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  • Title: Regional variations in the provision of NHS gynecological and abortion services.
    Author: Maresh M.
    Journal: Fertil Contracept; 1979 Jul; 3(3):41-8. PubMed ID: 12278184.
    Abstract:
    In the effort to investigate possible causes of the existing widespread variations in the provision of abortion services, analysis of the provision and workload of gynecological services in England was undertaken at an Area Health Authority level. A questionnaire was circulated to all 90 Area Health Administrators in England in November 1977. The total response was 75% (68). Due to the facts that Area Health Administrators (AHAs) often did not distinguish between residents and non-residents and private and National Health Service cases and that some AHAs were unwilling to divulge any abortion statistics, the data published by the Office of Population, Censuses and Surveys in their abortion monitor were used. There is a wide variation in the provision and usage of gynecological services when analyzed on the basis of AHA residents. Although the abortion rate is fairly constant in England, with a tendency to lower rates in some rural areas and markedly increased rates in 8 London AHAs, the National Health Service abortion rate varies more. The variation in the percentage of residents who have abortions performed by the NHS is more marked. The correlation coefficients show that the 6 factors analyzed - consultant gynecologic sessions per week, available gynecological beds, total gynecological admissions, gynecological waitings lists, gynecological admissions per available bed, and gynecological admissions per consultant session - are poorly, and in some cases not at all, related to the percentage of abortions performed under the National Health Service, and the scatter of points was large. The little correlation between available gynecological services and the proportion of National Health Service abortions suggests that other factors such as the personal policies of the consultants predominate. A way of improving the current situation is to have day-care National Health Service abortion facilities which can deal efficiently with the majority of abortion cases. In areas where it appears that consultant policy is greatly limiting Naitonal Health Service abortions, it may be necessary for outpatient abortion units to be established relatively independent of the gynecological service.
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