On a point of order, Mr. Speaker; I apologise for not having given you notice of it. It is on a matter of which I have learnt only in the last minute or two. I felt that it was necessary to raise it at this stage. It arises partly from our new procedures, with the possibility of announcements at 11 am. I apologise also to the Leader of the House for not having had the chance to inform him about it.

I understand that there are problems arising on the Committee dealing with the Transport Bill and about the procedures in operation there. I make no comment about them at the moment, but we wish to inquire about them in the next hour that is available to us.

I wish to ask you, Mr. Speaker, how the new procedure for the interruption of business would operate at 11 am. I presume that if the Leader of the House wished to make a statement about the Transport Bill—there having been the opportunity to have discussions in the meantime—it would be perfectly possible for him to do so at 11 am, if he so decided. We would then be able to put questions to him in the light of any statement that he might make. I am not sure yet whether he would find it necessary to make such a statement.

I raise the point of order as we have not operated this procedure before and in order to safeguard the position. I should be grateful if we could have your ruling. Mr. Speaker, on how we might proceed.

The new circumstances in which we meet on Fridays ensure, first, that if there is notice of any private notice questions I let my decision be known at 10 am. It is then stated on the notice boards that there is to be a private notice question at 11 am. Secondly, if there is a statement to be made, a notice to that effect will appear on the indicator at verious times between 10 am and 11 am.

I beg to move, That the clause be read a Second time.

With this we may take amendment No. 13, in clause 2, page 2, line 32, leave out "being born alive" and insert "sustaining independent life".

For reasons that have already been given in the exchanges on the points of order, it would be difficult to confine the moving of this new clause to excluding the generalities of clause 1 of the Bill, which is the essential part of the Bill and which sets out the basis on which its supporters aim to reduce greatly the number of abortions carried out in Great Britain. I do not seek to interfere in what has been said about voting, but the issues themselves will be affected by other amendments that will be moved by my hon. Friends.

Clause 1 goes to the very heart of a number of the moral problems which I know disturb hon. Members and people up and down the country. I doubt whether Members of Parliament have received as many representations on any other issue. We have received representations from people who feel very deeply about this issue.

What is life? Does life, in the sense of terminating life, begin at the moment of conception? That argument could be, and has been, put forward by some. It could be argued that every part of a person's body is alive, and this argument could vary from a beneficial heart or a beneficial kidney, which are essentially live parts of a live body, to a malignant tumour which itself is alive and part of a live body. No one would say that no part of a live human being should be removed in any circumstances. I know of no one who has put forward that argument. There are men and women among us who have the heart, the kidneys or the eyes of another human being who is now dead.

At the other extreme there are women who died in the prime of their lives because an abortion was not carried out at the right time. Children are born congenitally handicapped for the same reason; sometimes they are grossly malformed for the rest of their lives.

What is life in the context of the Bill? Very few, and certainly no one in the House, would be evil enough to wish to destroy a human life. Every human being has a right to live, as set out in the United Nations declaration on the rights of the child. But surely a live child is one capable of sustaining a separate and independent existence. This is the thesis that we seek to set forth in the new clause and in amendment No. 13. I believe that this issue is fundamental to the debate which will take place in the House today and possibly on other days.

The Bill, if it contained clause 1 without amendment and the new clause, would lead to more mothers dying in childbirth, more children born handicapped, more unwanted and unloved children and more social problems that we as a society would have to face. It would mean more back-street abortions and more death and disease for young girls and women because of the absence of properly controlled, supervised and reasonably legalised abortions. It would give freedom to the charlatans whose objective is to earn their living as they did before the 1967 Act, at the expense of unfortunate pregnant women. It would mean an abortion performed not only outside the law but sometimes later than should be permitted and in dangerous and insanitary circumstances.

If it is murder that we are talking about—and some have used that emotional term in relation to the Bill—I believe that the Bill, unless we are able to change it, is likely to promote murder.

Let me make my position clear. I voted for the 1967 Act. As I said on Second Reading, I have never been in favour of abortion on demand. I speak as one who, first as Minister of State in the Department of Health and Social Security with the same responsibilities as the hon. Member for Reading, South (Dr. Vaughan), who is sitting on the Government Front Bench, and secondly as Secretary of State, had responsibility for the follow-up to the 1967 Bill and the responsibility to use, which I did, as rigidly and effectively as I could, the powers of licensing and inspection.

10 am

Without the new clause and amendment No. 13, I submit that we shall find ourselves going back to the dark days that preceded the 1967 Act. It may be that some hon. Members have failed to recall, or were too young to know, the misery of the circumstances that existed for many thousands of people before the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel) put his measure on the statute book.

The figures show that that Act has worked well. Only one death was recorded in 1977 after an illegal, or induced but unspecified, abortion compared with 22 in 1968. The number of discharges from hospital after septic abortion—a common result of botched, illegal abortions—fell from 3,110 in 1968 to only 600) in 1975. As regards hospital admissions, the number of cases where treatment was recorded following illegal abortion fell from 520 in 1968 to 180 in 1975. I do not have the figures for a later date than that. Illegal abortion offences known to the police have dropped from 257 in 1967 to only 10 in 1978.

One could proceed with these and other figures to show that, on balance, the 1967 Act, which was a bold experiment has, as a result of the wisdom of the House at that time and the way in which successive Secretaries of State have sought to carry out their responsibilities, dramatically changed the situation.

Clearly, the medical profession is very much involved with the wording of new clause 1 and amendment No. 13. For the record, I should like to read what I believe is a remarkable letter, published in the Lancet on 2 February, from 70 of the most distinguished doctors in this country, including Sir George Godber, who was principal medical officer at the Department of Health and Social Security when I was Minister of State, as well as many other leading figures—presidents of Royal colleges speaking with the great authority not only of their profession but of the colleges that they represent. I read the letter because every word is germane to what is proposed this morning. It states:

"We write representing a broad band of medical opinion to express our concern over the proposals in Mr. Corrie's Abortion (Amendment) Bill which is due for its next stage in the House of Commons"—

today.

"This Bill, which was presented as a moderate measure to eliminate very late abortion, is in fact a most swingeing attack which would, according to one of its supporters, cut abortion by two-thirds and 'destroy the charities'.

We do not oppose reduction of the upper time limit to 24 weeks, however, 20 weeks, even with exceptions for fetal abnormalities, is too early and will cause suffering in the very small number of severe cases where, unhappily, late abortion is necessary. An upper time limit of 20 weeks will inevitably mean that many doctors will be unwilling to do terminations after 16 or 18 weeks because of the impossibility of being absolutely certain about gestation dates."

I should add, as an aside, that they will face the full rigours of the law, and that is a risk that they are not prepared to take.

"As practising doctors we know that the 1967 Abortion Act…'reduced human suffering'. We know that the abuses that did exist in the early stages have now been eliminated and that, with one exception, the Act was beginning to work well."

I shall not quote the one exception, because there is a later amendment about putting heavier responsibilities on the National Health Service.

The last paragraph of the letter reads:

"Septic abortion, which caused so much illness and suffering, has been greatly reduced by the 1967 Act. A report from the DHSS for 1973–75 showed that only 10 of 235 maternal deaths in those three years were due to illegal abortion compared with 98 out of 579 in the years 1964–66. Because of the Bill's restrictive nature there is a real danger that if Mr. Corrie's Bill is passed by Parliament, septic abortion could become a scourge in this country once again."

As I said, that letter is signed by 70 of the most highly respected doctors, consultants, gynaecologists and general practitioners in this country.

My right hon. Friend may have observed that Mr. Speaker pointed out that the amendment is concerned with a totally different Act—the Act relating to the destruction of children at birth. I have not yet heard one word why my right hon. Friend wants that Act altered. That Act was specifically excluded by the measure introduced by the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel). Will my right hon. Friend explain, what he has not yet begun to explain, why he wants the child destruction Act altered and in what way? So far, all we have heard has been a Second Reading speech which has not been directed to the specific amendment.

I must assume that my hon. Friend the Member for Pontypool (Mr. Abse) has not read the new clause. Paragraph (b)(2) states:

"For the purposes of this Act, a child is capable of sustaining independent life if and only if the woman has been pregnant for a period of 24 weeks or more."

The period is an essential part. That is why I have moved the amendment. The paragraph above refers to a

"child capable of being born alive".

That same point is made in amendment No. 13. Rather than deal with "being born alive", we deal with the question of "sustaining independent life".

I was referring to the attitude of the medical profession. One remarkable thing about the medical profession is the extent to which its attitude has dramatically changed in the 12 years following the passing of the Abortion Act 1967.

I have been reading the new clause carefully and listening intently to my right hon. Friend, who at one time was Secretary of State for Social Services, including health. What is the child destruction Act to which my hon. Friend the Member for Pontypool (Mr. Abse) referred?

That question must be put to the hon. Member for Pontypool. As far as I know, there is no Act of that title.

