely to the hon. Member for Congleton and to the former Attorney-General, the right hon. and learned Member for Beaconsfield (Mr Grieve), but I point to the text of new clause 1, which it is worth reading out:

“Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the unborn child.”

It says that nothing is to be so interpreted, so that includes medical grounds, the well-being of the mother, and gender-specific abnormalities. At best, this would create uncertainty and doubt for doctors who administer abortions in these situations and a legal grey area for women who are already facing a very difficult decision. I heard the former Attorney-General’s intervention, but I have listened to many legal experts who have written on the pages of many papers—

Mr Grieve: I appreciate that there may be policy arguments and all sorts of good arguments to make, but it is simply incorrect to argue that the new clause would have the consequences that have been claimed of preventing, for example, abortion from taking place where, because of the gender, there was a likelihood of disability. The Minister confirmed that. She was a bit hesitant about it, but she eventually did so when I intervened on her, so I repeat her assurance. My view is that this argument is completely groundless.

Luciana Berger: I thank the right hon. and learned Gentleman for his intervention, but, as we have heard, many legal experts dispute that position. I refer to the specific text of the new clause, which says nothing about, and is in direct conflict with, paragraphs (a) to (d) of section 1(1) of the Abortion Act.

The Genetic Alliance has said that

“the consequences of this amendment could be devastating to women and couples at risk of having a child affected by a serious x-linked condition.”

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I have heard from one family where two sisters were carriers of x-linked severe combined immunodeficiency, a disease that affects only boys. After years of thinking, one sister decided not to have any children, because she did not want to risk the chance of having to choose between having a very poorly son or a termination. Her sister decided—also after many years of consideration—to have children and went on to have three healthy daughters. Those were the choices that those women made after much consideration and deliberation with their families. How can Parliament take that decision away from them? I am sure that no one would wish to deprive their daughter, sister or partner of that choice. It is surely not for Parliament to rush this through in the short time available and deny families the opportunity to have children or a healthy baby.

Another serious concern is that new clause 1 is not just a clarification of the law, but a fundamental reform of the essential principles on which existing abortion law in this country been based for 47 years. The Abortion Act 1967 places the physical and mental health of the woman as the overriding concern of a doctor authorising abortion. Our current legislation refers to the foetus rather than the unborn child. That is because, across our legislation and common law, children are accorded a wide range of protections and rights that Parliament has previously agreed should not be accorded to the foetus.

Changing the language of the Abortion Act, as this new clause would do, would send a very different signal to the courts and open up different judicial interpretations of abortion or new consequences and restrictions that would go far beyond the issue of sex selection. For the first time since legislation in 1929, new clause 1, if passed, could afford the foetus rights that would be in conflict with those of the mother and it could seriously jeopardise the future of safe, legal abortion in the UK.

Fiona Bruce: Will the hon. Lady give way?

Luciana Berger: I am not going to give way. I am going to wrap up, because I am conscious of the time and Madam Deputy Speaker wants me to conclude.

There are many other points that I would have liked to address, particularly the issue of custom and practice and why new clause 25 addresses the issue of coercion in communities, which is something we all want to deal with.

Voting against new clause 1 is not an indication of support for sex-selective practices, but an acknowledgement that it would do nothing to address the causes or reduce the incidences of sex-selective abortion and that some serious negative unintended consequences would result from enacting this proposed change to the Serious Crime Bill.

Few people would support the idea that families should be able to have abortions on the grounds of gender alone. That is why it is illegal under our current law. New clause 1 represents a significant departure from the current principles on which abortion law in this country is based. Instead, new clause 25 would require a review of the evidence relating to abortion on the grounds of gender alone, to ensure that we have a full understanding of the practice and the extent of the problem, and for that to be followed by a Government strategy to tackle it accordingly, based on the evidence

23 Feb 2015 : Column 126

of what works. I sincerely hope that Members on both sides of the House will vote against new clause 1 and in support of new clause 25.

