Parliamentary References on Reproductive Health
March 2001

Emergency Contraception

Health Action Zones and emergency contraception

Baroness Young asked how many health action zones have been established which will permit girls as young as 12 to have the morning after pill.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): we have been notified of 12 schemes which have been established by health action zones and health authorities. Although they are open to women of all ages, experience has been that there are very few requests from under-16s. Supplies can be made to an under-16 within the legal framework established for health professionals in 1986.

Baroness Young: what measures are to be taken to monitor the effect of all this, particularly as regards the number of girls under the age of 16 who are likely to receive those particular pills? Will he monitor also the incidence of sexually transmitted diseases as a consequence of the availability of the morning after pill?

Lord Hunt of Kings Heath: certainly I accept that it is important to monitor the progress of health action zones. I assure the noble Baroness that the issues which she has raised will indeed be monitored. My understanding is that in the Manchester health action zone, the average age of women presenting in the Manchester pharmacy scheme was 24 and only 4 per cent were under the age of 16.

The Earl of Longford: does my noble friend agree that sex between children, adolescents and unmarried young people should be discouraged by government action?

Lord Hunt of Kings Heath: the House is always asking the Government to take action. We wish to do everything that we can to reduce the degree of teenage pregnancy, which is very much associated with the question asked by my noble friend. Our national media campaign in relation to sexual health and teenage pregnancy focuses on giving young people, first, the facts about the risk of unprotected sex and also, importantly, helping them to face down the pressure to have sex before they are ready to do so.

Baroness Blatch: in view of the fact that the morning after pill is available to young people under the age of 16, what protection is there in relation to the culpability of a teacher or a head teacher who refers a girl to a nurse and/or a pharmacy if something goes wrong?

Lord Hunt of Kings Heath: if the contraceptive was issued under a patient group direction, the professional prescribing that contraceptive would be open to regulation and discipline by his regulatory body. In addition, the medical doctor who was concerned with and signed the patient group direction would himself be accountable if an error were made in that patient group direction.

On the question of the supply of contraception by school nurses, the noble Baroness will recognise that that occurs only after a decision by the governing body of the school after consultation with the parents.

Baroness Massey of Darwen: does the Minister agree that there is overwhelming evidence to show that very few girls of 12 are having sex in the first place and that the vast number of women who use emergency contraception are in the age range of 30 to 40? Does he further agree that it is better to use emergency contraception than for a child to have a child?

Lord Hunt of Kings Heath: I agree with all those statements in my noble friend's question. Indeed, the evidence from the Manchester scheme confirms that.

Lord Clement-Jones: does the Minister also agree that in the majority of the other health action zones, particularly the one of which I am aware; the Lambeth, Lewisham, Southwark health action zone, the figures are very similar to those referred to by the noble Baroness, Lady Massey?

Lord Hunt of Kings Heath: that is why I responded positively to the original Question by the noble Baroness, Lady Young. Clearly, it is extremely important for us to monitor the figures and make them known because that will inform other potential schemes up and down the country.

Baroness Knight of Collingtree: asked the Minister to say what warnings his department issues to reach those very young girls to ensure that they know about the now known danger of starting a sexually active life very early?

Lord Hunt of Kings Heath: in relation to the overall sexual health strategy, the Government are keen to ensure that the risks of having under-age, unprotected sex should brought home to young people. We seek to do that. At the same time, I believe that when unprotected sex has taken place it is absolutely right that contraceptive advice is available to those young people, as long as the legal framework is followed.

Baroness Uddin asked the Minister to inform the House what data are kept in relation to women taking the morning after pill, not only in respect the age of the children and women but also in respect of their ethnicity and race?

Lord Hunt of Kings Heath: it is important that we keep as much information as possible in order to inform our future polices and programmes. The Government's sexual health strategy, which will be launched in due course, will focus on information requirements.