I move on to the question of the medical profession, because it has sought to give its answer to the difficult questions: what is life? What is sustainable life? During how many weeks from gestation is it possible to say that a foetus is alive?

As regards a change to 20 weeks, another group of representative doctors has said:

"In our view, this change…is misguided, and reflects a misunderstanding of foetal viability. To say that a foetus is viable means that it is capable of independent life—it has reached the stage of development when its heart can beat outside the mother and its lungs are sufficiently developed to be able to take in air. This stage has never been knowingly reached before 24 weeks gestation, and only rarely as early as that; the limiting factor is that before this stage the lungs are solid and cannot take in air."

As I have said, it is a question of what is life. Is a foetus simply a part of the body that is living within a body? Is it something that can sustain life independently? The doctors continue:

"Technological advances in perinatal care have increased the chances of survival of babies born after 25-26 weeks, but can do nothing to enable a foetus born before 24 weeks to survive. In other words, it is survivability rather than viability which has changed and will no doubt continue to change."

Is my right hon. Friend aware that the Minister read a letter from Professor Reynolds to the Committee on 21 November? Professor Reynolds runs the biggest unit in the country for the preservation of the premature baby. His letter pointed out that at 28 or 29 weeks 85 per cent. of premature babies survive. At 24 to 26 weeks, 50 per cent. survive. Although no baby has survived at 23 weeks, Professor Reynolds pointed out that such babies are very much alive when born. Although no baby has survived at that age, he anticipates that with modern developments it will not be long before that is possible. He made it clear that he is neither pro nor anti abortion. He is concerned with saving the lives of infants.

The Minister also confirmed that there is no proven record that a child has lived after a gestation period of 24 weeks. There have been a number of scandalous rumours. Perhaps they were spread by well-intentioned people. It has been suggested that the cry of a child has been heard or that a foetus could live on its own. The Department of Health and Social Security and the Minister—with his own sense of responsibility—looking into all those charges and made a statement in Standing Committee. I hope that he will repeat that statement. The examination showed that in no single case had a child had independent existence. Perhaps the Minister will confirm or deny that statement later

Is my right hon. Friend aware that I have received a letter from Professor Macnaughton, of Glasgow university's department of obstetrics and gynaecology, in which lie draws my attention to the remarks of Professor Reynolds? Professor Macnaughton said:

"I have been in touch with UCH. There are 2 survivors at 24-26 weeks. One is severely mentally retarded and has a shunt for hydrocephalus, the other has sensory severe hearing loss".

There were no survivors before 24 weeks. I think that my right hon. Friend has made that perfectly clear.

I am grateful to my hon. Friend as he has given specific confirmation of something that no hon. Member should question, whatever he may feel about the morality of the issue. We are taking a difficult decision, but we should not be in any doubt about the facts. The facts are important.

No doctor is happy to perform a late abortion. He feels only justified in doing so in exceptional circumstances. I cannot deny that I have sometimes disagreed with some of the conclusions of the medical profession on other issues. However, on this issue the medical profession is united. Not only are the Royal colleges united, but the British Medical Association is also united and it speaks on behalf of the vast majority of doctors.

At the beginning of his speech, the right hon. Gentleman made a very important point. I wonder whether he is prepared to elaborate on it. He said that it was a question of proving the period of gestation. However, that is one of the most difficult things to establish. Women are often unaware of when gestation began.

Doctors as well as women cannot produce proof as to when gestation started. In imposing a law that will be binding upon the medical profession, we may be imposing restrictions that cannot properly be fulfilled. That is serious. It is the medical profession and women who are bound by the Bill. That is why doctors have been bursting with indigation and are anxious that the House should understand the dilemma in which they will be placed if the Bill is enacted.

Part of the purpose of the new clause and of the amendment is to ease that problem. I am confident that doctors do not want to perform late abortions. They want to perform abortions as early as possible. Preference for early rather than late abortions has also been expressed by women. A recent study of women who had had ante-natal screenings for neural tube defects described how dreadful the experience could be. Women are concerned that any impediment to their access to abortion may make things worse.

The group of doctors concluded:

"However, we consider that the best way to increase the proportion of abortions carried out before 12 weeks is not to restrict the numbers of late abortions but to improve women's access to early NHS abortions. The other obvious way of reducing late abortion in particular, and abortion in general, is to ensure a contraceptive service which is accessible to everyone who needs it".

There are many other arguments, but many hon. Members are waiting to speak. The new clause, the amendment and the question of what is life are deep moral issues for the House. We face those issues in the consciousness that the public are divided. However, I think that a large majority are in favour of the amendments and that they are against the Bill in its present form. As representatives of our constituents, we must face the moral problems without question and with courage.

My right hon. Friend has stressed the moral issues involved. Does he concede that the moral issues are no longer before us, because supporters of the Bill have now conceded that this is an abortion Bill? Therefore, they have accepted that the facts of abortion are facts of detail.

The case put forward by those who stand by the 1967 Act has been immensely strengthened by the statements and conclusions reached by those who support the Bill. It is a question not of whether there should be abortion but of certain circumstances and of where the responsibilities lie. The crux of the issue is, what is life? Does a human life have independent survival? That is the argument put forward in the new clause and in the amendment.

It might be for the convenience of the House if I were to reply to the point of order that was raised earlier.

I have looked at amendments Nos. 3, 2 and 48. If amendment No. 3 is carried, amendment Nos. 2 and 48 will fall. If amendment No. 3 does not carry, a separate Division is possible on amendment No. 2. If amendment No. 2 does not carry, a separate Division is possible on amendment No. 48. We shall work along those lines.

Further to the point of order, Mr. Speaker. May I suggest that copies of that statement be provided in the Lobbies to avoid great confusion?

Order. I honestly believe that, if I speak slowly, it is quite simple. I shall repeat what I said.

If amendment No. 3 falls or is defeated, it is possible to call amendment No. 2. If amendment No. 2 is defeated, it is possible to call amendment No. 48.

Further to that point of order, Mr. Speaker. May I seek further clarification? Am I right in thinking that each amendment will not be the subject of independent debate but that the House will debate the merits of all three amendments at one and the same time?

I have already suggested that list of selection.

My right hon. Friend the Member for Norwich, North (Mr. Ennals) performed a valuable service to the House in explaining the purpose of new clause 1 in language that I hope will be understood by every hon. Member. During the past few days I have been approached by several hon. Members asking exactly why new clause 1 has been tabled.

My hon. Friend the Member for Pontypool (Mr. Abse) referred to the Infant Life (Preservation) Act 1929, which has concerned us throughout the debate on abortion, right back to the 1967 Act. I believe that my hon. Friend is unfair to suggest that the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel) ignored the 1929 Act. The 28 weeks, which is often referred to as the existing time limit, is precisely the time limit in the 1929 Act. There is no mention of it in the 1967 Act.

We have two objects in introducing new clause 1. First, we wish to seek to define viability more accurately. Secondly, we wish to insert a time limit of 24 weeks and avoid referring back to the 1929 Act.

We have sought to deal with the controversial question of viability partly because of the cases that come up—and I was expecting one in this morning's newspapers—of a foetus on a slab which made a noise, and it was therefore assumed that that foetus was viable and capable of independent life. Over the months and years while this controversy has been continuing, these cases have been repeatedly produced, have hit the headlines and, one after the other, have been shot down by independent medical analysis and investigation by the Department. I could quote each one, and not a single one bears objective examination.

Therefore, we are proposing in this new clause to redefine viability, mainly to ensure that a doctor will not be prosecuted for aborting a foetus that shows signs of life but which is, nevertheless, incapable of maintaining an independent existence. That is the main purpose of the first part of new clause 1. If the law remains unchanged, doctors will still be at risk of being taken to court and having to prove that that foetus was incapable of an independent existence.

I cannot forbear from remarking that three lady hon. Members are present in the Chamber. The rest of us are men. None of us has had or is likely to have an abortion. The three ladies present are all against the Bill. They reflect the massive majority of opinion, particularly among women, against the Bill. Indeed, one of the features of the campaign is the remarkable unanimity outside the House against the Bill among professional, medical and nursing organisations and virtually all female organisations, right across the political spectrum. It is a remarkable example of public opinion being massively in favour of the 1967 Act, with the one additional provision of a time limit of 24 weeks as against 28.

May I return to the question of viability? I wish to read into the record a long letter from the Department. I apologise for its length, but it is important to have it on the record. It is written on behalf of the Minister for Health.

Before the hon. Member reads the letter, will he assist the House on one point? In the second part of the new clause it is stated:

"For the purpose of this Act, a child is capable of sustaining independent life if and only if the woman has been pregnant for a period of 24 weeks".

Am I right in thinking that pregnancy for that period will be treated only as prima facie evidence that the child is capable of sustaining an independent existence?

To be honest, I do not know what the answer is. Before I sit down, I am sure that the answer will be available to the hon. Gentleman, either directly through me or through some other hon. Member. That illustrates one of the great difficulties that the ordinary lay Member has in dealing with highly technical matters.