Mr David Burrowes (Enfield, Southgate) (Con): It is important that we try as far as possible to develop a consensus on subjects such as this. Everyone across the House is against abortion on the grounds of gender alone. We have communicated that view, the Government have written it in guidance and we want to make it clear in statute. It is as simple as that. We do not seek to have a Trojan horse or to upgrade the status of the unborn child. On that point, one simply needs to look at section 1(1)(d) of the Abortion Act 1967, which refers to “child” as a legal term, so that definition is not unknown.

We could support new clause 25, which aims to develop further research and have a plan, but it is not an alternative to new clause 1. Yes, we should develop more understanding and evidence, but we should not ignore the main point of this debate, which is what brought together more than 50 Members from both sides of the House—whether they were pro-choice or pro-life—when they signed a letter in 2013. Some of them have now signed different new clauses and are seeking to divide one another when we should be coming together to show that we want to clear up the law.

We have talked about different legal experts. Why not take one, Keir Starmer, the then Director of Public Prosecutions? On 7 October 2013, he said:

“The law does not…expressly prohibit gender-specific abortions”.

That no doubt came as a surprise to many members of the public. To put it simply, that is what new clause 1 is about—it would expressly prohibit such abortions. What does the law do? As Keir Starmer went on, rather the law

“prohibits any abortion carried out without two medical practitioners having formed a view, in good faith, that the health risks of continuing with a pregnancy outweigh those of termination.”

8.45 pm

What drew Members from both sides of the House and all sides of the ethical debate to be concerned in 2013? They jointly said that the Crown Prosecution Service’s decision not to prosecute

“could lead to the conclusion that gender-specific abortion is merely a matter of professional misconduct rather than illegal.”

The issue is whether we simply delegate this matter to professionals’ judgment in performing a balancing act and to their conduct, or deal with it—as we as parliamentarians should do and are charged with doing—by recognising that at the very least we must ensure that the law is clear.

What did the Department do? It responded to the concerns expressed in 2013 by deciding to issue departmental guidance to set out its interpretation of the law. As we have already heard, and we have been bombarded with lots of briefings from many organisations —the royal colleges, the TUC, the BMA and the British Pregnancy Advisory Service—there are different interpretations of the law.

Sir Edward Leigh: We have to base the law on the law. There is no mention of this in the 1967 Act. There was no possibility of mentioning it in the Act, because it

23 Feb 2015 : Column 127

was not possible to determine gender when it was passed. Keir Starmer is therefore absolutely right: the law is unclear.

Mr Burrowes: That is right. The Department issued helpful guidance that abortion on the grounds of gender alone was illegal. However, guidance is not sufficient. We do not simply rely on guidance in many areas of policy.

As freedom of information requests have revealed, the Government’s attempt jointly to badge all stakeholders together did not succeed, because the BMA rejected the very guidance published by the Government. It said that gender selection abortion is “normally unethical”, but that the guidance

“fails to reflect the…full legal situation regarding abortion and gender.”

The BMA therefore had a different interpretation. It also said that, separate to the issue of gender-related disability that has quite properly been raised,

“in some cases doctors may come to the conclusion that the effects of having a child of a particular gender are so severe to the physical or mental health of the pregnant woman as to provide legal and ethical justification for an abortion”.

We need greater clarity than can be given in guidance; we need to be sure that such a prohibition is clear in statute. The law as it stands is not clear. We have a duty not just to leave it to a doctor to perform a balancing act. No longer should we be silent on this issue. I urge hon. Members to support new clause 1.

Several hon. Members rose—

Madam Deputy Speaker (Dame Dawn Primarolo): Order. May I ask Members to make their comments very brief, because the debate will end at 9 pm and I want to get in as many as I can?

 

Jim Shannon (Strangford) (DUP): Many Members, including myself, strongly support new clause 1 as a means of clarifying the law to make it absolutely clear that sex-selective abortion, which is plainly discriminatory, is illegal in the United Kingdom. In so doing, we seek to inspire the Government to develop interventions that will address the issue of why boys are more desired than girls—the issue of son preference.

