Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the answer by Baroness Merron on 12 November (HL Deb col 252), what specific reasons she has for saying that "the evidence base for telemedical medicine is sound".
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Abortions are generally very safe, and most women will not experience any complications. The evidence-base for home use of early medical abortion pills has been assessed by leading statutory and professional organisations and it is recognised to be a safe procedure in evidence-based guidance, including the World Health Organisation’s abortion care guideline, the Royal College of Obstetricians and Gynaecologists 2022 report on best practice in abortion care, and the National Institute for Health and Care Excellence’s clinical guidelines on abortion care.
The Abortion Notification System (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. Since 2015, there has been a marginal downward trend in complication rates reported in the ANS. In 2022, complications were reported in only 0.12% of abortions.
The Department continues to work with NHS England, the Care Quality Commission, and abortion providers to ensure that women have safe and timely access to abortion services as decided by Parliament.
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend to publish an updated version of the Department for Health and Social Care guidance on completing the EMA1 abortion form or similar certificate to reflect any potential uncertainty in the opinion of the medical practitioner as to the patients’ gestation period where an in-person consultation has not taken place.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department keeps guidance on completing the EMA1 abortion form under review. There are currently no plans to update the guidance.
The medical practitioner terminating the pregnancy is required to form an opinion in good faith that the gestation of the pregnancy will be below 10 weeks at the time the first pill is taken. This opinion can be formed either during a teleconsultation, or an in-person appointment.
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 LMP alone.
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. If she does not attend in-person when requested, the terminating practitioner would not be able to form an opinion in good faith that the pregnancy is below 10 weeks gestation, and therefore would not be able to prescribe abortion pills for home use.
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the answer by Baroness Merron on 12 November (HL Deb col 254), what was the specific evidence base for saying that "The data available does not point to concerns about the provision of telemedicine".
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Abortions are generally very safe, and most women will not experience any complications. The evidence-base for home use of early medical abortion pills has been assessed by leading statutory and professional organisations and it is recognised to be a safe procedure in evidence-based guidance, including the World Health Organisation’s abortion care guideline, the Royal College of Obstetricians and Gynaecologists 2022 report on best practice in abortion care, and the National Institute for Health and Care Excellence’s clinical guidelines on abortion care.
The Abortion Notification System (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. Since 2015, there has been a marginal downward trend in complication rates reported in the ANS. In 2022, complications were reported in only 0.12% of abortions.
The Department continues to work with NHS England, the Care Quality Commission, and abortion providers to ensure that women have safe and timely access to abortion services as decided by Parliament.
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 whether they intend to publish abortion statistics in England and Wales for (1) 2023, and (2) 2024; if so, when; and, if not, why not.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department does intend to publish abortion statistics in England and Wales for 2023 and 2024. The publication dates for these statistics have not yet been announced.
Publication of the 2023 statistics is provisionally planned for winter 2025/26. We will announce the exact dates for publication of the 2023 and, later, 2024 data in due course.
The statistics have 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.
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: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the report of the Commission on Palliative and End-of-Life Care Opportunities For England, published in May.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Minister of State for Care (Stephen Kinnock MP) met the Hon. Member for York Central and Baroness Finlay of Llandaff to discuss the progress of their independent commission into palliative and end of life care, including the commission’s first of three reports, published on 13 May 2025, which he has formally responded to.
In line with the 10-Year Health Plan, the Government is determined to shift more healthcare out of hospitals and into the community. The palliative and end of life care sector will have a big role to play in that shift.
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 steps they are taking to improve the accuracy of data about complications arising from medical abortions.
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 HSA4 abortion notification form is provided to collect the required information up until the time of the patient’s discharge from the abortion service. 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 continues to work with abortion providers to ensure that abortion complications known up until the time of discharge from the abortion service are recorded on the HSA4 form. There are no plans to require the notification of complications that occur after discharge from the abortion service.
Abortion continues to be a very safe procedure, for which major complications are rare at all gestations. Home use of early medical abortion pills is recognised to be a safe procedure by the Royal College of Obstetricians and Gynaecologists, and the World Health Organisation
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they considered the legal opinion by Tom Cross KC and Ruth Kennedy entitled In the Matter of the Terminally Ill Adults (End of Life) Bill published on 28 April when updating the ECHR Memorandum for Terminally Ill Adults (End of Life) Bill, published on 26 June.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We were aware of the advice, but did not reference it in our European Convention on Human Rights (ECHR) memorandum. The Government prepared the ECHR memorandum to assist the Joint Committee on Human Rights. In that memorandum, the Government has set out the articles of the ECHR which it considers are likely engaged by the bill, including Article 14 together with Article 2.
Asked by: Lord Jackson of Peterborough (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they consulted the Equality and Human Rights Commission before publishing the Equality Impact Assessment for the Terminally Ill Adults (End of Life) Bill.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Equality and Human Rights Commission was not consulted before the Equality Impact Assessment (EQIA) was published for the Terminally Ill Adults (End of Life) Bill. However, the briefing authored by the commission in November 2024 has informed the EQIA.
The Terminally Ill Adults (End of Life) Bill is a Private Member’s Bill, and the Government has taken a neutral stance. The EQIA for the Terminally Ill Adults (End of Life) Bill is a neutral and independent assessment of the impact of the bill, and the Government did not undertake a consultation process on this assessment.