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Northern Ireland (Executive Formation etc) Act 2019: Section 3(5) - Motion to Take Note

Part of the debate – in the House of Lords at 6:10 pm on 17th October 2019.

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Photo of Baroness O'Loan Baroness O'Loan Crossbench 6:10 pm, 17th October 2019

My Lords, I will talk about abortion and the return of the Assembly. It is really important that we remember why we are debating this provision; it is because of the recommendations of the report produced by the CEDAW committee, which were deemed to be so imperative because of concern for women’s rights in Northern Ireland. When moving the provision that became Section 9, the honourable Member for Walthamstow in another place said that she wanted women in Northern Ireland to have the same rights as women in England and Wales.

We need to keep this in mind as we consider the Secretary of State’s report and what it says about the period between 22 October 2019 and 31 March 2020 if regulations are not laid before then. The report acknowledges that during this period the law will not be quite all that it should be and seeks to deal with that problem by saying that,

“there are no plans for additional services to be routinely available before 31 March”.

That is a curious statement. It seems to be predicated on the thoughts that if additional abortion services were made available they would be provided by the government -controlled National Health Service, and that the Government can prevent abortions being provided in the new legal void by simply instructing the NHS not to provide them.

There is a huge problem with that approach, which the noble Lord, Lord Morrow, and the noble and learned Lord, Lord Mackay, have referred to: that the NHS will not be the only body which will be able to provide abortions lawfully during this period. Unless the Assembly is restored, Sections 58 and 59 of the Offences against the Person Act will be repealed and only two laws engaging with abortion in Northern Ireland will remain. Under the Criminal Justice Act (Northern Ireland) 1945, as noble Lords have heard, abortions cannot take place lawfully from the time at which a child is capable of being born alive. The presumption in the Criminal Justice Act is that that is 28 weeks, but we know that babies now routinely survive at 22 weeks. It means that there will be a legislative void regarding abortions until that point.

Abortion procedures are dangerous, so responsible governance provides legislation regulating how they should be provided. In England, for example, every private abortion clinic must have a licence. The licence is not a generic clinic licence but a specific abortion clinic licence, and clinics have to perform to required operating standard procedures. Under Regulation 20 of the Care Quality Commission (Registration) Regulations 2009 there are requirements relating to the termination of pregnancies, including an obligation to ensure that two medical opinions are provided before an abortion is carried out, a restriction on who can carry out abortions after twenty weeks, because of the risks, and a requirement for detailed records to be kept.

The English legislation very properly recognises that the procedure of abortion requires abortion-specific regulation of both the premises and the procedure. In addition, under the Health and Social Care Act 2008 and associated regulations, any person who offers or undertakes abortion carries out a “regulated activity” and has to be registered with the CQC. Subject to limited exceptions, it is a criminal offence to carry out a regulated activity unless you are registered for the provision of that activity. So in England the practitioner, the location and the process are all subject to regulation. None of this regulation, designed to protect women and their unborn children, will apply to private abortion clinics in Northern Ireland which, unless the Assembly is restored, will be free to operate until regulations are laid.

From Tuesday, any provider of medical abortion services by a doctor at an independent clinic has to be registered under the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003. If it is registered, the clinic will be inspected and its services will be quality assured, but only as generic clinic services. No specific reference is made to standards for abortion. Moreover, this is the real danger: if the regulations say that if one medical professional who works for the National Health Service works in the clinic, it does not have to be regulated or assessed by the RQIA, so there is lots of scope for private abortion clinics employing one registered medical practitioner working for the NHS not to be subject to any regulation at all. Even worse, there will be no prohibition on anyone without medical qualifications providing abortion services in any context, and no prohibition on women accessing abortion as long as they give consent. I have to remind noble Lords that if there is a challenge as to whether a woman has given consent, it can be determined only after the event.

As the noble Lord, Lord Morrow, and the noble and learned Lord, Lord Mackay, referred to, we have seen legal opinions on the law in this area. David Lock, an eminent lawyer in the field of NHS and medical legislation and a former Labour MP, has written this:

“A person who was not a doctor (whether a nurse, other clinical professional or with no qualifications) who provides abortion services outside any form of clinic, agency or establishment does appear to not need to be registered under the 2003 Order. Further, there does not appear to be any other regulatory regime that will apply to such a person or any law which means that such a person will necessarily be acting unlawfully”.

He concedes that other criminal offences may be committed depending on the precise facts. He also says:

“In general, under the common law it is lawful to do anything unless there is a specific legal prohibition against doing that thing. Thus an individual is entitled to carry out any form of activity unless the activity is regulated by law and the regulatory framework imposes restrictions on the way in which the activity can be undertaken”.

There will be no such regulation and no framework for Northern Ireland until we see what the regulations say, possibly as late as 31 March 2020. David Lock goes on to say:

“It follows that an unintended consequence of section 9 of the 2019 Act may be the possible return of unregulated ‘backstreet abortion’”.

