Published: 10:30, 20 October 2017
One of the country's largest providers of abortions has been accused of offering bonuses to staff to encourage women to have procedures.
The allegations came to light in a report by health watchdog the Care Quality Commission (CQC) on Marie Stopes International Maidstone Centre.
Staff at the Brewer Street site told inspectors they believed their performance bonus was affected by the number of women who choose not to go forward with treatment.
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Investigators also found evidence of a company policy encouraging staff at all 70 clinics to contact so-called 'do not proceeds' (DNP) to offer them a later appointment.
The inspection was carried out in May 2016 but the report was only published this month.
Staff referred to the Maidstone centre feeling like a cattle market with one describing it 'feeling like a hamster in a wheel'.
The watchdog concluded staff showed limited empathy for how patients might be feeling and that support from a partner, friend or parent was discouraged.
"People who came along to support clients were asked to leave while the procedure took place.
The report states: "Staff were concerned that ‘Did Not Proceed’, the term used when women decided not to proceed with treatment, was measured as a KPI and linked to their performance bonus.
"They felt that this encouraged staff to ensure that patients underwent procedures."
Later, it adds: "Minutes dated 15 July 2015 recorded a company-wide focus on ‘Do not proceeds’.
"Where a patient of less than 5 weeks and three days gestation had decided not to go ahead with the termination they were being called and offered a later appointment."
In August 2016, the firm temporarily stopped providing terminations under general anaesthetic, and to under 18s and vulnerable women, but services were resumed last October, after the health regulator said standards had improved.
Anne Scanlan, director of eduction at the charity Life, said: "Last year we called on the Secretary of State for Health to withdraw MSI's licence to operate.
"We were promised that the Department of Health will continue to monitor the situation at MSI closely.
"A year after its suspension there are still reports from inspectors about health and safety failings at MSI clinics. When will the Government act to protect women?"
Ann Furedi, chief excutive of the British Pregnancy Advice Service, who also run clinics in the UK, added: "It's unthinkable that any organisation committed to choice would measure performance against the decisions women make.
"Women need to be able to trust that they will be cared for in a way most suited to their individual needs, not the needs of the organisation providing that care."
Marie Stopes UK is Britain's second biggest provider caring for 70,000 patients each year. Last year the Maidstone clinic carried out 5,000 abortions.
"None of these KPIs relate to client numbers, and it is untrue that any member of our staff receives a performance related bonus for the number of clients they treat" - Richard Bentley
"The organisation also provides a range of sexual health services.
They said the allegations in the report are categorically untrue and the DNP rate is not a key performance indicator and not linked to staff pay.
Richard Bentley, managing director, said: "It’s true that our team members are measured against key performance indicators (KPIs) that relate to quality and client care.
"However, none of these KPIs relate to client numbers, and it is untrue that any member of our staff receives a performance related bonus for the number of clients they treat.
“Informed choice is at the heart of our charity’s mission, and every woman we serve is talked through her options before booking an appointment and again at the clinic.
"We follow a stringent consent process, and we will not proceed with a procedure if we have any doubt at all that a woman is unsure of her decision."