I am sorry to press the hon. Gentleman, but I am confused. I have before me the Infant Life (Preservation) Act 1929, which makes it clear that the period of 28 weeks there referred to is only to be treated as prima facie evidence of survival. Would the 24 weeks be prima facie evidence or conclusive evidence? The hon. Gentleman should answer that question.

I wish I could. I am being honest. As a layman, I simply cannot answer. The Minister or others who are better qualified than I may well reply.

The question of viability was raised and debated at great length in Committee. The proposer of the Bill wrote to the Minister and received a reply on 1 February:

"Dear Mr. Corrie,

Dr. Vaughan has asked me to write to you in his absence.

During the Committee hearing on 4 December you undertook to give further consideration to two amendments put down by Mr. Ian Mikardo and his colleagues which sought to define the expression 'capable of being born alive'. That term is as you know used in the ILPA 1929 and in the proposed Section 1A(1)b (referred to in Clause 2(1) of the Bill), and any definition would bite upon late abortions performed under new Section 1B (Clause 2(3) of the Bill) on the grounds of foetal abnormality. Officials of this Department, in conjunction with Parliamentary Counsel, and the Home and Scottish Offices, have been considering this matter—which has presented many complexities and difficulties—but have been unable to find a satisfactory formulation.

It was understood the definition of viability that was required was one that could be applied prospectively by medical practitioners on the basis of the presence or absence of specific criteria and which could be verified retrospectively. In order to give effect to such a definition the criteria used must be identifiable by objective clinical or pathological tests both before and after the termination procedure. There is unfortunately a major stumbling block to such a definition as, apart from the loose correlation with gestational age, there is at present no criteria or test that satisfy this aim The fact that a foetus had a separate existence can only be established in retrospect, either by its survival, or by autopsy.

The medical investigations that are available while the foetus is in utero are essentially predicters of gestational age, rather than viability. During the period of gestation that we are considering, that is between 22 and 28 weeks, these tests, of which ultrasound is the most reliable, cannot distinguish prospectively between the viable and non-viable foetus because development and maturation varies from one foetus to another. At best, estimates of gestational age will indicate that a foetus is likely to be viable or otherwise and this is reflected in the rebuttable presumption contained in the Infant Life Preservation Act 1929. The correlation between gestation and viability is not thought to be a sufficiently sound basis for a legal definition at this stage of pregnancy. Moreover, there is an inevitable margin of error associated with estimating gestational age by ultrasound; this was, you will recall, discussed by the Standing Committee.

Another serious difficulty is the complex interplay between the separate branches of law concerned with abortion, child destruction, murder and manslaughter. Indeed, I am advised that a medically precise definition, if it could be achieved, would be likely to have unpredictable legal effects, because of the complexities of the law, possibly even contrary to both your intention in agreeing to consider the matter, and the intention of the authors of the original amendments.

This leads me to another point of concern as I am advised that the inclusion of the definition of 'capable of being born alive' in abortion legislation would inevitably be regarded as affecting the interpretation of the same phrase used in the 1929 Act which, as you know, applies solely to England and Wales and to wilful acts as performed before a child has an existence independent of its mother. This could be a source of difficulty in Scotland."

I speak here as a Scottish Member. The Infant Life (Preservation) Act 1929 did not apply to Scotland and in that respect even the 1967 Act was regressive in Scotland. In Scotland, prior to 1967, a woman could get an abortion on request. There was no time limit and there is still no time limit in Scotland. There has been no problem there. I shall continue with the latter part of the quotation, and I apologise for the length of it:

"Officials have carefully considered a wide range of definitions but in the light of all these factors have concluded that it is not possible to devise a form of words that would be helpful to the medical profession. The advice I have received, therefore, is that the existing legal and ethical constraints, which are familiar to the medical profession and are reflected in existing practice both in Scotland and England, should not be altered. These require the doctor to make a clinical judgment in each individual case based on all the evidence available to him."

That point was underlined by my right hon. Friend the Member for Norwich, North—the importance of leaving the clinical judgment as far as possible in the hands of the doctors without recourse to rigid legislative shackles. This point has been made repeatedly by the Minister in the course of the proceedings on the Bill. The letter concludes:

"Naturally Dr. Vaughan would have no objection if you wished to show this letter to Mr. Mikardo"—

and my hon. Friend has given me permission to use this letter—

"or other members of the Committee. I am sorry we are unable to be more helpful but you can see the difficulties."

In fact, the Minister will argue against the definition in this new clause, and the doctors will still run the risk of prosecution in that matter. However, it is a genuine attempt to get a new definition of viability because of the number of cases that are produced at strategic points in the course of discussions on these highly controversial matters in the House. One hears of cases in which people have said "We have heard the foetus making a noise, and therefore it is presumed that it is capable of independent life." But all such cases have shown that that is not true.

I turn to the question of the upper time limit. I shall look at the provisions of the Bill as it stands. I apologise for the identification of the clauses, but this is a very complex matter for the Press Gallery, and still more complex for the Strangers' Gallery. Clause 1(1)(a) refers to "20 weeks". The present intention of the Bill's sponsor reduces the 28 weeks, provided in the 1929 Act, to 20 weeks for England. Wales and Scotland. This would be the first time that a time limit of any kind has been imposed in Scotland. As I said, the 1929 Act does not apply to Scotland.

If one then turns to the time limits referred toin Clause 2(1)1A(1)(a), one sees that there is no time limit in certain circumstances. Then one looks at clause 2(1)1A(1)(b), which states that when an abortion takes place under clause 2(1)1A(1)(a) the doctor must use the method of termination least likely to harm the child, and I quote:

"which is or may be capable of being born alive"

unless this method involves

"substantially greater risk to the life or of injury to the physical or mental health of the pregnant woman."

Clause 2(1)1A(2) states that the signature of only one doctor is necessary if the abortion is immediately necessary to save the life or to prevent grave permanent injury to the physical or mental health of the pregnant woman. Clause 2(1)1B(1)(a) states that abortion is permissible if two doctors are of the opinion that there is a substantial risk that the child, if it were born, would be "seriously handicapped". Clause 2(2)1B(1)(b) sets an upper time limit of 28 weeks in Scotland for abortions performed on the grounds already mentioned—that is, the handicap question.

On Second Reading, the Minister explained the difficulties involved in lowering the 28-week limit. A case can be argued, and I think that it will be argued by my hon. Friend the Member for Barking (Miss Richardson), for leaving the limit at 28 weeks. There is a legitimate case for that.

I said on Second Reading that if the Bill had contained only one provision, reducing the time limit to 24 weeks, there would have been virtually unanimous support. I think that the hon. Member for Bute and North. Ayrshire (Mr. Corrie) had that intention originally, but he was pushed in a direction that he did not want to go in. Now he is landed, and I think that no one regrets it more than he does.

However, we are dealing with the Bill as it is. In speaking about the time limits, the Minister emphasised how difficult it would be to legislate for all the cases that should be exempted should a lower time limit be introduced. He went through them in great detail then and subsequently in Committee.

There are already strict controls of abortions that take place after 20 weeks. But I think, and I believe that my hon. Friends and the majority of hon. Members would accept, that the case for 24 weeks is overwhelming. The Lane committee suggested it, as did the British Medical Association and virtually every professional and nursing organisation outside.

I do not wish to interfere unduly with the hon. Gentleman's speech, but we are debating solely the question of

"capable of sustaining independent life".

We shall be discussing the time limit later. We do not want to allow the two sorts of amendments to be mixed with each other. The right hon. Member for Norwich, North (Mr. Ennals), who opened the debate, kept to that matter.

The new clause specifies

"a period of 24 weeks or more",

as distinct from the 28 weeks in the 1929 Act, which we are seeking to amend. My right hon. Friend spent a great deal of time on the time limits.

I suspect that the House has considerable sympathy with the arguments about 24 weeks, but we are faced with a new clause in two parts. The hon. Gentleman said that subsection (a) was unlikely to command the Government's support, for the reasons that he read out. Has he any serious external support for the words that he has suggested? Have they been drafted on a legal basis?

One of the remarkable aspects of our consideration of the Bill—I speak only for those of us who oppose it—is that we have had absolutely superb legal and medical assistance from outside. I am not disclosing any secrets when I say that I think that the Department was very grateful that we had it. Again, I am disclosing no secret when I say that the Departments are very much opposed to the Bill—both the Scottish Home and Health Department and the DHSS. They not infrequently came to our advisers for help in these matters. The new clause and the amendments have been drawn up with great care with the help of medical and legal advisers outside.

My hon. Friend recognises, as I do, that in these matters the doctor's clinical judgment is essential. My hon. Friend will presumably also recognise the sharp difference between being capable of being born in the sense of "one scream and dead" and being born and being able to sustain life. If the clause is carried, that terminology would have to be judged on the basis of the clinical judgment of the doctor concerned.