I know that this was discussed yesterday in the other place and I heard the Minister, but I think that the other place was labouring under a misunderstanding about the actual state of the law in Northern Ireland after 22 October if the Assembly and Executive are not formed. That is why I have set out the law as clearly as I can. This point was also raised last month by the Northern Ireland Human Rights Commission when it referred to the fact that the,

“likelihood of individuals resorting to potentially unsafe practices remains while prosecutions under the criminal law have been removed and the healthcare process has not been established”.

If even one mother or one baby suffers as a consequence of this legislative void, this Parliament will be responsible, as will be those who do not return to the Assembly. That is a very sombre thought.

In addition, the new guidelines issued by the Secretary of State state that,

“there is no expectation that general practitioners (GPs) will prescribe medication for early medical abortion”.

Such medication should be taken only up to nine weeks and six days of pregnancy. In England and Wales, this medication is available from private services because GPs do not provide abortion services. David Lock QC has also advised that,

“there is no legal bar on a GP issuing a prescription for medication for an abortion (either privately or as part of NHS funded care). These are ‘prescription only medicines’ which a GP would be fully entitled to prescribe for his or her patient if the GP considered that it was clinically appropriate to do so”.

So there will be no legal bar on women asking GPs for medication. The Government’s expectation therefore seems irrelevant.

What then of the rights of conscientious objection, which are required to give effect to the protection of human rights of medical practitioners? A couple of weeks ago, over 800 healthcare professionals wrote to the Secretary of State to oppose the imposition of this new regime, saying,

“our consciences demand that we not be silent”.

The medics say that they,

“wish to make known our opposition to the imminent introduction of abortion in Northern Ireland”,

and that their,

“concern throughout is for pregnant mothers and their unborn children”.

The only reference to conscience in the recent report by the Secretary of State is that current UK law permits conscientious objection only in “hands-on situations”. This is entirely inadequate—there is no legal definition of hands-on situations. However, it is also inadequate to suggest, as the report does, that medical practitioners should consult the GMC and other professional bodies. The reality is that that does not provide any guidance to medical practitioners during the lacuna period from 22 October. Of course, it is not possible to provide such guidance in the absence of regulation. The UK professional guidance is predicated upon compliance with existing law. That law does not apply here.

As the noble Lord, Lord Morrow, said, the situation is entirely unnecessary; government could have behaved entirely differently. When Back-Benchers come up with proposals that have dangerous unintended consequences —I am absolutely sure that neither the Minister here, the Secretary of State nor anybody else intended that this situation would prevail—it is the job of departments and Ministers to point out those dangerous unintended consequences. It is also their job to point out that the dangers can be avoided with a proper understanding of the imperative—or lack of it, as I would argue—attached to the findings of the UN committees. Government should have insisted that our existing legislation should not be repealed until such a time as there was new legislation to take its place.

With that in mind, I introduced my Northern Ireland (Executive Formation etc) Act 2019 (Amendment) Bill the day after the Act received Royal Assent to change the date of the repeal of Sections 58 and 59 to the time when the new regulations are introduced, thereby doing away with this dangerous five-month period, and seeking the consent of a majority of MLAs to any new proposed regulations tabled under the Act. In this sorry, sad, dangerous situation, the Secretary of State must do everything he can between now and Monday to get the Assembly Executive up and running by Monday. The political parties in Northern Ireland are under an even greater obligation to do so.

As we speak, some 26,100 people have signed my petition to the Secretary of State and to MLAs calling for the recall of the Northern Ireland Assembly and for it to become operational. A petition by unionist MLAs has been laid for the recall of the Assembly on Monday, as the noble Lord, Lord Morrow, informed the House. The Assembly will now be recalled on Monday and for the first time in over 1,000 days, at this time of extreme urgency—not just because of the abortion provisions but because of Brexit and all the other things that affect Northern Ireland so terribly—the Assembly will gather. There are people who say this is a political stunt, but the people of Northern Ireland have been calling for the Assembly to reconvene for years. This is no political stunt. As I said in my letter to the Secretary of State on Monday:

“We need our own legislature to deal with matters relating to Brexit, to all the numerous and urgent problems which exist in Northern Ireland, and most of all to deal with the difficulty of the situation with regard to abortion if the assembly and executive are not reformed”.

I appeal to all those who do not share my views on this matter to study the David Lock and Ian Wise opinions to which the noble Lord, Lord Morrow, referred, and to recognise the hazards to the safety of women and their unborn children, of which I have spoken tonight, and so to restore the Executive. An opinion poll just released by LucidTalk shows that 60% of people in Northern Ireland are concerned about the prospect of unregulated abortion for one day, let alone five months.

I cannot express too strongly the fact that the 26,000-plus people who signed the petition come from all parts, all parties and all communities in Northern Ireland and represent so many nationalities. I have watched the signatures rolling in. I can see the different nations of the world represented among the signatories. I can see people I know and do not know, but because of the way we work in Northern Ireland, I know that they come from all parts of the community.

I say to Northern Ireland’s elected politicians: respond to this opportunity; respond to the call to appoint an Executive and get back into government. I know that only our politicians can do this. We, the people, have waited long enough.