In setting out my position, I want to address head on the argument that the new clause will criminalise women. That is not the case: the legal standing of women would in no way be changed, but doctors would instead be held to account, and rightly so. Sex-selective abortion is already illegal in the United Kingdom. In fact, the Prime Minister suggested in March 2014 that abortion on the grounds of gender was not only unacceptable, but illegal. It is alarming that medical organisations, such as the British Medical Pregnancy Advisory Service and the British Medical Association, have suggested that that is not the case, or that at the very least the law is silent on the matter. That must be addressed.

Mr Jeffrey M. Donaldson (Lagan Valley) (DUP): Thankfully, we do not have the Abortion Act 1967 in Northern Ireland. One of the difficulties is that organisations, such as the BMA and others, which

23 Feb 2015 : Column 128

constantly call for clarification of the law in Northern Ireland by seeking to extend the level of abortion there are quick to say that we do not need to clarify the law when it comes to tightening the law on abortion in Great Britain.

Jim Shannon: I thank my right hon. Friend for making that clear and salient point.

If abortion laws are unclear on whether sex-selective abortion is legal, let us tighten them up using new clause 1, so that it is clear beyond reasonable doubt that the practice is unacceptable. The new clause would inevitably clarify the law by stating explicitly that the termination of pregnancy on the grounds of the sex of the unborn child is illegal. It would add clarity and certainty for women and medical professionals, so that neither party would be left wondering what their rights and obligations were.

New clause 25 would not provide adequate means for holding doctors to account, because a prosecution would still hinge on the ambiguity of section 1 of the Abortion Act 1967. It is clear that it would do nothing to move forward the debate on the clarity of the law. New clause 1 would make it certain, without a doubt, that sex-selective abortion is illegal. There would be no conflicting interpretations, just the black letter of the law. It would force the Government not only to clarify the law, but to create initiatives to address the issue of son preference.

I will conclude, because I am conscious that others want to speak and I want to allow time for that. New clause 1 is vital for at least two reasons. First, at the moment it is possible to ask whether sex-selective abortion is illegal and to get three different answers that appear to be contradictory, but that are all correct. That will not do. If there are varying interpretations of the law and the legality of a practice is unclear, the law must be amended to thwart any confusion, particularly for women, who should be in no doubt as to their rights in this area. It is therefore important that we support new clause 1.

Secondly, campaigners such as Jeena International and Karma Nirvana suggest that a prejudicial attitude towards girls is a phenomenon that is occurring in the United Kingdom. Therefore, the time to act against sex-selective abortion is now, not when our sex ratios become distorted to the same levels as those of India and China. New clause 1 sends a clear, unequivocal message to doctors and medical practitioners that sex-selective abortion is illegal and cannot be tolerated in our society. I urge right hon. and hon. Members to vote for it tonight.

Dr Wollaston: We all agree that it is abhorrent to terminate a pregnancy on the grounds of a belief that daughters are less valuable than sons. However, I will vote against new clause 1 for three reasons: it is unnecessary, there would be unintended consequences and we have insufficient time to debate what would be a fundamental change to an underlying principle of the Abortion Act 1967.

We have heard clearly that it is already illegal to terminate a pregnancy on the grounds of gender alone, and rightly so. That has been clarified since many of us agreed that there was an issue. I agree that there was an issue. It was not possible to bring prosecutions until the clarification was issued by the Department of Health and the chief medical officer.

23 Feb 2015 : Column 129

The updated data on this issue, which examines not only ethnicity but birth order, shows that there is no evidence of a systematic practice of gender-based abortion in this country. It happens in other parts of the world, where it is having a serious distorting effect on societies and on the status of women, but there is no systematic practice here, although I have no doubt that there are individual cases.

New clause 1 would have unintended consequences. At present, women may have the confidence to disclose to a doctor in the confidence of a consulting room that they feel under pressure. If we brought in the new clause, women might feel that they may be criminalised. That would do more harm than good and bring about the exact reverse of the intended consequence of the new clause. We also risk stigmatising communities through the implication that this is a widespread practice, which it is not in the UK. We have to be clear about that.

