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.
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, what steps he is taking to help prevent abortion drugs sent in the mail from being used to commit crimes.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Before an early medical abortion can be undertaken at home, a consultation is held with the woman requesting the termination. Women are given the choice to have either an in-person consultation or a virtual consultation. If the medical practitioner has any concerns during a virtual consultation, the woman will be asked to attend a clinic for an in-person consultation.
The prescription of mifepristone and misoprostol for abortions is controlled by the Abortion Act 1967 and the Human Medicines Regulations 2012. During the consultation, women are informed that it is illegal to give their prescribed abortion medication to anyone else.
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, what steps he is taking to ensure that (a) gestational ages of pregnancies are accurately recorded in cases without ultrasound scans and (b) abortion pills are not sent in the mail to women beyond the legal limit of 10 weeks.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Pregnancy duration can be assessed from the first day of the last menstrual period (LMP). Advice from the Royal College of Obstetricians and Gynaecologists is clear, that most women can determine the duration of their pregnancy with reasonable accuracy by their LMP alone.
Before an early medical abortion can be undertaken at home, women are given the choice to have either an in-person consultation or a virtual consultation. However, if there is any uncertainty about the gestation of the pregnancy, the medical practitioner would ask the woman to attend an in-person appointment to enable them to form an opinion that the pregnancy will not have exceeded 10 weeks at the time the first abortion pill is taken.
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 steps they are taking to ensure that medical complications and associated risks arising from at-home tablet-induced abortions are accurately monitored, recorded, and reported.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is a legal requirement in England and Wales that all terminations must be notified to the Chief Medical Officer within 14 days of the procedure. The Department provides the HSA4 form for this purpose. Information is collected on the abortion and the woman that had the abortion, including the method of the abortion, whether any abortion pills were taken at home, the gestation, or number of weeks, and details of any known complications.
The Department publishes data from these notifications in annual abortion statistics reports, which include data on complications up until the time of discharge from the abortion service.
In November 2023, the Department published a one-time analysis comparing data from the Department’s Abortion Notification System and the Hospital Episode Statistics, which are produced and controlled by NHS England.
Abortion continues to be a very safe procedure for which major complications are rare at all gestations. The complication rates for the Abortion Notification System and the Hospital Episodes Statistics data remains similar to both before and after the introduction of the home use of early medical abortion pills.