HSE Publishes Audit of Crisis Pregnancy Counselling Services
The HSE today (Wednesday 10th December) published an audit report of crisis pregnancy counselling services provided by HSE funded agencies. The audit was undertaken in response to allegations concerning certain crisis pregnancy counselling practice that emerged when a group of women visited a number of State-funded crisis pregnancy counselling services posing as genuine clients, secretly recorded the counselling sessions and provided the recordings to the Irish Independent.
The Irish Independent printed an article in October 2012 alleging that breaches in the law relating to crisis pregnancy counselling practice had taken place, citing transcripts of the counselling sessions.
The article alleged that counsellors had provided inappropriate information on accessing the abortion pill and that they had inappropriately advised women that they did not have to reveal that they had an abortion to a medical professional, should they require post-abortion medical assistance.
In response to the allegations, the HSE Sexual Health & Crisis Pregnancy Programme initiated discussions with crisis pregnancy counselling services and HSE Quality and Patient Safety carried out an audit on all services to ensure that crisis pregnancy counselling services adhered to good practice, provided good quality services and operated within the law.
The audit was overseen by Ms. Brigid McManus, former Secretary-General, Department of Education and Skills. Documents published today include the main audit report, an executive summary, a cover note on the audit by Ms. McManus, and a list of actions that have been implemented by the HSE in response to the recommendations contained within audit report.
The audit took place between January and June 2013 and involved a high level desktop examination of all 15 service policies and guidelines and site visits to six crisis pregnancy counselling services. Four services of the six services chosen were those against which the allegations were made. The audit report includes 11 recommendations.
Publication of the report had been delayed at the request of An Garda Síochána while they completed their investigation into alleged malpractice at crisis pregnancy counselling services. An Garda Síochána sent a file to the Director of Public Prosecutions (DPP). The DPP has now decided that there will be no prosecution arising from the case.
The audit found that services had written policies and guidelines in place for confidentiality, complaints, a code of practice and the reporting of alleged child abuse, but some did not have specific written policies and guidelines on quality assurance, supervision and the Abortion Information Act. The audit report recommended that services be required to develop specific policies and guidelines on these and other topics and this work has since been completed.
The audit also found that policies and guidelines they reviewed did not adequately address the issue of disclosure of a termination in a medical setting should a woman experience complications post abortion. Nor did the policies and guidelines adequately address the issue of accessing the abortion pill through on-line sources in Ireland.
The audit report recommended that the HSE Sexual Health & Crisis Pregnancy Programme develop additional guidance for service providers to assist them in developing policies and guidelines in these areas. This work has been completed.
Specifically, the HSE has provided guidance to counselling services stating that a woman should always be encouraged to reveal her full pregnancy history including natural miscarriages and abortions to a health professional as not to do so could result in misdiagnoses and subsequent problems.
In relation to the availability of the abortion pill, the HSE has clarified, through training workshops with counsellors that if a client brings up the subject of the abortion pill, the counsellor should clarify that abortion pills are not legally available in Ireland and it is illegal to purchase medicines on-line. Women should also be advised that it is unsafe to take the abortion pill without medical supervision while also ensuring that if women who take the pill experience complications they should not be afraid to get medical help.
Ms.Brigid Mc Manus, who provided independent oversight of the audit said: “This was a major audit of the systems in place both within the Sexual Health & Crisis Pregnancy Programme of HSE and in individual service providers. I would like to acknowledge the professional work of the audit team and the cooperation and engagement of the HSE Sexual Health & Crisis Pregnancy Programme and the service providers involved’’.
Commenting on the publication of the audit report, Dr. Cate Hartigan, Assistant National Director for Health Promotion and Improvement said: “Crisis Pregnancy Counselling is a sensitive and complex area and service providers working in this area are highly skilled in supporting women who are traumatised and distressed. The HSE Sexual Health & Crisis Pregnancy Programme and the services it funds have implemented a range of actions to ensure that the recommendations of the audit are being implemented”.
-ENDS –
A copy of the Audit is available here http://www.hse.ie/eng/about/Who/healthwellbeing/Contact_Health_Promotion/cpc/
For more information contact:
HSE National Press Office
Dr Steevens Hospital
Dublin 8
Tel: 01 635 2840
Email: press@hse.ie
Notes for Editors
Quality and Patient Safety Audit Services
Quality and Patient Safety Audit (QPSA) provides assurance to the HSE that the services it provides meet statutory obligations and are delivered in accordance with best practice.
The QPSA function is a key part of the HSE’s overall Assurance Framework. It adds value to our services by building trust and confidence based on evidence that we are improving patient experiences and delivering quality and safe sustainable services. More information is available at http://www.hse.ie/eng/about/Who/qualityandpatientsafety/auditservices/
Terms of Reference for Audit of Crisis Pregnancy Counselling Services
- To review 2012 service- level arrangements between the HSE and the services and agencies included in the audit with regard to regulation, compliance and quality assurance.
- To identify the current reporting, monitoring and oversight arrangements in place within the HSE with the crisis pregnancy counselling services and agencies subject to a service- level arrangement.
- To provide assurance to the HSE for a sample of HSE and HSE-funded crisis pregnancy counselling services and agencies:
- That protocols in place for the provision of crisis pregnancy counselling services and information are in accordance with the relevant legislation and in line with current good practice.
- To validate evidence to confirm that these protocols are operational and adhered to by the services and agencies included in the audit.
- To validate evidence to assess whether existing protocols adequately address all of the alleged breaches of crisis pregnancy counselling practice.
- To identify the approach to training and supervision of crisis pregnancy counsellors by the services and agencies included in the audit.
- To identify any gaps and make recommendations to improve practice.
