Nadine Dorries & BACP: Mixed Messages

I have an admission to make this morning. Yesterday, I underestimated the ingenuity of the Guardian’s editorial team and suggested that it was unlikely that any of the content of Nadine Dorries’ response to Suzanne Moore, which I fisked here, would find its way on to Comment is Free.

I was wrong. Despite the obvious lack of veracity in Dorries’ article, the Guardian’s editorial term and media lawyers have managed to rescue enough of Dorries’ remarks to make up a right-to-reply article, which the newspaper published last night – although I correctly predicted on Twitter that comments would be closed on this article overnight, long before it appeared either at the Guardian or at Dale & Co.

What is, I think, instructive here – and well worth taking careful note of – is the amount of material from the Dale & Co version which failed to make it onto CiF. The full article weighs in at 1,002 words, pretty much the optimum length for an op-ed at a broadsheet newspaper. The CiF version runs to only 529 words and omits most of the more egregious and indefensible untruths from the original, not least the ridiculous claim that Ann Furedi, the Chief Executive of the British Pregnancy Advisory Service, receives a £200K a year ‘financial package’ as remuneration for their work.

One claim that did make it into the CiF article relates directly a statement issued by the British Association of Counselling and Psychotherapy, which Dorries has been promoting on her own blog, and at the website of her ‘Right to Know’ campaign on the pretext that it shows that the organisation is supporting the work of her campaign. The ‘Right to Know’ campaign website states, quites explicitly, that:

UK’s largest counselling body backs pre-abortion counselling amendment

THE UK’s leading professional body for counsellors and psychotherapists has declared its full support for an amendment to the Health and Social Care Bill, tabled by Nadine Dorries MP and Rt Hon Frank Field MP. If passed, women considering abortion would have a legal right to independent, non-compulsory counselling.

Regular visitors to the Ministry,  and Liberal Conspiracy, will already know that following the publication of this statement, Tim Ireland contacted BACP’s media spokesperson, Phillip Hodson, and obtained a statement clarifying the organisation’s position on Dorries’ amendment, which I posted in full here.

The salient points in this initial exchange with BACP are that:

1. Nadine Dorries’ amendment – which, incidentally, does not also carry the name of Frank Field as yet – does NOT deal solely with the provision of ‘independent counselling‘.

The actual text of the amendment adds an additional item to a list of commissioning duties/powers to be conferred on GP consortia by the government’s controversial Health and Social Care Bill as follows:

after paragraph (f) insert a new paragraph as folllows—

“(g) independent information, advice and [sic] couselling services for women requesting termination of pregnancy to the extent that the consortium considers they will choose to use them.”.’.

A second amendment, also in Dorries’ name, goes on to define ‘independent’ in the following terms:

In this section, information, advice and counselling is independent where it is provided by either—

(i) a private body that does not itself provide for the termination of pregnancies; or

(ii) a statutory body.”.’.

Taken together, these amendments would, if accepted by parliament, prevent GP consortia from commission any  information, advice or counselling services relating to the termination of pregnancy from both the British Pregnancy Advisory Service and Marie Stopes International, NOT just counselling services.

There is also a third amendment in Dorries’ name, which seeks to strip the Royal College of Obstetricians and Gynacologists (RCOG) of its long-standing role in formulating guidance on the provision of abortin services, including the provision of information and advice services, transferring that role, instead, to the National Institute for Health and Clinical Excellence (NICE). This is, in part, a revenge attack on RCOG which follows closely in the wake of the anti-abortion lobby’s failure to influence its guidance on abortion, a failure that seems set to be repeated in relation to the Royal College of Psychiatrists (RCPsych) systematic review of the evidence relating to abortion and mental health. It also, however, reflects the fact that NICE’s stakeholder-based approach to consultations on clinical guidance is seen to afford the anti-abortion lobby a greater opportunity to inveigle its way into positions of influence in the consultation process and, consequently, influence its published guidance.

