Jeremy Hunt has no evidence for his abortion stance

Health Secretary says 24-week limit should be halved to 12 weeks. But where's his evidence?

Jeremy Hunt appears intent on proving as controversial in his new job as he did in his old one. In his first newspaper interview since becoming Health Secretary, Hunt declares his support for halving the legal time limit for women to have abortions, from 24 weeks to 12. He tells the Times (£):

I'm not someone who thinks that abortion should be made illegal. Everyone looks at the evidence and comes to a view about when that moment is and my own view is that 12 weeks is the right point for it.

It’s just my view about that incredibly difficult question about the moment that we should deem life to start. I don’t think the reason I have that view is for religious reasons.

Hunt voted in favour of a 12-week limit in 2008, so this isn't the first time he's expressed his views on the subject, but his promotion to Health Secretary means they have taken on a new significance. Downing Street has emphasised that Hunt was expressing a personal view and that it has no plans to change the current law, something that would require a free vote by MPs. But at the very least, Hunt's status as Health Secretary affords him a powerful platform to argue for a lower limit and, upsetting the Tories' pre-conference preparations, he has chosen to do so.

In response, health professionals have warned that a 12-week limit would effectively end testing for conditions such as Down’s syndrome and force women into having terminations before they are ready. Just eight per cent of abortions currently take place after 12 weeks.  Kate Guthrie, spokeswoman for the Royal College of Obstetricians and Gynaecologists, told the Times:

If everybody had to have abortions by 12 weeks, my worry would be that women would be rushed into making decisions: ‘I have to have an abortion now or I can’t have one.’ That’s an absolute shocker. You will absolutely create mental health problems if you start dragooning women into making decisions before they have to.

The paper's columnist Alice Thomson points out (£):

The vast majority of those whose abortions take place after 12 weeks have a good reason for the delay and are the most complicated cases. It’s the women who have abortions before 12 weeks who tend to be more likely to be using abortion as a lazy contraception. The cases after 12 weeks tend to be young girls who didn’t realise they were pregnant or suspected that they were but were too afraid to discuss it, or women in their late 40s who believed they were menopausal and are worried about the risks of late motherhood.

One searches in vain for any consideration of these points by Hunt or any "evidence" in favour of a 12-week limit. The Health Secretary is entitled to his views - would we rather he concealed them? - but he will be judged accordingly.

Health Secretary Jeremy Hunt said "my own view is that 12 weeks is the right point for it". Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear