Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how not collecting data, through the Abortion Notification System and hospital episode statistics, on complications arising from at-home medical abortions after the patient’s discharge from the care of the abortion service accords with the commitment to collect empirical data to improve women’s health outcomes outlined in the Women’s Health Strategy for England.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Women’s Health Strategy sets out our ambitions to make better use of data already collected, and to address gaps in women’s health data to improve women’s health outcomes.
The Department routinely publishes data on abortion complications reported via the Abortion Notification System (ANS). The ANS collects information on complications that occur up until the time of discharge for all abortions, and where the medicine was administered for medical abortions.
The Department has published a one-time analysis exploring whether Hospital Episode Statistics (HES) can be used as a supplementary source for data on abortion complications. The HES data in the publication includes abortion complications arising from any abortion which resulted in an inpatient admission. The publication found that abortion complications are recorded differently in HES compared to the ANS and there are different strengths and limitations associated with using either data source. The Department has no plans to publish a separate annual report on abortion complications.
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what methodology they are using to measure the efficacy and impact on women’s health of the 2022 changes to the Abortion Act 1967 permitting early medical termination of pregnancy taking place in the patient's home.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Abortion continues to be a very safe procedure for which major complications are rare at all gestations. The Department works closely with NHS England, the Care Quality Commission, and abortion providers to ensure that abortions are provided safely, in accordance with the legal framework set by the Abortion Act 1967.
It is a legal requirement under the 1967 Abortion Act that the Chief Medical Officer must be notified of all abortions within 14 days of the procedure. The Department provides the HSA4 abortion notification form for this purpose. HSA4 forms collect information on the practitioner terminating the pregnancy, details of the patient and their treatment, including abortion method, gestation of the pregnancy, and the certified grounds for terminating the pregnancy. It also records known complications, up until the time of the patient’s discharge from the abortion service. The Department routinely monitors and publishes data reported via abortion notifications.
To consider the completeness of abortion complications data submitted via abortion notifications, the Department committed to publishing a one-time analysis comparing data from the Department’s Abortion Notification System and the Hospital Episode Statistics. This was published in November 2023.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many domestic abortions using (a) mifepristone and (b) misoprostol have occurred in England in each year since 2020.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department cannot separate out which of mifepristone or misoprostol were administered at home, only whether one or both abortion medications were administered at home.
Asked by: Baroness Foster of Aghadrumsee (Non-affiliated - Life peer)
Question to the Ministry of Justice:
To ask His Majesty's Government what assessment they have made of the impact of the introduction of telemedicine for first-trimester abortions on the number of criminal prosecutions in England and Wales over the past five years.
Answered by Baroness Levitt - Parliamentary Under-Secretary (Ministry of Justice)
The offences that apply in cases of unlawful abortion are administering drugs to procure an abortion and procuring drugs to cause abortion under sections 58 and 59 of the Offences Against the Person Act 1861, as well as child destruction under section 1 of the Infant Life (Preservation) Act 1929.
Publicly available Ministry of Justice statistics show the following number of prosecutions brought under those offences:
Proceeded against | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
Procuring Illegal Abortion (Sections 58 & 59 Offences Against the Person Act 1861) | 2 | 0 | 1 | 0 | 5 | 4 | 4 | 3 |
Child Destruction (Section 1 Infant Life (Preservation) Act 1929) | 1 | 1 | 0 | 0 | 3 | 1 | 1 | 0 |
This data is held on a principal-offence basis and therefore reports information relating to the most serious offence that a defendant was dealt for.
The available data does not specify how many of these prosecutions are linked to the use of telemedicine for early medical abortion. The Government has not made an assessment on the connection between the number of prosecutions for unlawful abortions and the availability of telemedicine for early medical abortion.
The Department of Health and Social Care is responsible for the policy relating to telemedicine for early medical abortion.
Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many GP practices returned more than 1000 HSA4 forms which record an abortion by medicine administered at home in (1) 2023, and (2) 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether the form was returned by a general practice.
The HSA4 form does capture information on the hospital or clinic where the termination took place, and whether any medicine was administered at the patient’s usual place of residence. However, the publication of the Abortion Statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.
Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many GP practices returned more than 100 HSA4 forms which record an abortion by medicine administered at home in (1) 2023, and (2) 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether the form was returned by a general practice.
The HSA4 form does capture information on the hospital or clinic where the termination took place, and whether any medicine was administered at the patient’s usual place of residence. However, the publication of the Abortion Statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.
Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many individuals received medicines for abortion at home via post in (1) 2023, and (2) 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department collects information on abortions via the HSA4 abortion notification form. The HSA4 form does not capture information on whether abortion medicine was sent via the post, and so the Department does not hold this information.
The HSA4 form does capture whether the medicine was administered at the patient’s usual place of residence. This information is published in the Abortion Statistics for England and Wales for the years 2018 to 2022. However, publication of the abortion statistics for England and Wales from 2023 onwards has been delayed due to several operational issues. These include issues associated with moving to a new data processing system and an increase in the number of paper abortion notification forms to process. We will announce the dates of the publication of the data for 2023, and later 2024, in due course.
Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government further to the Written Answer by Baroness Merron on 30 June (HL8647), whether they plan to include in their statistics abortions undertaken through abortion pills by post, and if so, how.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is a legal requirement that all abortions performed in England and Wales, including early medical abortions (EMA) at home, are notified to the Chief Medical Officers for England and Wales respectively, within 14 days of the procedure via the HSA4 abortion notification form. The HSA4 form captures information on where the EMA pills were taken, but not whether they were delivered by post or collected from the clinic.
Statistics on home use of EMA pills for residents of England and Wales are already published by the Department in the annual Abortion Statistics for England and Wales publication. These statistics are published in the main commentary and the additional data tables of the publication. From 2019 to 2022, the statistics on home use of EMA pills were derived using the place of termination information on the HSA4.
In 2022, Parliament voted to permanently approve use of one or both pills for EMA up to 10 weeks at home, following a telephone or e-consultation with a clinician for residents in England and Wales. Following this, in April 2023, new questions were added to the HSA4 form, to capture information on where the abortion medications were taken. Statistics on home use of EMA pills in future publications, from 2023 onwards, will be based on these new questions.
Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many abortion pills by post have been issued; how many people those pills have been issued to; and of those how many were under 16 years old.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
From 28 December 2018, eligible women in England could take the second of the two drugs for early medical abortion (EMA), misoprostol, at home. This was changed from 30 March 2020, to allow eligible women in England to take both drugs for EMA, mifepristone and misoprostol, at home, without the need to first attend a hospital or clinic.
The Department does not hold a record of how many drugs for EMA have been issued. However, from 2019 to 2022, latest available data on home use, for one or both drugs taken at home, for residents of England, there were 481,179 abortions where either one or both of the drugs were taken at home. Of these, 2,127, or 0.4%, were for those aged under 16 years old.
From 2020 to 2022, latest available data on home use, for both drugs taken at home, for residents of England, there were 316,795 abortions where both medications were taken at home. Of these, 1,250, or 0.4%, were for those aged under 16 years old.
Please note, the second set of statistics, both pills taken at home, is included within the first, one or both pills taken at home.
Asked by: Lord Porter of Spalding (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what are the criteria for determining whether an in-person consultation is required following a request for at-home abortion tablets.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In March 2022, Parliament voted to amend the Abortion Act to allow women in England and Wales to take one or both pills for early medical abortion at home at up to 10 weeks’ gestation. The legislation came into force on 30 August 2022.
Women should be given the choice to either have an in-person consultation with a clinician or to have a virtual consultation and, if eligible, will be able to take both pills for early medical abortion at home. If there is any uncertainty about the gestation of the pregnancy, or if the doctor has any concerns, the woman will be asked to attend a clinic. If she does not attend the clinic, the doctor would not be able to form an opinion in good faith that the pregnancy is below ten weeks, and would therefore not be able to proceed with prescribing abortion pills for home use.