Tuesday 23 July 2019

GPs warn of potential errors with abortion scans service

Ultrasound machines need to be operated by trained sonographers, who are in short supply. (Stock Image)
Ultrasound machines need to be operated by trained sonographers, who are in short supply. (Stock Image)
Eilish O'Regan

Eilish O'Regan

Ultrasound machines used by GPs to examine women seeking a medical abortion need to be reliable, otherwise there is a risk of a reading error similar to mistakes made by CervicalCheck, a leading GP has warned.

Dr John O'Brien, president of the Irish College of General Practitioners (ICGP), said the provision of ultrasound machines used to date a pregnancy is one of the many areas that must be worked out before services to provide abortion up to 12 weeks of pregnancy are ready.

Ultrasound machines need to be operated by trained sonographers, who are in short supply.

He asked: "How will the legislation define 12 weeks? Is it on the say-so of the mother's dates or ultrasound? Having the machine is only half the battle.

"You need to have somebody who can use it and read it properly in an accredited way so that you are not in a missed situation. We don't want a situation like CervicalCheck again.

"There is a lot more complexity around what we do before we are ready to roll out the service. I don't want to be standing in the way of anybody but the work is there and it needs doing."

Dr O'Brien outlined his views, along with Dr Andrew Jordan, chairman of the National Association of General Practitioners, during a discussion on the proposed abortion law on Newstalk radio's 'Between the Lines' presented by Andrea Gilligan. He said the ICGP had begun discussions with the Institute of Obstetricians and Gynaecologists around drawing up guidelines for doctors on how to operate the legislation.

There is a fear among many doctors, who are already overwhelmed, that this is yet more work being piled on them, he warned. The GP service is already "groaning at the seams" and suffering the effects of cuts which left an average practice of 1,000 patients with a €120,000 drop in income annually.

Dr Jordan described proposals by Health Minister Simon Harris to set up "exclusion zones" around services providing abortion as "abhorrent".

The exclusion zones would be aimed a protecting providers of services from potential protesters.

However, Dr Jordan said: "The only part of the health service where a person can walk in the door and be face-to- face with a clinician is general practice. The last thing any GP will want is anything in his surgery that adds to confrontation between him and the public at large.

"The idea of having to put an exclusion zone around a clinic is abhorrent."

He pointed out that any doctor can be a conscientious objector but the GP who does not provide medical abortion has a responsibility to refer the patient to a colleague who does.

He did not believe it would be necessary to provide a list of providers, and predicted that there will be GPs who will deliver a service, but it will not be known.

He said this will happen in remote rural practices where doctors have a relationship with patients over generations.

The cuts in fees to GPs have left general practice going "down the toilet", and the practices reliant on income from medical card holders are struggling.

He warned against "unseemly haste" in bringing in the service which the Government says will be in place by January 1 next, the start of the most chaotic week in the health service annually.

"We need to pedal back and take the foot off the gas. It needs to be right and fit for purpose," he added.

Irish Independent

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