There are over a thousand tabled amendments to the Health and Social Care bill. The debate is scheduled for just two days (tomorrow and Wednesday).

Is it not remarkably convenient for the for the government propaganda machine and the Tory Whips that all attention is on this one of those amendments and the ever-ready Nadine?

“It aims to ensure that any organisation contracted by the NHS to provide pregnancy decision-making support must meet the same high standards of medical accuracy and impartiality which abortion providers currently maintain, and seeks to prevent organisations which are ideologically opposed to abortion or which offer biased, inaccurate or judgemental advice from becoming part of any formal NHS care pathway.”

Huh?! The whole point of the amendment is that the supposed “impartiality” you refer to here is a myth, and to suggest otherwise beggars belief. Would you suggest that if Vodafone was discussing with you tariffs for theirs and Orange’s phones, that Vodafone was impartial? Of course you wouldn’t yet here somehow you think that the advice is impartial when the giver of that advice gets paid only if the woman says yes. How, in any sense of understanding of the word impartial, can that be impartial?

Then why rule out those ideologically opposed to abortion, but allow those ideologically in favour of abortion? I think that’s the most important point here. And how, exactly, do you propose this happens, in reality?

Of course you wouldn’t yet here somehow you think that the advice is impartial when the giver of that advice gets paid only if the woman says yes.

Except that the giver of that advice also only has to spend money in the first place if the woman says yes, and since they’re charitable non-profits it therefore makes no difference to their net financial position.

Cim

> Except that the giver of that advice also only has to spend money in the first place if the woman says yes…

That’s completely wrong! Who pays for the salary of the advice giver? It comes from the money gained by performing abortions! So they DO incur costs in giving advice -and the ONLY way they get recompensed is when the women says yes

Why do so many on LC find that logic so hard to grasp?

The huge number of LC folk who tweeted on this issue, sounds it’s a case of group think: abortion choice good: anything else bad.

I just had a thought – are the counsellors at BPAS unpaid volunteers?

It doesn’t look like it – the word ‘volunteer’ does not appear anywhere ontheir website, says Google.
And they have about 20 job vacancies, and all are professional medical ones.

Just Visiting: That’s completely wrong! Who pays for the salary of the advice giver? It comes from the money gained by performing abortions!

Could you give me your source for the NHS not separately paying for the advice services?

Remember that BPAS provides general advice – contraception, sexual health, etc. – it’s not just a provider of one medical procedure. So I would expect the advisors get paid whatever people decide to do.

So they DO incur costs in giving advice -and the ONLY way they get recompensed is when the women says yes

If you follow this logic through, and assume that the primary interest of medical staff is profit [1], NHS abortion advice must be strongly biased against abortions (if you don’t have one, they don’t need to spend money)

[1] Since the whole idea of “independent” advice seems to be a US import, I can understand that it hasn’t had this bit filed off on its transatlantic flight.

And they have about 20 job vacancies, and all are professional medical ones.

Well, yeah. If I was going in for a medical procedure, I would want the people hired to carry it out to be medical professionals too.

Cim

> Could you give me your source for the NHS not separately paying for the advice services?

Sorry, I may have been wrong – I’d not considered the possibility that BPAS may be paid one explicit sum for ‘abortion advice’ and a seperate explicit sum fot abortions.

But whether that is the case or not – the general point remains of potential bias, because of the abortion income.
Unless the ‘advice’ income is much higher than the abortion income, then there is an inevitable focus in BPAS on abortion as it’s their main money maker: and therefore an incentive for abortion income not to drop; and so quite likely to be pressure (overt or covert) on the advice dept to ‘fit in’ with the overall organisation focus on abortions.

>> And they have about 20 job vacancies, and all are professional medical ones.
> Well, yeah. If I was going in for a medical procedure, I would want the people hired to carry it out to be medical professionals too.

Just noteworthy that no ‘advisors’ job vacancies exist – ? Are all advisors medically trained? Or are there a tiny number of advisors as compared to practitioners.

More info on BPAS:

A)
They are a member of Voice for Choice, which in it’s briefing for MPs in 2008 says:

> Polls of general practitioners have shown that 18-24% describe themselves as broadly anti-abortion and do not refer women.

That’s quite a large percentage.

B) The BPAS website says:
> We offer a real choice to our clients, providing the most appropriate procedure to you based on information, advice and your needs and wishes.

Interesting use of the word ‘procedure’ – which is normally short hand for ‘medical procedure’: suggesting that BPAS’s choice does not include those declining medical intervention.

