The sickening grand-jury report charging a West Philadelphia doctor who performed abortions with murder is also an indictment of state and city health regulators.

Despite repeated warnings about dangerous practices at the Women's Medical Society, the state and city did nothing to stop Dr. Kermit Gosnell. They allowed him to endanger the public for 30 years.

The charges detailed by District Attorney Seth Williams portray Gosnell as a butcher of women and babies born alive. Witnesses said he routinely killed viable infants after inducing premature birth - hundreds of them delivered after the legal limit of 24 weeks - by snipping their spinal cords with scissors.

There were no limits to his alleged horror show. One infant was said to be alive for 20 minutes before being killed. Heavily drugged women were described as waiting on toilets for hours for Gosnell to dispose of their aborted fetuses. Pipes often became clogged with the aftermath.

The report said patients caught venereal diseases from filthy instruments. Fetal remains were packed into freezers. One woman apparently died after being given an overdose of sedatives; another patient died after Gosnell allegedly punctured her uterus.

The grand jury said that a man who can only be described as a back-alley abortionist pulled in as much as $15,000 per night. His patients were mostly low-income, minority women who lacked health insurance. Many came from out of state.

If the charges are true, Gosnell and several former employees at his Women's Medical Society should have the book thrown at them. The doctor also is under federal investigation for an allegedly illegal prescription-drug operation.

It's even more disturbing that the state, which could have shut down the clinic or revoked Gosnell's medical license, ignored complaints repeatedly. Gosnell's clinic was inspected in 1989, 1992, and 1993. Deficiencies were found each time. Yet state evaluators reapproved it without requiring corrective action.

The state Health Department decided after 1993 to stop inspecting abortion clinics for "political reasons," the grand jury concluded. That occurred during the administration of Gov. Tom Ridge, a supporter of abortion rights.

As a result, nail salons in Pennsylvania received tougher government scrutiny than Gosnell's clinic.

The grand jury recommended that the state Health Department license abortion clinics, obviously a needed step. Abortion services are medical care, and providers should be held to the same standards as nonhospital, ambulatory surgical facilities.

Reputable abortion providers in Pennsylvania adhere to standards that are more strict than what is required by state law, said Carol Tracy, executive director of the Women's Law Project in Philadelphia. Those standards include regular, thorough inspections.

Antiabortion forces will likely use this horrific case to call for further restrictions on the medical procedure. But Gosnell is charged with acts that violated abortion laws already on the books.

What's needed, beyond prosecuting Gosnell, is to ensure all women have access to safe and high-quality medical care that is regulated diligently.