New clause 1 uses the very emotive term, “the unborn child”. That would change the meaning within the Abortion Act. We have to be very careful about that. My hon. Friend the Member for Enfield, Southgate (Mr Burrowes) mentioned that the word “child” appears in the Abortion Act. I accept that, but we must look at the context in which the word is mentioned. It is mentioned in the grounds for terminating a pregnancy when there is a grave risk that a child may suffer a serious abnormality. In other words, it does not confer personhood on the foetus in the way that this change would. It may be the view of the House that that needs to change, but let us come back and debate this incredibly serious ethical point with the time it deserves, not shoehorn it on to the tail end of a new clause with which it is difficult to disagree—as I said earlier, we are all agreed that termination on the grounds that a daughter is somehow of less value than a son is totally abhorrent.

I urge hon. Members please to come back to this issue and give it the time it deserves. Let us debate it on its ethical merits, not try to pretend that we are talking about something else. We are all agreed on the fundamental premise, so let us give it the time it deserves and reject new clause 1 tonight.

Fiona Mactaggart: I speak as one of the 13 MPs who co-sponsored the original ten-minute rule Bill of the hon. Member for Congleton (Fiona Bruce). I did that because I think she was right to make people aware that sex selective abortion is illegal, and I thought her Bill was a powerful and good tactic to do that. However, I feel a bit as though I have been pulled along by a Trojan horse because, as the hon. Member for Totnes (Dr Wollaston) said, the new clause confers the status of an unborn child on the foetus, and that radically changes our abortion laws in a way I believe is dangerous.

As I said in an earlier intervention, clauses 73 and 74, which deal with coercive behaviour, contain a powerful tool that we should use to prevent the kind of coercion to which the hon. Member for Congleton referred. In those references she quoted extensively from an organisation based in my constituency, but personal experience of how that organisation has failed to help individual constituents has led me to the conclusion that it is not possible to depend on the accuracy of what it says. I am therefore concerned that we are using anecdote from an unreliable source to make legislation on the hoof.

23 Feb 2015 : Column 130

Having supported the hon. Lady’s original ten-minute rule Bill, I have since read something from an organisation in America that is closely linked to the all-party pro-life group that she chairs. The head of that group stated:

“I propose that we—the pro-life movement—adopt as our next goal the banning of sex…selective abortion. By formally protecting all female fetuses from abortion on the ground of their sex, we would plant in the law the proposition that the developing child is a being whose claims on us should not depend on their sex…This sense of contradiction will be further heightened among radical feminists—”

I think he means people like me—

“the shock troops of the abortion movement. They may believe that the right to abortion is fundamental to women’s emancipation, but many will recoil at the thought of aborting their unborn sisters.”

My final reason for arguing that we should reject the new clause is the concern of the British Medical Association that it will make doctors more fearful of providing abortion services and training to carry out abortions. One of the biggest risks for young women seeking help to terminate a pregnancy is not getting that help in time, as a result of which we end up with late abortions and women who cannot have abortions when they are entitled to them. One reason for that is the growing number of doctors who are reluctant to perform abortions because they practise defensive medicine. I have no doubt that the new clause is unnecessary and likely to increase that and make it more difficult for women to access their right to termination—a right that I am afraid the hon. Member for Congleton, although I agree when she says that we all agree that abortion should not be available on the basis of gender, does not support at all.

Sir Edward Leigh: If the whole House is agreed that it is morally repugnant to destroy a foetus simply on the basis of its gender—it is usually a girl—let us make that explicit in law.

Dame Angela Watkinson (Hornchurch and Upminster) (Con): Very briefly—

9 pm

Debate interrupted (Programme Order, 5 January).

The Deputy Speaker put forthwith the Question already proposed from the Chair (Standing Order No. 83E), That the clause be read a Second time.

The House divided:

Ayes 201, Noes 292.

