The Cholesterol

Family Planning Association and the Brook Centres has largely failed to contact social classes 4 and 5-who make up the greater part of the population. Local authorities were given power under the Family Planning Act of 1968 to set up birth control clinics, but few seem to have done so. Sir John Peel comments that "gynaecologists as well as general practitioners are getting more and more incensed by the increasing demand that they should recommend and carry out abortions within the Health Service for purely social convenience and yet are prevented from prescribing the drugs and issuing the appliances necessary for effective contraceptive practice as freely within the Health Service as any other drugs and appliances, unless there exists what is called a medical indication. " Is this the answer? Is there a good case for including contraceptives in the N.H. S. whatever the indication? If it became accepted that "you get your contraceptives from your G.P." there might be less embarrassment about asking for them. Family doctors know how often mothers of problem families are advised to use contraceptives but do not: the logical solution is for the doctor himself to do something about it. He can recognize many patients at risk as they come into his surgery for routine consultations: he should be able to offer them a prescription or fit an appliance on the spot. Just as important is contraceptive advice for women in hospital for abortions or delivery of babies. Referring the patient to a clinic or another doctor too often means that nothing is done. A major objection to free contraception is the costperhaps £20 million a year-described by the Secretary of State as a gratuitous waste of taxpayer's money. Some doctors may argue that people should be encouraged to take more and not less personal responsibility, and that free contraceptives would be yet another example of the mollycoddling of the Welfare State. But how many abortions and illegitimate births would need to be prevented to balance the account? The effects of such a change can only be guessed at, yet no other alternative has been put forward which seems likely to have any significant effect on the current rising trends in unwanted pregnancies. A second objection is that family doctors, already overworked, would be asked to take on yet another item of service. Again the effects can only be estimated, but there should be some reduction in the number of consultations for abortion. It would certainly help if the Review Body could be persuaded to price this service. So this would be the bargain. On the one hand doctors should refuse to compromise their principles and should not accede to popular pressure for abortion on demand. This attitude can be supported only by an unambiguous commitment by Government, family doctors, and gynaecologists to offer contraceptive advice and appliances within the N.H. S. to all comers (with the proviso that in this field as in any other, sincerely hold reliWious convictions must be respected, and that most doctors will do their best to dissuade teenagers from sexual experience at too early an age). Once such a service is available, unprotected sexual intercourse resulting in unDlanned pregnancy can be seen for what it is in an age of effective contraception-an example of thoughtless self-indulgence.