Buzzwords don’t pay for a service
GPs voice fears over funding for new regime
DOCTORS have warned there is a huge amount to discuss before any new abortion legislation can be implemented.
The chairman of the National Association of General Practitioners (NAGP) has warned that some doctors will be opposed to being party to any abortions.
The NAGP is set to convene an extraordinary general meeting within the coming days to assess whether the majority of doctors are in favour of a GP-led scheme.
Dr Andrew Jordan, chairman of the NAGP, told the MoS GPs are ‘already on their knees after being starved of funding for years.
‘GPs are already doing less with less. General practice has been destroyed, and there is a huge amount to discuss in terms of resources and the provision of abortion in Ireland,’ said the Tallaght-based GP.
‘It’s very easy in a campaign to use buzzwords and to talk about “free this and free that”, but now reality has to set in and the Government has to put the meat on the
‘We can’t pay staff if we’re not resourced’
bones when it says it is going to provide free services.
‘The State is talking about providing more and more for free but we literally can’t do it for nothing. We can’t pay staff if we are not resourced,’ he said.
Dr Jordan said the EGM has to discuss overall ‘consensus and the right approach to abortions’, and while he believes ‘the floodgates won’t be opened in terms of demand, it is an extra tranche of work that needs consideration and care’.
He said very few doctors have scanning equipment in their own surgeries, and it remains ‘very difficult to seek a scan just for the sake of a scan’ in public hospitals, with many women referred to the private sector. ‘Only an odd surgery would have ultrasound facilities, and that is limited,’ he added.
Dr Jordan stressed that the NAGP did not take a position on the referendum, and highlighted that Minister for Health Simon Harris did not specifically advocate a GP-led scheme, but rather it was used at the Oireachtas health committee on repealing the Eighth Amendment.
Dr Emmet Kerins, past president of the NAGP, which represents some 2,000 GPs, earlier said: ‘For the Minister to suggest that our profession should lead out an abortion service, without consultation with our member GPs, is an affront to our profession and could pose yet another strain on the provision of [GP] healthcare services.’
Dr Krysia Lynch, chair of the Association for Improvements in Maternity Services, said she is aware some GPs are likely to be conscientious objectors to facilitating abortions through the pill, which has proven to be the case in Italy.
Again, Dr Lynch also highlighted that few GP surgeries have scanning equipment, and queried if the Government would provide hightech, expensive scanners to GPs to determine whether a woman is within the 12-week window.
Dr Lynch said she did not imagine the number of women seeking abortions would impose huge pressure on GPs, as an estimated 10 women a day travel to the UK and, of those, some are over 12 weeks pregnant.
‘Abortion in Ireland should be community-based, with someone you know. It remains to be seen how many women will require or seek surgical abortions in maternity hospitals, and if they should perhaps have their own separate entrance to ensure they are not distressed by seeing women at advanced stages of pregnancy,’ she said.
However, Niall Behan, chief executive of the Irish Family Planning Association, told the MoS that the ‘days of bringing women who have an unintended pregnancy through the back door are over; this is what the campaign was all about’.
‘There will have to be lots of consultations on the best medical guidelines, but the services are there. As a procedure, it’s not particularly difficult and should be fairly straightforward. I don’t think the system will be overburdened with requests, whether it’s a GP service or a primary care service, or a hospital setting. The most important thing is the services have to be available for those who need them.’
He said any doctors who have a conscientious objection to abortion must outline that at the earliest opportunity, and that should be stipulated in legislation, particularly given the 12-week window.
There have been a number of stud-
ies carried out among doctors on whether they agree with facilitating abortions, with conflicting results.
In one survey of 497 GPs this year, nearly seven in 10 who voted in a closed doctors’ forum said they would not be involved in medical abortions. Around 15.7% said they would provide the service and 16.1% were ‘unsure’. A number of GPs said they are awaiting more detailed proposals from Government.
‘Unfortunately, like most GPs in the country, I am unaware of the exact patient-care pathways proposed by the Government at this stage,’ said one doctor. ‘I just hope the politicians put in the correct resources so patients receive the best care.’
Dublin-based GP, Dr Conor McGrane, who was involved in the survey, said doctors who said they would not become involved were likely to be influenced by having no training or lack of time due to their busy practices. ‘In the UK, a woman sees her GP but she is then referred for a medical abortion to an NHS clinic,’ he said.
Under proposals by the Government, GPs in regular practice here would be among the minority in Europe to provide the service directly, he added.
Currently, GPs are confined to providing abortion information but can’t make a referral to a clinic abroad.
Under the proposals, a woman who has a medical abortion under 12 weeks would take two medications, usually 24 to 48 hours apart, to induce a miscarriage. It is envisaged there will be a gap of 72 hours between a first GP visit and taking of the pills, to allow some time for reflection.
Another poll carried out by the Irish Medical Times suggested 75% of doctors agree with the proposed 12-week abortion regime. However, Dr Máire Neasta Nic Gearailt disagreed, saying there has been no valid poll of doctors on this subject. Dr Nic Gearailt said there has been no consultation with doctors about the impact of the proposed legislation.
‘Most GPs [here] do not currently perform ultrasounds, are not trained to use ultrasounds, and don’t have foetal assessment ultrasonography in their surgeries,’ she highlighted.
The Government has not, to date, proposed establishing abortion clinics. The Save the Eighth campaign said yesterday ‘if and when abortion clinics are opened in Ireland, because of the inability of the Government to keep their promise about a GP-led service, we will oppose that as well. Every time an unborn child has [their] life ended in Ireland, we will oppose that...’
‘No valid poll of doctors on this subject’