That is absolutely right. That is why I said that it was extremely important for us to have the minimum of legislation on these matters, lest we confine or restrict the clinical judgment of the doctor. The women's organisations, which know much more about these matters than we do, believe that ultimately all these questions should be resolved by the woman herself, in close consultation with her own doctor and nobody else—the law aside. Let the woman and her doctor, in close consultation, decide on the best solution to the problem, as she sees it.

As the hon. Gentleman has raised what I regard as a rather serious point about the advice given by the Department, I hope that he will agree that the Department gave completely independent advice whenever it was required. I recall that hon. Members on both sides of the Committee were very appreciative of the advice that we gave. As I understand it, it is not correct to say that the Department was unable to give advice of its own and had to seek outside advice of the kind that the hon. Gentleman implied.

I may have been misunderstood. I want to pay great tribute to the Minister and to the Department for the objective help that they gave the Committee. One of the reasons why it is such a bad Bill is that much of that advice was not accepted by the sponsor. I know that the Minister is greatly disquieted by the Bill as it stands. I know that, for example, he is very much in favour of a limit of 24 weeks. I hope that he will say that.

In reference to that matter, I want to come directly to what the hon. Gentleman said on Second Reading and in Committee. He talked about the massive support in the medical profession for 24 weeks, and said:

"the earliest authenticated case of survival—I choose my words very carefully—is at 24 weeks."

He added—and I ask hon. Members to note this very well in view of the amendment of the hon. Member for Grantham (Mr. Hogg):

"I believe that 22 weeks would be the worst of all worlds…it would create great problems for the medical profession…the medical advice was unanimously in favour of 24 weeks."

The Minister was referring to the invitations that he had sent out during the recess asking for all the advice and opinions of the medical professional organisations. He concluded:

"it is my hope that the Committee will go for 24 weeks."

Does the hon. Gentleman accept that that statement was made by my hon. Friend before he re- ceived Professor Reynolds's letter? He later read it to the Standing Committee. That letter recommended 22 weeks, and he gave great weight to it.

I wish that the hon. Gentleman would be patient and make his own speech in his own way. He is trying to make mine. I was coming to that very point, and I shall answer it fully.

Will the hon. Member give way?

No. There is plenty of time.

In the course of the same speech, the Minister said:

"During the recess we had extensive consultations with the medical profession, particularly on this point. The advice we received was that 24 weeks would achieve all the aspirations of people who feel that 28 weeks is unsatisfactory.…The profession feels strongly that, in the case of women seeking late abortions, it should retain the right between 20 and 24 weeks, to exercise its judgment…the circumstances can be extremely difficult, very personal and need most careful individual consideration."—[Official Report, Standing Committee C, 7 November 1979; c. 173–51.

Despite the Minister's assertion that 22 weeks was the worst of all worlds, two weeks later he read the letter from Professor Reynolds, to which the hon. Member for Grantham referred.

Professor Reynolds is professor of neonatal paediatrics at University College hospital medical school. He stated that it was inevitable that one will survive sooner or later at 23 weeks. That letter was hotly disputed by Dr. Pembrey, the senior lecturer at the Institute of Child Care, who wrote to the Minister on 23 November, a fortnight later. Dr. Pembrey's letter did not receive anything like the publicity that Professor Reynolds's letter received. Dr. Pembrey said:

"Any reduction of the legal limit below 24 weeks would be disastrous for the families wishing to take what I regard as the responsible action of pre-natal diagnosis and selective termination. I urge the Committee to stick at 24 weeks."

The Minister went some way towards asking us to base the law on one case where the foetus had survived at 24 weeks and on the basis of one letter. The BMA was extremely puzzled by the Minister's about-turn. Having said that 22 weeks was the worst of all worlds, the Minister accepted, on the basis of one letter, that that was nonsense.

In the Medical News of 29 November 1979, the BMA stated:

"Many eminent paediatricians have given us advice on the legislation, which we passed on to the Minister many weeks ago."

That was before the Minister received Professor Reynolds's letter. The BMA continued:

"It is difficult to understand why they"—

the Standing Committee—

"have ignored our evidence and preferred to take heed of a lone voice in paediatric medicine."

The Minister must ask himself why he put Professor Reynolds's letter on the record.

Professor Macnaughton's letter to me states:

"It is important to be able to perform abortions up to 24 weeks. Women seeking abortion at this time comprise about 1 per cent. of our abortion patients. They are a very special group who are either very young—12 to 15 years—or very disorganised in their lives and therefore need special consideration. Continuation of these pregnancies could cause grave consequences to the patient and serious risks, including suicide. I might add here that babies at this stage are non-viable. There are reports of survivors but those born naturally at this stage are very likely to be severely handicapped even if taken care of in very sophisticated units such as those at University College Hospital, London.

I am obliged to my hon. Friend the Member for East Kilbride (Dr. Miller). He is a medical practitioner with great knowledge of these matters. He is in constant contact with Professor Macnaughton, who takes a completely contrary view to Professor Reynolds, as do many others. It was unfortunate that the Minister used that letter and, on the basis of that, went back on his word about 22 weeks.

I hope that the Minister will come down in favour of 24 weeks. That is a reasonable compromise that will be acceptable in all parts of the House.

The letter came at a time when the Committee was discussing the possibility of an infant surviving at 23 weeks. We had a great deal of discussion about that. I got in touch with the foremost unit in the country to find out what the view of those working there was. In response, Professor Reynolds wrote to me. He confirmed clearly in his letter that there was no case in this country of a child surviving at less than 24 weeks.

I thought that it was right to give the Committee the whole letter. It would have been wrong to pick out that one tiny point. Professor Reynolds went on to point out that medical advances are being made and that quite soon, in his view, it might be possible for an infant to survive at less than 24 weeks. He went on to express his personal view that it might be wise to agree to a 22-week limit. He was not aware that the Committee was considering another way of dealing with the matter—that a24-week limit should be established with an escape provision so that if medical advances were made Ministers could reduce the limit. Professor Reynolds was not aware of that, so he gave his own solution to the problem.

The Minister is right factually, but he does not answer my argument. Before the Minister received that letter from Professor Reynolds, he had received the letters referred to by the BMA which took a contrary view. The Minister did not give the same publicity to those letters as he gave to Professor Reynolds's letter. The Department must weigh the evidence of the medical profession. The mass of medical evidence is contrary to that of Professor Reynolds. The House must take its decision on the basis of all the evidence presented to it.

It is sometimes suggested that the World Health Organisation supports a 22-week time limit. That is not so. The World Health Organisation is not on record on this subject although it has drawn attention to the increase in the complications to which late abortions give rise. That is about all.

My right hon. Friend the Member for Norwich, North has performed a service by introducing his new clause. He has explained the reasons for it. I do not believe that it is perfect. I should not be unhappy if it were rejected on the Minister's advice. We are searching for an acceptable definition of viability. I am not certain that we have found it, but we have tried. I hope that the Minister will give the official departmental view early in the proceedings.

Whatever else the Bill does, it compels us to reflect carefully on the moral and practical aspects of the difficult and complex question of abortion, to weigh with compassion the plight of the pregnant woman, who seeks an abortion, against the right of an innocent child to be born, and to decide the circumstances in which abortion is justified and those when it is not, and whether what we decide upholds the dignity of human life or undermines it.

In considering the questions of viability, of survival and of an upper time limit for abortion, we come face to face with this moral aspect. There is no escape for any of us. For abortion is not like any other medical procedure. It is not to be compared with the removal of an appendix. It is unique in the sense that it involves two lives, one of which, of necessity, must be destroyed. It is literally a matter of life and death.

Birth is a supremely important event in the life of every human being. But it is not the beginning of life. We know that the child in the womb becomes a recognisable human being long before its emergence into the world. After 20 weeks' gestation, its development is rapid, and very soon after that it is capable of not merely being born alive but of survival. We know that under the present law—this brings me to the new clause and the amendment we are discussing—after 28 weeks of pregnancy, to abort a child is child destruction, to use the legal term. But at 27 weeks it is not. That cannot be right. It is neither logical nor humane. The Bill says, rightly, that the upper time limit should be reduced to 20 weeks.

There is certainly an overwhelming weight of opinion in favour of some reduction. The Lane committee, reporting in 1974, observed that informed opinion at that time considered that, having regard to modern methods of sustaining prematurely born babies, an upper time limit of 28 weeks was too high, and concluded that it should be reduced to 24 weeks. The Lane committee conceded, however, that not all informed opinion agreed with that view. For example, the Peel report on the use of foetuses and foetal material for research defined a viable foetus as

"one which has reached the stage of maintaining the co-ordinated operations of its component parts so that it is capable of functioning as a self-sustaining whole independently of any connection with its mother".

That is a somewhat technical and dry, but essentially accurate, description of a baby struggling to be born. The report recommended that

"the minimal limit of viability for human foetuses should be regarded as 20 weeks' gestational age."

