Monday 16 September 2019

GPs warn of 'bad medicine' over big difference in fees

Doctors point to €200 gap between abortion and antenatal care as they are issued 38-page contract

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Eilish O'Regan

Eilish O'Regan

The Government has created another two-tier health service that pays GPs €450 to provide an abortion but just €250 to look after a woman during pregnancy, doctors warned yesterday.

The €450 HSE payment to the doctor covers three visits for a woman availing of medical abortion.

However, Dr Maitiú Ó Tuathail, president of the National Association of General Practitioners (NAGP), pointed out family doctors get paid €250 by the HSE to give free antenatal care to a woman for the duration of pregnancy and this could involve 12 visits.

He said it highlights "the chronic underfunding of antenatal care in Ireland, and the urgent need to review the fee structures under which GPs work, in the form of a new contract".

Dr Ó Tuathail also pointed out a woman can have an abortion for free, but will pay around €200 for reliable contraception to prevent pregnancy.

GPs have received a 38-page contract asking them to opt in to the service from January to provide medical abortions that involve giving medications and includes doctor visits.

"We find it incredibly disappointing that the agreement for the termination of pregnancy services excludes universal access to long-acting reversible contraceptives.

"The Government will provide universal access to the termination of pregnancy, but not equal access towards preventing a pregnancy in the first place. This is simply bad medicine," he said.

The Government has also to follow through on promises to subsidise fertility treatment, which continues to be a huge expense for women who need support to have a child, he added.

"The women of Ireland are entitled to a holistic, comprehensive women's health service. This is not what this delivers. It is bad medicine," said Dr Ó Tuathail, who is a pro-choice GP.

There are continuing concerns about the supports that will be available to GPs, including access to ultrasound to date a pregnancy.

"Many questions remain as to how GPs will be expected to provide a safe abortion service for the women of Ireland. We need clarity with respect to the availability of ultrasonography to date pregnancies.

"The provision of emergency aftercare does not seem to have been addressed. Issues around the medico-legal indemnity for GPs who opt to provide this service must also be clarified," he said.

A spokeswoman for Health Minister Simon Harris said he intended to introduce legislation in 2919 to allow for free contraception for women.

As a first measure to improve access, he will be increasing availability of barrier contraception for men as this does not require legislation.

Meanwhile, the lengthy contract sent to GPs to sign up to providing medical abortions has outlined what will happened at each of the three visits provided to patients.

At a woman's first visit the doctor must establish date of pregnancy.

A second visit should happen at least three days later, where she will get medication to end the pregnancy. She will get a second medicine to take at home.

The third visit will check if the pregnancy has ended and the woman will be offered contraception advice and referred to hospital if there are complications. The HSE will give the GP the two medicines.

A doctor who agrees to provide the service must give three months' notice if they want to opt out.

Irish Independent

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