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Law ‘ripe for change’ as MPs back telemedical abortions in England


Abortion law in England is “ripe for change”, a digital healthcare expert has said, following a landmark vote by MPs on telemedical pregnancy terminations.

MPs voted in favour of making permanent a temporary amendment to the 1967 Abortion Act allowing consultations to be done by telephone or videoconference, and for early medical terminations to be carried out remotely. The change was made in March 2020 amid restrictions on travel and hospital access in the early days of the Covid-19 pandemic, but was due to expire in August 2022.

Louise Fullwood of Pinsent Masons said that the amendment had had a “positive impact” on health and wellbeing.

“Practically, the pandemic has been transformational in its impacts on how we access healthcare in the UK – having positive effects on the speed, safety, waiting times and efficiency with which patients interact with healthcare professionals. There is evidence that remote access to termination services has also had similar positive impacts, for example a significant drop in the seeking of termination medications from non-licensed and illegal providers,” Fullwood said.

Fullwood Louise

Louise Fullwood

Legal Director

The pandemic has been transformational in its impacts on how we access healthcare in the UK – having positive effects on the speed, safety, waiting times and efficiency with which patients interact with healthcare professionals

She added: “From a legal perspective, it would therefore have seemed unjustified for telemedicine to be allowed for other healthcare services, but not for terminations. On top of this, to reinstate and continue the exclusion of terminations from remote consultation and prescription could potentially undermine the use of telemedicine for the delivery of other healthcare services.”

Prior to the change, the Abortion Act had stated that, except in an emergency, all terminations must be carried out at either a hospital or a place approved by the secretary of state for health. Approved places had traditionally been limited to clinical settings such as British Pregnancy Advisory Service (BPAS) premises. As of 2018, for early medical abortions – those taking place before 10 weeks’ gestation using non-surgical methods – the requirements were fulfilled provided the first of two required doses of medication was taken in a clinical setting.

The 2020 amendment enabled the remote consultation and prescribing model by designating the homes of women seeking terminations and/or those of prescribing clinicians to also be approved places. It also allowed for both doses of medication to be sent by post and taken at home.

Similar changes to the law were introduced in Scotland and Wales, which have both confirmed that these will be made permanent.

Fullwood said: “The underlying legal issues here are a good example of where existing legislation no longer reflects modern clinical practice and technology. In 1967 when the Abortion Act first came into force, the only available terminations were surgical - not medical - and remote consultations were not an established method of healthcare delivery.”

She added: “Outmoded legal provisions have been amended in recent years with regard to other healthcare services - like the 1968 Medicines Act which did not anticipate the development of online prescription delivery. The updated legislation has improved safety, speed and reduced fraud around prescription communication and dispensing. Now the law on telemedical abortions is ripe for change, and the pandemic has simply been the trigger for it.”

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