Abortion services in NI offered on ‘make do and mend’ basis, MLAs warned

By David Young, PA

Abortion services in Northern Ireland are being offered on a “make do and mend” basis due to the failure to properly commission them, MLAs have been told.

The Northern Ireland Human Rights Commission told the Assembly’s Health Committee that the ad hoc services being offered by health trusts were “deeply unsatisfactory” and not in accordance with abortion law in the region.

Chief commissioner Les Allamby said during the pandemic women who were unable to access services in Northern Ireland have been travelling to Liverpool and Manchester for terminations, often having to return on the same day due to the lack of accommodation in lockdown.

Abortion laws in Northern Ireland were liberalised in 2019 following legislation passed by Westminster at a time when devolution in the region had collapsed.

However, while individual health trusts have been offering services on an ad hoc basis, the Department of Health had yet to centrally commission the services due to an ongoing impasse within the Executive.

Mr Allamby, who stressed that the commission took neither a pro-choice or anti-abortion position, said the current situation was not acceptable.

Last month, a judge at Belfast High Court heard a legal challenge taken by the Commission against the failure to commission services centrally. Judgment has been reserved in that case.

The chief commissioner said the services currently offered by trusts were limited to early medical abortions prior to 10 weeks.

He said there had been an inconsistent offering, with three of the five trusts having suspended services for periods – a suspension that is still in effect in the Western Trust.

“It’s also clear that none of those trusts when they suspended the services were able to refer women to other parts of Northern Ireland to access the service,” he told MLAs.

“So there’s been a make do and mend approach, frankly through heroic efforts of clinicians within trusts.

“Two of the three suspensions, for example, were because the one person who was providing the service was no longer able to do so.”

Mr Allamby said services had only been offered by transferring staff from other sexual and reproductive health care services that had experienced reduced demand due to the pandemic.

“The Department of Health has provided no guidance, public information or other tangible support for the service,” he said.

“What the trusts were saying to us was that they are used to managing risk, and normally do so within a clear framework and operational guidance. And here what we’re being asked to do this without such a framework. The reality is the service has not met the legal requirements.”

He added: “I must emphasise that the service is not in accordance with the abortion regulations, its provision is precarious, it’s prone to suspension, and in the near term can only be provided at the expense of other sexual and reproductive health care services.

“And that’s deeply unsatisfactory.”

Stormont Health Minister Robin Swann has maintained he cannot centrally commission services without the approval of the wider five-party coalition Executive, insisting it is his legal responsibility to refer controversial or significant decisions to the other ministers.

However, for such an issue to secure Executive approval, the two main parties, the DUP and Sinn Fein, must both agree to it.

The anti-abortion DUP has to date blocked consideration of the commissioning issue at the Executive.

In March, the Government intervened to hand Northern Ireland Secretary Brandon Lewis new powers to direct the Department of Health to commission the services.

However, Mr Lewis has yet to act on these powers.

Mr Allamby said he agreed with Mr Swann’s position that approval of the wider Executive would be required to commission the services.

The Commission’s legal challenge was taken against the Government, Executive and Department of Health.