The BMA, in its evidence at that time, agreed. The House should understand that one reason for the Lane committee fixing on 24 weeks rather than 20 was the problem of detecting, at that time, whether a child might be born with a serious physical or mental handicap. Tests could not begin until between the sixteenth and eighteenth weeks of pregnancy and in certain circumstances might not be completed until the twenty-fourth week. One can understand and sympathise with the Lane committee's reservations. Since then, however, methods of diagnosis have improved. What is more, the difficulty is overcome in the present Bill by allowing late abortion in such cases without regard to the 20 weeks' limit.

The Select Committee, reporting more than two years after Lane—

As diagnosis is a specifically important point, will my hon. Friend define it more closely? He has not yet convinced me of the accuracy of the point he is making. Has he any more material to substantiate his view on this all-important question of diagnosis?

I am pleased to give my hon. Friend an answer. He has asked an important question. I am glad to reassure him. In England and Wales, the Bill makes no alteration whatever to the existing law as set out in the Abortion Act 1967. Section 1 (1) (a), if I recall it correctly, provides for terminations where two registered medical practitioners are of the opinion, formed in good faith, that there is a substantial risk that if the child was born it would suffer such physical or mental abnormalities as to be seriously handicapped.

Section 1 (1) (a) of the Act is removed by the Bill but is then restored verbatim as clause 1 (1) (b). I take it that my hon. Friend does not wish me to explain the situation in Scotland. I can assure the House that the Bill makes no change to the existing law.

The Select Committee came down firmly in favour of 20 weeks. This view was supported by Sir John Peel and again by the British Medical Association. The then president of the Royal College of Obstetricians and Gynaecologists told the Committee that

"to terminate pregnancies at 20 and 24 weeks is on the whole a hazardous business."

The president supported a reduction to 20 weeks subject to exemptions in the case of a grossly abnormal foetus or grave and serious maternal illness that might call for termination after the twentieth week. I have shown, thanks to my hon. Friend, that this is precisely what the Bill permits.

It is significant that the Department of Health and Social Security, in its evidence to the Select Committee, thought that, because of the hazards involved, all abortions at 20 weeks or above should be prohibited in the private sector, leaving late abortions to be performed solely in National Health Service hospitals, with exceptions where there was suitable resuscitation equipment and trained staff to operate it. The Select Committee observed that, by that action, the Department

"have given some sigfinificance to the 20 weeks' gestation"

and came down unequivocally in favour of a 20-week limit.

The hon. Gentleman is making great play of the Select Committee. Will he explain to the House—there are a large number of new hon. Members on both sides who were not in the House at that time—what was the composition of the Select Committee that produced the report to which he refers? Will he also deal with the point that, whether or not Sir John Peel came out in favour of 20 weeks, every reputable medical body since then and now, during the passage of the Bill, has come out in favour of 24 weeks? None, but none—not one single one—has supported 20 weeks.

I intend to deal with the latter point. The hon. Lady is anticipating me. I shall not give way again if that is the kind of interruption she intends to make. I shall deal with the first point she raised. The Select Committee was composed of hon. Members of all parties. It was presided over by a respected and senior Privy Councillor who is a member of the Labour Party. On every occasion when its recommendations have been discussed in one form or another in this House, a substantial majority has agreed. That is the answer.

Will the hon. Gentleman give way?

Since then, the House has approved the principle of 20 weeks on several occasions.

I must appeal to the hon. Gentleman in the interests of clarity and truth. He has not answered the first point 1 made, He knows perfectly well that it was not an all-party Committee that produced the report. All the members from the Labour side, including several women members who sat on the Committee—[Interruption.]

rose—

Order. The hon. Gentleman has given way to the hon. Lady.

I should like to help the hon. Lady.

The hon. Gentleman may wish to help, but he has given way. The hon. Lady is entitled to finish what she was saying.

The hon. Gentleman knows perfectly well that hon. Members from the Labour side of the House who supported the 1967 Act withdrew from that Committee and the Committee was left with a rump of hon. Members—I agree there were some Members from the Labour side—who were all opposed to the 1967 Act. Therefore, its report does not bear consideration.

The hon. Lady is now changing her tune—

No.

Earlier, she said that there were no members of her party on the Committee. In fact, the two hon. Members sitting immediately behind her were members of that Select Committee.

The hon. Gentleman did not listen to what I said.

This is relevant in an important sense because the recommendations of the Select Committee on this point—

They were all opposed to the Act.

—were debated when we had the Benyon Bill before us, when my own Bill was presented and when this present Bill was given a Second Reading. On each occasion, the House voted by a substantial majority in favour.

There are some new Members who may have misunderstood the exchange which the hon. Gentleman has just had with my hon. Friend the Member for Wolverhampton, North-East (Mrs. Short). The Lane report has already been quoted, and the hon. Gentleman is at the moment quoting from the report of the Select Committee which was set up to deal with the recommendations of the James White Bill. He knows, and the House should know, that, for reasons which may be good or bad, five Members who were appointed to the Select Committee did not attend. Therefore, all the recommendations that the Committee came up with were not from one side of the House or the other—this is not a party issue; instead, those who were in favour of greater restriction of abortion made the report.

I must repeat that, whatever the composition of the Select Committee—we can always criticise the composition of Select Committees—its its conclusions were agreed in principle by a majority of hon. Members on the Floor of the House on at least three occasions. I think that we can now safely leave the matter there.

As regards doctors, a poll of gynaecologists in 1977 reported that no fewer than 87 per cent. of those questioned were in favour of a limit of 20 weeks or less. There is, therefore, no moral or medical reason why hon. Members should now change their views, which they have expressed on this subject at least three or four times.

There is, however, an additional reason in support of my argument. Hon. Mem- bers have referred to uncertainty. They have unwittingly made the case for the Bill. When considering late abortions, we certainly face some uncertainty. According to official figures published by the Office of Population Censuses and Surveys—I hope that this will not be challenged—there were 133,004 abortions in 1977. Doctors who carry out abortions are required by law to state the gestational age. Yet in no fewer than 4,651 cases no gestational age was given.

We can draw two conclusions from this. One is that the doctors in such cases may have deliberately omitted to provide the information and the DHSS turned a blind eye. The other, which is much more likely and reasonable, is that the doctors simply did not know. Whatever the reason, therefore, there is a margin of error here which, in the case of babies aborted after 20 weeks, may mean that if we legislate for 24 weeks a child with a good chance of survival will be deprived of life.

We are talking here of viability and survival. Of course it is true, I concede, that there is no proven case yet of a baby surviving after an abortion at less than 24 weeks. There have been reports, however, of babies in North America and this country being born and living from 19 weeks, but it has always been said that there have been errors in calculating the gestational age.

It is impossible.

But it can no longer be claimed that a baby cannot survive before 24 weeks, since a distinguished gynaecologist, Mr. Ronald Norris, delivered a live baby at Chertsey hospital recently at 23 weeks.

He did not.

He did. It was a wanted baby. The gestational age in that case was carefully checked and rechecked by the new technique of ultrasound scanning.

It is also true that at 20 weeks we are talking of less than 1 per cent. of total abortions, but it must be remembered—I come back to the moral question—that that is over 1,000 babies a year. If we omit the exempt cases that would be permitted under the Bill, that still means a substantial number, running into hundreds, of children who might otherwise have survived.

Reference has been made to the views of Professor Reynolds. I heard his letter read in Standing Committee. Professor Reynolds is one of the leading neonatologists—specialists in the care of premature infants—in the world. In his letter, which my right hon Friend read to the Standing Committee on 21 November, he said:

"We occasionally admit babies born at 23 weeks gestation, and while none has yet survived, it is inevitable that one will, sooner or later. Infants born at 23weeks are, incidentally, sometimes very much alive at birth—whatever you may hear to the contrary!"

He came down in favour of 22 weeks on medical grounds, but we here are concerned not merely with medical fact but with the law and the safeguards that it must provide for the unborn. Some allowance must be made for the very uncertainties I have described and the possible miscalculation of dates.

If we were to legislate for 22 weeks, we should be in danger of permitting abortion of babies of 24 or 25 weeks' gestation. It is precisely for this reason—I have consulted the records on this—that the BMA originally attacked the Lane committee's advocacy of 24 weeks.

On the impossibility of being absolutely certain about gestational age, Dr. Michael Moore, reader in obstetrics and gynaecology at Manchester university, referred to Professor Reynolds's letter and wrote to me, saying that

"The experience of informed parents confirms this. The latest aid for the estimation of gestational age involves measurement of the fetus, usually the fetal head, by ultrasonography. If, instead of 20 weeks, it was decided to adopt 22 weeks as the upper limit for abortion, the danger of aborting viable babies would remain."

rose—

Let the man finish.

The hon. Gentleman has given way to me, and I appreciate it.

