Cost of Abortions in England – 2018.

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:

MA17CDilation and Evacuation, less than 14 weeks gestation
MA17DDilation and Evacuation, 14 to 20 weeks gestation
MA18CMedical Termination of Pregnancy, less than 14 weeks gestation
MA18DMedical Termination of Pregnancy, 14 to 20 weeks gestation
MA19AVacuum Aspiration with Cannula, less than 14 weeks gestation
MA19BVacuum Aspiration with Cannula, 14 to 20 weeks gestation
MA20ZMedical 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.

ServiceFee
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.

kevin@percuity.co.uk


[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.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

Create a website or blog at WordPress.com

Up ↑

%d bloggers like this: