Abortion Services (Safe Access Zones) (Scotland) Bill: business and regulatory impact assessment

Purpose and Intended Effect

Background

Around 16,000^[1] abortions take place in Scotland each year, the majority of which occur before 9 weeks’ gestation. These are regulated under the framework provided by the Abortion Act 1967^[2], and those who choose to terminate their pregnancies under that framework are accessing a healthcare service to which they are legally entitled.

Whilst legalised abortion has always provoked strong and often polarised debate, in recent years, there has been an increase in activity occurring directly outside premises at which abortions services are provided. In the last five years, documented anti-abortion activity has occurred outside Queen Elizabeth University Hospital (QEUH), Aberdeen Maternity Hospital, Sandyford Clinic, Chalmers Clinic, Royal Infirmary of Edinburgh and Glasgow Royal Infirmary. This activity has included silent vigils, displays of images of foetuses, signs with language such as “murderer”, and displays of religious iconography.

Testimonies of those accessing and providing abortion services provide clear evidence that anti-abortion activity directly outside premises providing abortion services can be distressing; for some, it compounds what is already a difficult and painful experience.

Objective

The aims of any intervention are to:

• protect access to abortion services across Scotland;
• ensure that people can access abortion services without fear of, and free from, intimidation, harassment or public judgement;
• ensure that at the point of access users are protected from attempts to influence or persuade them in relation to their decision to access services;
• take a preventative approach so all abortion services are covered, including those that have not experienced protests;
• ensure that providers or facilitators of the service are protected from attempts to influence their decision to provide or facilitate abortion related services at their place of work or where those services are delivered;
• prevent providers or facilitators from being reluctant to provide or facilitate services for fear of such protests occurring.

Importantly, the aim is not to prevent the expression of opposition to the provision of abortion services or restrict the expression of religious views on abortion. It is only to prevent their expression in limited areas to the extent necessary to achieve the overarching aims.

Rationale for intervention

As noted above, anti-abortion activity has been documented at a number of sites around Scotland, and the scale and frequency of this has increased in the last five years. The type of activity varies from small groups to large vigils, and varies in intensity and frequency throughout the year. A public consultation^[3], led by Gillian Mackay MSP, on a proposed Bill creating safe access zones provided clear evidence from respondents on the detrimental impact anti-abortion activity can have on those seeking to access abortion services, when such activity occurs within the vicinity of premises providing abortion services. Additional testimonies provided to Scottish Government from Back Off Scotland further supports this. A full discussion on the harms can be found in the Policy Memorandum, which has been published to accompany the Bill; however, notably, the conclusion that anti-abortion activity, in specific circumstances, can result in harm is supported by academic analysis. For example, the Royal College of Obstetricians and Gynaecologists and the Faculty of Sexual and Reproductive Healthcare in 2023 notes:

“Clinic protests often have an emotional or psychological impact disproportionate to the behaviour involved – largely because of the captive nature of the audience, the confidential nature of medical care, and the potentially heightened emotional state of many people accessing treatment.”^[4]

Crucially, the Scottish Human Rights Commission noted in its response to the consultation on safe access zones^[5]:

“…The demonstrations in question (sic) go beyond expressing opposition to (the existing framework regulating abortion) or calling for reform of either the common law or Abortion Act. Both the location and messages utilised in these particular demonstrations indicate the target of the message at individuals utilising and/or providing termination of pregnancy services without distinction as to reason.”

This distinction is at the heart of why steps must be taken to protect those accessing or providing services. Abortion services, when provided within the lawful framework, are healthcare services. It is for an individual to determine whether to access those services, just as it is a personal decision to access any other type of healthcare. That decision is not open for discussion or contradiction by anyone except medical professionals and those whom the individual gives permission to intervene.

In light of the increase in both anti-abortion activity and growing calls for steps to be taken to protect service users and providers, in May 2022, Gillian Mackay MSP noted her intention to bring forward a Member’s Bill to establish safe access zones around premises providing abortion services. Following a summit on abortion care held by the former First Minister, Nicola Sturgeon, in June 2022, at which a number of medical professionals and third sector organisations supporting women discussed the impacts of anti-abortion activity, the Scottish Government and Ms Mackay agreed to work together to develop and draft safe access zone legislation.