Is that just poor chooce of words, or freudian slip ?

@66 – Mirror, mirror…

Fanaticism like yours is, as ever, the enemy.

Grah, wrong thread. My bad!

@6 – Without that information, the discussion can’t be conducted on a rational basis, really.

CIM

I’ve not found any breakdwon of revenue from BPAS, their last annual report to the Charity commissioners lumps advice + abortion procedures into one sum:

Termination of Pregnancy advice treatment and care
Revenue: £23.2 M

And reading their mission statement – it is concerning:

bpas mission is to support reproductive choice by advocating and providing high quality, affordable services to prevent or end unwanted pregnancies with contraception or by abortion</blockquote.

So they say – that what they do is advocate and deliver abortion: not that what they do is offer impartial advice….

That mission statement could equally to high-sugar drink companies who could claim to 'support nutrition choice' by advocating and providing high quality sugar-rich drinks !

edit fail…. those last 2 paragraphs are mine.

Their annual report also says:

bpas exists to Provide support and care for women seeking legal abortion

Women seeking abortion? That suggests ‘women who have already decided they want an abortion’.

So they are not tere for women who have not made up their minds yet?

Wouldn’t a better aim be : “to support pregnant women who are considering abortion as one of several choices’ ?

Just Visiting: “Viestintä yleensä epäonnistuu, paitsi sattumalta” [1], as they say in Finland. Probably when they wrote those sentences they didn’t expect to have to make them completely semantically bulletproof against people looking for alternative meanings (which would be impossible anyway, of course)

I would read “advocating” in the context of that as “advocating high quality, affordable services”, which seems to be the more natural reading of that sentence.

Alternatively, by looking at that sentence in the context of the entire “aims” section, which later says “Advocate the need for safe, legal abortion” you could read “advocating” as entirely separate to the rest of the sentence – so “Advocating” is one aim and “Providing services for contraception and abortion” is another. That’s also plausible.

Also, bear in mind that there are three sorts of “advice” here:
1) Advice on how abortion procedures should be carried out for particular individuals. There is no need for this to be impartial. Indeed, one doesn’t want this to be impartial. Likewise for all other medical procedures: you’d want advice on “local or general anaesthetic” to be given by your anaesthetist for the operation, or perhaps the co-ordinating surgeon, not an impartial “expert” not employed by the hospital [2]
2) Counselling for people unsure as to whether they need any of the medical procedures on offer. Counselling should always be impartial, but is explicitly not advice.
3) Advice on contraception and sexual health unrelated to abortions, which BPAS also provides on NHS contracts.

I would read your quoted statement B in comment 8 as referring to the first and perhaps third type of advice, not the second type.

Women seeking abortion? That suggests ‘women who have already decided they want an abortion’.

Anyone referred to BPAS by the NHS for an abortion has already had to get the agreement of two doctors for the referral. I think it’s reasonable to describe them at that stage as “seeking an abortion”. It doesn’t mean that they can’t or won’t change their minds, or that the “support” will in all cases consist of providing an abortion for them.

(And it’s hardly their only aim either.)

Wouldn’t a better aim be : “to support pregnant women who are considering abortion as one of several choices’ ?

What if they’re only considering abortion as one of two choices? Is “two” several?Or what if they have already decided? Shouldn’t they be supported too? (As I said, writing unambiguous text, especially in a few short words, isn’t possible. But I don’t think the current wording is particularly unclear or implies a single narrow focus: “support” can be interpreted broadly)

As regards the revenue breakdown or lack thereof, I’m not sure you’ve shown any of the evidence necessary for there to be an actual acted-on conflict of interest.

– you haven’t shown that the NHS-BPAS contract only pays for the abortions themselves, with advice, admin overheads, contraception services, etc. having to be paid by taking a bit of money out of each abortion payment (as opposed to paid separately, or as a general annual fee, or whatever). Without that there isn’t a financial conflict of interest at all. Likewise you haven’t shown that BPAS aren’t paid per referral, as opposed to per termination. If that were the case they would have a financial incentive to discourage abortions. Or they could be paid something for each referral, and additional costs for each termination resulting from referrals, in which case there’s no financial incentive in any direction. Or they could be paid an annual fee based on the number of referrals the NHS expects to send them in that year. There are several different funding models that could be agreed in the outsourcing contract, very few of which even give a potential financial conflict of interest.

