Health and Care Bill

Debate between Diana Johnson and Caroline Nokes

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Dame Diana Johnson]

I am talking about women’s experience, so I will continue, if the hon. Gentleman does not mind.

The woman may have to make arrangements if she has childcare or caring responsibilities, or she may have to take time off work. In the case of a coercive and controlling relationship, she would have to explain where she is going to a perpetrator, such as the Mumsnet user who said she had to visit a hospital to access abortion care and was “terrified” of her abusive ex-partner finding out where she was. She spoke of having to construct “various lies” about where she was that day and why she had to have someone look after her children.

I referred to NICE and the World Health Organisation in an intervention, but we should be aware that since telemedicine was introduced the risk of complications related to abortion has reduced, as women are able to access care much earlier in their pregnancy. I will rehearse the long list of supporters of the measure continuing: The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the British Medical Association, the Royal Pharmaceutical Society, the Faculty of Sexual and Reproductive Health, the TUC, Women’s Aid, Rape Crisis, Karma Nirvana, the Terrence Higgins Trust, End Violence Against Women, Mumsnet, and many others. What I find most disappointing is that the Government are going against a wealth of robust and widely accepted peer-reviewed evidence from medical professionals and women’s charities, and appear to give greater weight to anecdote, erroneous opinion and misinformation focused on campaign groups with extreme views who bombarded a consultation. Sadly, that further emphasises that this is not an evidence-based policy decision.

[Caroline Nokes (Romsey and Southampton North) (Con)]

Will the hon. Lady give way?

[Dame Diana Johnson]

I want to address the issue of safeguarding. Let me be clear: creating more barriers to access does not help women; it helps abusers. The End Violence Against Women coalition and other major VAWG organisations reject the claim that telemedical abortions put women at greater risk of coercive abortions. The fact is that coercive pregnancies are far more common than coercive abortions, and since the introduction of telemedical abortions providers have seen a rise—a rise—in safeguarding disclosures, highlighting that the system provides a safe space for women to come forward if they are being coerced. Nurses are highly trained to assess safeguarding issues, and if concerned they will ask the women to come to the clinic for face-to-face assessment.

Finally and crucially, women themselves strongly favour keeping telemedicine for early medical abortion. A clear majority want it to continue.

As a country, we have an opportunity to be seen to be a shining light for women’s reproductive rights around the globe at a time when those rights are being rolled back elsewhere. The weight of the evidence in favour of maintaining this essential women’s healthcare pathway is overwhelming. I ask Members to support the amendment in lieu.

International Women’s Day

Debate between Diana Johnson and Caroline Nokes

Thursday 10th March 2022 Commons Chamber

[Dame Diana Johnson]

I absolutely agree with the right hon. Lady. Let me clear, so we are all aware in the Chamber, that telemedicine for early medical abortion services has enabled thousands of women to access care at home via both pills being posted to them following a telephone consultation with a qualified nurse or midwife. The evidence from the medical community is absolutely crystal clear. A study of more than 50,000 abortions before and after the change in England and Wales, published by the British Journal of Obstetrics and Gynaecology in February 2021, concluded that telemedical abortion provision is

“effective, safe, acceptable, and improves access to care”.

Evidence also shows that telemedicine means women can access an abortion much earlier in their pregnancy, with 40% of abortions provided at less than six weeks.

As well as the consensus in the medical community, women—including the influential Mumsnet—also support the continuation of telemedicine for abortion services. An independent poll of more than 1,100 women throughout the UK, commissioned by the Faculty of Sexual and Reproductive Healthcare, shows that a clear majority want telemedicine for early medical abortion to remain.

As the right hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) said, the Welsh Government have announced that they will make the pathway permanently available in Wales. I therefore struggle to see how the decision to end this service in August is in line with the Government’s commitment to put women at the centre of their own healthcare, as set out in the vision for the women’s health strategy. It is simply based on the Health Minister’s own prejudice. It is deeply disappointing and it flies in the face of all the other measures that have been taken within the NHS around virtual appointments and to use digital technology.

[Caroline Nokes]

I thank the right hon. Lady for her comments on this matter; she is making a really powerful point. Does she feel, as I do, that this is sending a message that the Government do not trust women to make their own decisions about their own reproductive health?

[Dame Diana Johnson]

The Chair of the Women and Equalities Committee puts that very well. That is exactly the message that is being sent out. I notice that time is going by, so I will conclude.

I, alongside many parliamentary colleagues across the House and in the other place, medical bodies and women’s groups, such as the British Medical Association, the Royal College of General Practitioners and Women’s Aid, are calling on the Government now to explain exactly how they will review this decision, as they have promised to do. Where access to reproductive healthcare is limited, there is a ripple effect on the health and social wellbeing of women and girls. We must continue to stand up for the rights of women to have full control over our own health and our own bodies. We still, apparently, have some way to go to achieve that.