HC Deb 29 January 1979 vol 961 cc314-7W
Sir George Sinclair

asked the Secretary of State for Social Services what progress has been made in authorising day-care abortion treatment in private nursing homes; and whether he will make a statement.

Mr. Moyle

Following the recommendations of the committee on the working of the Abortion Act—the Lane committee—and the third special report of the Select Committee on the Abortion (Amendment) Bill, the two major charitable trusts providing abortion services in the private sector—British Pregnancy Advisory Services (BPAS) and Pregnancy Advisory Services (PAS)—were authorised to carry out day-care abortions for a trial period of two years. These trials began in February 1976 within specific conditions laid down by my Department.

Full reports on the working of the trial have been furnished by the two organisations concerned. These satisfy me that day-care abortion treatment can be provided in the private sector for suitable patients without detriment to standards of professional care or the safety and welfare of the patient.

In the light of the results of the trials, I am, therefore, now prepared to consider applications from other private nursing homes which are approved under the Abortion Act 1967 for permission to carry out day-care abortion treatment. Approval will not be given unless I am satisfied that all necessary facilities are available at the home. Moreover, as in the case of the BPAS and PAS, proprietors will be required to give firm assurances that they will observe special conditions laid down by my Department. These are the conditions which applied during the period of the trials, modified in the light of the experience gained during those trials. The conditions are as follows:

1. Acceptance of patients: The following categories of patient shall be excluded from day-care:

  1. i Non-resident women.
  2. ii Resident women whose pregnancy is of more than 12 weeks' gestation or in whose case operative techniques or anaesthesia necessitating prolonged recovery are indicated.

2. Theatre register: Day-care treatment shall be recorded either in the theatre register or in similar theatre register for day-care patients, giving the time of operation and type of anaesthetic used.

3. Discharge of patients: Patients shall not be discharged until at least three hours after the operation.

4. Arrangements for travel: Before accepting a patient for day-care treatment, nursing homes shall satisfy themselves that she will not have to travel for more than two hours to reach her home or the address where she will spend the night after the operation. This condition applies irrespective of the method of travel. Nursing homes must also satisfy themselves that patients using public transport will be accompanied on the journey, and that patients travelling by road will not be driving the vehicle.

Where a patient is to travel by public transport, the nursing home should take account of any waiting time involved and should not expect the patient to undertake a difficult journey.

5. Arrangements for patients to be accompanied: Nursing homes will need to be satisfied that, on discharge, the patient will be accompanied to her home or to the home of a relative where she will spend the night after the operation and that the patient will not spend the night alone. The proprietors may provide sleeping accommodation, which is under their supervision, in the vicinity of the nursing home.

6. Arrangements for overnight stay: When a day-care service is being provided, nursing homes shall be required to reserve one bed approved under the Abortion Act for every 20 patients—or any number less than 20—treated during that day to enable overnight treatment to be given if the need arises.

7. Arrangements for further medical attention: Nursing homes shall be satisfied that the patient can return to the care of a registered medical practitioner in the locality where she will be after the operation.

8. Arrangements for record keeping: The name and address of the practitioner accepting the patient for after-care shall be recorded in a separate day-care register with the patient's name and address. The following information shall also be recorded:

  1. i. the times of admission and discharge;
  2. ii. the address where the patient will be staying the night, if this is not her usual address; and
  3. iii. if the patient is unable to be discharged on the day of admission, the reasons for this.

My Department will continue regularly to inspect the operation of the arrangements for abortion in the private sector to ensure that approved nursing homes observe the detailed assurances given to me, with special attention being paid to the conditions attaching to the day-care arrangements which I have approved.

Day-care abortion treatment is, of course, available within the National Health Service. I have asked health authorities to include the provision of such services among the priority areas for development in the service.