Complications from Abortions (Annual Report) Bill [HL]

(Limited Text - Ministerial Extracts only)

2nd reading
Friday 13th December 2024 Lords Chamber

[Lord Frost (Con)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Foster, who spoke, as she always does, powerfully, compellingly and rationally—it is important keep that rational focus on this important Bill. I thank my noble friend Lord Moylan, who set out the rationale for it clearly, compellingly and in some detail, and I am delighted to have this opportunity to support it.

Whatever one’s views on the substantive question of abortion, I find it hard to see why we would not want as much information as we could possibly get on this question, especially when, as my noble friend Lord Moylan noted, there is clear evidence for at least a potential anomaly that needs addressing in the statistics. It is surely in the interests of any woman considering an abortion to have the best possible information about the possible risks involved.

In the short time available, I want to make one further point to those that have been made already, on the objection from the British Pregnancy Advisory Service—which the noble Lord, Lord Moylan, has already noted—that this Bill would in some way “exceptionalise” abortion. I find that worthy of a brief comment. As the noble Lord said, abortion is already exceptional in various ways. One might note in passing that it is the only form of healthcare that has required the suspension of free speech rights—and even non-speech rights, those of free thought—to allow it to be transacted. Passing on from that, more substantively, it is exceptional because it is one of those areas of care where there really are starkly clashing worldviews. I am sure that we will hear much more about that later on this morning. That means that it always is going to be subject to debate, unless there is some fundamental change in the ethical basis of our society. Therefore, ways through have to be found, in a free society, to accommodate that.

The need for debate around abortion provision will, and I think should, always make it exceptional. It means that we need that debate to be as well-founded as we can possibly make it—well-founded in the moral judgments that we bring to it and well-founded in having the best possible information and analysis around it at a technical level. That is what this Bill would help to provide, and that is why I support it.

--- Later in debate ---

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I thank the noble Lord, Lord Moylan, for tabling this Private Members’ Bill, and all noble Lords for their contributions. For my part, I am looking at the main purpose of the Bill, which is to impose a legal duty on the Secretary of State to

“publish and lay before Parliament an annual report on complications from the termination of pregnancy in England under the Abortion Act 1967”.

I note that the purpose of the annual report is

“to inform policy and safe practice regarding the termination of pregnancy”.

Of course, this Government are entirely committed to safety being a top priority. However, the Government have also expressed reservations about the Bill on the basis that, as many noble Lords have said, legislation is not needed. My feeling, in listening to the debate, is that the Bill is something of a solution in search of a problem. The aims of the Bill can be achieved through existing routes—as the noble Baronesses, Lady Sugg and Lady Miller, among other noble Lords, indicated—and further legislation is unnecessary. I know that noble Lords completely understand the need to uphold a duty of care not to legislate when there are other reasonable processes in place.

As we have been reminded, the context in which we are having this debate is that abortion in Great Britain is governed by the Abortion Act 1967. I appreciate it is not in the Bill but, having listened to the debate—and the context given by the noble Baronesses, Lady Bennett and Lady Barker—any change to the circumstances under which abortion can be legally undertaken is a matter of conscience for individual parliamentarians, rather than for the Government. The Government follow the will of Parliament.

On the matters highlighted in the Private Members’ Bill, I agree with the noble Baronesses, Lady Sugg and Lady Bennett, and other noble Lords, that abortion continues to be a very safe procedure in which major complications are rare at all gestations. This has been supported by existing data and clinical guidance from the National Institute for Health and Care Excellence, NICE, and—as has been referred to a number of times already—the Royal College of Obstetricians and Gynaecologists.

It is a legal requirement that all terminations performed under the Abortion Act must be notified to the Chief Medical Officer within 14 days of the procedure. These notifications are submitted via HSA4 abortion notification forms and the abortion notification system. Complication rates by procedure and gestation, as routinely recorded by that system, are published as part of the abortion statistics report for each calendar year. According to the HSA4 notifications submitted in 2022, complications were reported in 1.2 per 1,000 abortions in England and Wales.

The abortion notifications submitted to the Chief Medical Officer record known complications, as raised a number of times in the debate, up until the time of the patient’s discharge from the abortion service. Complications that occur after discharge are not required to be recorded on HSA4 notifications and I suggest that it would present a complete impracticality to do so. Complications are also recorded in other patient record systems such as hospital episode statistics, where the woman has been admitted as an inpatient. Of course, serious incidents have to be notified to the CQC.

On the specific point about the annual report, the comparison publication was never intended to be a part of the then-Government’s routine publications and, in keeping with this, we have no plans to issue a similar publication annually. In answer to the noble Baroness, Lady Sugg, it is not believed—and clearly the previous Government did not believe, beyond producing one report—that this is a good use of resources, nor that it adds anything to patient safety. That, as the noble Lord, Lord Scriven, rightly reminded us, is exactly what we are here for.

I have heard the noble Lords, Lord Frost and Lord Moylan, along with other noble Lords, and while they have not used this word, I feel that they have taken exception to it being said, “this Bill would exceptionalise abortion”. I emphasise—as the noble Lord, Lord Scriven, and others did—that no other complications from NHS procedures are separately required to be published through legislation. I am afraid I cannot call that anything other than exceptionalism towards abortion in this instance. However, I can give the assurance to your Lordships that we continue to work with providers and commissioners to ensure that abortions are delivered safely, in accordance with the Abortion Act, and that complications are recorded accurately as required.

We are inviting views on abortion statistics for England and Wales, including the future publication of abortion complications data, via an online user engagement survey and via email. In other words, we are not complacent; we are always seeking to improve.

The noble Baroness, Lady Foster, asked about data on abortion in Northern Ireland. It is collected by the Department of Health in Northern Ireland because, as I know the noble Baroness is aware, it is a devolved matter. The noble Lord, Lord Moylan, asked why there is not a recording of what were referred to as incomplete abortions. For the abortion notification system, the HSA4 form explicitly states that

“an evacuation of retained products of conception is not a complication”,

and therefore they are not included in the ANS complication rates.

I absolutely share the passion of the noble Lord, Lord Scriven, for improving NHS data provision across the board, and I am glad to assure him that this will be an integral part of the 10-year health plan. To the noble Baroness, Lady Sugg, I say that the existing ANS is used to ensure that patients are receiving safe and appropriate care, as abortion tends to be provided by private providers. That data can be helpful to ensure that it is delivered safely and effectively, but it is our view that we do not need any further statistical reporting—and certainly not in the way described in the Bill—because, as I emphasise, I believe this would exceptionalise abortion without adding to patient safety. I am glad to welcome the comments of the noble Lord, Lord Sandhurst, who is as committed to that as all noble Lords in this House.

The Government have expressed reservations about this Private Member’s Bill. This is an unnecessary process: mechanisms already exist, it will not add to patient safety, and it is therefore not appropriate to legislate further.