Earl Howe: does Minister remember from the debate at the end of January that one of my concerns in relation to the morning after pill being available in pharmacies is that continuity of healthcare can be compromised. What is the situation in the health action zones where a young person under the age of 16 requests the morning after pill from a pharmacist? Does the pharmacist have an obligation to refer that young person to a GP? What transfer of information takes place?

Lord Hunt of Kings Heath: I do not believe that a pharmacist has an obligation to refer such a young person to a general practitioner. But whatever conversation takes place between the pharmacist and the young person, that provides an opportunity for information to be imparted about safe sexual health practices. I believe that that happens.

Earl Ferrers: if the Minister agreed with the observation made once in this House by a distinguished member of the party opposite, Lady Summerskill, that the best contraceptive was the word "No"?

Lord Hunt of Kings Heath: there are those who believe that "Just say no" policies will lead to a reduction in sexual activity among young people and reduce teenage pregnancy rates. I do not believe that there is any evidence to show that.

House of Lords Report 8 March 2001

Teenage pregnancy

Lord Hylton: will the Government study the progress made in the state of Illinois in reducing the incidence of teenage pregnancies, including Project Reality.

Lord Hunt of Kings Heath: the teenage pregnancy programme is based on evidence of what is likely to be most effective. We are aware of abstinence programmes in the United States, including Project Reality. However, a recent expert review found no robust evidence that these programmes are effective.

Lord Hylton: is the Minister aware that, not only in the state of Illinois but throughout the United States, young people are receiving the message that it is in their own interests to abstain from sexual relations until marriage? Has this not had a marked effect on reducing teenage pregnancies and abortions? Is there not a strong case for putting in place similar programmes in this country?

Lord Hunt of Kings Heath: I have studied a paper produced by the Resource Centre for Adolescent Pregnancy Prevention in the United States. It undertook a review of the published studies in this area. The centre found that only a limited number of studies were sufficiently robust to stand up to analysis. Indeed, the only study sufficiently robust to enable a comparison to be made between one approach and another found that the programme did not delay adolescent sexual activity. Like many noble Lords, we are concerned about the level of teenage pregnancy in this country. An important part of our own programme is a strategy to help young people to resist having sex before they are ready. However, the strategy also involves helping teenagers to understand and avoid the risks of unprotected and uninformed sex. I believe that a rounded programme in this area is likely to be more effective.

Earl Howe: does the Minister agree that, when a teenage girl finds that she is expecting a baby, it is important that she is able to gain access to advice about the options open to her? Can the Minister say whether the forthcoming Adoption Bill will contain measures to ensure that girls receive advice not simply about abortion, but also about the opportunities for adoption?

Lord Hunt of Kings Heath: the noble Earl has raised an important point and agreed with him that young girls in that situation should have access to a range of advice so that they can make informed choices. I would wish to see that all is done to ensure that that is the case.

Baroness Blatch: does the noble Lord agree that to offer so freely to girls who have become sexually active at such an early age the morning-after pill, either through school or over the counter at a local pharmacy, is a policy of despair?

Lord Hunt of Kings Heath: we have debated this matter thoroughly and at length in your Lordships' House. The fact is that in the event that a young woman wishes to seek emergency contraception, the rules that have been approved by this House allow for professional advice to be given. Ultimately, faced with the prospect of an unwanted pregnancy and the availability of emergency contraception, I believe that such contraception should be made available.

The Earl of Listowel: does the Minister agree that, in the efforts being made to delay adolescent sexual activity, everything possible should be done to improve the sense of self-esteem of young people through education, meaningful youth activity and so forth?

Lord Hunt of Kings Heath: such efforts should move alongside a rounded approach to sexual health and education. That is why the Teenage Pregnancy Strategy, developed by this Government, is very much concerned with taking a holistic view of these matters.

