Women seeking abortions are facing “cruel” delays because they are being blocked from choosing where they can get treatment, it has been warned.
Charities have said that the failure of some NHS funding bodies to pay for out-of-area terminations is a breach of NHS rules and standards and is putting patients at risk.
Dr Jonathan Lord, the medical director of MSI Reproductive Choices, told The Independent that the “complex and heavily bureaucratic rules” result in patients being forced to use their sole local provider or to travel long distances to a service run by that same provider elsewhere.
And the Royal College of Obstetricians and Gynaecologists warned that women must be given the right to choose their preferred abortion treatment, as well as where they receive healthcare.
Dr Lord, a consultant gynaecologist at the Royal Cornwall Hospitals NHS Trust, said: “Patient choice is being taken away. This choice is enshrined for all NHS procedures but is being denied for abortions.
“They are just not following the NHS rules which ensure patients have a right to have treatment with any NHS provider. This would never happen with any other field of healthcare. It is leading to delays which are cruel for patients.”
He claimed Buckinghamshire, Oxfordshire and West Berkshire Integrated Care Board (ICB), which commissions NHS services in the area, was refusing to pay his organisation for out-of-area treatments it had provided. As a result, it is contemplating reclaiming the money via debt collection.
Dr Lord said there were a number of reasons why a woman would choose to access treatment elsewhere, including shorter waiting times, privacy or choice of procedure, and his organisation had women calling in tears due to having their request denied.
Abortion services are arranged differently from other forms of healthcare, with about 75 per cent of NHS abortion services carried out by independent providers.
Data gathered by MSI Reproductive Choices UK, previously seen by The Independent, revealed women in 15 areas across England can only use their local provider.
Dr Lord, whose organisation works with every NHS funding body in the country, said another reason a patient may not want to use their local abortion provider is that they have had a difficult experience there or because the service does not provide the type of healthcare they want.
Some services do not provide surgical abortions and only offer induced labour which means women must have a stillbirth, he added.
She was sobbing down the phone. She was utterly distraught at being forced to go back to where she had such unhappy memories.— Jonathan Lord
He said: “In Oxford, there was a patient who had a severe foetal anomaly who needed an abortion and did not want an induced labour. She wanted it done surgically.
“It is very common to prefer surgery over induced labour. Surgery is a treatment which is all done in one sitting.
“The whole process of an induced labour takes about three days and involves giving birth, which can be very traumatic when you know the baby is not going to be alive. Also, there are higher complication rates with induced labour.”
Another key reason a patient may not want to use their local service is if they want to be asleep or awake for the procedure but the option is not offered at the service.
Dr Lord, who is also chair of the British Society of Abortion Care Providers, added: “Women call up in tears. I remember a woman from the Oxford region who had to have a repeat abortion. She was so fertile the contraception failed twice.
“She had an incredibly traumatic first experience of an abortion which was not the fault of the provider but she did not want to go back there. The funding bodies refused point blank.
“She was sobbing down the phone. She was utterly distraught.”
They are just not following the NHS rules which ensure patients have a right to have treatment with any NHS provider. This would never happen with any other field of healthcare. It is leading to delays which are cruel for patients.— Jonathon Lord
He also gave the example of a woman from Somerset who wanted to be under a general anaesthetic so she was not awake while having her surgical abortion but this was refused, meaning she had to travel from Somerset to London.
Dr Lord said: “This is a result of a wilful disregard for NHS standards. I don’t understand how anyone managing healthcare can act so cruelly.”
Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, said it backed the National Institute for Health and Care Excellence (Nice) abortion care guidelines that state patients should choose where they are treated.
She added: “Women have the right to choose what abortion treatment they would prefer, and where possible, should also have the right to choose where they receive care.”
Kerry Abel, chair of Abortion Rights, a UK campaign group, said abortion was a common and safe procedure so it was “imperative” that those who chose to have one can get them in a timely manner without added stress.
“Abortion services should be patient-focused – we are concerned about any barriers to access to abortion at a local level and call out the postcode lottery of abortion services.”
NHS England and ICBs for Somerset and Buckinghamshire, Oxfordshire & West Berkshire have been contacted for comment.
