Complications from Abortions (Annual Report) Bill [HL]

Baroness Finn Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

[Lord Moylan (Con)]

My Lords, it might be helpful if I spoke next so I could update the House on various developments that have taken place since Second Reading. I am grateful to the noble Baroness, Lady Thornton, for her remarks about the importance of improving data and the importance of that data for women’s health. Nearly all of the other points she made were dealt with and debated at Second Reading, which the noble Baroness was unable to attend.

However, the fact is that there is nothing in the Bill which exceptionalises abortion, because the statistics on abortion complications already have to be collected under the existing abortion regulations using a system that relies on data provided by the abortion provider. That might have been sensible when the regulations were put in place, but currently the majority of abortions take place by the use of pills at home. Therefore, if there are complications, they are presented, in most cases, at hospitals in A&E and they are not part of the abortion notification system, so the majority of those complications are no longer captured by the current system.

The royal college says it is impossible to capture the complication statistics, but it seems to be completely unaware that, in November 2023, the Office for Health Improvements and Disparities produced a report that, with some labour, did actually capture them and showed that it could be done. All that is in this Bill is a requirement that that report, which is being treated by the department as a one-off and not to be repeated, should be repeated. It is wrong to suggest that this cannot be done; it has been done, and it can be done again.

I want to be brief, as I am conscious of the words of the Chief Whip before we started. I will move on to some developments that have occurred since Second Reading, because at the end of Second Reading, thinking that perhaps the Bill would not proceed to Committee, I tabled some Written Questions on this matter. I had one reply from the noble Baroness, Lady Twycross, on behalf of the Cabinet Office, which effectively introduced me to Mr Ed Humpherson, the director-general for the Office for Statistics Regulation, with whom I have since had correspondence.

Before I read from his letter to me of 20 February, I will remark that, as was mentioned at Second Reading, these statistics are referred to as national statistics and they are required to comply with the statistics code. In that light, the last compliance check was carried out in 2012 and because of that, Mr Humpherson says: “We have agreed with DHSC that a compliance check of the statistics would be beneficial”. A great deal of what the Bill seeks to achieve is likely now to be pursued by the Office for Statistics Regulation in consultation with the DHSC. Since it is very unlikely that any compliance check would consider that the current system was successfully capturing complications arising from abortions, I am therefore very pleased with what Mr Humpherson said.

I will continue with his letter a little bit, because my pleasure at his agreement to carry out a compliance check is slightly modified by his timetable and approach. He goes on to say: “We plan to carry out this review in the first quarter of 2026/27, giving DHSC time to undertake its planned developments. These include supporting data providers to move to DHSC’s digital submission system and working with digital experts and system users to improve the design of the Abortion Notification System”. I am certain that the noble Baroness, Lady Thornton, and I would agree that that work would be very welcome. My only quibble with Mr Humpherson—and I have written to him to say this—is that I would have thought the sensible thing would be to have the compliance check first, in order to identify the deficiencies and agree between DHSC and the regulator what the deficiencies are, and then for the department to invest in the digitisation of the collection of the statistics in such a way that they will comply with the regulator’s requirements.

When the Minister comes to reply, I am sure she will say that she will collaborate fully with the Office for Statistics Regulation and its work, because I fully expect the department to do that—it is the responsible thing to do. Can she agree that she will consider whether this is being done in quite the right order? Would it not be sensible to bring the compliance check forward so that the developments being carried out, which will involve investment and time, are not wasted but achieve what the regulator will be satisfied with at the end of the day?

[Baroness Finn (Con)]

My Lords, I apologise for not being able to attend Second Reading. I begin with the observation that, as a healthcare service, abortion is highly regulated and subject to the same oversight as any other care. As a result of the Abortion Act 1967, it is also subject to additional oversight which predates many of the regulatory and monitoring systems in place across the health service today.

This context is relevant to the Bill before us, which seeks to build on this 58 year-old framework. I am wholly in favour of monitoring all forms of healthcare provision and entirely agree that further work needs to be done on the collection and analysis of large datasets relating to women’s reproductive health. However, I have concerns that this Bill in primary legislation is not the best way to approach this important work.

I am aware that both the Royal College of Obstetricians and Gynaecologists—the RCOG—and the British Pregnancy Advisory Service have shared with noble Lords their concerns that, as the noble Baroness, Lady Thornton, has said, singling out abortion for new legislation in this way exceptionalises it and fails to treat it like other forms of healthcare. This would potentially stigmatise abortion care for both women and the medical professionals who provide the care. It would also indicate that abortion is considered to be such a high-risk intervention that it is in need of particular oversight.

The RCOG points out that abortion is a “safe and effective procedure”. Some one in three women in the UK will have had an abortion before the age of 45 and international studies have repeatedly found that abortion is of less risk to women than complications that can arise from continuing a pregnancy to term and giving birth. As a result, I am concerned by any indication that this House considers abortion to require increased monitoring and oversight, over and above that of comparable healthcare, and indeed the message that it would send to the nearly 300,000 women who access abortion services across the UK every year.

I agree with my noble friend Lord Moylan that we need to improve collection of data, but this must be done across women’s healthcare more broadly, and I would be interested to hear from the Minister about what plans the Government have to achieve this. We know that in many areas, women wait a disproportionately long time for diagnoses of devastating conditions, such as endometriosis, and in that time often suffer complications that come from lack of treatment.

It was for this reason that the previous Government published the widely welcomed, first ever women’s health strategy for England, to take a holistic approach to women’s healthcare. I pay particular tribute to my former colleague, Emma Dean, for her tireless and excellent work to make this happen. We also appointed the brilliant Dame Lesley Regan as the first women’s health ambassador to support the implementation of this strategy. I was pleased to note that the Minister for Secondary Care confirmed in the other place the Government’s commitment to the women’s health strategy, though I am concerned about the lack of progress against the strategy’s widely welcomed commitments, especially the Government dropping targets for ICBs around the creation of women’s health hubs. The RCOG has said that the existing hubs have reduced unnecessary referrals, provided training opportunities for professionals and enabled women to access support quickly.

The NHS 10-year plan and monitoring of the women’s health strategy would, I hope, offer an opportunity to address the challenge of good monitoring without adding unnecessary legal burdens to the healthcare system. I hope that we can all agree that the purpose of this monitoring has to be to improve information and care for women, and that singling out abortion is unfortunately likely to do more harm than good.

Before I close, I want to touch on the practicality and operability of this legislation. I understand that the information currently used by the department to produce abortion statistics, such as the type of abortion, gestational age, and information about women accessing care, is separate in the majority of cases from a woman’s broader healthcare record. It seems incredibly important to protect this right to privacy for women accessing abortion care, particularly for women at risk of domestic abuse, honour-based abuse or reproductive coercion. I know that my noble friend will not want to place women at risk as a result of this legislation, so I wonder if the Minister can confirm that the department is able to link abortion records with wider healthcare records in the way this legislation would require, and if so, whether that would mean that abortion care would appear on a woman’s medical record, whether or not she had given consent.

Given my concerns about the impact of the proposals in the Bill on women and the wider healthcare system, I am not able to support it in its current form and support the noble Baroness, Lady Thornton, in her opposition to the clause standing part.

[Lord Weir of Ballyholme (DUP)]

My Lords, I join others in apologising for not being here at Second Reading—on medical grounds, in my case—which seems to be a consistent theme in this debate. In looking at the amendment and legislation today, it is important that we actually focus on what is there rather than debating—I appreciate that the noble Baroness does not intend to push this to a Division—something that is not there.