It was said earlier that one of the problems for those of us who are not doctors, which is the vast majority of us here, is that we are dependent upon evidence which comes to us from those who know far more about these matters than we do. The hon. Gentleman is relying on evidence from individual consultants. I read a letter which expressed the view that 24 weeks was the figure. It had the endorsement not only of Sir George Godber, to whom I referred, but of Sir Richard Doll, professor of medicine at Oxford university, Dame Josephine Barnes, president of the British Medical Association and the presidents of the Royal College of Physicians, the Royal College of Surgeons, the Royal College of General Practitioners, the Royal College of Psychiatrists, the Royal College of Pathology and the medical and surgical Scottish Royal colleges. We cannot, just because one consultant sends us his views, disregard the views of those who represent the profession.

The right hon. Gentleman has fallen into a trap of his own making. A letter in The Times only this week from Sir John Peel, former president of the Royal College of Obstetricians and Gynaecologists, Professor Ian Donald and Professor Scott, as well as the very distinguished past secretary of the BMA, Derek Stevenson, came down in favour of 20 weeks.

The right hon. Gentleman and I have both been Ministers in the DHSS. We cannot duck our own responsibility. This is a moral question which, at the end of the day, Members of Parliament have to decide on behalf of our constituents.

When talking about the attitudes of doctors, let us consider the 1980 BMA ethical handbook. Page 29 says:

"The doctor should recommend or perform termination after 20 weeks only if he is convinced that the health of the woman is seriously threatened or if there is good reason to believe that the child will be seriously handicapped."

The House will note that it does not say 24 or 22 weeks. It says 20 weeks. We shall also hear a great deal in this debate about the word "serious" from the opponents of the Bill. They will ask how that word should be defined. When it comes to medical ethics which have to be written down for doctors to read and observe, doctors know perfectly well what the word "serious" means.

The Bill is in line with the ethical guidance given by the BMA. Hon. Members may find it extraordinarily odd that doctors can be reminded that it is unethical to abort after 20 weeks, save in the exceptions laid down in the Bill, but that Parliament must not legislate. With great respect to the BMA, I say that the law of our land should reflect the highest standards of a great profession and not, as the unamended 1967 Act is permitting, the lowest standards.

The right hon. Member for Norwich, North (Mr. Ennals) has challenged me. He should know what the figures are because they are shown in the returns of the Office of Population Censuses and Surveys. I wonder whether hon. Membersrealise the extent to which the existing law is being flouted. If we take the OPCS figures for 1977 we find that, of 1,095 abortions carried out after 20 weeks, over half were carried out in the private sector, for money, and the remainder were carried out in National Health Service hospitals. Yet 75 per cent. of such abortions were not carried out for the serious reasons stipulated in the BMA ethical handbook.

My interest in these figures goes back over many years. Many doctors have approached me on this subject during the last 15 years, as I am sure they have approached the right hon. Gentleman. It is not true to say that the whole of the medical profession is lined up in opposition to the Bill. No secret poll of doctors has been conducted on this subject by the BMA.

:The hon. Gentleman must not misrepresent me. The statement that I read out included the names of the presidents of the Royal colleges. Those Royal colleges speak on behalf of their members. I do not say that there are not individual consultants who will take a different view. The presidents of the Royal colleges have given their evidence before this House. The hon. Gentleman said that I had fallen into a trap of my own making. He has fallen into one of his own making.

If he says that, even under the present law, there are more illegal abortions than there should be, surely he would agree that if the law is made more vigorous more abortions will be carried out, not only illegally but at great danger to the lives of the mother and the possible child.

With great respect to the right hon. Gentleman, the only time that presidents of the Royal colleges and representatives of the medical profession have given evidence to this House was before a Select Committee. I have shown, and it is on the record, that when they did so they were in favour of 20 weeks. I cannot be responsible for the way the medical profession conducts itself. All I can say is, and I guarantee that there are many hon. Members of this House who have had the same experience, that there are scores, if not hundreds, of doctors who have written to me expressing disgust with the views of their so-called leaders in this matter.

Of course, one must take into account the views of a still noble profession.

rose—

I do not need to take instructions from the hon. Lady on this. I will give way when I have finished. Parliament must make up its mind and not be guided by letters and the like. What really matters is the evidence that these people are prepared to give to a Select Committee. When they did so, they came down firmly against all the propositions from opponents of the Bill.

I should like my hon. Friend the Member for for Essex, South-East (Sir B. Braine) to clarify a point. I think that I heard him say something that was unworthy of him. I thought I heard him say that the medical profession and medical opinion that supported the 1967 Abortion Act was of the lowest medical, ethical and moral standard whereas he wished to take the highest moral and ethical view. I am sure that he would not wish to give the House the impression that he believed that scientifically, morally and ethically held views opposing his own are of the lowest medical standards.

I did not say that. I said that the law of the land should reflect the highest standards and not, as is often the case, the lowest standards. What I charge, and I will give proof to the House—though I do not wish to go wide of the amendment—is that the law is being flouted. I have documentary proof—

Give the evidence.

I know that the hon. Lady does not wish to listen. She did not listen in Standing Committee. However, on a matter that touches the conscience of hon. Members, most hon. Members wish to hear the argument.

I do not doubt that every day of the week abortion on demand is taking place either in private clinics or, in some cases, in National Health Service hospitals. I can prove it. What is more, I said as much in Committee in the presence of the Minister—[Interruption.]

Order. I cannot hear what is going on in the Chamber. The hon. Member for Essex, South-East (Sir B. Braine) has given way frequently. We may not agree with what he says, but we must listen. I must listen with everybody else, but I cannot hear him because of the noise.

I do not wish to prolong the argument. I know that the law is being flouted every day and that there are doctors—

Where?

If the hon. Member for Wolverhampton, North-East (Mrs. Short) presses me and if it is the wish of the House that I go into detail, I will.

Yes, it is.

I have in my hand the green form, certificate A, required to be completed by two doctors who, acting in good faith, are of the opinion that a termination should be granted. Because of my connection over many years with this distressing subject, many doctors have written to me. They are distressed at what they know is going on. In this particular case the doctor referred his patient to a wall-known hospital saying that in his opinion there were no grounds for a termination but that the matter ought to be considered. The termination was carried out. The certificate in question is signed by only one doctor.

Which hospital?

The requirement under the law that one of the four criteria which must be observed should be signified was not complied with. The discharge certificate that was sent to the patient's general practitioner gives the diagnosis as "unwanted cyesis", which means an unwanted pregnancy. That was an illegal abortion. The law was not complied with. It was not complied with by the doctor who carried out the abortion. This kind of thing is illegal and disgraceful and is taking place every day of the week.

rose—

Will the hon. Gentleman indicate to which hon. Member he is giving way?

I give way to the hon. Member for Crewe (Mrs. Dunwoody).

I am grateful to the hon. Member for that courtesy. Would he be kind enough to tell the House how confidential records of any case of that kind—which presumably are the responsibility of the doctor and not of anyone outside the doctor-patient relationship—came into his possession?

I cannot describe the distress of a doctor who knows that this sort of thing is going on. [Interruption.] I am answering the hon. Lady in my own way. The document is indeed confidential, and that is the reason why it is extremely difficult to pinpoint what is taking place, although many doctors in the land know that it is taking place.

rose—

The answer to the hon. Lady is that if the Minister is interested in this matter—because that sort of thing is illegal—I shall certainly convey to him the documents in my possession.

rose—

Order. The hon. Gentleman has indicated that he was giving way to the hon. Member for Aberdeen, North (Mr. Hughes). Is that not correct?

No, I give way to my hon. Friend the Member for Devizes (Mr. Morrison).

I am grateful to my hon. Friend for giving way. He is claiming that the present law is being flouted and that certain doctors are performing illegal actions. Even if that is so, why on earth does it follow that changing the law will stop its being flouted?

I do not quite follow my hon. Friend. I am giving a clear illustration of a case where the law is being flouted. At least, we should be certain that if an abortion is granted on the grounds laid down in the present Act—it may be amended by the Bill, but the Bill is not yet law—the law is being observed. I am saying that the law is not being observed.

rose—

Therefore, coming back to the question of viability and survival, the case for rejecting the amendment—

rose—

I can deal with only one interruption at a time. I am perfectly willing to go on doing so at considerable length, but I do not wish to weary the House. [Interruption.] I am trying to answer the point that has been put to me. [Interruption.] This is a matter with which I have been familiar for many years. Doctors confide in me on this, and it is for that reason—

It is quite clear—I hope the hon. Gentleman will forgive me for saying this—that there has been the grossest breach of medical ethics in making available to him the case notes of a patient. If the medical practitioner who made those notes available to the hon. Gentleman had been seriously concerned about the gross illegality to which the hon. Gentleman referred, why were the papers not sent to the police so that there might be a prosecution?

