Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many sets of pills for early medical abortions at home have been distributed; and what assessment they have made of the number of early medical abortions that have been carried out at home.
Answered by Lord Bethell
Abortion data is published annually and data for 2020 is not due to be published until 2021. The data requires full quality assurance prior to release. The Code of Practice outlined in the Statistics and Registration Service Act 2007 prohibits the pre-release of official statistics before the due date of publication.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made, if any, of the impact on the mental health of women performing an early medical abortion on their own at home during the COVID-19 pandemic lockdown.
Answered by Lord Bethell
The Department is carefully monitoring the impact of and compliance with the temporary approval of home administration of both sets of abortion medication during the COVID-19 pandemic. Officials have regular meetings with the Royal College of Obstetricians and Gynaecologists, the Care Quality Commission and abortion service providers to discuss the impact and any issues arising.
The Department’s Required Standard Operating Procedures for independent sector providers set out that ‘Women are not required to have compulsory counselling or compulsory time for reflection before the abortion. Clinicians caring for women requesting abortion should be able to identify those who require more support than can be provided in the routine abortion service setting, for example young women, those with a pre-existing mental health condition, those who are subject to sexual violence or poor social support, or where there is evidence of coercion. For the minority of women who require formal, therapeutic counselling, services should have referral pathways in place with access to trained counsellors with appropriate expertise.’
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they made of the risk of allowing the at-home administration, following a telephone consultation, of mifepristone and misoprostol for an abortion.
Answered by Lord Bethell
The Royal College of Obstetricians and Gynaecologists (RCOG) has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan, however it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The RCOG guidance has recently been updated and now includes a decision aid for clinicians to use to help determine if an ultra-sound scan is required.
The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. Abortion providers will discuss possible complications with the woman in the consultation, and women will be provided with information about possible symptoms, including those which would necessitate urgent review. Copies of these guidance are attached.
It is a legal requirement for two doctors to certify that there are grounds for an abortion before treatment can proceed unless an emergency situation has arisen.
The approval to allow women to take both sets of pills for early medical abortion at home is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what safeguards are in place to ensure that mifepristone and misoprostol are only prescribed for medical abortions at home where women are less than 10 weeks pregnant; and what plans they have, if any, to reconsider allowing such treatment to be prescribed without seeing a clinician in person.
Answered by Lord Bethell
The Royal College of Obstetricians and Gynaecologists (RCOG) has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan, however it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The RCOG guidance has recently been updated and now includes a decision aid for clinicians to use to help determine if an ultra-sound scan is required.
The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. Abortion providers will discuss possible complications with the woman in the consultation, and women will be provided with information about possible symptoms, including those which would necessitate urgent review. Copies of these guidance are attached.
It is a legal requirement for two doctors to certify that there are grounds for an abortion before treatment can proceed unless an emergency situation has arisen.
The approval to allow women to take both sets of pills for early medical abortion at home is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what factors are considered when determining whether a pregnant women should see a clinician in person during the COVID-19 outbreak to (1) have an ultrasound to determine the gestational age of the pregnancy, and (2) have two doctors certify the grounds for a termination.
Answered by Lord Bethell
The Royal College of Obstetricians and Gynaecologists (RCOG) has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan, however it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The RCOG guidance has recently been updated and now includes a decision aid for clinicians to use to help determine if an ultra-sound scan is required.
The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. Abortion providers will discuss possible complications with the woman in the consultation, and women will be provided with information about possible symptoms, including those which would necessitate urgent review. Copies of these guidance are attached.
It is a legal requirement for two doctors to certify that there are grounds for an abortion before treatment can proceed unless an emergency situation has arisen.
The approval to allow women to take both sets of pills for early medical abortion at home is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the ability of a medical professional to establish the gestation period of a child accurately via a telephone consultation before prescribing the at-home administration of mifepristone and misoprostol for an abortion.
Answered by Lord Bethell
The Royal College of Obstetricians and Gynaecologists has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan. However, it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. A copy of this guidance is attached.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the statement by the Secretary of State for Health that “they have no proposals to change any abortion rules as part of the COVID-19 response” on 24 March (HC Deb, col 244) and the remarks by Lord Bethell that “it is not right to rush through this type of change in a sensitive area such as abortion without adequate parliamentary scrutiny” on 25 March (HL Deb, col 1762), what (1) steps they took, and (2) consultation they undertook, before deciding to permit at-home abortion using the administration of mifepristone and misoprostol following a telephone consultation.
