British Pregnancy Advisory Service v Secretary of State for Health

“Treatment for the termination of pregnancy” includes the use or administration of abortifacient medicines, not merely their prescription. Termination describes the intended consequence of treatment; it does not define treatment as the point at which a prescription is issued. The statutory scheme places responsibility for approving places of treatment, medicines and the manner of their administration on the Secretary of State. That allocation cannot be displaced by an updating construction based on developments in medical science. The interpretation is also supported by the conscientious-objection protection in section 4 of the Abortion Act 1967. A declaration which would permit self-administration at home without the Secretary of State’s approval would be contrary to Parliament’s intention.

The claimant sought a declaration concerning a proposed early medical abortion process. Under the proposed process, a registered medical practitioner would prescribe abortifacient medicines, with the woman taking the second-stage medicine at home. The issue was whether treatment for the termination of pregnancy under section 1(3) of the Abortion Act 1967 ended with prescription, or included administration and use of the medicine. The claim was brought under Part 8 of the Civil Procedure Rules 1998 as a statutory construction issue involving no substantial factual dispute.

1. Claim dismissed. The words “any treatment for the termination of pregnancy” bear their natural and ordinary meaning. In their medical context, “treatment” includes the medical application or use of remedies, including the taking of an abortifacient drug. Prescription alone makes treatment available; it does not establish that treatment has occurred (paras 23–25).
2. Royal College of Nursing of the United Kingdom v Department of Health and Social Security [1981] AC 800 establishes that termination of pregnancy may describe the whole process of treatment designed to bring about an abortion. The reasoning applies equally to medical treatment and supports treating administration of the drug as part of the treatment process (paras 26–30).
3. Section 1(3A) of the Abortion Act 1967 confirms that treatment may consist primarily in the use of medicines. It also assigns to the Secretary of State responsibility for approving classes of places, medicines and the manner of administration or use. The provision is persuasive evidence when construing section 1(3), although it does not retrospectively alter the meaning of that subsection (paras 29–32).
4. The “always speaking” or updating principle does not assist the claimant. Section 1(3A) already addresses changes in medical science and gives the Secretary of State power to respond to them. The proposed development falls within the statutory genus of treatment, but the statutory purpose can be fulfilled only by retaining the Secretary of State’s approval function (paras 32–34).
5. Section 4 supports the same construction. The protection for persons with a conscientious objection applies to participation in treatment authorised by the Act, including the direct administration of abortifacient drugs. The claimant’s interpretation would create an unintended gap in that protection for nurses, midwives and others administering the drugs (para 35).
6. The proposed declaration was also objectionably broad. It would extend beyond the particular early medical abortion process relied on, potentially covering different stages of pregnancy, different abortifacients and medicines with different safety records. Regulatory arrangements could not replace the statutory controls Parliament had assigned to the Secretary of State (paras 36–37).

First-instance judicial review and statutory construction proceedings. No prior appellate decision is stated in the judgment.