I just watched episode two of "Surrogates" this weekend. Honestly, there's only so much I can take, it's not a series one wants to binge watch!
I am interested in the dynamics between Kate the boss, and Caitlin, her employee and surrogate mother. You'd have to have a heart of stone not to have sympathy for Kate and not to be moved by her wonder at finally having a baby in her arms. Which doesn't get away from the problems. Hopefully in their case they will stay friends and it will prove to have been a success, but I'm fascinated by how much maternity leave Caitlin will get, and how their work relationship will pan out. Alderney is a small island with limited other employment options, so if Kate reaches a point where she feels she wants to get back to boss/employee status quo and has done enough gratitude to Caitlin, and that causes friction it will be tricky.
The main takeaway from their story though (for me) was Kate's response to the breakup of Caitlin's relationship with her boyfriend (poor chap wanted more sex and less moaning about haemorrhoids). Her immediate concern was that the stress would put the pregnancy at risk and she quickly arranged to take Caitlin to one of the bigger islands for a scan and a consultation. All the discussion about the health of the baby, the risk of stillbirth and the advisability of getting things moving with a cervical sweep was between Kate and the (male) doctor, Caitlin didn't say a word as her head swivelled from one on the left to the other on the right of her.
I have seen this dynamic often before, with private patients. The male doctor bonding with the male partner/father who either is paying or is assumed to be. The two of them chatting away whilst the woman gets on with the next labour pain and the doctor starts discussing forceps (get the baby out quickly so the men aren't inconvenienced by having to wait too long).
If the Law Commission proposals to transfer legal parentage to the commissioning parents at birth go through then this sort of behaviour with the commissioning parents seeking to make all medical decisions regarding the pregnancy and birth will be turbo charged.
It would be nice to think that the NHS, with a strong safeguarding culture would resist but I'm not convinced, certainly not in all cases, as the dialogue between Kate and the doctor showed. Too many midwives also think surrogacy is a lovely gift, and with their rose tinted spectacles on will they be sensitive to the changing needs of the surrogate mother? And of course if they go private (I wasn't sure if Kate had arranged private care for Caitlin, it looked as if she had, given the ease with which she seemed to be arranging everything on Caitlin's behalf) then commissioning parents will be the customer.
Remember private hospitals aren't subject to FOI, and although they must still have a duty regarding safeguarding I suspect it is likely to be more "light touch", especially in these sorts of cases.