Crime and Policing Bill

Baroness Gerada Excerpts

Report stage
Wednesday 18th March 2026 Lords Chamber

[The Lord Bishop of Leicester]

My Lords, I shall speak to the amendment in my name, Amendment 426D. I start by thanking the Minister for meeting me a couple of weeks ago to discuss this matter—and I want to be direct at the outset about what the amendment would do and would not do.

The amendment is distinct from Amendment 425, which stands on its own merits, and which your Lordships will consider on its own terms. This amendment says nothing about adult women’s access to abortion, nothing about where medication is taken and nothing about the broader questions that have been part of our debate up till now. It rests entirely on one safeguarding principle—that when a child is the patient, a professional should meet her before prescribing. I believe that that is something that your Lordships can support, regardless of the views that you hold on everything else before the House today.

The amendment is brought on behalf of the National Network of Designated Healthcare Professionals for Children—NHS doctors and nurses who carry statutory safeguarding responsibilities for children across every local safeguarding partnership in England. Its concern is that the needs of children, particularly looked-after children who become pregnant, are not sufficiently accounted for in this clause. Since 2022, a girl of 14 can telephone an abortion service, receive medication by post, take it at home, and no clinician will ever meet her. How does that give confidence that safeguarding risks are being properly assessed? How does the provider of medication know whether there is someone else in the room when they speak to the child on the phone? How do they know whether someone else has suggested that the child should make the phone call? Surely the only safe way to assess risk is to meet in person.

The noble Baroness, Lady Blackstone, says that telemedicine is safe. I fully respect her experience in this field and, in many situations, I would agree, but in the case of children, of which I note she made no mention in her speech, I believe she is wrong. Telemedicine is not safe for children.

[Baroness Gerada (CB)]

Is the right reverend Prelate aware that coercion can also occur in the consultation room, as I have seen many times? It may actually be safer for the girl—or the child, as he is calling her—to be able to choose the place and the time where she has that consultation.

[The Lord Bishop of Leicester]

I am very aware that there are risks to all forms of consultation. My argument is simply that the risks are minimised by in-person consultation.

The considered view of safeguarding professionals in the NNDHP is that the current guidance put in place by the Royal College of Paediatrics and Child Health in 2022 is simply not robust enough. That guidance, I note, requires an in-person meeting for children under 13. Children under 16 are,

“normally … required to complete their consultation in-person, unless there is a compelling indication to do otherwise”.

Evidence, however, suggests that most providers of abortion care are arguing that the option of telemedicine itself is a compelling indication that an in-person consultation is not required. For those aged 16 or 17, the guidance says only that children—and, of course, 16 and 17-year-olds are still children under the Children Act—should “be encouraged” to attend in person. More fundamentally, guidance can currently be changed unilaterally, without parliamentary scrutiny or public consultation, at the discretion of the body that issued it. I believe, therefore, that legislation is required. What Parliament enacts, only Parliament can remove.

The case for this amendment, however, does not rest on my view or the NNDHP’s alone. The Government’s own consultation found that safeguarding organisations specifically identified under-18s as the group for whom in-person assessment was most critical to reduce the risk from those who sexually exploit children, manipulate the system or force their victims to obtain abortion. Indeed, MSI Reproductive Choices has documented that face-to-face appointments are associated with a significant increase in domestic abuse disclosures compared with telemedicine. This is especially significant given that girls and young women face a higher risk of coercive or abusive relationships than those aged over 24, and are often less equipped to ask for help.

The clinical risks compound this. Beyond 11 weeks’ gestation, home management is not appropriate and the risks to the patient increase significantly. As has been mentioned, accurate gestational age assessment is the foundation on which safe prescribing depends, and it cannot be done reliably by telephone. These are not theoretical risks. We have heard stories already. I would simply add that of a 16 year-old who was estimated by the clinic to be under eight weeks pregnant, but the baby she delivered was in fact 20 weeks. She later said, “If they had scanned me and I knew that I was that far gone, I would have had him”. An in-person appointment would have changed everything for that young woman. This amendment would require such an appointment.

