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Abortion and disabled children: a tale of two Care Quality Commission reports

by Sarah Ditum

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Serious failings in the support of disabled children are glossed over, while an unpublished report on abortion is leapt on...

 

It feels like cheap point-scoring to say that abortion opponents are more concerned with saving foetuses than protecting actual, living children, but the contrasting reactions to two pieces of research by the Care Quality Commission this week suggest exactly that.

 

On Thursday, the CQC (the independent regulator of health and social care services in England) published a report that showed serious failings in the support of disabled children: unacceptably long waits for wheelchairs, a lack of cohesion between different services, and families feeling that they hadn't been sufficiently consulted about their children's care.

 

The result: no outrage, no contrite statements from the secretary of state – even though the uncertain effects of the health and social care bill have increased concerns about co-ordination between patient care agencies for children with disabilities. Just a whisper of news coverage, barely audible over the clatter of budget day. This story, and these children, didn't matter very much.

 

Today, something very different. According to the Telegraph, the CQC has found that "one in five abortion clinics breaks law". Well, that's according to the Telegraph's headline: according to the actual article, the CQC visited 250 private and NHS clinics, and found that "more than 50 were 'not in compliance' with the law or regulations". It doesn't diminish the importance of health practitioners following regulations to point out that this is a substantially different figure to the one in the headline: not 20% of clinics breaking the law, but evidence of lawbreaking found in less than 50 of the clinics inspected.

 

How many clinics, what kind of lawbreaking? We don't know, because the CQC's report hasn't been published and won't be for at least a month, although the main cause for concern is that some doctors may have pre-signed consent forms. (Both Marie Stopes and the British Pregnancy Advisory Service say that this does not take place in their clinics.) A dereliction of duty on the doctors' part, but ultimately not likely to harm the patient: the law requires two doctors to consent to an abortion, but they don't have to assess the patient directly, and often rely on consultations with nurses and counsellors.

 

According to the CQC, Andrew Lansley ordered it to inspect abortion clinics "as a priority", and these checks have taken place over the past few days. Usually, the CQC passes on evidence of lawbreaking to the police, then conducts further investigations and gives providers their legal right of reply before publishing their report, but in this case, the secretary of state has ensured that the entire process is an irrelevance.

 

Whatever the report says, the story has already been written, and it's been written in the interests of pro-life campaigners: Nadine Dorries was among the first to share the Telegraph's report, triumphantly tweeting that "abortion clinics break the law". But the ultimate aim of the pro-life movement isn't to make sure that all clinics act within the law: it's to change the law so that most of these clinics' activities become illegal, a situation that would place both women and the children they are forced to bear in perilous situations.

 

In fact, had the very sensible recommendations of the 2007 select committee on abortion been followed, the double consent requirement would have been dropped and the excessive burden of multiple form-signing might not even exist. Holding abortion to a higher standard than any other elective procedure doesn't protect women – it can delay access to a legal, safe and (critically) time-sensitive operation.

 

The CQC has allowed its work to be hijacked by people who don't care about the patient's wellbeing so long as they can compel a few more pregnancies to term. That's a betrayal of the CQC's own function – and of the patients who are genuinely endangered by poor care. While the CQC pursues an anti-choice agenda apparently directed from inside the cabinet, it's neglecting the truly vulnerable people being let down by our supposedly patient-centred new health service.

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    PinkPolitika (2.4.2012, 16:15)

    Well said, Sarah. Nobody, but nobody, likes the act, or even the idea, of abortion. It's a difficult and often extremely distressing topic. But in the end the person who has to make that choice (within the limits of the law) must be the person via whose own body that abortion has to be carried out. She is the one who must be conscious of the consequences for the rest of her life; and she, if she continues with the pregnancy, must also live with the knowledge that she will be responsible for decades to come for a dependent child who, when the decision was made, was not yet a cognisant being. How dare others who may not know anything about the circumstances bring to bear such callous and public pressure on that woman? What crass bullies they are, when anti-choice demonstrators and their political backers pick on vulnerable individuals in this way. It is outrageous that others impose their preference - for that's what it is - on already extremely vulnerable women. And when the CQC effectively colludes in this imposition, that's even more outrageous. Why, as you say, has the CQC prioritised this all of a sudden over even the care of children with disability? And why, to give another example, are politicians actually reducing the requirements for the administration of Health & Safety at Work (a source of sometimes grievous harm to individuals and their families), just as they also gear up the emphasis on much more nuanced, personal and intimate issues? The answer has to be because the managers of such bodies don't respect real, cognisant people (reluctantly pregnant women, or disabled children, or injured / killed employees) as much as much as they are intimidated (?) by hostile populist politics. Abortion is always an unpleasant matter, but sometimes by any reasonable measure it's on balance the way forward. This kind of crassly uncaring bullying by objectors is never 'necessary' and, as you, Sarah, say, it demonstrates a deep disregard of the needs of truly vulnerable people. Whatever their private beliefs, shame on these interfering, sham 'caring' bullies. And shame on the CQC when it buckles to this sort of pressure.
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