 

Raif Badawi – facing yet more public beating – and the right to believe or not to believe

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Raif_Badawi_cropped

20 Jan 2015 : Column 1206

Lord Alton of Liverpool (CB): My Lords, on freedom of speech, does the Minister agree that this is not just about freedom of expression but, under Article 18 of the 1948 Universal Declaration of Human Rights, about the freedom to believe or not to believe, as in the case of Raif Badawi? In addition to torture, does she not agree that the reported 90 beheadings last year— 10 in this past month alone—in Saudi Arabia are one reason why groups such as Daesh have been able to take the law into their own hands in places such as Syria, emulating what has been done routinely in Saudi Arabia?

Baroness Anelay of St Johns: My Lords, one of the priorities of the Foreign Office is that the death penalty should be abolished throughout the world. However, it is clear that Saudi Arabia is not yet in a position where it will consider that. Sharia law is part of the very nature of its operations in the judiciary, and therefore we are not going to move to abolition. However, that does not stop us making strong representations about it. The House can be assured that at every opportunity I make the point that the death penalty does not work—quite simply, it is wrong in itself. The more we can explain that to countries around the world, the more we can improve the kind of result that we had in the United Nations vote before Christmas and the more we can persuade other countries to follow the right route, which is to abolish the death penalty.

Raif Badawi, the Saudi Arabia blogger, faces another 50 lashes this Friday for writing about free speech. The Saudi authorities postponed Raif’s weekly lashes last Friday – in order to allow his wounds from the previous week’s lashings to heal before they beat him again.

You can express your concern to His Excellency, the Saudi Arabian Ambassador in London, Prince Mohammed bin Nawwaf bin Abdulaziz Al Saud at the Saudi Arabian Embassy: 30 Charles Street, London W1J

raif-badawi

EDUCATE THE NORTH AWARDS, IN ASSOCIATION WITH THE TELEGRAPH MEDIA GROUP, ARE NOW OPEN FOR ENTRIES

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EDUCATE THE NORTH AWARDS, IN ASSOCIATION WITH THE TELEGRAPH MEDIA GROUP, ARE NOW OPEN FOR ENTRIES.

http://www.educatethenorth.com/

Educate The North is a one-day conference and high profile awards event, which will celebrate, recognise and share best practice and excellence in the education sector in the North.

This will be the first high profile and prestigious event of its kind, held to focus on a growing sector which, some see, as critical to the economic and cultural health and future of not only the Northern economy but the UK generally. The event will allow us to examine the threats and risks facing the sector, open a debate of the future of the sector and its value and place in our society, as well as celebrate the Further and Higher Education institutions throughout the North across 21 categories.

Awards entries can be made until 20 March 2015. The short-lists for the awards will be published in April following a rigorous two-stage judging process, judges by our prestigious list of industry experts. Full details of the competition and how to enter can be found at http://www.educatethenorth.com

The event will take place on 3 June 2015 at The Hilton Manchester Deansgate, and is being staged by Carm Productions working in partnership with Prolific North and Don’t Panic Event Management.

For further information on entering or to book your place please contact Don’t Panic on 01706 828855 or e-mail rowan@dontpanicprojects.com

Debate in Parliament on Maternal and Neonatal Health in the Developing World

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Liverpool School of Tropical Medicine
Liverpool School of Tropical Medicine

LSTM

5.48 pm January 15th: House of Lords Debate on Maternal and Neonatal Health in The Developing World.

Lord Alton of Liverpool (CB):

My Lords, we are all greatly indebted to my noble friend Lady Hayman for instigating this debate and for the way that she introduced it.

As she told us, my noble friend is chair of the external advisory group of the Liverpool School of Tropical Medicine’s Centre for Maternal and Newborn Health. Her work for the school has given it very great encouragement. For more than 30 years I have been privileged to be associated with the work of the school and serve as an honorary vice-president. The centre designs and implements innovative healthcare packages, and offers unique expertise in research and in developing evaluation frameworks. It works collaboratively and strategically with Governments and global agencies, saving the lives of women in countless countries, along with the lives of their babies.

