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The policing of abortion services in England
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  1. Sam Rowlands
  1. Lead Clinician, Contraception and Sexual Health Service, Dorset HealthCare, Bournemouth, UK
  1. Correspondence to Dr Sam Rowlands, Contraception and Sexual Health Service, Dorset HealthCare, The Junction, 235 Holdenhurst Road, Bournemouth BH8 8DD, UK; sam.rowlands{at}dhuft.nhs.uk

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Introduction

In 2012, abortion services in England came under intensive scrutiny, with the Care Quality Commission (CQC) conducting synchronised inspections of all abortion providers. In the light of some procedural irregularities that were found, doctors and nurses were reported to their professional bodies. A team set up by the Metropolitan Police continues to investigate possible criminal activities. This article examines the laws that may have been infringed, what brought about this reaction, the detailed findings, whether or not the inspections were justified and their knock-on effects, and ends with some proposals on what should happen next. It may be concluded that rather than contributing to an improvement in abortion services, this inspection process has undermined some positive developments.

Background

More than 30 Western European countries allow abortion without restriction as to reason.1 British abortion law with its socio-economic grounds2 is more restrictive; it has requirements for medical approval and for notification.

The law on abortion is the same in England and Wales, but is different in Scotland and very different in Northern Ireland.3 However, the regulation of abortion is different in England and Wales, with English services overseen by the Department of Health (DH) and Welsh services overseen by the Welsh Assembly. Abortion providers in Wales were not subject to any targeted inspections in 2012.

The remainder of this article will therefore address the situation in England only. It is set in the context of an ambivalent Conservative-Liberal Democrat coalition government whose approach has been described as one of ‘abortion pragmatism’.4 A policy that supports improving access to abortion sits alongside a politics estranged from the idea of reproductive choice.

The legal situation since 1967

The Abortion Act 1967 brought an end to the serious medical and social problem of ‘backstreet abortion’.5 It was amended by the Human Fertilisation and Embryology Act …

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