– you haven’t shown that, even if those were the case, that as a non-profit BPAS has any financial interest in increasing the number of abortions that occur (as opposed to the ease of access for those that do). So even if there is a potential financial conflict of interest, you haven’t shown that there is an actual one.

– you haven’t shown any evidence that people who go to BPAS for an abortion (who, as above, by definition, have already talked to two separate doctors about it) are being badly advised. So even if there was an actual financial conflict of interest, you haven’t shown that they’re acting on it over both their professional medical duty of care to patients and the maintenance of their professional reputation and accreditation. (It’s probably not the medical staff doing the contract negotiations with the NHS, or balancing the books, so you’d also need to show that the staff specifically, rather than the organisation, also have such a conflict)

That’s not to say that there can’t possibly be a live acted-on conflict of interest leading to poor patient care – but the evidence presented so far seems to consist of “the medical staff don’t work for free, and medical equipment also costs money” and “a text written in English has multiple potential meanings” which doesn’t seem remotely sufficient.

[1] Rough translation: “Communication always fails, except accidentally”
[2] Well, or perhaps you wouldn’t. Perhaps you’d be suspicious that they’d obviously be trying to push you towards a local anaesthetic regardless of whether it was medically desirable or in your best interests, because that would be much cheaper for them. But if that’s the case there are severe issues with the entire NHS and private health care system, and concentrating on abortion alone leaves 99.999% of them ignored.

CIM

you haven’t shown that, even if those were the case, that as a non-profit BPAS has any financial interest in increasing the number of abortions that occur

But that is EXACTLY one of the stated aims of BPAS -read their documents to the Charity Commission.

They say themselves they want to do more abortions!

They say that the extra abortions they did last year; plus cost savings they have made means their costs were £1M less than their income last year.
And that they want to raise that ‘cash left over’ to £2M this year. Money that they choose how to spend (within limits). Their money.

QED.

CIM

PS I ignored your long word games. Were you trying to bury the issue at hand in obtuse verbosity? Quoting a Finnish phrase suggested a great desire to wander away from the focus….

@ Just Visiting

“But that is EXACTLY one of the stated aims of BPAS -read their documents to the Charity Commission.

They say themselves they want to do more abortions!”

Have you got a source? Because there’s a big difference between “we want to do more abortions because they’re great” and, e.g., “we want to make more women aware of their options, which would be expected to raise the number of abortions, for which we would therefore need to be prepared”.

“They say that the extra abortions they did last year; plus cost savings they have made means their costs were £1M less than their income last year.
And that they want to raise that ‘cash left over’ to £2M this year. Money that they choose how to spend (within limits). Their money.”

The organisation’s money, yes, but as it’s a non-profit, it presumably isn’t going into any individual’s pocket beyond the wages they’d get paid anyway. Which is kind of the point: there isn’t a financial incentive.

They say themselves they want to do more abortions!

There’s a difference between “of the abortions which are carried out in the UK, we would like to do a greater proportion of them” (presumably as they believe they are able to provide a higher standard of care?) and “we would like there to be more abortions carried out in total in the UK” [1].

You could call this “word games” or you could call it “reading sentences in the context of the entire document, rather than out of context to seek the worst possible meaning”.

And quite obviously even a non-profit should be aiming to run a small operational surplus – and £1M on a turnover of almost £24M is small – so that it can build up reserves against contingencies, for capital spending, and so on. Given current economic uncertainty, wanting to have a slightly larger reserve seems entirely reasonable.

[1] Given that BPAS also provide contraception and sterilisation (advice and procedures) the successful provision of which will reduce the total number of abortions needed, any reading that suggests that they want an increase in the total number is implausible.

You can see the BPAS accounts for your self:

http://www.charity-commission.gov.uk/Accounts/Ends45%5C0000289145_AC_20100331_E_C.PDF

They are not so helpful, in that counselling and giving abortions are always bunched together – so no breakdown available.
Not sure if they do that on purpose, eg lines like this suggest that there is 1 consulting per abortion,why don’t they show the two numbers seperately?

Total number of consultations and abortions was 109,596

Also, nowhere do they saw what they are paid per abortion, or per consulation.

But in answer to CIM and Chaise, this is what BPAS say:

Significant achievements in 2009-2010…… an additional 2,400 NHS procedures in 2009 over 2008

Note that ‘procedure’ I guess means abortion.