I echo the concerns of the noble Baroness, Lady Stroud, in her amendment. Without an in-person consultation, it is unclear how we will ensure that early medical abortions take place within the law. Indeed, challenges around vulnerability and correct gestational assessment apply to adulthood as well, which is why I fully support Amendment 425.

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[Baroness Fox of Buckley (Non-Afl)]

I have finished. That was it.

[Baroness Gerada (CB)]

My Lords—

[Lord Winston (Lab)]

My Lords—

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[Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)]

My Lords, can we please take the temperature down and respect the Clock? There are 10 minutes for Back-Bench contributions. Of course, many people want to get in, but please take the temperature down—there is no need to constantly interrupt others. Everyone can speak. We will come to the Cross Benches first and then go to the noble Baroness opposite.

[Baroness Gerada (CB)]

My Lords, I would like to pick up some of the safeguarding issues around telemedicine that have been mentioned in the House. To put things in context briefly, I have been a GP now for nearly 40 years, and over the past five years I have been conducting many remote consultations.

First, you can assess safeguarding issues remotely. A paper was published in 2025—very recently—on young girls under 16. More than 600 young girls were involved in the study. It found that 100% of the safeguarding issues—some of these girls then had to be seen face to face—were identified remotely. The conclusion, which is very short, states:

“Requiring in-person adolescent consultation is associated with reduced access to medication abortion without enhancing safeguarding”.


We do want to work with evidence. You might think it is safer to consult face to face, but the evidence shows that it is not safer: it can actually make it more harmful.

[Noble Lords]

Oh!

[Baroness Gerada (CB)]

Well, the evidence is there. You either believe in evidence or anecdotes.

The second issue is about ultrasounds. The National Institute for Health and Care Excellence does not recommend ultrasounds for judging gestational age, unless there are problems: for example, if a woman’s menstrual cycle is long or if there are other issues. Again, we have to go by the evidence: not what we think or feel, what we read in the papers or what we discuss with our friends.

I will also comment on assessing competence in younger children under 16. The noble Baroness, Lady Lawlor, has an amendment about mental capacity. I am sure that she is aware that the Mental Capacity Act cannot be used in relation to under-16s. Therefore, the noble Baroness’s amendment, if passed, would automatically mean that a 16 year-old would be prosecuted if she had no mental capacity, yet a 17 year-old could use that Act. So it is a nonsense amendment in that respect.

I fully support Clause 208 and I urge the House—on humane reasons, on competence and capacity, and, moreover, on evidence—to support it.

[Baroness Spielman (Con)]

My Lords, I will speak in support of Amendment 424, tabled my noble friend Lady Monckton, and Amendment 426C, tabled by the noble Baroness, Lady Wolf. I have put my name to both amendments. I will be brief.

Despite the careful unpacking in Committee of the human and legal problems that Clause 208 will create, no amendments have been put down that address them. As we know, there have been no impact assessments and no public consultation, though third-party polling shows a very large majority opposed to abortion up to the point of birth. No effort has been made to gain insight into the extent to which the existing telemedicine scheme is abused, as its laxness means it must inevitably be to some extent. The lack of real answers to the questions asked in Committee make it all too clear that the Government intend to keep their eyes closed and ears stoppered to shut out evidence of abuses. Sadly, some, though not all, of the medical profession also find it easier not to think about the lives of unborn children, no matter how close to birth.

The status quo is, therefore, profoundly unsatisfactory. If this clause is passed, it will signal to all women that there is zero risk to them personally in abusing the telemedicine scheme or procuring an illegal abortion in another way. So, of course, abuses will increase—that is how humans respond to bad incentives—and each abuse is likely to mean that a viable child is killed with impunity. I recognise that, despite the obvious risks that the clause introduces, it is tempting to support it in order to feel good about yourself and show that you are someone who really cares about women—but this requires suppressing all thoughts of children’s lives.