Abortion (Northern Ireland) Regulations 2021

Diana Johnson Excerpts

Monday 26th April 2021 General Committees

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

It is a pleasure to see you in the Chair, Mr Hosie. I thank the Secretary of State and the Minister for bringing forward these regulations to ensure that women in Northern Ireland can access abortion services, as was agreed by this place more than a year ago. We all understand that taking this action is a very significant step—a big step, as I think the Minister said in his opening speech. We have also heard that there have been many attempts over the past year to try to ensure that proper provision is put in place in Northern Ireland so that women can access reproductive healthcare and abortion services, as required by law.

Although abortion is legal in Northern Ireland and women are no longer criminalised, challenges remain regarding the implementation of services as set out in the legal framework. In particular, there is no public information about abortion services from the Department of Health in Northern Ireland. Telemedicine is not permitted in Northern Ireland, despite it being available in England, Wales and Scotland. The existing service is not supported by the Department of Health, and it is patchy and fragile. In fact, the Northern Ireland Department of Health has failed to commission and fund services properly, and has actively blocked attempts to do so. Alongside that, no central funding is available to allow women and girls to access appropriate services. That job is currently being done by the voluntary sector. I would be interested to know what steps the Minister believes should be put in place to ensure that there is proper signposting and help to access services, supported by public funds.

The Northern Ireland Human Rights Commission has initiated legal action against the Secretary of State for Northern Ireland, the Northern Ireland Executive and the Department of Health in Northern Ireland for failing to commission and fund abortion services in Northern Ireland. The commission believes that the failure of the Northern Ireland Executive and Department to agree to fund and commission these services breaches the European convention on human rights.

The law states that abortion services should be available in Northern Ireland. It is therefore our job at Westminster to ensure that that happens, in line with all our international obligations relating to the human rights of women and girls. I am grateful that the Minister has indicated that he is looking for progress before the summer recess, but I also wonder, alongside my hon. Friend the Member for Pontypridd and the right hon. Member for Basingstoke, whether he could give a more specific timetable and set out what his intention will be if that progress does not happen.

It is certainly worth reflecting on the effect of the failure to act by politicians and Ministers in Northern Ireland on women and girls in Northern Ireland. Over the past three months, three different local health boards have, for a period, stopped providing abortion services. On 5 October 2020, the Northern Health and Social Care Trust suspended its services because the trust had to transfer staff back into other sexual and reproductive healthcare services, and therefore ceased to take any new referrals for termination services. The service resumed in December. During the break in service, 89 women were denied treatment within the NHS in Northern Ireland. On 5 January 2021, the South Eastern Health and Social Care Trust ceased providing a service, as the only staff member doing the work went on maternity leave and no replacement had been found. That resulted in a further 24 women being denied local NHS treatment. Those women could not be accommodated in other trusts, so the majority used unregulated online providers. Other trusts did not have the resources to pick up the work in either of those two trusts.

Just last week, as has been referred to, the Western Health and Social Care Trust announced that from 5pm on Friday 23 April, it would stop early medical abortion services. The service had been maintained over the past year by just one doctor, working without any support, and that had become unsustainable. That development also highlights the conditions that service providers currently face and underlines the need for the regulations that we are considering.

Amnesty International has described the situation in Northern Ireland as a “postcode lottery”. Added to the picture is the fact that there are currently no routine services for pregnancies beyond 10 weeks, and no local service for women between 10 and 12 weeks’ gestation. That is because those women will need to be seen in hospital and none of the trusts is prepared to provide that service without it being funded by the commissioning process. Clinicians estimate that in excess of 100 women a year fall into that category. Those women are at increased risk when taking pills unsupervised, and are also at increased risk of complications from surgical procedures. Currently, the only option available to them is to travel to England, even during the pandemic, to access abortion services under the Abortion Act 1967.

The ongoing uncertainty and the cancellation of services have made life even more difficult and challenging for women and girls seeking reproductive healthcare and access to abortion in Northern Ireland. The situation for far too many women and girls has resulted in their having to travel from Northern Ireland to England to access those services. We have all heard the horrific stories of women and girls having to travel, and about the emotional impact of being away from family and loved ones at such a difficult time, but that is even more stark and cruel in the middle of a pandemic, as my hon. Friend the Member for Pontypridd said. I am told that up to five women a week are still travelling to England to seek abortion care. That is during a time of restricted travel and risk of transmitting covid-19—it is unacceptable. Doctors have continually stated that the resultant harm to women will be severe, and clinicians in Northern Ireland have expressed frustration and dismay at the lack of provision of abortion services. Has the Minister made any assessment of how many women in Northern Ireland have had to travel to other parts of the UK to access abortion services during the covid-19 pandemic?

I think it is right to highlight, in the current pandemic, how the failure to act has further impacted on women and girls. It appears that at the outbreak of covid-19, funding was diverted from cancelled services to commission abortion services, and all trusts were able to commission 10-week early medical abortions. However, all the clinics appear to have been in a precarious situation regarding being able to offer care pathways.

