A funny thing happened on the way to the forum
Giving Life a seat on the Sexual Health Forum is a bit like including Jehovah’s Witnesses on a panel to discuss blood-transfusion services.
The anti-choice charity Life, opposed to abortion in all circumstances, was last week invited to join the Sexual Health Forum, a new UK government advisory group on sexual health. The Department of Health said that Life’s inclusion on the panel, alongside Brook and the Family Planning Association (FPA), would ‘provide balance’ and ensure ‘a wide range of interests and views are represented’.
At the same time, in the interests of balance, the Department of Health withdrew its invitation to British Pregnancy Advisory Service (BPAS), the organisation of which I am the chief executive, which provides pregnancy counselling throughout Britain and carries out more than a quarter of the country’s abortions.
This has turned out to be a controversial move. Especially as civil servants, somewhat ill-advisedly, sent an email briefing to Nadine Dorries MP before a BBC Newsnight debate with me, claiming: ‘We offered them [BPAS] a shared membership but they declined.’ This caused Dorries to state on air that, in protest at Life’s inclusion in the forum, BPAS had ‘taken its bat and ball home’.
This ‘handling line’, which the Department of Health has since confirmed was sent by ‘ministerial advisers’, was not only untrue – it was also particularly stupid since the email being waved about by Dorries coincided with a letter to BPAS from the Department of Health confirming that ‘ministers have decided to invite Marie Stopes International to sit on the Sexual Health Forum’ and not BPAS because ’including two organisations on the core group who carry out a role as independent sector abortion providers is not necessary…’.
The letter concludes on the following conciliatory note: ‘[Y]ou are not the only organisation to be disappointed at not being on the Core Group. We will, of course, welcome BPAS’ participation in the Sexual Health Forum’s wider group which is due to meet later this year, where your experience and expertise will be extremely useful in encouraging collaborative working and good practice across the sector.’ (Personal correspondence, 24 May 2011)
It’s difficult to imagine how the official’s reference to our disappointment at not being on the core group fits with the claim that BPAS ‘declined’ membership. But then, as I have argued recently, thought processes at the Department of Health seem to resemble the chaotic incompetence of The Thick of It – but without the talent of Malcolm Tucker running the press.
Much of the concern expressed about Life’s invitation to join the Sexual Health Forum has been about the government opening itself up to advice from a group that is opposed to abortion in principle. Personally, I don’t share that view. Although most people in Britain believe that abortion is legitimate, some do not and it’s fair enough for their views to be sought to inform policy discussions about the rightness or wrongness of abortion.
Like BPAS, Life is a registered charity. It provides help and support for women with unplanned pregnancies. It opposes abortion but, if you don’t want to consider abortion and are committed to having your baby and either raising the child or surrendering it for adoption, Life may be able to provide much-needed help. An age ago, before I worked in reproductive health, I was commissioned as a journalist to write an ‘exposé’ of hostels run by Life for young pregnant women. Rumours were rife that Life treated the women appallingly, kicking them out of accommodation once it was too late for abortion. As part of my investigation, I visited a Life house in London and found the stories to be absolutely untrue. The staff were kind, the facilities pleasant and the girls (many from Ireland) were well cared for and supported. And that was what I reported back to my editor. There was nothing to ‘expose’.
Had the Department of Health been recruiting to a forum to advise on the management and support of women with unplanned pregnancies, I would have supported Life’s inclusion; they provide support for a specific group of women. But not all women. Women considering pregnancy termination, who stumble into Life’s counselling service on the misapprehension that they provide comprehensive, non-directive counselling, are ill-served: often subjected to gruesome videos of what abortion involves and information that exaggerates the risks of the procedure.
While Life might have a place on a pregnancy forum, it is hard to extend that concession to a forum advising on sexual health. Life’s pregnancy counselling centres do not provide contraceptive services and they do not provide testing for sexually transmitted infections. They could not refer to abortion services, even if they wanted to, because they are not included on the Department of Health’s register of Pregnancy Advisory Bureaux. Inclusion on this register ensures that pregnancy advice, counselling and care meet approved standards and that women are genuinely provided with accurate information on all their options and are not steamrollered into a decision.
Life’s contribution to the discussion on sexual health seems to be limited to telling people not to have sex. It seems a bit like including Jehovah’s Witnesses on a panel to discuss how to improve blood transfusion services.
It is difficult to believe that either ministers or civil servants genuinely believe that Life has much to add to policy. Its seat at the table is most likely a concessionary gesture towards faith-influenced Tory players such as Iain Duncan Smith MP, and others who are seen as policy heavyweights, like Labour MP Frank Field. These are the people who have argued that the inclusion of groups like Life is essential in the orientation towards David Cameron’s ‘Big Society’.
In truth, sexual health is way down on the government’s (even the health secretary’s) list of priorities. A tokenistic concession of a seat for Life radiates goodwill towards the parliamentary conservatives across all parties in both Houses of Parliament, while giving no guarantee of influence.
