EDITOR, - Gillian C Penney and colleagues' audit of the management of induced abortion in Scotland was very restricted, being concerned only with the hospital component of care, and those aspects considered important by medical staff.1 Care should be taken in interpreting the quality of care without considering the contributions of other health professionals, users' views, and particularly the input of primary care. For example, from the patient's point of view waiting time starts at presentation to the general practitioner or family planning services. It would be imprudent to assume that a patient with a brief waiting time after referral experienced high quality care if her general practitioner delayed referral for two weeks. Audit criteria should reflect the overall experience of patients with health services as much as possible.

All improvements quoted after the second audit round refer to measures of process, whose relation to patient outcome may vary. For example, there is a difference in relation to quality of a criterion such as grade of surgeon and …