The Health and Care Act 2022: inserting telemedicine into the Abortion Act 1967
Adelyn L. M. Wilson
Abstract
On 28 April, the Health and Care Act 2022 (HCA) received royal assent. Seen as a successor to the Health and Social Care Act 2012, the new Act encompasses significant structural changes to healthcare services. The HCA is likely to become best known for its formalization of Integrated Care Systems and copious transfer of powers to ministers, which have raised objections from both the UK Parliament’s scrutiny committee and the medical profession.1 Additionally, the HCA includes the first statutory reform of English abortion law in more than thirty years. Section 178 places early medical abortion by telemedicine on a statutory footing in England and Wales. The HCA thus makes permanent an emergency arrangement introduced during the COVID-19 pandemic, which itself was an extension of a narrower interpretation of home abortion introduced across the UK between 2017 and 2020. This commentary will examine section 178 and show its significant importance for abortion law in England and Wales, while highlighting the rather different positions in Scotland and Northern Ireland. It will first explain the legal framework for home and telemedical abortion prior to the HCA’s enactment, then examine the circumstances of section 178’s incorporation into the HCA and the framework for telemedical abortion which it provides. This commentary will then consider two innovations section 178 has introduced, which in turn will make the statutory framework for abortion more adaptable to future developments in the available treatments than has previously been the case, and will recognize the wider treatment team in a new way. Finally, this commentary will consider the complexity of the interaction between section 178 and the executive’s powers under the Abortion Act 1967 Act (as amended), and reflect on what this means for the future of abortion law reform.