Getting back to main thread of this article, the statement that Tim Ireland obtained from Phillip Hodson, BACP’s media spokesperson, sets out it ethical position on the provision of pre and post-abortion counselling and takes great pains to draw a clear distinction between the provision counselling and the provision of information, advice and other ancillary services – for brevity’s sake, I’ll reproduce here only the key passages of that statement:

1. In response to an enquiry, BACP issued a statement saying it believes counselling should be an independent accountable and ethical process free from ideological bias and manipulation…

2. Our statement in its entirety reads as follows:

“BACP believes that all women (and their partners if required) considering terminating a pregnancy should be offered free, independent, unbiased and ethical abortion counselling at any point, supplied by trained counsellors. Counselling can help women (and their partners if required), reflect on and understand the often complicated feelings surrounding termination, and can aid decision-making. Counselling can also help women come to terms with the psychological consequences of the decisions they make. BACP respects that the laws governing termination of pregnancy in Northern Ireland are laid down in statute and fully understands that counsellors who work in this field in Northern Ireland should pay due regard to the document: Guidance on the Termination of Pregnancy: The Law and Clinical Practice in Northern Ireland”…

4. BACP has never suggested or implied that organisations like BPAS and Marie Stopes International should stop providing abortion advice or any of their other ancillary services. Counselling and advice-giving are in any case separate activities – “counsellors never give advice”.

Quite obviously, this statement falls some considerable way short of offering the full support for her amendments that Nadine Dorries claims on both her own pseudoblog and on the ‘Right to Know’ campaign website, particular in respect to item four which draws a sharp line between counselling and advice in addition to the statement that ‘BACP has never suggested or implied that organisations like BPAS and Marie Stopes International should stop providing abortion advice or any of their other ancillary services’.

Hodson kindly provided this statement, via his personal email account, even though he was out of the office at the time Tim contacted him and, having published his statement in full, I’m entirely satisfied that my own post provides a perfectly reasonable assessment of the BACP’s stated position, based on my understanding of the content, purpose and intent of Dorries’ amendment.

On receiving Hodson’s statement, Tim and I had a quick conflab by email and we agreed that it was worth pushing the issue of exactly who it was that contacted BACP about Dorries’ campaign. Tim received a reply to that inquiry, from Hodson, with a further ‘clarification’ of BACP’s position is regards to the Right to Know campaign, which I’ll reproduce below and in full:

Dear Tim,

I said I’d get back to you when I knew the facts.

We were approached by the ‘Right to Know’ campaign not the other way round.

We were asked whether we favoured more abortion counselling that was fully impartial.

We issued our statement on that basis to which we remain committed (see below).

And in the context of the above, we expressed support for Ms Dorries’ “work” by email.

So it is untrue to suggest she had no backing from us and I apologise if the wrong inference was drawn.

Best wishes,

Phillip Hodson
BACP Media Consultant

Clearly, I’d dispute the suggestion that I drew the ‘wrong inference’ from Hodson’s original statement. What I addressed, in my own post, was Dorries claim that she had the full support of BACP for her proposed amendments and it is quite clearly the case that she doesn’t. BACP’s support is limited to the proposition that counselling, and counselling alone, should be provided on an independent, unbiased and non-judgmental basis and there is nothing in this email which indicates any support or backing for Dorries’ proposals as they relate to the provision of information and advice.

To be scrupulous fair to Hodson, he is acting only as the messanger here – so, please, don’t shoot the guy – and he comes across as a perfectly honest and decent man, for all that he finds himself, in this email, landed with the job of diplomatically addressing what seems to be a rather awkward and questionable position that his organisation has adopted. One cannot, therefore, criticise him for trying to make the best of what – to me – looks like a bad job that has been dumped on him by others.

And, yes, if the name ‘Phillip Hodson’ seems familar, this is the same Phillip Hodson who used to do an ‘agony uncle’ slot on the BBC’s ‘Saturday Superstore’ and ‘Going Live’. He’s gigged with Gordon the Gopher and deserves a bit of respect for that.

