Contribution
My Lords, I know the hour is late, and it might be as well to record for posterity that a number of us were prevailed upon to regroup our degrouped amendments to keep the number of groups at three instead of four. The quid pro quo, as far as I understood from the usual channels, was that we would be allowed a decent amount of time to transact the business. The noble Baroness the Government Whip looks at me innocently—with an innocent visage—but the reason that the hour is late is that, obviously, we have had tributes to the former Lord Speaker, dinner break business and a UQ. I am sorry that your Lordships’ Committee is having to sit later than I would otherwise have liked.
I will not labour again the points I made at Second Reading about Clause 191, but I believe it will exacerbate the dangers inherently present in the pills by post regime. Suffice it to say that the new clause will make it easier to get abortion pills, it will make it easier for abusive partners to coerce women into having an abortion and it will lead to more abortions, including more late-term abortions, thereby putting more women at risk of dangerous complications. My Amendment 457 would introduce a statutory review of Clause 191 to provide a mechanism that is, in my opinion, the bare minimum gesture of seriousness this Parliament ought to make when undertaking such a profound change to the criminal law relating to the protection of human life.
Amendment 457 has three core elements. First, within 12 months of the clause coming into force, the Secretary of State must conduct a review of its operation and impact, followed by annual reviews thereafter. Secondly, there is a requirement that the reviews examine maternal complications, including maternal deaths, the health and safety of women having abortions, late self-induced abortion, connected coercion or abuse and the application of the criminal law to third parties involved in abortions. Thirdly, there is a power for the Secretary of State to repeal Clause 191 if the review shows it to be causing harm. The areas specified for review are not arbitrary but the categories where risk concentrates. They are the precise pressure points where this legislation is most likely to go wrong.
Let me outline a couple of these areas. It is vital we look at maternal complications. There is a serious discrepancy in the Department of Health’s reporting on this. The DHSC’s latest figures published just last month claim a complication rate of just 0.3 per 1,000 early medical abortions, equating to 71 abortions out of 236,000 in total. That sounds very good. It allows the noble Baroness, Lady Merron, the Minister, to repeatedly claim that abortion pills are safe. That is incredibly misleading. The official DHSC figures do not include complications reported after being discharged from a clinic. In other words, they do not include cases where a woman has taken one or more abortion pills at home, then has to go to hospital with infections, haemorrhaging or what is euphemistically called retained products of conception.
Those kinds of early medical abortions make up 82% of all abortions for residents of England and Wales in 2023. When you take into account hospital episode statistics publicly available for the NHS, you find that an estimated 12,000 women were admitted to hospital in 2023 with complications after taking abortion pills. There is a world of difference between 71 and 12,000, but the Government consistently refuse to report on the real picture. I have asked a number of Written Parliamentary Questions about upgrading the HSA4 form but to no avail. The Minister confirmed to me in writing in November:
“The Department has no plans to publish a separate annual report on abortion complications”.
I fear that, with Clause 191, the disparity between the official statistics and what is happening on the ground will only get worse. Modes of abortion provision have changed rapidly. Home-use pills, telemedical arrangements and so on all raise new questions. If Clause 191 increases the risk that women undertake dangerous procedures without clinical oversight or at later gestations, we must know.
Then there is coercion and abuse. Coercive partners, traffickers and other abusers sometimes pressure women into ending pregnancies. We must know whether decriminalisation for the woman inadvertently empowers abusers. Amendment 457 would require that to be examined.
That brings me to the third feature of this amendment: the power to repeal Clause 191 if the evidence demonstrates harm. Without this mechanism, the review would be merely an academic exercise. The repeal mechanism is a safety valve; it would not mandate repeal but make it possible where the evidence demands it. This is entirely normal, especially in sensitive areas of law. We have sunset clauses, review clauses and renewal clauses, all designed to ensure that legislation remains under scrutiny.