….. operating surplus before pension costs, depreciation and refurbishment of £2.6M

Goal 3:
Generate a surplus £2M before depreciation and refurbishment …
…
Plans for future periods:
Build on the financial successes of previous years

Their Head Office costs (inc staff) are fairly high: £5.3M out of £23M. I’m not sure exactly: but nearly 25% head office sounds rather ‘HQ heavier’ than private companies.

Staff salaries total are £11M of the £23M.

Average full-time equivalent staff headcount: 339
At average salary of: £32,300.

7 staff are on over £60K, of which: 2 are over £100K

They are not so helpful, in that counselling and giving abortions are always bunched together – so no breakdown available.

Large amounts of bundling is fairly typical of published accounts. (Rather than internal management accounts). I doubt you’d find that many charities publishing significantly more detail.

(I checked a few charities in unrelated fields with similar results – and also similar statements in their annual plans about how they intended to raise more money next year)

Note that ‘procedure’ I guess means abortion.

Includes, yes. They also, among other things, carry out sterilisations, vasectomies, and vasectomy reversals, which can reasonably be described as medical procedures.

At average salary of: £32,300. [...] 7 staff are on over £60K, of which: 2 are over £100K

Medical professionals get paid a fair bit, after all. I was actually surprised that their high-wage staff are so few in number, given how expensive doctors are to hire.

Just Visiting, no amount of tedious, inane, whining on about how/why an organisation is paid, what it presents in its accounts etc is actually evidence that it’s doing what you and other religiously inspired intellectual dwarves are claiming.

Do you have any actual, real, statistical evidence to suggest that

a.) women who have counselling from BPAS are more likely to have an abortion than women who don’t

b.) if they are, it’s necessarily a bad thing?

No, of course you don’t. That’s why you’re reduced to “oooh, their accounts aren’t very clear …..WELL, I WONDER WHY THAT IS, EH? nudge-nudge, wink-wink.”

I’m guessing that your burning desire for balance and fairness would evaporate if the counselling was being offered by the George Bush Foundation for Religious Stupidity.

Apathy

Why so aggressive towards me? I’ve only asked a very obvious and prudent question – could the BPAS have a bias in their counselling given the model of their financial incentive.

> I’m guessing that your burning desire for balance and fairness would evaporate if the counselling was being offered by the George Bush Foundation for Religious Stupidity.

You are showing your own bias.

If I was talking about your ‘george Bush Society’ you would NOT be pooh-poohng my question ! You would be absolutely concerned about the lack of clarity and potential for bias.

But because it’s the BPAS, you willing to waive normal critical facilities, and to ignore a sensible calm question. Yo’re trying to shutdown the discussion, by wanting evidence before th question is explore.
Simply because you are pro-abortion and therefore BPAS are in your tribe.

Just Visiting, what you were, in fact, doing was implying that there is bias in BPAS advice. But, for the moment, let’s go along with your obvious lie that you were only asking “a very obvious and prudent question – could the BPAS have a bias in their counselling?” How should such a question be answered? By examining the evidence, surely. What actual evidence do you have that there is bias? None. If you did, you’d have provided some.

And ” Yo’re [sic] trying to shutdown the discussion, by wanting evidence before th question is explore” is priceless, even for you. I mean, who ever heard of actually introducing facts or evidence into a discussion? Obviously, the best way to proceed is to extrapolate from your interpretation of the way they present their accounts to the quality and nature of ttheir counselling. So, I repeat, what actual evidence do you have that there is bias?

“If I was talking about your ‘george Bush Society’ you would NOT be pooh-poohng my question ! You would be absolutely concerned about the lack of clarity and potential for bias.” Ah, yes, pretending to misunderstand the point. On the other hand, maybe not pretending. Maybe you’ll understand this: I suggest that, if the organisation providing the counselling was a christian one then, because you’re a religious bigot, you wouldn’t be complaining. That clear enough for you?

Back to the question of evidence, and the lack of it, in everything you write. Do you have any to support your claim that I’m “pro – abortion” (whatever that means)? The fact that I point out that you write garbage doesn’t count as evidence of my views on abortion, by the way. It’s a pretty good indicator, though, of my views on you and similar small minded people who seem to think that their belief that magic is contained in a much translated text, of questionable provenance, listing the folk tales and superstitions of a bronze age tribe of middle eastern nomads provides sufficient justification for them to attempt to impose their own nasty little prejudices on other people.

Finally, why so aggressive? I’m not being aggressive. I’m pointing out that what you write is rubbish and why. I know that must be hard for you but try and take something positive from the experience.

No evidence then, JV?

Waiting for that evidence, JV

And still no evidence from JV.