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Abortion Services Directions 2021

Volume 699: debated on Thursday 22 July 2021

Today I am issuing a direction to the Department of Health, the Minister of Health, the Health and Social Care Board, and to the First and Deputy First Minister, to commission and make abortion services available in Northern Ireland as soon as possible, and no later than 31 March 2022. I am also directing that there should be immediate support for interim services of early medical abortion, which are at risk of collapse.

I have a statutory duty to protect the rights of women and girls in Northern Ireland, imposed by section 9 of the Northern Ireland (Executive Formation etc) Act 2019. This duty requires me to ensure that the recommendations in paragraphs 85 and 86 of the 2018 Convention for the Elimination of Discrimination Against Women (CEDAW) report are implemented in full. I therefore have a duty to “provide women with access to high-quality abortion and post-abortion care in all public health facilities”. I acknowledge and respect the deeply held views that individuals hold on this issue. However, it is the clear will of Parliament that the rights of women and girls in Northern Ireland are properly upheld.

The Government laid the Abortion (Northern Ireland) Regulations 2020 and they came into force on 31 March 2020. Those regulations delivered a framework for abortion services which struck the appropriate balance between delivering a CEDAW compliant legal framework that ensures the health and safety of women and girls, and gives clarity and certainty to the healthcare profession, but is also sensitive to the circumstances in Northern Ireland.

In March 2021, we took a further step and made the Abortion (Northern Ireland) Regulations 2021. We took this important step because a year after the 2020 regulations were made, women and girls in Northern Ireland are still unable to access high-quality abortion and post-abortion care in Northern Ireland in all the circumstances allowed by the regulations we made on 31 March 2020. This remains the case today.

The Abortion (Northern Ireland) Regulations 2021 gave me a power to direct a Northern Ireland Minister, a Northern Ireland department and the Health and Social Care Board of the Public Health Agency to take action necessary to implement all the recommendations in paragraphs 85 and 86 of the CEDAW report. The regulations were debated on 26 and 28 April 2021 in the House of Commons and House of Lords respectively and both Houses supported the regulations overwhelmingly, with a majority of 431 to 89 on a free vote in the Commons.

For over a year, the Northern Ireland Office has continued to work closely with the Department of Health, and other relevant Northern Ireland Departments, trying to progress this work. Some service provision commenced on the ground from last April and I put on record my thanks to the medical professionals and Informing Choices Northern Ireland who have ensured that women and girls have had some local access to abortion services in Northern Ireland, and the organisations that have supported this work.

Though I recognise the huge strain that covid-19 has placed on healthcare in Northern Ireland, I remain extremely disappointed that full commissioning proposals have not yet been brought forward by the Department of Health and that the Executive has not an opportunity to discuss them. This ongoing stalemate leaves me no choice but to issue a direction. I have a legal and moral obligation to ensure the women and girls in Northern Ireland are afforded their rights and can access the healthcare as set out in the 2020 regulations.

I am now directing the Department of Health to secure the commissioning and availability of the relevant healthcare services. The direction also includes an immediate requirement for the Department of Health to continue to support the central access point provided by Informing Choices NI (ICNI) who are key to providing early medical abortion services. I have chosen to impose a deadline for the availability of commissioned services of 31 March 2022 to account for the Department of Health’s estimate that it would take 8-12 months to make fully commissioned CEDAW compliant services available.

I am also directing the Department of Health and the regional Health and Social Care Board. The direction includes a requirement to commission, provide and fund abortion services so that they are available in all of the circumstances in which abortions are lawful. This includes access to services in cases of fatal foetal abnormality and severe foetal impairment in line with the Abortion (Northern Ireland) (No 2) Regulations 2020 in any service commissioned. It is for the Northern Ireland Executive to allocate all necessary funding for abortion services from its Barnett-based block grant or its own resources.

I am also directing the First Minister and Deputy First Minister that once proposals are brought forward by the Department of Health, they must be included on the agenda at the next meeting of the Executive Committee.

At the heart of this matter are the women and girls in Northern Ireland, who have been, and continue to be, denied the same reproductive rights as women in the rest of the UK. Parliament determined that this should be corrected and by exercising the power to direct, we will ensure that it is.