Health and Care Bill — After Clause 148 — Permitted Locations for Abortion Treatment — 30 Mar 2022 at 17:11

The majority of MPs voted to permit drug-mediated abortion, up-to ten weeks into a pregnancy, without requiring an in-person consultation with a registered medical practitioner, and to permit the drugs to be taken at home.

The majority of MPs voted to permit the required consultation with a registered medical professional to take place in person, by telephone or by electronic means.

MPs were considering the Health and Care Bill.^[1][2][3]

The motion supported by a majority of MPs in this vote was:

• Amendment (a) proposed in lieu of Lords amendment 92.

Lords amendment 92 began:^[4]

• Insert the following new Clause—
• “Permitted locations for abortion treatment
• (1) The Abortion Act 1967 is amended as follows.
• (2) In subsection 1(3) after the first “section” insert “, or section 1A of this Act”.
• (3) After section 1 insert—
• “1A Approved places
• (1) The home of a registered medical practitioner is approved as a class of place for treatment for the termination of pregnancy for the purposes only of prescribing the medicines known as Mifepristone and Misoprostol to be used in treatment carried out in the manner specified in subsection (3).
• (2) The home of a pregnant woman who is undergoing treatment for the purposes of termination of her pregnancy is approved as a class of place where the treatment for termination of pregnancy may be carried out where that treatment is carried out in the manner specified in subsection (3).
• (3) The treatment must be carried out in the following manner—
• (a) the pregnant woman has—
• (i) attended an approved place,
• (ii) had a consultation with an approved place via video link, telephone conference or other electronic means, or
• (iii) had a consultation with a registered medical practitioner, nurse or midwife via video link, telephone conference or other electronic means; and
• (b) the pregnant woman is prescribed Mifepristone and Misoprostol to be taken for the purposes of the termination of her pregnancy and the gestation of the pregnancy has not exceeded nine weeks and six days at the time the Mifepristone is taken

Explanatory notes to the Lords amendments state:^[5]

• Lords Amendment 92 would insert a new clause ('Medical Termination of Pregnancy') into the Bill, which would amend the Abortion Act 1967 to allow the medication for early medical abortion to take place in the home (in England) of the pregnant woman where the pregnancy has not exceeded 10 weeks. It would also permit registered medical practitioners to prescribe the medication for early medical abortion from their homes (in England). This would maintain the existing provisions of at-home early medical abortion following a telephone or video consultation with a clinician, which were adopted in March 2020.

Amendment (a) which was supported by a majority of MPs in this vote stated:^[6]

• Page 127, line 39, at end insert the following new Clause—
• “Early medical termination of pregnancy
• (1) Section 1 of the Abortion Act 1967 is amended as follows.
• (2) In subsection (3), for “subsection” substitute “subsections (3B) to”.
• (3) In subsection (3A)—
• (a) the words from “includes” to the end become paragraph (a);
• (b) after that paragraph insert—
• “(b) is not limited by subsections (3C) and (3D).”
• (4) After subsection (3A) insert—
• “(3B) Subsections (3C) and (3D) apply where—
• (a) the treatment referred to in subsection (3) consists of the prescription and administration of medicine, and
• (b) the registered medical practitioner terminating the pregnancy is of the opinion, formed in good faith, that, if the medicine is administered in accordance with their instructions, the pregnancy will not exceed ten weeks at the time when the medicine is administered (or in the case of a course of medicine, when the first medicine in the course is administered).
• (3C) If the usual place of residence of the registered medical practitioner terminating the pregnancy is in England or Wales, the medicine may be prescribed from that place by the registered medical practitioner.
• (3D) If the pregnant woman’s usual place of residence is in England or Wales and she has had a consultation (in person, by telephone or by electronic means) with a registered medical practitioner, registered nurse or registered midwife about the termination of the pregnancy, the medicine may be self-administered by the pregnant woman at that place.””

Amendment (a) appears to seek the same aim as Lords amendment 92, however it does not refer to any specific drugs, and has different wording in-respect of the 10 week limit.

This appears to be a case of the Government accepting the principle of an amendment but placing it its own words before approving it. Indeed the minister speaking to explain amendment (a) prior to the vote stated it was intended as a "legally robust amendment in lieu" to "achieve the intended purpose of" amendment 92.^[7]

It is important context that MPs had already rejected Lords amendment 92 prior to this vote, so the vote was on if to permit drug-mediated abortion, up-to ten weeks into a pregnancy, without requiring an in-person visit to a clinic. The vote was not to decide between the two versions of the provision, but on if to have the provision at all. The consequence of amendment (a) not being supported would have been to require those seeking a drug-mediated abortion, up-to ten weeks into a pregnancy, after 29 August 2022, to have an in-person consultation with a registered medical professional at a hospital or clinic and, if prescribed, and wishing to take, drugs to effect an abortion, to be required to take the first course of those drugs at the hospital or clinic.^{[8][9][10][11][12]}.

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• [1] Parliament's webpage on the Health and Care Bill, Parliament.uk
• [2] Health and Care Bill as brought from the Commons, 24 November 2021, Parliament.uk
• [3] Explanatory notes to the Health and Care Bill as brought from the Commons, 24 November 2021, Parliament.uk
• [4] Lords amendments to the Health and Care Bill, 24 March 2022, Parliament.uk
• [5] Explanatory notes to the Lords amendments to the Health and Care Bill, 24 March 2022, Parliament.uk
• [6] Amendment paper for consideration of the Health and Care Bill on 30 March 2022, Parliament.uk
• [7] Edward Argar MP (Charnwood, Conservative), House of Commons Official Record, 30 March 2022, TheyWorkForYou.com
• [8] House of Commons Official Record, 30 March 2022, TheyWorkForYou.com
• [9] The Abortion Act 1967 - Approval of a Class of Places, Approval from the Secretary of State at the Department for Health and Social Care, 21 March 2022, Gov.uk
• [10] Abortion Act 1967, as amended, as of 11 April 2018, Legislation.gov.uk (The Act, as amended, as at the time of the vote).
• [11] The Abortion Act 1967 - Approval of a Class of Places, Approval from the Secretary of State at the Department for Health and Social Care, 27 December 2018, Gov.uk
• [12] The Abortion Act 1967 - Approval of a Class of Places, Approval from the Secretary of State at the Department for Health and Social Care, 30 March 2020, Gov.uk

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