Last week there was some media coverage, and plenty of twitter action, on a Parliamentary debate about reducing the upper time limit for legal abortions from 24 weeks to 20 weeks. This resulted in the BMA issuing a disputable press statement ‘clarifying’ its official position on abortion counselling. The association later gave a similar statement to its membership.
Abortion tends to generate polarised opinions and there is usually little meeting of minds and views. However the Parliamentary debate on the 20 weeks reduction was generally well informed and gave both sides the chance to make their cases.
However the debate completely changed course when the Health Minister, Anna Soubry, gave her response at the end. Soubry is newly in place, since the last reshuffle, and has made clear from the outset that she is strongly pro-abortion.
She decided to use the debate on 20 weeks to announce the scrapping of an important Government consultation on pregnancy and abortion counselling. This Government consultation had been promised by the previous Health Minister, Milton a year or so ago and had been progressing well, with MPs from all sides and parties contributing to it.
Soubry’s announcement was received with barely concealed delight by the pro-abortion MPs in the debate as well as by abortion providers who were rubbing their hands with glee on twitter later that day.
The BMA was drawn into this because Nadine Dorries MP, initiator of the Parliamentary debate (and supporter of a reduction to 20 weeks), immediately responded to Soubry’s announcement on the consultation by saying that: ‘The Government made an absolute commitment to consult. In fact, the British Medical Association moved a motion in agreement. Why have the Government changed their mind about the consultation on non-compulsory independent counselling?’ (my emphasis).
Clearly the BMA ethics committee were unhappy with Dorries’ perspective on the association’s stance on pregnancy counselling and very soon issued the following, strongly worded, public statement:
The BMA has rounded on misleading comments made by an MP about the association’s stance on abortion counselling.
Doctors’ leaders have sought to correct the claims made by Mid Bedfordshire Conservative MP Nadine Dorries, who suggested the BMA had called for a consultation on counselling provision for women considering abortions.
…
‘The BMA supports timely and impartial counselling and advice for women requesting abortion, should they wish to receive it.
‘Policy established at this year’s BMA [annual representative meeting] simply reflects the BMA’s long-standing position on this issue.’
Dr Calland points out that the policy agreed at the ARM in June was to support ‘the universal availability of non-directive counselling for women considering abortion’. The BMA has also made efforts to correct several newspaper articles written following the ARM, suggesting that members wanted counselling to be provided independently of abortion providers.
So who is right? Have the BMA been misrepresented by Dorries and others, in Parliament and the newspapers? Who is misleading whom?
In short, the BMA statement is telling the truth but not the whole truth. In doing so, it is being disingenuous and thus misleading parliament, the public and its own members.
The key claim of the BMA is that:
‘…the conference did not call for counselling to be separated from abortion providers…’
but they did support:
‘…the universal availability of non-directive counselling for women considering abortion’
In order to back their new statement up, the BMA referenced a brief review from their own website that was written after the BMA debate in June. However the BMA review is also misleading!
So what actually happened at the BMA debate?
This CMF blog written in June immediately after the BMA debate, and in consultation with members present, clarifies the outcome in some detail. In short, the motion that was put down and proposed by GP, Dr Mark Pickering, was that this meeting:
i) supports the universal availability of non-directive counselling for women considering abortion; – this was passed as policy
ii) believes that any counselling provided for women considering abortion should accord with NHS standards; – this was passed as a reference
iii) believes that women considering abortion should be able to access counselling that is independent of the abortion provider; – this was passed as a reference
iv) deplores picketing and intimidation around abortion services. – this was passed as policy
The relevant parts are i) and iii).
Part i) was passed as policy and was largely uncontentious primarily because it was calling for optional counselling. Any call for mandatory counselling would have been resolutely rejected at the ARM. The BMA therefore is correct in its statement that they support: ’the universal availability of non-directive counselling for women considering abortion’.
However, by ignoring part iii) the BMA is being disingenuous. On the one hand they can argue that this part was not ‘passed as policy’. However when a motion is passed as ‘reference to Council’ it essentially means that the meeting was supportive of the spirit of the part, but was unable to pass them as policy, usually due to technical reasons of wording or implications. The BMA is still mandated to take the motion and do what they can to enact it, but would strive to work within the spirit of the motion and is not bound by the exact wording.
So what the BMA has left out of their new statement is what was ‘passed as a reference’, and why it was taken as a reference.
In the debate part iii) was passed as a reference because, whilst it was acknowledged that there should indeed be optional NHS counselling provided separate to the independent abortion providers, the wording as it stood might imply that NHS hospitals (who provide around 30% of UK abortions), would have to offer NHS counselling that is independent of the same NHS hospital. This was not the intention of the motion and was the only reason it could not be passed as worded.
So the BMA’s own review after the debate, their press statement now and their statement to members give a misleading reading of the debate. There was real support in principle for the whole motion, including independent counselling, even though this specific part was not adopted as currently worded as policy.
Thus the option of independent counselling, was in fact supported in principle – if not policy – by the BMA. Although not official BMA policy, the BMA would normally work within the spirit of the parts passed as reference. Furthermore the BMA has still to consider the reference and report back to its members about it.
Many people assume that women considering abortion have access to independent counselling and advice. In fact there is no legal guarantee that they do. The drive to make abortion swift and easily accessible has meant that many women enter the process rushed, confused and panicked. Abortion is not always a fully informed, rationally made decision. Sadly, many women are unaware of, or unable to access, truly independent counselling from providers who are not tied into the abortion industry and many feel they have been placed on a conveyor belt towards just one option, abortion.
With this in mind, it is right that independent counselling is offered to all women experiencing an unplanned or unwanted pregnancy and it is incredibly shortsighted of the Government to fail to recognise this need and to jettison a vital and progressive Parliamentary consultation.
It is good that the BMA membership supported access to independent counselling in principle. However the BMA Ethics Committee should be clearer in spelling out the whole story behind this, not just the part of it that suits them.