The patient in this case suffered later from a serious breakdown. The general practitioner's duty is primarily to the patient. The doctor's advice had not been that there should be a termination. A termination was carried out. The law was broken in the way that I have described. It is impossible to establish these things save in the High Court of Parliament, where there is a degree of privilege. We are talking here about a matter of life and death. Legal niceties of the kind that the hon. Gentleman has mentioned do not impress me, and I do not think that they will impress the House.

rose—

Order. The hon. Gentleman has not given way. That being so, the hon. Member for Aberdeen, North, (Mr. Hughes) must resume his seat. The hon. Gentleman has given way a good deal and he has been on his feet now for a long time.

I would have finished long ago, Mr. Deputy Speaker, had it not been for the interruptions, but I am anxious to meet genuine anxieties where these are expressed.

I have very much in my mind the evidence given to the Select Committee. We were told that some women who had abortions deliberately chose to become pregnant again within 12 months. When we talk about the rights of the women concerned, this is where the law must be very careful to ensure adequate safeguards.

A Bristol university paper, published in the British Medical Journalof 29 May 1976, revealed that 43 per cent. of women who had had an abortion in that hospital area were pregnant again within a year. In other words, we are dealing with a situation which certainly no man can understand. I suspect that no woman who has not faced an abortion, or has not borne children, would understand it either. Of course, there are unhappy circumstances in which a child in the womb is unwanted. Paradoxically, the doctors tell me that there are also cases in which a child, wanted passionately during pregnancy, is rejected after birth, but nobody suggests that such a child, once born, should be destroyed.

Who among us can explain these mysterious attitudes? What we can be sure about is that there need never be an unwanted baby, for we live in a society in which tens of thousands of families are crying out to adopt a baby.

rose—

Let me sum up by saying that a law which is broken every day of the year cannot be a good law. A law which does not automatically provide a woman, faced with this agonising dilemma, with objective counselling—independent of those who have a vested financial interest in the number of abortions—is a law which trivialises life itself. A law which results in a denial of life to 150,000 potential human beings, and which results in the deliberate killing of babies in the womb after 20 weeks for purely social reasons, as the statistics show, is one about which we should all he deeply ashamed.

That is the case against the amendment. That is the case against the arguments that we have heard previously from the opponents of the Bill in this House, fighting, as they are, a retreating battle against the arguments of reason and morality for the denial of safeguards for the unborn. It goes right to the heart of the Bill.

The hon. Member for Essex, South-East (Sir B. Braine) appeared to me to be producing some evidence to the House that the provisions of sections 1 and 2 of the Abortion Act 1967 may, in the particular case that he produced to the House, have been broken. If so, that seems to me to be a good case for enforcement of the law, but it does not seem to me to add up to an argument for changing a law which is not being enforced at the present time.

I want briefly to turn to the new clause—[Interruption.] I hope that this is not a revolutiontary departure. The new clause is about the Infant Life (Preservation) Act 1929 and not about abortion law as such.

I should like briefly to explain to the House, as I have on a previous occasion, that the 1967 legislation on abortion did not make any change in the law touching on the question of viability. We simply included in one section of the 1967 Act a reference back to the law on viability established in England and Wales in 1929. It is important that the House should understand what that law is, because it is widely misunderstood and misrepresented—not wilfully but mistakenly.

The 1929 law, in layman's terms, as I understand it, says that it is an offence to interfere with the life of a viable child. In order to create some kind of protection for the viable child, a presumption was written in, in 1929, that where the pregnancy had reached the twenty-eighth week there was a presumption to the benefit of the potential child that it would be viable.

It is important that the House should note that there was no reverse presumption—that if the pregnancy had not reached 28 weeks, the child was not viable. I think that this is the point that the hon. Member for Grantham (Mr. Hogg) was trying to clarify earlier this morning. As I understand it, what the new clause seeks to do is to create for the first time precisely such a reverse presumption and to say that so long as a pregnancy has not reached 24 weeks there must be a general presumption that the foetus is non-viable.

I am waiting to hear what the Attorney-General or the Minister will have to say on this matter, but I have grave doubts as to whether we are right to proceed in this direction at all. What I want the House to understand is that it is a completely different matter from the law as at present in force, established in 1929 and presumed and continued in the abortion law of 1967.

Precisely because there is no reverse assumption, it is the case that if an abortion were carried out on a foetus in the twenties ofpregnancy—let us not define it more closely than that—and there were any suspicion that that foetus was viable, an offence would be committed. It does not have to be 28 weeks, 24 weeks or 20 weeks; at any stage. I am glad to see the Minister nodding. I think that this is the right explanation of the present law and that the burden is, therefore, very heavily on the medical practitioner to watch that he is not breaking the law, because he has no protection in relation to termination of any pregnancy up to the twenty-eighth week. That is not what the present law says.

Therefore, a great deal of the discussion that has gone on outside and inside the House on putting in a time limit has been misunderstood right from the start, because there is no time limit at present in the law at all. The burden of responsibility rests with the medical profession.

I think that it was against that background and that proper understanding of the law that the Lane committee came to the view that Parliament ought to consider, in the light of modern medical techniques, whether it was enough to leave the 1929 presumption, standing at 28 weeks, as being the law governing abortion. The Lane committee recommended to us that we should consider putting in a time limit of 24 weeks. As the right hon. Member for Norwich, North (Mr. Enna1s) has read to us, that 24-week limit is also recommended by the bulk of the leaders of the medical profession—I think that that is the best shorthand to use.

I believe that the reason for that is a good one. It is, of course, that since 1929 medical techniques have developed, machinery has been evolved and research has taken place which enables the foetus below the twenty-eighth week of pregnancy to have a much greater chance of survival than it had when the statute was being framed in 1929.

But the medical profession then goes on to point out to us that if one tries to establish a hard and fast limit of 24 weeks there will still be some cases in which the life of the mother is at risk or in which gross foetal abnormality can be detected, where exemption has got to be provided beyond the twenty-fourth week. The promoter of the Bill seeks to do that in the Bill as it stands, but I believe that the House would be well advised to accept the general view of both the Lane committee and the leaders of the medical profession at present—that we should try to create the general presumption at 24 weeks, for this reason.

There have been a large number of newspaper stories—some of them malicious, I think, but the others perfectly well intentioned—of foetuses surviving below 28 weeks and in some cases below 24 weeks. As the Minister told the Standing Committee, as I read the report, all the cases reported to the Department have been investigated and not one has been found to stand up when under investigation. Nevertheless, I think that there is some public anxiety arising out of these cases. The hon. Member for Fife, Central (Mr. Hamilton) quoted a letter from the Department which referred to "margins of error." I think that the general public view, as well as the medical view, would be that on this issue of abortion we should give the benefit of any margin of error to the foetus and that it would not be right to run the risk, in the state of the law that we have, that the life of a viable foetus could be terminated.

For that reason, rather than any purist analysis of the law, which, as I have said, fully covers the point at present because there is no time limit at present in law, I think that public opinion would expect us to lower what is thought to be a limit of 28 weeks and to create a fresh statute on this subject establishing a limit for routine abortions of 24 weeks.

11.45 am

If the hon. Member for Bute and North Ayrshire(Mr. Corrie) had brought forward to the House a Bill saying that, full stop, I am not saying that he would have got unanimity, but I think that he would have had general consent. I deeply regret that he did not do that.

I deeply regret that the Bill before us is a mess. I think that matters will be very difficult. I am waiting to hear the Minister's guidance to see how we get out of this mess. If we cannot get out of the mess based on the Bill, I think that the Department itself should seriously consider bringing forward in the next Session, as a matter of general law reform, perhaps in a general Bill, a provision, which would achieve wide assent in the House, to lower the limit to 24 weeks. If the Department is not willing to do that, we must see whether we can, out of the Bill before us—either today or some Friday next year or whenever we actually reach the end of this Bill—seek to make that simple adjustment. If we did that and nothing else, I believe that we could improve the state of the law.

I am glad to be following the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel) in what he has just said. He has made many of the points that I was just about to make. He is absolutely correct in what he says, so at this stage I shall be very brief indeed.

I should like, however, to refer to what the hon. Member for Fife, Central (Mr. Hamilton) has said—that I am likely to favour 24 weeks, because he is absolutely correct about that. But that, of course, is partly a personal view. I am advised that the new clause is not the best way of achieving a new upper time limit, because, for example, at 28 weeks there can be no absolute evidence that a foetus is viable. There can be only prima facie evidence, about which we have heard comments already.

In some cases a foetus of more than 28 weeks is not viable. The argument applies even more forcefully when one looks at lower numbers of weeks—for example, 24 weeks. At that stage of gestation, only a tiny minority of foetuses will be capable of separate existence and thus be viable. So there can be no reasonable presumption of viability even at 24 weeks. For this reason, the new clause is really not an appropriate way, and I advise the House accordingly.

Another serious objection is that the law would have a different effect in Scotland if abortion law relied on a reduced rebuttal presumption in the 1929 Act. For those who want to change the period to 24 weeks, I would advise that they support amendment No. 2, which would achieve what they desire, and that we reject the new clause.