What’s most interesting about this email – and particularly revealing in terms of what it has to say about the manner in which Dorries operates – is this series of statements:

We were approached by the ‘Right to Know’ campaign not the other way round.

We were asked whether we favoured more abortion counselling that was fully impartial.

We issued our statement on that basis to which we remain committed (see below).

What that seems to imply is that BACP were, in effect, sold a false prospectus by Dorries and/or her campaign – its not clear who actually made contact – inasmuch as it does not appear, from this email, that the campaign gave BACP a full, open and honest account of nature and scope of the amendments tabled by Dorries’. As such, BACP appear to have responded honestly and in all good faith to what clearly appears to have been a dishonest enquiry and have, in effect, been painted into a rather awkward corner for which they cannot easily extricate themselves without being seen to repudiate an ethical position they’ve held for a number of years.

What this calls most immediately to mind is the term ‘stitched up’ although one does have to wonder quite how and why the organisation failed to carry out any background checks that might readily have indicated that the approach from the ‘Right to Know’ campaign was not entirely on the level. It’s not as if the text of Dorries’ amendments is difficult to obtain or has failed to attract comment and controversy since its publication earlier this year.

Having received the email, via Tim, we had another quick conflab and agreed that Tim should seek a further clarification from Hodson after first supplying him with evidence which clearly demonstrated that Dorries’ has both a long history of acting in bad faith in regards to public statements she’s made on the subject of abortion and, of course, that Dorries’ proposed amendments do not relate solely to the provision of counselling.

Again, Tim received a reply by email and, again, Hodson’s comments are diplomatic but, ultimately, set out what many would consider to be a rather unsatisfactory position:

Dear Tim,

I won’t reply at length but let me say I accept that you make your argument in good faith and with incredible industry.

To put it simply, the “work” in question is the promotion and provision of more, better and impartial counselling for women who undergo abortion.

Impartiality predicates that no group, religious or secular, would attempt to indoctrinate their clients. This in any case is a hanging offence under our Ethical Framework.

The acid test is whether impartiality is properly delivered. You are clearly sceptical. We shall have to wait and judge. Anything less than full delivery would be unacceptable to the clients and to us.

Ms Dorries herself volunteered that religious groups should be subjected to these constraints during a phone conversation she had with me the day before yesterday.

All best,

Phillip

Some may see that in terms of BACP sticking to its guns on an important point of principle.

Others – myself included – may be inclined to interpret the organisations’ chosen position as one in which it could be argued that it seeking to have its cake and eat it.

One way or another, BACP has put itself – perhaps inadvertently – in a rather awkward and questionable position and this is, therefore, a matter that at least some BACP members may wish to take up with the organisation.

It is noticeable, also, that after Hodson’s original statement was posted both here and at Liberal Conspiracy, he was contacted by Dorries and given something vaguely resembling an ‘assurance’ that religious groups would be bound by the constraints set out in BACP’s ethical framework were her campaign successful. What this, perhaps, indicates is something of the nature of the backroom negotiations that are taking place between Frank Field and the Department of Health in relation to his efforts to bring about a change in NHS commissioning policy via the back door and without the matter being subject to debate in parliament.

My understanding of legal position here is that the DoH cannot directly exclude BPAS and MSI from the provision of abortion-related advice, information and counselling services without providing an objective justification for such a decision. What it may be able to do is, at the very least, require GP commissioning bodies commission such services from a wider range of suppliers and it may also, as a matter of policy, be able to compel commissioners to accept tenders only from organisations where the provision of counselling services is undertaken only by appropriately qualified staff or independent contractors who hold a professional membership of a recognised counselling organisation with ethical standards equivalent to those set out in BACP’s own ethical framework. This would not afford BACP a stranglehold in this area; there are other organisations, notably the British Psychological Society – whose ethical standards are at least as stringent, if not more so, than those adopted by BACP, but it would place any organisation which accredits is counselling staff through BACP at a distinct advantage when tendering for NHS contracts relating to the provision of pre and post-abortion counselling.

