Women seeking abortions face ‘cruel’ delays due to NHS funding row
Women seeking abortions face “cruel” delays because they are prevented from choosing where to seek treatment, it has warned.
Charities have said the failure of some NHS funders to pay for out-of-area terminations is a breach of NHS rules and standards and is putting patients at risk.
dr Jonathan Lord, medical director of MSI Reproductive Choices, said The Independent that the “complex and heavily bureaucratic rules” result in patients being forced to use their only local provider or to travel long distances to a service operated by the same provider in a different location.
And the Royal College of Obstetricians and Gynecologists warned women they must have the right to choose their preferred abortion treatment and where to receive medical care.
dr Lord, a consultant gynaecologist at the Royal Cornwall Hospitals NHS Trust, said: “The patient’s freedom of choice is being taken away. This choice is enshrined for all NHS procedures but is denied for abortions.
“They are simply not complying with NHS rules which ensure patients have the right to be treated by any NHS provider. This would not happen in any other area of healthcare. It causes delays that are cruel to patients.”
He claimed the Buckinghamshire, Oxfordshire and West Berkshire Integrated Care Board (ICB), which commissions NHS services in the area, is refusing to pay his organization for the treatments it provides outside the area. She is therefore considering claiming the money back via debt collection.
dr Lord said there are a number of reasons why a woman would choose to seek treatment elsewhere, including shorter wait times, privacy or choice of procedure, and his organization has left women in tears because their applications have been denied .
Abortion services are organized differently from other forms of healthcare – around 75 per cent of NHS abortion services are provided by independent providers.
Data collected by MSI Reproductive Choices UK previously seen by The Independentrevealed women in 15 areas across England can only use their local provider.
dr Lord, whose organization works with every NHS funder in the country, said another reason a patient might not want to use her local abortion provider is because she’s had difficult experiences there or because the service isn’t the type of healthcare provides what it wants to offer.
Some services don’t offer surgical abortions and only offer induced labor, meaning women must have a stillbirth, he added.
She sobbed into the phone. She was deeply disturbed at being forced to return to where she had such unhappy memories.
He said: “At Oxford there was a patient with a severe fetal abnormality who required an abortion and did not want labor induction. She wanted to have it surgically done.
“It is very common to choose surgery over labor induction. An operation is a treatment that is performed in one session.
“The entire process of induced labor takes about three days and includes delivery, which can be very traumatic when you know the baby will not live. Also, there are higher complication rates when inducing labor.”
Another important reason a patient may not want to use their local service is if they would like to sleep or be awake for the procedure, but that option is not offered by the service.
dr Lord, who is also Chair of the British Society of Abortion Care Providers, added: “Women call in tears. I remember a woman from the Oxford area who had repeated abortions. She was so fertile that contraception failed twice.
“She had an incredibly traumatic first experience with an abortion that wasn’t the provider’s fault, but she didn’t want to go back. The funding agencies flatly refused.
“She sobbed into the phone. She was completely desperate.”
They are simply not complying with NHS rules which ensure patients have the right to be treated at any NHS provider. This would not happen in any other area of healthcare. This causes delays that are cruel to patients.
He also gave the example of a Somerset woman who wanted to be under general anesthesia so she would not be awake during her surgical abortion, but this was refused, meaning she had to travel from Somerset to London.
dr Lord said: “This is the result of a willful disregard for NHS standards. I don’t understand how someone who manages healthcare can act so cruelly.”
dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said she supports the National Institute for Health and Care Excellence (NICE) abortion guidelines, which says patients should choose where they receive treatment.
She added, “Women have the right to choose which abortion treatment they prefer and, where possible, should also have the right to choose where they receive treatment.”
Kerry Abel, chairman of Abortion Rights, a UK campaigning group, said abortion is a common and safe procedure so it is “imperative” that those who choose to have one can obtain it in a timely manner and without added stress.
“Abortion services should be patient-centred – we are concerned about any barriers to access to abortion at the local level and are calling the abortion services zip code lottery.”
NHS England and ICBs for Somerset and Buckinghamshire, Oxfordshire and West Berkshire have been asked for comment.