Professor Nynke van den Broek, who is head of the Centre for Maternal and Newborn Health, graphically sets out the scale of the challenges that face developing countries in reducing maternal and neonatal mortality. She says that an estimated 300,000 women die each year from complications in pregnancy and childbirth and—as the noble Baroness, Lady Tonge, said a few moments ago—this represents a decline. The school says it is about 45% overall since 1990. However, this should not lead us to any kind of complacency because it still equates to a woman dying every 90 seconds or 800 women a day. There are also at least 2.6 million stillbirths every year and an additional 2.9 million neonatal deaths. At least 43% of deaths in children under five occur in the first month of life.

maternal and neonatal care

The World Health Organization says that 99% of all maternal deaths occur in developing countries. Inevitably, this loss of life is at its most acute in rural areas and—as the right reverend Prelate the Bishop of Derby said—in poorer communities. UNICEF reminds us that more than 50% of women still deliver without the assistance of skilled health personnel, with 80% of maternal deaths caused by direct obstetric causes. Pivotal to addressing this shocking and avoidable loss of life is the challenge of improving the health and nutrition of mothers and providing access to good-quality support services for mothers-to-be and newborns, before and after birth.

At a personal level, two decades ago I was struck by what a difference those factors could make. While working in Namibia, my sister gave birth to my niece at 32 weeks’ gestation. My niece weighed less than two pounds and no baby as small as that had previously survived in Namibia. I was told that important to her survival was her mother’s breast milk and the antibodies it contains, but obviously she was too small to be able to suckle. There was no electric breast pump available at the hospital. I was able to buy one and ship it out. How different the outcome would have been if she had been living in the bush or a remote village without access to resources. That is surely the challenge we have to address.

Consider this tale of two countries: 2013 data highlight UK maternal mortality rates as standing at eight deaths in every 100,000, with three neonatal deaths for every 100,000 live births. By contrast, in Zimbabwe—visited by my noble friend—there are 470 maternal deaths in every 100,000 and 39 neonatal deaths for every 100,000. The vast majority of stillbirths, newborn deaths and maternal deaths occur around the time of birth and in developing countries. Ultimately, the health and survival of babies depends on the health and survival of mothers and that requires resources.

It has, of course, been crucial that millennium development goals 4 and 5 have helped to shape the agenda for action to improve these health indicators. That progress has been made is borne out in the report Financing Global Health 2013 from the Institute for Health Metrics and Evaluation. It noted a welcome increase of nearly 18% in development assistance for maternal, newborn and child health. Although I join others in congratulating DfID on the role it has played in this, nevertheless the spending per live birth remained at just £32 per child.

Even where death does not occur, failure to provide resources and care at this crucial moment in a woman’s life can have, as we have heard, long-term consequences. For each maternal death, an estimated 20 to 30 women live but suffer lifelong morbidity including  fistula, which my noble friend Lord Patel has done so much work to tackle and was mentioned by my noble friend Lady Hayman. In addition, there is chronic infection, anaemia and infertility. The Liverpool School of Tropical Medicine is currently working with the World Health Organization to develop new tools to provide more detailed data—something that DfID might want to support.

Improving the availability and quality of data helps to capture and understand the reasons for maternal and neonatal deaths, and to develop the necessary initiatives to prevent deaths. Digging deeper into the currently available statistics, it starts to become clear where we should concentrate our resources and our efforts. Baseline surveys under the Liverpool School-led and DfID-funded Making it Happen programme show that across 11 countries early newborn care packages are simply not consistently available.

maternal and neonatal care2

Out of 749 hospitals and health centres, only 173 were able to provide the required emergency obstetric care package, which is 23.1% or less than one in four. A study of reasons for unavailability of the care package shows that in 17% to 75% of cases there was lack of functioning equipment; in 13% to 17% of cases the reason was lack of a staff cadre—doctors or senior midwives—able to lead the team or provide the more technical aspects of care; and in 2% there was a reported lack of drugs. Not surprisingly, then, sub-Saharan Africa accounts for 62% of all maternal deaths, followed by south Asia with 24%.