Answered by Lord Bethell
On 30 March, Ministerial powers under the Abortion Act 1967 were used to temporarily approve women’s homes as a class of place where both abortion pills can be taken for early medical abortion up to 10 weeks gestation following a telephone or e-consultation with a clinician. Doctors’ homes have also been approved as a place from which abortion medication can be prescribed. Following the debate on 24 March the Department was presented with strong evidence from providers that the situation in relation to abortion provision was rapidly changing, services closing and large numbers of appointments for treatment were being cancelled. It was therefore considered that the balance of risk to allow a temporary modification of the arrangements for treatment for early medical abortion had shifted and the temporary modification should be allowed. In reaching this decision account was also taken of wider advice regarding the need for some groups to isolate, that access to abortion is an urgent matter: the procedure’s risk increases at later gestations and there are legal gestational limits for accessing services. This position is being kept under review and the temporary approvals will end once the risk from the COVID-19 pandemic recedes.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to their decision to allow at-home administration of mifepristone and misoprostol to induce an abortion following a telephone consultation, what plans they have to review their guidance on abortion that states that “the purpose of the requirement that two doctors certify the ground(s) for termination is to ensure that the law is being observed; this provides protection for the woman and for the doctors providing the termination”.
Answered by Lord Bethell
The Government has no plans to amend the legal requirement for two doctors to certify abortion procedures under the Abortion Act 1967. In light of the COVID-19 pandemic, we have put in place two temporary measures in England; one of which is to ease the pressures of health professionals during the COVID-19 pandemic by allowing registered medical practitioners to prescribe both pills for the treatment of early medical abortion up to 10 weeks from their own homes.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask Her Majesty's Government what assessment they have made of the number of SMEs employing staff with disabilities between 2015 and 2020.
Answered by Baroness Stedman-Scott
Small and medium-sized enterprises (SMEs) are defined as businesses which employ less than 250 employees.
In 2019, there were 5.82 million small businesses (0 to 49 employees) and 35,600 medium-sized businesses (50-249 employees) in the UK. 4.46 million of these do not employ anyone. 1,155,385 had 1-9 employees, 211,295 had 10-49 employees, and 35,585 had 50-249 employees.
Source: Department for Business, Energy and Industrial Strategy (2020). Business population estimates for the UK and regions: 2019 statistical release.
While there are currently no robust estimates of the total number of businesses that employ staff with disabilities, DWP research does provide evidence of the proportion of establishments who have recruited employees who are disabled or have a long-term health condition in the previous 12 months.
The 2015/2016 DWP Employer Experience Survey and the 2018 DWP Employer Engagement Survey collected data from 4,200 and 4,201 telephone interviews of GB employers respectively. The surveys only considered workplaces with at least two members of staff.
The fieldwork periods for the two surveys were October 2015 to February 2016 and February to June 2018.
The surveys asked those employers who said they had tried to recruit in the last 12 months whether they had recruited someone who is disabled or who has a long-term health condition:
Establishment size | % of establishments that had recruited in the last 12 months | Of those establishments that had recruited, whether they had recruited someone who is disabled/has a long-term health condition | ||||||
Yes | No | Don’t know | ||||||
2015/16 | 2018 | 2015/16 | 2018 | 2015/16 | 2018 | 2015/16 | 2018 | |
2-9 employees | 43% | 38% | 12% | 11% | 86% | 82% | 2% | 7% |
10-49 employees | 82% | 76% | 15% | 19% | 81% | 74% | 4% | 6% |
50-249 employees | 96% | 96% | 31% | 31% | 57% | 51% | 11% | 18% |
250+ employees (2015/16 only) | 97% |
| 55% |
| 22% |
| 23% |
|
250-499 employees (2018 only) |
| 99% |
| 44% |
| 35% |
| 21% |
500+ employees (2018 only) |
| 100% |
| 53% |
| 25% |
| 22% |
Sources: Department for Work and Pensions (2019). DWP Employer Engagement survey 2018. Research report 977.
Department for Work and Pensions (2017). DWP Employer Experience survey 2015/16. Research report 948.
Asked by: Baroness Stroud (Conservative - Life peer)
Question to the Department for Levelling Up, Housing & Communities:
To ask Her Majesty's Government what assessment they have made of the report A housing design audit for England, published on 21 January, which found that the majority of new housing developments audited were considered mediocre or poor.
Answered by Baroness Bloomfield of Hinton Waldrist
We have received and read the report with interest. The authors of the report provided evidence from their audit to the Building Better, Building Beautiful Commission and it has informed the recommendations within the final report. The Government will be issuing their final response to the Commission’s report in due course.