Background

Before the creation of the National Health Service (NHS), the health of the British nation was in a perilous state and hospitals survived on the philanthropy of rich benefactors. Following its introduction on 5 July 1948, the NHS was the biggest and most expensive social reform of the era.1 It was founded on three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that its use should be based on clinical need, not ability to pay. These principles govern the NHS today.

The NHS should not discriminate against anyone who requires health care. Yet abortion care remains almost the only acute health need not comprehensively provided for within the NHS.2 In England and Wales in 2013, 98% (185 331) of all abortions were funded by the NHS,3 but only 34% of abortions took place in NHS settings. The majority were in the independent sector, funded by the NHS.4 This is in sharp contrast to Scotland, where in 2013 only 40 women out of 12 447 (0.3%) had …