What this points to are some of the potential conflicts of interest within this debate which have yet to explored in detail.

The anti-abortion organisation, Life, which is one of Dorries’ main backers, currently puts all of its counselling staff through BACP accreditation and would expect to be a major beneficiary were BPAS and MSI pushed out of providing abortion-related information, and counselling services. It, therefore, has both an ideological and pecuniary interest in seeing BPAS and MSI propelled out of the ‘market’ for these services as one would assume, quite reasonably, that it would expect to be paid for taking NHS referrals.

BACP, likewise, could benefit significantly from such a move both indirectly – in the sense that at least some of its members might obtain employment that they might not otherwise have secured, should the NHS adopt a commissioning policy of this kind – and also, perhaps, directly in terms of increased membership (and membership fees) from individuals and organisations seeking BACP accreditation in order to capitalise on the availability of NHS contracts and referrals for abortion-related counselling. If nothing else, a commissioning policy which favours, or requires, the professional accreditation of counselling staff seems likely to lead to both an expansion in Life’s services and a rush by at least some members of the CareConfidential network* of so-called ‘crisis pregnancy centres’, to obtain accreditation for their staff in the hope of getting onto the NHS referrals gravy train.

*CareConfidential, it must be pointed out, is operated by an offshoot of an explicitly Christian charity called ‘Christian Action Research and Education’ (CARE) which has exclusively religious charitable objects – a fact that is not disclosed openly on the Careconfidential website. CARE, in common with Life and Dorries’ other backers, e.g. ‘Christian Concern’, which was formerly called ‘Christian Concern For Our Nation’ (CCFON), is doctrinally opposed to abortion in all circumstances, including pregnancies arising as a consequence of rape, serious foetal abnormality and even serious risk to the life of the pregnant woman. CARE has, for some years, operated an internship programme which places interns with supportive Members of Parliament – one of the MPs that has taken advantage of this programme is Liberal Democrat, Paul Burstow, who currently holds the position of Minister of State for Care Services at the Department of Health.

Update: It’s been brought to my attention that CareConfidential has now been hived off into a separate charity – Care Confidential Ltd – under notionally secular objects. This is avery recent move – the new charity was only incorporated in March and as it usually takes around 2-3 months from incorporation to charity registration, it has only just popped up on the Charity Commission’s register. This raises some questions as this could indicate that CARE’s operation of this network has been challenged on the grounds thatthey were operating ouside their religious object, but it seem more likely that the organisation is aiming to cash in on the activities of Dorries and Frank Field and put itself in a position to tender for NHS referral contracts – so much ‘independent’ not giving rise to conflicts of interest.

BACP may be content to wait and see as to whether Dorries’ can deliver on her ‘assurances’ but in doing so they are ignoring a gaping – and,  one suspects, deliberately contrived – hole in Dorries’s proposals which serves to render her assurances entirely meaningless and, at the same time, place the reproductive rights of women under serious threat.

BACP’s ethical framework, its limited support for Dorries’ proposals and the ‘assurances’ it has received from Dorries relate only to the provision of counselling services, and to counselling services alone. In the context of an NHS referral for pre-abortion counselling to an anti-abortion organisation, there is nothing whatsoever to regulate or set ethical standards for the provision of information and advice outside the counselling process and, therefore, nothing to prevent women being subjected to false and misleading anti-abortion propaganda during the course of such a referral, provided that any such ‘information’ and ‘advice’ is given by members of staff who are not directly involved in the provision of counselling.

Dorries’ campaign for so-called ‘independent counselling’ is nothing more than a Trojan Horse which has been designed specifically to prople women who are considering terminating a pregnancy into a hostile environment operated by organisations whoseclear  intent is not to support women to make their own choices based on their own appreciation of what constitutes their own best interests but rather to persuade, if not pressure, women into choosing not go ahead with an abortion.

