Opinion Comment

Friday 20 September 2019

Eilis O'Hanlon: 'It's not only women with crisis pregnancies who deserve care'

Tackling the treatment gap needs the same effort that steered the abortion bill through the Oireachtas, writes Eilis O'Hanlon

Health Minister Simon Harris. Picture: Arthur Carron.
Health Minister Simon Harris. Picture: Arthur Carron.

Health Minister Simon Harris was on RTE radio's News at One last Friday, assuring women who want an abortion that they will, whatever the naysayers are claiming to the contrary, be able to get one in Ireland from January 1.

Access won't be available through all hospitals or GPs' surgeries, but there would, he insisted, be a functioning abortion service nationwide starting on that date. In preparation, thousands of doctors are already receiving training in their new duties, and a 24/7 helpline, staffed by nurses and counsellors, will be good to go from one minute past midnight at the start of 2019, dispensing advice to women with crisis pregnancies.

"Once this law is signed by the President," Minister Harris further pledged: "I will then be able to immediately authorise the HSE to start a public information campaign."

Listeners at home could have been forgiven for wondering: What is this comprehensive, wrap-around system of care which the young minister is describing? More to the point, is there any chance of rolling it out for the rest of the health service too, replacing the one where procedures are rationed, patients are made to wait for months, sometimes years, for treatment, and where expectations that those who desperately need help will get it while it's still of use to them are dismissed as fanciful utopianism?

Naturally, there is a time limit to pregnancy, which demands that doctors act fast. The 12-week limit up to which abortions can now be sought on request will be quickly reached. A long waiting list for abortions sounds too much like the punchline of a sick joke. Even so, it's no victory if one set of patients is suddenly thrust, for political reasons, to the top of the queue, at the expense of the longer-suffering.

September of this year saw a new record set, as 718,000 people were revealed to be on waiting lists. Over a quarter of a million of them had been on the outpatients' waiting lists for more than six months.

Figures had come down by November, a rare dose of good news, but some GPs remain concerned that their patients, often elderly, are being removed from the waiting list when they don't respond to follow-up inquiries within a certain time frame. That doesn't mean they don't still need care, just that they've become effectively invisible.

For his part, Independent TD Michael Healy-Rae has taken to organising buses to take constituents in Co Kerry up to Belfast for knee and hip operations, thereby avoiding waits of more than four years at home. (The costs of this private care are refunded under the Cross Border Health Directive.) As for cancer, it would be obscene to suggest the urgency for those in its clutches is any less pressing than for women seeking abortions.

This treatment gap is particularly incongruous in the case of children. Pro-life activists are frequently accused of caring more about life in the womb than the lives of those babies once they are born and start growing up - but the same accusation could be levelled at those in charge of health policy. The red carpet is rolled out for abortion at the same time as HSE figures show 6,300 troubled children and teens are currently waiting for psychological counselling, 1,600 of them for more than a year. More than 900 of the children are under four.

Children with a range of other needs are passing under the radar. One mother in Waterford, who gave birth to two sons with Down Syndrome within three years of one another, explained the difficulties earlier this year: "Once they reach six, the intervention ends. Once they go into mainstream school, it's waiting list after waiting list."

Many services available from Down Syndrome Ireland (DSI) are only possible because of parental fundraising. Some months ago, journalist Breda O'Brien raised the issue of the Louth/Meath branch of DSI, which, for just €75,000 a year, was providing help to 50 children. Two-thirds of that was raised by parents themselves; the final third came from the HSE. In the New Year that was cut from €25,000 to €10,000. Think of it as a tale of two Januarys. The high rate of termination of foetuses with Down Syndrome (up 50pc in the UK in the last decade alone, a figure likely to be replicated here in due course) is probably not unrelated to the lack of help available for mothers struggling to cope.

Some of the criticism of the Taoiseach and health minister for being so gung-ho about the prompt roll-out of abortion services has come from pro-life factions still smarting at the referendum result. Ireland voted decisively to remove the Eighth Amendment and to give the Dail control over abortion law. The Government is duty-bound to enact that expression of popular will. Had it failed to do so by January, there would have been hell to pay from pro-abortion campaigners too, so there's a definite element of "damned if they do, damned if they don't".

Many detractors said it couldn't be achieved in the limited time frame; others still insist that what's being rolled out isn't sufficient, because hospitals across large swathes of the midlands and elsewhere in the country will not be ready come January.

Simon Harris deserves considerable credit, though, both for steering the bill through the Oireachtas on such a tight schedule, and for ensuring that preparations are as far advanced as they are. His work ethic has been prodigious. Politically speaking, he has proved his mettle.

But optics matter too. The language of celebration which greeted the abortion bill as it cleared its final stages, as if the Government couldn't wait for the abortions to begin, sent out all the wrong signals, laying pro-choice politicians open to the accusation that their priorities are skewed too much towards women with unwanted pregnancies, rather than the needs of what will always be a much larger group, namely those with unwanted, and potentially life-limiting, illnesses.

Insofar as any government should keep its word, it's admirable that this one has moved promptly to make good on its promise to bring forward legislation, rather than seeking get-out clauses. If nothing else, it shows what can be done with sufficient political determination.

Now the greater challenge is to put the same effort into getting services to legions of others in need of a helping hand, who are left languishing on waiting lists because they don't complain loudly enough.

Sunday Independent

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