In 2012, A, a 15-year-old resident in Northern Ireland, became pregnant. She reasonably believed that she would not be able to obtain an abortion in Northern Ireland or through the NHS in England because she was ordinarily resident in Northern Ireland and, consequently, she travelled to England for a private abortion accompanied by B, her mother, at a total cost of £900. She sought judicial review, arguing that the Secretary of State's failure to make provision for Northern Irishwomen to access abortion services through the NHS in England was unlawful. Her claim was dismissed both at first instance and in the Court of Appeal. The issues before the Court were whether the Secretary of State's failure to exercise his power to require the NHS to provide abortion services to women ordinarily resident in Northern Ireland was a failure to discharge his duty under section 3 of the National Health Service Act 2006 to take such steps as he considers necessary to meet all reasonable requirements for services and whether that continuing failure infringed Articles 14 (prohibition of discrimination) and 8 (right to respect for private and family life) of the European Convention on Human Rights.

Lord Wilson (with whom Lords Reed and Hughes agreed) dismissed the appeal and concluded that the human rights challenge failed because the difference in treatment was justified. Article 8 was engaged; however, a difference of treatment between UK citizens present in England on the grounds of usual residence fell within the scope of ‘other status’ for the purposes of Article 14. In short, the aim of the Secretary of State's decision in relation to women who were UK citizens but usually resident in Northern Ireland was to stay loyal to a legitimate scheme for health services to be devolved and was rationally connected to his decision not to make the direction sought by the appellants; with that aim in mind, he could not have reached any decision less intrusive upon their Article 8 rights. The Secretary of State's position struck a fair balance between their rights and the interests of the UK community as a whole and was not discriminatory; moreover, extending the duty would result in health tourism to England.

Dissenting, Lord Kerr (with whom Lady Hale agreed) argued from the position that a Northern Irishwoman visiting England who needed an emergency appendectomy would be treated without charge but the same woman would have to pay for an abortion: That could not be right. He suggested that the majority decision rested on a false premise: what the applicants were claiming was that, when in England, they should be entitled to the same treatment as Englishwomen in relation to abortion services. Lady Hale added that, although there was no question of trying to change the criminal law of Northern Ireland, women were not prohibited from travelling to England to have a lawful abortion. The current law in Northern Ireland could not constitute a good reason for a policy of denying them health services which are lawful in England. [Frank Cranmer]

Subsequently, in advance of a vote on the issue in the House of Commons, the Chancellor of the Exchequer announced that Northern Irishwomen would in future be able to obtain NHS terminations in England.