Doctor warns 2023 target for NI abortion service resumption may not be met

Fear and uncertainty remain among many NHS staff about outworking of legislation, says Dr Laura McLaughlin

A doctor involved in a campaign to liberalise abortion laws in Northern Ireland has warned that an April 2023 target to create a permanent service for terminations may not be met.

Dr Laura McLaughlin was reacting to an intervention by Northern Secretary Chris Heaton-Harris on Friday, when he formally instructed the NI Department Health to commission services with funding provided by the UK government.

The move comes three years after the North’s strict abortion legislation was relaxed as a result of a landmark vote by Westminster MPs during a period of Stormont collapse.

Welcoming the Northern Secretary’s announcement, Dr McLaughlin said it was a “long time coming” but that she and her colleagues were “absolutely delighted”.

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The Belfast consultant obstetrician and gynaecologist, who is a co-founder of Doctors for Choice NI, also cautioned however that many parts of the service “need ironed out” and that its development would be an “evolving process”.

“It’s a full, brand new service being developed from scratch and something that’s never been done here in Northern Ireland,” she told BBC’s Sunday Politics programme.

“We’ve been given a time frame of full surgical services by April 2023. It would be great if that is the case. We will have clinicians trained by that time but really it’s not just the people involved in the operational part of the service, it’s beyond that as well.

“Other things such as bereavement services and linking in with perinatal mental health services. There are a lot of pathways that need to be developed; whether they’ll be developed in the next six months, I don’t think so.”

In an interview with The Irish Times in October, Dr McLaughlin revealed that three years on, she is “still explaining” the North’s abortion laws to “a lot of people, even medical professionals” who “don’t understand what decriminalisation of abortion actually means”.

Fear and uncertainty remain among many NHS staff about the outworking of the legislation, she added.

While early medical abortions have been offered in the North’s health trusts since April 2020, access is fragmented as the Department of Health never fully commissioned the service due to a political impasse.

Severe staffing shortages forced two trust clinics to close temporarily, resulting in many women travelling to England for terminations.

Former Stormont minister for health Robin Swann always insisted the full roll-out of services required sign-off by the powersharing executive – which could never happen due to the DUP’s fierce opposition to abortion – but in May the UK government directed that Mr Swann’s department had the authority to act alone.

It also gave the Northern secretary the power to step in and commission services himself if the devolved minister failed to do so.

Mr Heaton-Harris said the availability of new funding means health trusts can now recruit and train staff in coming months to “support the development of sustainable services in Northern Ireland so that a full range of high-quality services are available”.

In a letter sent to party leaders on Friday, seen by The Irish Times, he wrote that it remains “the responsibility of the Northern Ireland Executive to fund abortion services in Northern Ireland” but added:

“The UK government will continue to ensure funding is made available in line with the financial requirements for phase one of commissioning until March 2025 or (if earlier), until the Department of Health is able to take full responsibility for the provision of that funding.”

On Sunday, Dr McLaughlin told the BBC it was “unfortunate” the money had to come from the UK government and would have “preferred” it was supported by the “Department of Health and Chief Medical Officer”.

She also expressed concerns about future funding if Stormont is restored given the previous political deadlock on the issue.

“We’re getting ring-fenced funding. We’re aware it’s non-recurrent, so we’ve got it for at least another couple of years. As to how long we’ll have it after that does remain uncertain but it allows us to recruit into the service, it allows to have specific designated clinics ... and we’ll be able to train up other health professionals to provide a full service though the gestational period.”

In a statement, the Department of Health acknowledged the legal requirements placed on it and said it had been working closely with the Northern Ireland Office (NIO) on the planned commissioning of abortion services in Northern Ireland.

Meanwhile, Catholic Archbishop Eamon Martin said in a statement that he “rejects Westminster’s priority of abortion at time of health and cost of living crisis”.

“This urgency to push through abortion while the Northern Ireland Assembly is down, continues as Christmas approaches, while little is seemingly being done to ensure the urgent provision of Westminster support for the most vulnerable, including children, impacted by the Cost of Living Crisis.”

He said the Catholic Bishops of Northern Ireland remain “committed to working with all sectors of society in Northern Ireland so that a culture of life and care becomes a reality for all”.

Seanín Graham

Seanín Graham

Seanín Graham is Northern Correspondent of The Irish Times