Issue 191 of SOCIALIST REVIEW Published November 1995 Copyright © Socialist Review

The government has been forced to climb down over the recent announcement on the safety of the contraceptive pill, amid increasing signs that cost cutting was one of its key motivations.

A million and a half women, 50 percent of all pill users in Britain, were warned by the Department of Health that they should consult their doctors before starting their next packet. The Committee on the Safety of Medicines advised the government that seven leading brands containing the hormones desogestrel and gestodene could lead to a doubling of the risk of developing thrombosis.

But both the World Health Organisation and a doctor responsible for one of the unpublished studies, on which the new advice is based, have accused the government of scaremongering and acting too hastily.

A previous pill scare in 1983 led to a sharp rise in unwanted pregnancies and abortions. The Family Planning Association has stressed that women should not panic. Pregnancy carries at least twice more risk of thrombosis than taking any of the pills named. And the pill has a number of well documented health benefits. Over 4,000 women die every year as a result of ovarian cancer. Another 2,000 die from cancer of the womb. The pill reduces a woman's chance of developing either of these by half.

The biggest obstacle women in Britain face is obtaining a full range of contraceptive services. Family planning clinics are being closed down all around the country.

One possible explanation for the government's apparent keenness to publicise the slightly increased thrombosis risk with certain pills may be linked to cost. It has been estimated that the government could save up to £25 million a year if women switched to the older, lower cost pills.

The seven brands of pills named are all so called third generation pills containing newly developed hormones and they cost around £2 per packet. Many women will be changed back to second generation pills which only cost about 60p. But second generation pills can cause more side effects.

There are alternative third generation pills available, such as Cilest, that don't contain the implicated hormones, but they also cost more.

Just last year the government attempted to remove certain pills from the approved NHS prescription lists as a cost cutting exercise. Two of the pills the government wanted to axe, purely on the grounds of cost, contained the hormone gestodene. These two pills appear again on the latest hitlist.

Another new contraceptive method, the Intrauterine System (IUS), is also a victim of cost cutting. It offers women the benefits of a low maintenance coil without many of the old side effects.

However, many doctors are reluctant to offer this method because the cost of £120 would be attributed to a single financial year--even though, spread over three or five years, it would work out cheaper than the pill.

The pill is far from perfect but it has undoubtedly transformed the way women can control their own fertility.

The government is in the process of radically altering the ways in which some medicines are available. It is very likely that the morning after pill will soon be available to buy over the counter. This has led to fears that it is dismantling free provision of all contraception on the NHS.

While women should be given full information about contraception, it is obvious that lack of effective research and cost cutting within the NHS are the real problem. It seems likely we are going to find it increasingly difficult to get either the information or the services we need.
Andrea Butcher