With regard to the letter to The Times signed by Sir John Peel and other distinguished medical persons published this week, to which the hon. Member for Essex, South-East (Sir B. Braine) referred and which my hon. Friend the Member for Fife, Central (Mr. Hamilton) has sought to rebut, is there any evidence from the Government of the views of the World Health Organisation? It is widely believed that after a very substantial study it has come to a very definite conclusion on the figure of 22.

That was in a slightly different context. I expect that the House will want to come back to it when we discuss the amendments later.

I intervene briefly from the Front Bench, but I make it clear that the views I shall put forward are my own. I have strong views on this subject, as do some of my hon. Friends and some Government Members. Though the House is aware that strong views have been expressed on this issue—not least in the Labour Party and the trade union movement—there is no mandatory pressure on my hon. Friends to follow those views.

I am a supporter of the 1967 Act introduced by the right hon. Member for Roxburgh, Selkirk and Peebles (Mr. Steel). I supported that measure at the time, and I still support the basic principles in it. I am much in favour of supporting amendment No. 2.

Having looked at new clause 1and the other amendments, I say to the supporters of the new clause and the amendment that it might be better for the House to have a clear decision on amendment No. 2 and not cloud the issue on the new clause. While it would be an expression of opinion on new clause 1, especially the last sentence of it which refers to 24 weeks, I think that the House should make a clear decision on the principle—I endorse here what the Minister said—and amendment No. 2 would crystallise opinion in the House. Therefore, that is what I recommend to my hon. Friends.

A reference was made just now to the World Health Organisation. That illustrates the complexity of what we are talking about and the difficulties. As I said, the World Health Organisation's comments were made in a different context. The WHO definition that mentions 22 weeks was in the context of collecting statistics for comparative epidemiological purposes only and had nothing to do with abortion.

I hope that the House understood the Minister's clarification.

The medical evidence that has been put forward this morning and the editorial in The Guardiantoday shows that there is overwhelming support for terminations to take place before 24 weeks, and that the 24-week time limit would meet not only the medical but the moral aspects of this issue.

We shall return to more detailed discussion of the 24-week period, and I therefore ask my hon. Friends not to press new clause 1 and amendment No. 13. Let us have a clear-cut decision on amendment No. 2, after which the House will have a clearer view of how it should proceed.

On a point of order, Mr. Deputy Speaker. In view of what has just been said from both Front Benches, is it possible for you to invite the sponsors of this amendment to consider withdrawing it so that we can get on to the meat of the business which is contained in amendments Nos. 2, 3 and 48?

I agree with those who say that we need to get on, and I have no desire to detain the House. Therefore, I shall be brief. I agree with what my right hon. Friend the Member for Salford, West (Mr. Orme) said about having the real argument on amendment No. 2.

I rise to say two things only. First, I thank the Minister and my right hon. Friend for the guidance they have given. Secondly, I say what has been said before. Those of us who served on the long and difficult Committee considering the Bill were unanimous in our gratitude to the Minister for the way in which he did his share of the work. He saw his function not as being either to facilitate or to impede the passage of the Bill but to clarify confusion—and there was a heck of a lot of confusion.

The hon. Member for Essex, South-East (Sir B. Braine) referred to confused situations and people changing their minds. The reason why we have such a heavily loaded Amendment Paper on Report is precisely that. Hon. Members on both sides of the House, and on both sides of the argument, who did not participate in the discussions in Committee may well have looked at the Amendment Paper and Mr. Speaker's list of selection and come to the conclusion that the Committee did not do a very good job. For the Committee to report a Bill to the House with a need for so many amendments may prompt hon. Members to ask "What the heck was the Committee up to? Why did it not do its job?" If you will allow me, Mr. Deputy Speaker, I shall explain because I think that it will help those who were not members of the Committee to understand some of the confusion that has arisen and was apparent in the observations of the Minister and my right hon. Friend.

The Bill before us today is absolutely unrecognisable as the Bill which received a Second Reading. Of course, Committees amend Bills; that is their purpose. But there is a great difference between amending a Bill that goes to a Committee and totally rewriting it.

Let me quickly run through what happened and what created the confusion—

Order. I know that the hon. Gentleman is trying to help the House, but I think that there is another hon. Gentleman who seeks to help the House also. I hope that the hon. Gentleman will not go into what happened in Committee.

All I wanted to do was to refer to some observations made by the hon. Member for Essex, South-East, who said that there had been a lot of confusion. I want to explain that that confusion arose from two things. First, the Bill was so badly drafted that its sponsors had to vote—

Order. The hon. Gentleman knows that that is completely out of order on this amendment. I hope that he will either speak to the amendment or make some suggestion about what the House might wish to do about it.

You know, Mr. Deputy Speaker, that I would be the last person in the House who would wish to incur your displeasure. All hon. Members know that I am an innocent old gentleman and that cast iron would not melt in my mouth. However, in view of what you have said, I will depart from the point I was making and, very shortly, make only one other comment on what was said by the hon. Member for Essex, South-East, which concerns the letter from Professor Reynolds. The proposition that was put forward on the basis of that letter is a strange legislative doctrine. The worthy professor said "We have never had a foetus of 23 weeks survive, but sooner or later one will."

12 noon

On that basis, the proposition is that the House of Commons should legislate not for circumstances as they are now but for an event that may take place at some indeterminate stage in future. If we applied that principle to all legislation, Bills would be three times as long as they are—and some are too long anyway. It is an extraordinary proposition.

When circumstances change—this is why the House legislates all the time—we introduce legislation to deal with the fresh circumstances. That is always open to the House. If there were a sudden breakthrough in medical science in the near or distant future, which not even Professor Reynolds envisages, the House would be free to legislate.

The point has been made that at this time 23 weeks has not proved viable and that no baby has survived. I use the word "baby", not "foetus". But, according to Professor Reynolds, at 24 to 26 weeks the rate of survival was 50 per cent. in his premature unit. Therefore, we must seriously consider that matter. At 28 to 29 weeks the rate of survival in the premature unit was 85 per cent.

That does not controvert my argument. I am arguing not for 26, 28 or 29 weeks but for the figure in the new clause. I shall repeat what I said to make it clear. If we go lower than that figure, on the arguments put forward by Professor Reynolds, we shall be legislating for an event that may or may not take place. I suggest that it is better to legislate for that event, if it takes place, at the time that it takes place.

I am aware that there is a provision in the Bill that would cover that point, but there is an amendment to delete it, and doubtless we shall debate it in due course. As the Minister pointed out both in Committee and this morning, that provision would give him power to fix a shorter period by statutory instrument. I do not want to anticipate the debate on that matter, but I think that a change of that kind should be the subject of direct rather than indirect legislation. The point has been made that there will be an opportunity to relegislate. The Bill provides for the possibility of relegislation. I put it to the hon. Member for Essex, South-East, with all the respect and affection that he knows I feel for him, that there is no case whatever for a period shorter than 24 weeks on the possibility of an advance in medical science.

Am I to understand that if we fix the period at 24 weeks and it becomes possible within the foreseeable future for a child to be viable at 22 weeks, would be in favour of giving power to the Minister to reduce that period of 24 weeks? I am asking for clarification.

I do not know why hon. Gentleman should ask for clarification. I have just said precisely what I feel about that matter. But, in case the hon. Gentleman had his attention distracted for a moment and did not quite take in what I said, I am happy to repeat it for his benefit. If there were a breakthrough in medical science that indicated that we should go for a shorter period than 24 weeks, my view is that such a change—I repeat word for word what I said—should be made by direct rather than by indirect legislation. That would be too serious a matter to be decided by statutory instrument, which is not amendable, between 10 o'clock and 11.30 pm at night. But, as the Minister pointed out, we shall discuss that matter later.

I submit that the principle is already accepted in the Bill that we can legislate a change if we wish to do so. Of course we can, because Parliament is sovereign. Therefore, whatever argument may be used against the 24-week period, we cannot rest on the argument that we should not accept it because it is all right for now but it might not be in the future.

That is the only observation that I want to make. I am sorry that I have taken a little longer than I intended, but there were interventions.

rose in his place and claimed to move, That the Question be now put.

I think that it might be for the convenience of the House—

The Question is. That the Question be now put.

I think that it would be for the convenience of the House—

Order. The mechanics are that the Question on the closure has to be put. The Question is, That the Question be now put.

On a point of order, Mr. Deputy Speaker. I rose to my feet because I was watching the right hon. Member for Norwich, North (Mr. Ennals) very carefully, and he did not rise.

Further to that point of order, Mr. Deputy Speaker. I was—

Order. I have accepted the closure. The right hon. Gentleman did not rise before the hon. Member for Buckingham (Mr. Benyon) moved the closure.

On a point of order. Mr. Deputy Speaker. I was on my feet, but that is not the point of order that I want to raise. Are we to proceed to a vote on this amendment to the Bill—

Order. The closure has been accepted and I must put the Question. Whilst I am putting it, I cannot take any further points of order.