Telemedicine is not permitted in Northern Ireland under the Abortion (Northern Ireland) (No. 2) Regulations 2020, despite it now being available in England, Wales and Scotland. Telemedicine has been a vital way of accessing reproductive healthcare for women in England, Scotland and Wales during the pandemic. Its availability has provided women with a safe option that has allowed them to minimise travelling to clinics. That was essential, particularly during the first lockdown, when stay-at-home orders were in place across the whole United Kingdom.

The largest ever study of UK abortion care, by the British Pregnancy Advisory Service, the University of Texas at Austin, MSI Reproductive Choices and the National Unplanned Pregnancy Advisory Service, found that telemedicine is safe, efficient and reduces the waiting period for women accessing abortion services. Professor Dame Lesley Regan, the past president of the Royal College of Obstetricians and Gynaecologists, said:

“This study proves there is no medical reason not to make the current telemedicine service permanent.”

The fact that telemedicine has not been available in Northern Ireland represents another failure of women and girls by the Northern Ireland Executive and the Northern Ireland Department of Health. Has the Minister made any assessment of the need for telemedicine in Northern Ireland during the covid-19 pandemic, and what steps would he look for to ensure that it is rolled out as part of future abortion care?

I once again thank the Secretary of State and the Minister for all their hard work in taking this action to ensure that the UK’s legal obligations to women and girls are upheld, and for moving towards ensuring the provision of, and access to, abortion services in Northern Ireland, for which this Parliament has already legislated.

--- Later in debate ---

[Miriam Cates]

I absolutely agree. The law is in place, but the question is whether it is the role of the UK Parliament to enforce the commissioning on the Health Ministers. As I will argue, I believe that the right way forward, given that the Northern Ireland Assembly is sitting again, is to repeal the legislation and let abortion return to being a devolved matter.

I believe the most sensible action is to repeal section 9, which is a measure I would gladly support. As has been made clear, however, the Government do not intend to take that course of action and instead will continue to press ahead with the regulations. For obvious reasons, there is plenty of support among Members from different parties. Why are the Government choosing to follow that course? From the perspective of someone who does not support such action, I have no doubt that Ministers would be wary of a backlash if they chose to withdraw the legislation, but I am also prepared to believe that Ministers and many right hon. and hon. Members genuinely hold that this is the morally right thing to do. I want to explain why that is.

There seems to be a view that the presence or absence of an abortion regime is somehow an indicator of attitudes toward women’s equality and that, in not having such a regime in Northern Ireland, the approach that the Government are taking is justified in order to bring Northern Ireland into line with the rest of the United Kingdom. However, I strongly question the belief that any particular abortion regime, liberal or otherwise, is indicative of women’s empowerment and whether women are being discriminated against.

The UK has the second highest abortion rate in western Europe, which sadly means that hundreds of thousands of women each year feel that they have no choice but to have an abortion. I empathise with people who are in a position where they have no choice but to terminate their pregnancy and their opportunity to become a mother. In a country where contraception is free, and where there is now very little social stigma attached to having a baby regardless of whether someone is married, is in a relationship or is single, how is that something to be celebrated?

Whatever our personal views on abortion, we have to ask what the abortion figures really demonstrate. I believe that they demonstrate not the freedom of women in the UK, but the way that we have devalued family life and failed to support parents in their crucial role of raising the next generation. In a country where our tax policy makes families worse off than in many comparable countries, where child benefit is not available for third and subsequent children, and where social policies drive parents into longer and longer hours at work—[Interruption.] I am going to make progress, as I have nearly finished.

We are sending a powerful message about how we value families in Great Britain, and we need to learn from the comparisons between GB and Northern Ireland. Instead of seeking to impose an even more liberal version of what we have in GB, perhaps we should reflect on what Northern Irish communities have to teach us about valuing families.

[Dame Diana Johnson]

Will the hon. Lady give way?

[Miriam Cates]

No, I am going to make progress because I know many other Members want to speak.

In not withdrawing the legislation, Ministers are sending a signal that they believe the right of a woman to choose whether to end her pregnancy trumps all other rights and freedoms at stake here: the right of the unborn child to live, the right of disabled people not to be discriminated against, the right of Northern Irish people to have their deeply held values respected, and the right of women to be protected against coercion and potential abuse. I ask Ministers what moral criteria we have to rank those competing rights. If we see the issue only as a question of rights, we will soon tie ourselves in knots. Using rights to construct a moral framework is deeply problematic, because if we base morality on the protection of the rights of different groups and individuals, we will always reach a point of unresolvable conflict.

However, we do not have to view the debate through the lens of competing rights. We can instead view it through the lens of the social covenant that exists among us and that defines us as individuals, families, communities and nations by the relationships we share and the responsibilities we owe each other. That covenant —that shared identity—is strengthened by trust and cultural diversity. The covenant is weakened when those in power seek to impose their cultural views on those whom they rule, as we have seen so clearly over the past five years.

The regulations are unnecessary, dangerous and overreaching, and they threaten the trust and tolerance on which our Union depends. I urge the Government not to press ahead, but instead to repeal section 9 and restore agency, democracy and dignity to the people of Northern Ireland.