Telemedical Abortions

Question

Asked by

To ask His Majesty’s Government what assessment they have made of recent proposals to extend access to telemedical abortions, and how they will ensure women’s safety and informed consent in the absence of in-person medical consultation.

Before I respond, I join the Lord Speaker—I am sure on behalf of the whole House—in extending our condolences sincerely to the late noble Baroness’s friends, family and loved ones. We will miss her greatly.

The Government have no plans to extend access to telemedical abortions. As with other matters of conscience, abortion is an issue on which the Government take a neutral stance. It is for Parliament to decide. The safety of women accessing abortion services is of paramount importance. All providers are required to have effective arrangements in place to ensure women’s safety and to obtain informed consent.

My Lords, before I ask my supplementary, I pay tribute to the noble Baroness, Lady Newlove, who was so brave and effective in all she did in this House and in her work for victims after the murder of her beloved husband, Garry. Helen had such compassion and courage, and she really was such a lovely person that she will be sorely missed, not only by her family, to whom I am sure we all send great sympathy, but by so many of us in this House and in the world beyond. We were indeed blessed by her presence among us.

I thank the Minister for her reply. It is not possible on the telephone to ensure a woman’s privacy, to ensure that she is not being coerced, or to verify that the woman seeking the medication is actually the person who will take it, particularly in cases involving domestic abuse, child abuse and trafficking. Government stats show that, since 2020, 54,000 people have been admitted to hospital in England for complications from abortion pills. Last year alone, some 12,000—over 6% of women taking such medication—required hospital treatment. To safeguard women and girls, will the Minister take action to restore the requirement for face-to-face consultations? Will she also assure the House that there will be no extension of the time limits for access to medical abortions?

My Lords, the evidence base for telemedical abortion is sound. It has been thoroughly evaluated and it is recommended as safe by the World Health Organization, the Royal College of Obstetricians and Gynaecologists, and NICE’s evidence-based guidelines. There are no plans to do what the noble Baroness has requested, and I have to say that I do not recognise the statistics she raised, although I would be interested to hear more about them. But I assure your Lordships’ House that telemedical abortion is and must be carried out in line with clinical guidelines published by the royal college.

Can the Minister confirm that the changes voted in to the Crime and Policing Bill in the Commons do not extend the provision of telemedicine, and that the 10-week limit remains? The introduction of telemedicine has meant that 40% of abortions now occur at less than six weeks’ gestation, in comparison to 25% previously. Does the Minister agree that the earlier that women can access abortion, the better it is for their health and well-being?

I certainly can confirm that the changes voted into that Bill involve no change to the provision of telemedicine. To the noble Baroness’s other point, we would need to review the data, including the available data in respect of her question about health and well-being, on which I would be pleased to write to her further.

We on these Benches would like to note that the dedication of the noble Baroness, Lady Newlove, to sticking up for victims applied no matter who was in government at the time, and that was a very laudable thing to witness in this House.

Does the Minister agree that all the peer-reviewed evidence suggests that women who are in vulnerable situations find it easier and safer to access abortion services on the phone, and that study after study has shown that professionals employed in those services are very well attuned to finding out what, if anything, is happening to the person on the end of the phone, particularly if they are under duress?

I most certainly can agree with the points the noble Baroness has rightly made. There is a very clear pathway to providing safe care. The provision of telemedicine in this regard came in in 2022, and it has given safe abortions further ballast, so it is nothing other than a safe procedure, as I mentioned earlier.

My Lords, I associate myself and these Benches with the kind tributes paid to the noble Baroness, Lady Newlove. She was a fierce campaigner, particularly after the sad and premature death of her husband—in fact, her death could be seen as premature, and we will all miss her greatly.

As the Minister and other noble Lords have said, much of the clinical evidence shows that telemedicine is just as safe as administering medication in a clinic. However, whatever your views on abortion, there are clearly some concerns about the coercion of women. Can the Minister repeat her assurance to the House that telemedical abortion consultations will include robust safeguarding assessments carried out by trained clinicians? Can she assure us that, if there are any concerns about the safety of women, or that women may be being coerced by an abusive partner into seeking an abortion, they are referred to an in-person appointment?

I certainly can confirm that, and I am grateful to the noble Lord for emphasising the point. Two doctors have to certify that in their opinion, the abortion meets the grounds of the Abortion Act. For a telemedical abortion, the doctor must also certify that in their opinion the pregnancy has not exceeded 10 weeks at the time when the first pill is taken. Let me also say that, if there are any concerns, the woman will be asked to attend an in-person appointment.

My Lords, can the Minister ensure that, whatever the umbrella of this legislation is, it will cover women in a variety of circumstances? We all know that, unfortunately, many women live in situations where they do not have much control over their own lives. There is also, of course, the circumstance where a woman might happily find herself pregnant, only to discover a couple of months later that something else has happened and it is going to be a disaster. We need to ensure that, whatever the different circumstances that women might find themselves in, the legislation will enable them to access whatever is right for them and their families.

My Lords, I do understand the point my noble friend makes. I can indeed assure your Lordships’ House that, while the Abortion Act is at the heart of this, we have other Acts of Parliament and, as I said at the outset, it is right that Parliament makes that decision. In addition to the groups my noble friend refers to, we commissioned, for example, the Royal College of Paediatrics and Child Health to develop new safeguarding guidance for children and young people under 18 who are accessing medical abortion services, so we understand her concern and are acting on it.

My Lords, the extension of the regulations to enable early medical abortion to be provided without requiring in-person medical consultation was a significant change. We have heard about the tragic cases of early medical abortion pills being provided outside the law and women being put at risk as a result. We are now three years on from this change. What data has been collected in that time and what does it tell us about the workability of the new system in providing safe abortions within the law?

The data available does not point to concerns about the provision of telemedicine. I should emphasise that, of course, abortions can take place only in an NHS hospital, in a place approved by the Secretary of State, or via telemedicine at the woman’s usual place of residence. Approval has to be given by the Secretary of State, and there is inspection by the Care Quality Commission, which inspects providers. The data thus far does not flag a difficulty in respect of telemedicine. In fact, all aspects of this are saying that this ensures that this safe procedure is assisting the situation for the women concerned.