As my noble friend Lord Patel reminded us, two countries stand out: Nigeria and India. India accounts for 17% and Nigeria 14% of the total. The right reverend Prelate told us of his experiences in India.

India is is one of the world’s greatest nations, yet in its treatment of women, from conception to death, India justifies its title as the land of paradoxes. A 2012 report by the United Nations Department of Economic and Social Affairs found that the ratio of boy to girl deaths is severely skewed. Between 2000 and 2010, 100 girls aged one to five died for every 56 boys. Putting that into plain language, an Indian baby girl is almost twice as likely as an Indian boy to die before the age of five, and the problem seems to be getting worse. In 1961, 976 girls were born for every 1,000 boys, and in 2011 that number was 914. The horror stories that have filled Indian papers, describing bodies of baby girls decomposing in heaps by refuse pits or being discovered in their scores in rubbish bins, should rouse our consciences, and I should like to hear from the Minister when we last raised this issue with the Government of India.

Another country that stands out and, because of Ebola, is much on our minds is Sierra Leone. It is estimated to have the highest ratio of maternal deaths, with 1,100 per 100,000 live births. This estimate was made in 2013 and the situation then was bad enough, but obviously, with the inevitable decline in the infrastructure in Sierra Leone today, the situation is getting worse. I hope that the Minister will be able to say something about that.

Are we involved in the formulation of new development goals to ensure continued global advocacy and to ensure that action is under way? A proposed new goal is universal health coverage. Surely a universal gold standard, strengthening health systems worldwide and ensuring that care for mothers and babies is available, accessible and affordable, is one that the United Kingdom should be championing.

As we look at best and worst practice, do we ask what was done well, what was not done well, how care can be improved in the future and how much involvement there is of users and providers? Are we working to see the better development of perinatal audit and cause classification for maternal deaths, and the introduction of an urgently needed system to identify the cause of, and contributing factors to, stillbirth? I hope that my noble friend’s initiative today will help us to achieve some of those life-saving objectives. I am indebted to her for giving us the opportunity to contribute to this debate.

——————————————————————————————————————————————————————-

Also see:  India has earned the dubious honour of being the worst G20 country to be female (if they make it out of the womb alive, that is).

http://www.bbc.com/news/world-asia-india-20863860

India also lacks midwives: http://www.who.int/bulletin/volumes/86/4/07-048454/en/

By contrast Nepal has focused on tackling the issue with spectacular results ( see first 2 paras):

http://www.economist.com/news/international/21586601-eradicating-extreme-poverty-no-longer-pipe-dream-first-governments-must-agree

The presence of midwives and their ability to refer women to hospital at the appropriate moment is clearly a big factor in the MDG’s improved statistics on maternal mortality & infant mortality.

http://www.popcouncil.org/uploads/pdfs/SafeMom_TBA.pdf

Question in the Lords on 3% Mesothelioma Levy – Liverpool conference on Mesothelioma and the Law – reply from Lord Freud

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mesothelioma
Lord Alton of Liverpool to ask Her Majesty’s Government, further to the reply by Lord Faulks on 9 December 2014 (HL Deb, col 1710), what evidence they have for the assertion that a lack of good research proposals is deterring research into mesothelioma and that there are no problems concerning availability of funding. HL3669
†Tuesday 9 December at 2.30pm
†*Lord Alton of Liverpool to ask Her Majesty’s Government, following the decision of the High Court that the consultation on mesothelioma legal fees was unlawful, and the lack of new funding for mesothelioma research, what is their policy with regard to combatting mesothelioma and supporting victims.
Mesothelioma
Question
2.58 pm

Asked by Lord Alton of Liverpool
To ask Her Majesty’s Government, following the decision of the High Court that the consultation on mesothelioma legal fees was unlawful, and the lack of new funding for mesothelioma research, what is their policy with…

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