Baroness Gardner of Parkes: can the Minister expand on his address to the Pharmaceutical Service's Association committee dinner, at which he was the guest speaker? He said that he would like all pharmacies to contain an area for private consultation. Can he reconcile that comment with his statement of a moment ago saying that opportunities for confidential consultation were already available?

Lord Hunt of Kings Heath: I am not aware that I said that confidential booths were available in every pharmacy. However, it is certainly my hope that, with the introduction of local pharmaceutical services, we can put in place an incentive programme that will encourage community pharmacies to install private consultation areas. Having seen some community pharmacies introduce them, I am sure that that is the best way forward. It will enable us to look to community pharmacists to give even more advice to the public.

Lord Rea: has the Department of Health paid due attention to the sex education programmes in the Scandinavian countries and in the Netherlands, which have the lowest teenage pregnancy rates in Europe?

Lord Hunt of Kings Heath: One point to note about countries that are more successful in this area is that they have had very proactive sex education programmes. Also young people in some of those countries seem much more willing to discuss sex and health education matters with their parents. I am keen to see parents in this country encouraged to do the same. It is a great disappointment that the research suggests that fewer than a quarter of the young people in the UK talk with their mother about sexual relationships, and only 10 per cent with their father. It would be a jolly good thing if we could do better than that.

House of Lords Report 26 March 2001

Teenage lone parents

Caroline Flint MP asked the Secretary of State for the Environment, Transport and the Regions how many foyer projects have been established for teenage lone parents since 1997; how many teenage lone parents they accommodate; and where they are located.

Robert Ainsworth MP (Minister for the Environment, Transport and the Regions) replied that the Edmund's Court Foyer in Birmingham, which opened in July 1997, has 48 bedspaces for teenage lone parents. Aberdeen Foyer, which opened in April 1998, also has a number of units held exclusively for teenage lone parents to use. Many other foyers across the country also have a small number of flats or converted units, which would be appropriate for use by this group.

Written answer 5 March 2001

Anti-abortion activity

Human Fertilisation and Embryology regulations

Lord Alton of Liverpool: asked Her Majesty's Government why they did not inform the House of Lords on 22 January that Lawyers acting on behalf of the Secretary of State for Health intended to tell the High Court on 26 January that they would need five months to prepare scientific evidence in defence of the regulations on human embryos arising out of the Donaldson Committee Report.

Lord Hunt of Kings Heath: an application for permission for the Pro-Life Alliance to bring a judicial review was considered in the High Court on Friday 26 January. The application was adjourned to allow time for both parties to prepare their cases before the resumed application for permission and the substantive arguments were heard together on or after 15 June this year.

The court order set out a timetable for this process, including time for statements to be made by both sides about the scientific principles on which each side would rely. Lawyers for the Secretary of State for Health did not ask for five months to prepare a statement on the scientific principles but were granted six weeks to do so by the court.

Written answer 9 March 2001

Human Fertilisation and Embryology Regulations

Lord Rawlinson of Ewell asked Her Majesty's Government what was the outcome of the proceedings in re Bruno Quintavalle v. The Secretary of State for Health heard in the High Court on 26 January, the same day that the Human Fertilisation and Embryology (Research Purposes) Regulations 2000 were approved.

Lord Hunt of Kings Heath: On Friday 26 January the High Court ordered that the question of whether permission should be granted for Mr Bruno Quintavalle and the Pro-Life Alliance to bring a judicial review should be adjourned and considered at a full hearing to be held on or after 15 June. At the full hearing the court will decide whether the application should proceed. If this is permitted, the court will then go on to consider the substantive issues.

The application concerns the Human Fertilisation and Embryology (Research Purposes) Regulations 2001, and the definition of 'embryo' in the Human Fertilisation and Embryology Act 1990.

The House of Lords debated and approved the Human Fertilisation and Embryology (Research Purposes) Regulations on Monday 22 January.

Written answer 14 March 2001

Early Day Motion 351, 14/2/01, 82 signatures
INFERTILITY TREATMENT