It is also worth noting, going back to the text of Dorries’ amendments – that the provision made for commissioning abortion-related information, advice and counselling services is merely discretionary. The text of the amendment specifies only that these services may be commissioned only ‘to the extent that the consortium considers they will choose to use them’ and it is, therefore, possible – hypothetically – for a GP consortium in which a majority of GPs are opposed to abortion for personal/ideological reasons to decline to commission any such services at all, leaving women with no recourse but to turn to the private sector and meet the costs of a termination out of their own pocket, should their GP also refuse to refer them on to an NHS hospital for a termination.

The devil is, as ever, in the detail and its only when one looks careful at the detail of Dorries’ proposals, and the dishonest methods she uses to secure ‘support’ for her campaign, that the full extent to which her amendments constitute an attack on women’s reproductive rights become apparent.

Personally, I’m of the opinion that BACP should reconsider its position on Dorries’ campaign and withdraw the limited support it has given to date. On the face of it, it has an entirely honourable way out the highly questionable position it find itself in insofar as the email’s that Tim Ireland received from Phillip Hodson suggest that Dorries’ campaign operated in a less than honest manner when putting forward the enquiry which secured BACP’s statement of ‘support’ and in promoting that statement as an expression of the organisations ‘full support’ for her amendments, when this is clearly not the case.

I’m am not, however, a member of BACP and, as such, I can only leave it to members of that organisation to decide for themselves whether or not they believe that it has adopted and ethically sound and justifiable position in relation to Dorries’ ‘Right to Know’ campaign based on the evidence that has emerged over the last couple of weeks.

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  • Anonymous

    What an amazing coincidence that just as Care Confidential
    tries to present an image of being independent from its religious fundamentalist
    roots and expands its service offering abortion counselling, information and
    advice…up pops Nadine Dorries, with a proposal to drive more business towards
    organisations like…Care Confidential.  
    Perhaps if abortion providers had MPs doing their business development,
    they wouldn’t need to employ staff to do this and they would then be able to
    offer their services at an even bigger cost saving to the NHS.

     

    And what a coincidence that Care Confidential’s only
    apparent benefit is that it is NACP registered and this becomes an additional
    requirement in Dorries’ proposal.  

     

    And even more of a coincidence that although bpas and Marie
    Stopes have been offering these services for over 40 years and also have well
    respected information, advice and counselling services for contraception, STIs
    and sterilisation, it is only the abortion part that comes into question.

     

    Where is the detail on how much these proposals will
    cost?   How will the abortion providers
    be prevented from setting up arms length organisations to offer these services
    as Care has done and how will they get informed consent for treatment without
    providing advice and information on the abortion procedure?

     

    Perhaps under this new Dorries principle, teachers shouldn’t
    give advice or information on education; police officers shouldn’t give advice
    or information on policing, the Department of Health shouldn’t give advice and
    information on managing the health service and perhaps, some MPs would be
    advised not to give advice and information on creating or amending legislation.

     

    If the Department of Health, the Care Quality Commission,
    the Charity Commission, the RCOG, the Chief Medical Officer, the press and most
    importantly their patients don’t have a problem with the way abortion providers
    offer their service, why should Nadine Dorries?

     

    Before this becomes another embarrassing U turn on a health
    issue, shouldn’t the government just quietly let this drop, or is there a
    hidden agenda and if there is, then who is behind it?   Cameron has come out in favour of reducing the term limits on abortions and restricting
    the woman’s right to choose.   Lansley is
    also in favour of reducing the upper limit for abortions to take place and Milton,
    the Public Health Minister is on record as saying that reducing the abortion rate was “an absolute
    priority” for the Government.

     

    So
    is it just a further coincidence that Dorries total disregard for the facts and
    evidence has been allowed to gain momentum and who is going to provide some
    common sense here?

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