Freedom of information responses show that in 2018, NHS England paid £96 million for abortion services, at an overall average cost of £510 per abortion. From BPAS published financial statements[1] and a number of FOI responses, we can derive that the average price charged to the NHS by the independent sector providers in 2018 was £390. Combining these data with the abortion statistics published by the Department of Health and Social Care[2] we can show:
- In 2018, NHS England spent £96 million on abortion.
- At an overall average cost per abortion of £510.
- The average payment to independent sector providers was £390 per abortion.
- The average cost within the NHS providers was at least £880 per abortion.
- The NHS paid at least £55 million to independent sector providers, 93% of which was paid to BPAS and Marie Stopes UK.[3]
In 2018, there were a total of 191,555 abortions for residents in England; 98.2% (188,187) were funded by the NHS and of these, 75.4% (141,811) were performed by the independent sector.1
- The independent sector providers performed 75% of all NHS-funded abortions at 60% of the total cost; due to lower-cost cases and economies of scale gained by the CCGs contracting independent specialist clinics.
The NHS England budget for 2018/19 was £114 billion, of which £75.6 billion was allocated to the 195 Clinical Commissioning Groups.[4] The allocation to the CCGs was subsequently increased to £84.5 billion.[5]
- The £96 million paid by the CCGs in England for abortions, was 0.1% of the total CCG spend in 2018/19.
Freedom of information data.
Our research team made freedom of information requests about abortion costs in 2018 to each of the 195 Clinical Commissioning Groups (CCGs) in England.[6] We received usable, complete, responses from 177 CCGs, a completion rate of 91%
Some of the CCG responses provided a single total cost for abortion provision in 2018, combining together monies paid to specific independent sector providers and identifiable costs from NHS providers including hospitals and other healthcare facilities providing acute and secondary care.
Other responses provided totals paid to each independent sector provider and each of the NHS providers. The NHS costs were based on Payment by Results (PbR) tariffs for services provided against each of the following Healthcare Resource Group (HRG) codes:
| MA17C | Dilation and Evacuation, less than 14 weeks gestation |
| MA17D | Dilation and Evacuation, 14 to 20 weeks gestation |
| MA18C | Medical Termination of Pregnancy, less than 14 weeks gestation |
| MA18D | Medical Termination of Pregnancy, 14 to 20 weeks gestation |
| MA19A | Vacuum Aspiration with Cannula, less than 14 weeks gestation |
| MA19B | Vacuum Aspiration with Cannula, 14 to 20 weeks gestation |
| MA20Z | Medical or Surgical Termination of Pregnancy, over 20 weeks gestation |
In a small number of the FOI responses, the CCG included details of the contractual prices charged by the independent sector provider for each of its services including consultations, medical abortion, and surgical abortion. The cost of an abortion procedure will include the consultation fee plus the applicable service fee for that procedure.
The following table is an example of the contractual service fees agreed with independent sector providers.
| Service | Fee |
| Consultation | £ 80 |
| Medical Abortion <9w | £ 317 |
| Medical Abortion 9w – 18w | £ 503 |
| Medical Abortion =>19w | £ 1,053 |
| Manual Vacuum Aspiration with local anaesthesia <14w | £ 319 |
| MVA with general anaesthesia (up to 14 weeks) | £ 319 |
| Surgical LA <14w | £ 319 |
| Surgical GA <14w | £ 319 |
| Surgical GA 15w – 18w | £ 500 |
| Surgical GA =>19w | £ 1,534 |
The following table shows a sample of the FOI responses and our calculations:
| CCG | (a) NHS funded abortions[7] | (b) Total cost[8] | Average cost = (b/a) |
| NHS Brighton and Hove | 1,105 | £ 508,000 | £ 460 |
| NHS Coastal West Sussex | 1,200 | £ 525,342 | £ 438 |
| NHS Dorset | 2,185 | £ 1,051,863 | £ 481 |
| NHS Herts Valleys | 1,794 | £ 964,942 | £ 538 |
| NHS Leeds | 3,249 | £ 1,819,878 | £ 560 |
| NHS Lewisham | 1,754 | £ 857,000 | £ 489 |
| NHS Liverpool | 2,391 | £ 1,444,950 | £ 604 |
| NHS Manchester | 3,085 | £ 1,440,000 | £ 467 |
| NHS Warrington | 703 | £ 489,983 | £ 697 |
| NHS West Leicestershire | 938 | £ 420,556 | £ 448 |
Kevin Duffy.
[1] https://register-of-charities.charitycommission.gov.uk/charity-search/-/charity-details/289145
[2] https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2018
[3] Clinic data tables: https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2018
[4] https://www.england.nhs.uk/wp-content/uploads/2019/07/Annual-Report-Full-201819.pdf
[5] https://www.england.nhs.uk/wp-content/uploads/2019/10/financial-information-4th-quarter-2018-19.pdf
[6] https://data.gov.uk/dataset/ca5ea4db-11f2-4460-87ca-1a33a9a6cca8/clinical-commissioning-groups-april-2018-names-and-codes-in-england
[7] Table 11a: https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2018
[8] Total costs are taken directly from each of the relevant FOI responses.
Percuity 