So, is it a problem that Life has a seat on the forum, while the door has been slammed shut in BPAS’ face? In short: yes.
There are three reasons why Life’s inclusion is a problem. Firstly, this alters the consensus that discussion on policy should be informed by scientific fact and medical evidence, by including an organisation that denies what can be demonstrated. My objection to Life is not that it stands by a particular set of views and values, but that it is seemingly casual as to the clinical evidence on which these views are based. To borrow from former MP Dr Evan Harris, ‘Life representatives are entitled to their own opinions, but they are not entitled to their own facts’.
So I accept that Life can argue that the morning-after pill is immoral; but I cannot accept that the group should have a platform to argue, as it does, that emergency contraception damages women’s health (it doesn’t) or that it is a method of abortion (it isn’t – crucially it doesn’t work if you are pregnant!). Similarly I can accept that Life believes that abortion is wrong; but not that the Department of Health should indulge the group’s poorly substantiated fantasy that it causes breast cancer, infertility and post-abortion psychosis.
Secondly, even though it is unlikely that the Department of Health will be influenced substantially by Life’s eccentric claims, it is undeniable that its presence affects how the middle ground is defined. The middle ground in a conversation that includes a body that believes abortion is always wrong is at a different location to the middle ground in a landscape where everyone accepts abortion can be a beneficial option. In times such as these, when political apparatchiks aim for consensus and avoid polarisation according to principle, it is important to be clear how the ‘middle ground’ is mapped out.
Thirdly, the inclusion of Life to achieve ‘balance’ reinforces the view that organisations such as Life and BPAS represent ‘two sides of the same coin’, whereas in reality we have very different values and approaches. Life is anti-abortion; BPAS is pro-choice.
Life does not accept that abortion is a legitimate and safe choice for a woman. When a woman requests an abortion, Life counsellors believe it to be in her interests to dissuade her – so they do their best to persuade her it’s a bad idea. They may concede that it is a legal option, but they are clear that it is a worse option than continuing the pregnancy: having the baby, in their view, is always the preferable option.
By contrast, BPAS does not ‘promote’ abortion as a preferred option. The charity does not exist to encourage abortion as Life encourages motherhood; BPAS exists to promote and enable a women’s choice. It’s all a matter of providing the information, and the space, to allow her to make the decision that is right for her at this time. It is as much a BPAS counsellor’s job to help a young girl reconcile her parents to her desire to have her baby as it is to advise her on abortion options. Although most thankyou letters sent to BPAS staff are from women relieved to have been supported through their abortion choice, a large number are also from women who came to the view that having their baby was possible and what they wanted.
The notion also implicit in Life’s inclusion – that an anti-abortion entity is required to provide the forum with a moral compass – is hugely insulting to its other members. Life has made much of its role in arguing for abstinence-based sex education, so as to empower young people to say ‘no’ to sex, implying that organisations such as Brook and the FPA encourage sex early and often, when nothing could be further from the truth.
And, as there are problems with Life’s inclusion, so there are problems with BPAS’ exclusion. The centre ground will not only be shifted with the inclusion of an organisation with illiberal views about sex and fertility regulation, but by the removal of the most liberal. BPAS is the only voice on the spectrum that has persistently argued that abortion is not in itself a problem, but a solution to the problem of unplanned pregnancy. We have argued against targets to reduce abortion numbers and rates, stressing that such targets can most easily be achieved by making abortion less accessible, by reducing provision and reducing funding. While we advocate and deliver improvements in contraceptive services, we insist that abortion must remain as a back-up to birth control.
We have argued that unplanned pregnancy, even among teenagers, has caused more complicated, inadequate sex education and contraceptive services. And we have argued that we need to be cautious of the government’s behavioural change agenda, lest we are ‘nudged’ into a society where abortion is ‘de-legitimised’.
For years, BPAS has been stubbornly ‘off-message’, prepared to call out the inadequacies of official policy. In February, in its struggle to provide abortion medication in a manner consistent with international best practice but prevented by officials’ interpretation of the law, BPAS took the government to the High Court. We lost the court case, but won the battle for public opinion and achieved a judgement that allows the secretary of state licence to approve better services, if he has the stomach to do it.
It is now perfectly clear that the barrier to evidence-based abortion care is not a legal process, but a politician’s inclination. It’s hard not to see the decision to exclude BPAS from the inner-sanctum as ‘pay back’.
So, what next? It’s BPAS’ job to make sure that women do not suffer the consequences of the current political manoeuvres and intrigues. We will continue to expand our services and provide the best contraceptive and abortion care available, and we will continue to argue in support of women’s right and responsibility to make their own lawful decisions about their pregnancies.
Compared to ministers, government officials and their advisers, BPAS has a remarkably easy job: to provide the reproductive health care services that women want and need, regardless of what our ideological opponents think. And that’s what we will do.
Ann Furedi is chief executive of BPAS, the British Pregnancy Advisory Service.
Niall Gooch of Life responds to Ann Furedi here.