Yesterday we looked at the controversy last year surrounding a Daily Mail investigation from 2017, where undercover reporters phoned Marie Stopes call agents, the second biggest abortion provider in the U.K.
They reported that on stating that it wasn’t the right time for them to have a baby, the call agents (who are not medically qualified and who work to a script) stated that this would count as ‘client is unable emotionally to continue with pregnancy’, which fits the legal conditions and that the conversation took as little as 22 seconds. They described numerous failures that were identified by health watchdog Care Quality Commission C.Q.C. which included in one case the bulk signing of 26 consent forms by a doctor in Marie Stopes in 2 minutes.
Whereas the interpretation of the 1967 U.K. abortion law does not require doctors to see patients before abortions, it is considered ‘ good practice’ by the Dept of Health. One concern that appeared in the article was that whereas a nurse may go through the consent process according to N.H.S. guidelines and the doctor must sign off afterwards, in fact, health care assistants were doing this in Marie Stopes and while pre-signing of consent forms may not have been happening, the checks and balances were questionable to say the least.
(2): TODAY’S POST:
‘The first point of contact in the clinic was with a health care assistant or H.C.A.
The H.C.A. had just 20 minutes to explain the procedures to each patient, perform an ultrasound and take a medical history and a blood sample. On top of that, the HCA had to complete the paperwork. It was a punishing schedule.’
‘At that time, Marie Stopes was performing around 30-35 surgical terminations a day at the clinic I worked in alone. About a quarter of them were over 14 weeks. Some 95 per cent of patients were funded by the NHS.’
‘Many women are upset when they arrive at a clinic. Time should be given to talk to them, and to pick up on any signs that they don’t want to go through with the termination. But you couldn’t always be sure this had happened, because of the pressures everyone was under.’
‘Legally, abortion forms require two medical signatures. I would fill in the forms without having met a patient, ticking the appropriate box to confirm that was the case.’
‘I just had to rely on the health care assistants and hope that if a woman was unsure or had been forced into a termination by her partner or parents, they had picked up the signs in the short time they had with the woman. There was a climate of fear at Marie Stopes. If we were taking too long signing forms, we’d be chivvied by administrative staff. Sometimes, I’d already be in the operating theatre, performing a procedure, when documents would be presented for me sign. To say it was a rushed would be an understatement.’
‘Every now and again, a patient on my operating table would change her mind and leave the room. Could she have been better counselled? Certainly, more time spent with her might have thrown up her doubts. It’s likely she had simply not felt able to express doubts about what lay ahead to the H.C.A. as she was sped through their checks.’
‘I sometimes got the impression that the women I treated hadn’t been given the full picture, or had the pain properly explained to them. They often appeared to feel more pain than you’d expect, and that upset me, because once you have started a termination you can’t stop. I would just have to carry on, despite their cries.’
‘The next level up from a no-anaesthetic abortion was ‘conscious sedation’ – something which is used very commonly throughout NHS services, including dentistry – whereby the patient is given low dose anaesthetic drugs so they don’t lose consciousness. The drugs used – which had similar effects to the ‘date-rape’ drug Rohypnol – would wipe the memory of the pain.’
‘It sped up the process, because women recover quicker than after general anaesthetic and there’s less aftercare needed. But is it all right for a doctor to hurt someone simply because she won’t remember the pain?’
‘I would be trying to perform a termination on a patient who was wriggling or shuffling up the operating table, trying to get away. I’d have to pull her back down again to continue the procedure. After a termination – and to keep a rapid throughput of patients – women would be taken into a small room where they were allowed to lie for ten minutes before being taken upstairs to sit in a reclining chair. On the occasions I had to examine someone who had post-operative pain, the fact that there was no bed available made it far more difficult.’
‘Late surgical terminations, from 18 weeks pregnancy on, were carried out under general anaesthetic. There was one anaesthetist but never a trained assistant during the time I was working at the clinic. I felt it would have been safer – and better practice – to have an assistant present as well.’
‘And when I carried out terminations at the British Pregnancy Advisory Service, one of these assistants was always in theatre. Certainly, my anaesthetist colleagues at King’s College Hospital were shocked by this when I told them. I don’t know if this practice has since changed at Marie Stopes.’
‘The founder of Marie Stopes International, Tim Black, once told me: ‘Whatever is good enough for a black woman in Africa is good enough for a white woman over here.’ The implication was that Black was aware that Marie Stopes was providing a basic service.’
‘The aim was always to save money – the faster the recovery, the faster the patient would be out of the door. To my great discomfort, I felt it was an organisation that didn’t have its patients at the centre of the service they were offering.’
‘I had never see anything like that in an NHS clinic. We were constantly under pressure, with junior administrative staff harassing medical staff to get a move on.’
‘We worked in an atmosphere of bullying and pressure – it was nothing more than a conveyor belt service.’
Day 52….. Mass appeal….A Health Care Assistant organised abortion pills in 20 minutes