The Department of Health has persistently missed targets to implement full abortion services in Northern Ireland since July 2019, when MPs in Westminster voted to bring Northern Ireland in line with the rest of the UK by decriminalising abortion and extending rights to Northern Ireland.
Instead, individual health trusts have offered services on an ad-hoc basis, without any central commissioning, often meaning a post-code lottery for those in need of service provision.
Health Minister Robin Swann MLA has previously cited the “significance and sensitivity of the issue” for the need for Executive approval, despite numerous interventions from MLAs demanding that the Department unilaterally commission services.
In May 2022, then Secretary of State Brandon Lewis MP laid regulations to remove the need to seek Executive Committee approval in relation to commissioning abortion services in Northern Ireland, citing inaction from the Department and the Executive to guarantee the relevant healthcare services.
Lewis had originally set a 31 March 2022 deadline for a fully-funded abortion service to be set up, but told a Westminster Committee he did not expect “the Department of Health or Health Minister to take forward the commissioning of abortion service”.
Citing the current absence of provision high-quality abortion and post-abortion care for women and girls in Northern Ireland, Lewis not only removed the need for Executive Committee approval before services can be commissioned and funded by the Department of Health, but also gave the Secretary of State additional powers to “do anything that a Northern Ireland Minister or department could do for the purpose of ensuring that the recommendations in paragraphs 85 and 86 of the CEDAW report are implemented”.
The Abortion (Northern Ireland) Regulations 2021 were approved by both Houses of Parliament at the end of April 2021. The Abortion (Northern Ireland) Regulations 2022 were subsequently laid on 19 May 2022.
The Department of Health has failed to respond to several requests asking what work it has undertaken to commission abortion services since the legislative changes, since mid-July. It has also failed to clarify whether it was the Minister of Health’s intention to provide the “clear and unambiguous” commitment which the then Secretary of State stated he would be seeking.
Critics have pointed out that two years on from Westminster’s intervention, and despite numerous threats of action, the UK Government has yet to instil change to service provision in Northern Ireland, highlighting that the then Secretary of State’s threat to “intervene further”, if the Department does not commission and fund abortion services, as directed, lacks impetus.
There is evidence that ad hoc services set up by the various health trusts are falling well short of demand. The Department of Health’s own figures show that in 2019/2020 just 22 terminations of pregnancies took place in Northern Ireland, compared to 984 NHS-funded terminations of pregnancy carried out on Northern Ireland residents in England and Wales in 2019. These figures do not include privately funded treatments.
Speaking during his short-term stint as Secretary of State, Shailesh Vara MP, indicated his intention to follow the course set out by Lewis.
“The Secretary of State believes it is unacceptable women and girls in Northern Ireland cannot access the same level of abortion healthcare as the rest of the UK,” a UK Government spokesperson said.
“The Department of Health should drive forward the commissioning of abortion services without further delay. If it does not commission and fund abortion services as directed, the Government will intervene.”