SUMMARY

Twenty-five years ago, in 1989, family planning services in Britain faced a serious crisis with contentious cuts for community clinics being contemplated by health authorities. There was extensive discussion on ethical issues relating to the provision of abortion services. Social acceptance of abortion occurred in association with departure from traditional values due to the exigencies of modern life. Twenty-five years later, in 2014, abortion unfortunately continues to cause controversy in international health, despite guidance for its incorporation in comprehensive reproductive health care services.

Source of services

By 1989, there should have been freedom from unwanted pregnancy in Britain through government recognition of the right of individuals to contraceptive services. But although those services were recognised as being highly effective, with a five-fold return on investment, they were unfortunately under threat.1 Family planning sessions in community clinics were suffering from the limited budgets of district health authorities, which used short-term vision and easy options to implement simple solutions for controlling costs.2 Cutbacks in service provision consisted either of the closure of clinics or a decrease in the number of sessions and of their staffing, while demand was reduced through inconvenient opening hours, poor premises and lack of prominent publicity to promote services.

Admittedly, the contraceptive services provided by general practitioners (GPs) were not adversely affected because of their separate funding through the open-ended budgets of Family Practitioner Committees. Nevertheless, this approach was regrettable as it failed to acknowledge the essential role of client choice in selecting the type of service delivery point, the value of anonymity and the convenience of on-site availability of supplies in community clinics. With the complementary nature of community clinics and GPs, a unified funding policy would have facilitated the provision of services during this crucial period for the family planning movement. As the poor state of community …