Comment: The coalition’s miserable record on abortion

Behind the scenes, women’s abortion rights are being chipped away.

By Darinka Aleksic

After bubbling along largely under the surface for the past few months, the abortion counselling debate finally became headline news last Sunday with reports that the Department of Health would tighten current rules in the 'biggest shake up for a generation'.

A week later, the run-up to the health and social care debate has been effectively hijacked by the issue, which has turned into a battleground between social conservatives and liberals, in one of the biggest tests of coalition unity to date.

How did we get here? The current showdown has not come as a complete surprise to those concerned with the state of the nation's abortion laws. The past year has provided ample warning of trouble ahead, from David Cameron's comments prior to the general election on re-opening the time limit debate, to the loss of 140 MPs who had lent their support to the status quo when abortion was last debated in the Commons in 2008.

When Nadine Dorries and Frank Field tabled their amendments to the health and social care bill in March, however, there was still no sign that the issue would explode in the way it has.

But then in May, 'Life', an organisation opposed to abortion in all circumstances, was appointed to the government's new Sexual Health Forum, at the expense of BPAS, one of the country's largest abortion providers, in the name – according to the Department of Health – of 'balance'. Concern mounted.

Then in June, Frank Field revealed that the Department of Health would press ahead with his proposed changes without parliamentary debate, implicitly accepting the premise that there was something amiss with current abortion regulation and backing the argument advanced by Dorries and Field that abortion providers could not be trusted to counsel women on their pregnancy options on account of their 'vested financial interest' in the matter.

Department of Health officials were soon telling concerned enquirers that it was "drawing up proposals to enable all women who are seeking an abortion to be offered access to independent counselling", which should "focus on the risks to health (including mental health) posed by the abortion procedure".

The government's motivation is unclear. Perhaps they thought that regulatory change would generate less publicity than a full blown parliamentary debate on the issue, or perhaps they accepted at face value the idea that more counselling for women seeking abortion could only be regarded as a good thing. Or maybe they thought that tightening abortion laws would be an easy win at a time when NHS reforms in general were running into trouble.

Whatever their reasoning, it has backfired spectacularly. Just three months later the Department of Health has had to engage in a humiliating climb-down, first withdrawing their support for the key demand that abortion providers should be stripped of their role in counselling patients and then being forced to write to MPs advising them to vote against the amendments next week – an unprecedented step in a vote on a conscience issue.

They can't say they weren't warned. From the outset, those opposed to change in the current system have asked why the assumption has been made that abortion providers have failed in their duty to advise women correctly. Absolutely no evidence has been presented that they have done anything other than comply with clinical guidelines and provide impartial advice, as they are required to do.

It has quite reasonably been pointed out that if abortion providers – the largest of which are non-profit organisations – working under contact to the NHS, have a conflict of interest in both counselling their patients and carrying out treatment, then surely the same can be said of the private, for-profit healthcare companies which are being offered an ever greater role in the delivery of NHS services.

Those campaigning against the amendments have questioned where the proposed 'independent advice and counselling' will come from, if not from abortion providers themselves. Concerns have been raised that the 'counselling gap' would likely be filled by the very anti-choice and faith-based organisations which the Department of Health itself warns women against using, such is their track record of providing misleading and inaccurate advice to clients.

In fact, the most cursory investigation would have revealed that the Dorries/Field proposals were unworkable, misguided and struck at the very heart of a commitment to evidence-based policy and medicine within the NHS.

As vocal opposition has grown in recent days, the Royal College of GPs has spoken out against the measures, health and equalities groups have registered their opposition, as has the Conservative Women's Organisation, and MPs of all parties have expressed their unease, perhaps as a result of the 6,000-plus emails filling their inboxes objecting to the plans.

Now, on the eve of the health and social care bill being debated in parliament, we have the spectacle of coalition MPs squabbling over whom to blame for the debacle, with accusations that David Cameron has 'caved in' to Liberal Democrat demands.

It now seems likely that if the amendments are called for debate this week they will be defeated and that the Department of Health will commit itself to no more than a consultation exercise, with no pre-emptive admission of the need for change.

It is too early to draw real political lessons from this most recent round of the ongoing abortion debate. No doubt it will rear its head again in a year or two, or maybe sooner if the new intake of Tory MPs want to run with the ball (step forward Louise Mensch).

For now, those who have lost most credibility in this saga, more even than Nadine Dorries, who has burned bridges left, right and centre in recent days, are at the very top of the Department of Health. Somewhere down the line, heads may roll.

Darinka Aleksic is campaign co-ordinator for Abortion Rights.

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