Eilish O’Regan: Swift law-change under threat from service shortfalls
The swift rollout of planned abortion legislation is at risk of being hindered by shortfalls in the wider health service, it emerged yesterday.
There are basic deficiencies such as a lack of GPs and surgeries which are already overwhelmed with patients and no longer able to provide a same-day service.
Many family doctors, who would be willing to provide medical abortions, may have to opt out as a result.
Dr Maitiu O'Tuathail, president of the National Association of General Practitioners, warned about the dangers of fast-tracking an abortion service when basic supports are not in place.
He pointed out that GPs will need access to ultrasound to date a pregnancy if the legislation makes it permissible to provide a medical abortion within the first 12 weeks of gestation. "At the moment my patients can wait 24 weeks for ultrasound," he said.
GPs will also need access to psychotherapy to offer to the woman having the termination.
It can take six to nine months for a patient to get an appointment with a psychotherapist in the public health system.
The proposed new legislation "cannot get done on the cheap", he added.
An average consultation with a GP now takes around 10 to 15 minutes.
But this will be inadequate for a woman who is to have a termination.
The GPs will be obliged to counsel the woman and explain the procedure which involves taking two tablets to induce a miscarriage.
This can lead to complications in a very small number of cases and the woman will need to be able to get specialist attention.
The concerns were echoed yesterday by the Irish Medical Organisation (IMO) which stressed the need for adequate resources.
In a statement released by the IMO, doctors urged the Government to engage with them throughout the process in order for both supporters and opposers to the new legislation to be content with the final outcome.
"The organisation expects that given the deeply held views which exist on this issue, any legislative proposals will create a regime which facilitates access to abortion services by women while also catering for medical professionals who have deeply held conscientious objections on this matter," it said.
No fee has been agreed yet for the GP who will be obliged to provide the termination free under the medical card scheme and this will inevitably involve tough negotiations.
At hospital level there are concerns about the pressure that abortions will place on gynaecological waiting lists.
There are currently 4,383 women waiting for inpatient or day case gynaecological surgery, hundreds of whom are facing delays of more than a year.
The plan is to offer a termination to women seeking the procedure after receiving a diagnosis that their unborn baby had a fatal foetal abnormality.
But there is a lack of access to the 20-22 week anomaly scan in several maternity hospitals across the country. Around 20,000 women go through their pregnancy without getting the benefit of this diagnosis.
It will be next year before these scans are provided in the affected hospitals and it depends on securing enough funding and attracting staff.