Crime and Policing Bill

Debate between Baroness Gerada and Lord Bishop of Leicester

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.