Eilish O'Regan: 'GPs have now agreed abortion fee - but where's the training?'
GPs agreed to a €450 fee for a medical abortion this week, despite not yet being trained in how to deliver the service.
It's one of the many hurdles to overcome with just six weeks to go to the introduction of a far-reaching abortion regime we could not have forecast a year ago.
The medical abortions, involving three visits to the GP and two medications, will be free to women who are up to nine weeks pregnant. GPs, who will be paid by the HSE per patient, will be written to next week asking them if they are interested in participating.
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Training courses for family doctors are now being finalised by the Irish College of General Practitioners and will take the form of e-learning and tutorials.
The proposed legislation, the Health (Regulation of Termination of Pregnancy) Bill 2018, will start its report stage at the end of this month but this could be prolonged as amendments are proposed and debated.
It allows for unrestricted abortion up to 12 weeks. After that abortion will be allowed where there is a risk to the life or the health of the mother or if an unborn child has been diagnosed with a fatal foetal abnormality.
The January date for the start of the service is still the target, but there remains concerns about the resources to be made available to doctors and hospitals. The recent marathon debate on amendments at the Oireachtas Health Committee brought dedicated contributions from pro and anti-abortion TDs and also Health Minister Simon Harris, who was well briefed. Chairman Dr Michael Harty, a GP, set the right tone with an even-handed approach.
Fianna Fáil TD Stephen Donnelly, who had clearly done his homework, said yesterday a number of areas in the legislation have to be clarified. These include when is the start of the three-day pause women seeking an abortion must observe. If she is referred to a maternity hospital for ultrasound the three-day wait should apply from the point she was certified for an abortion by her GP and not from when she has the scan.
Deputy Donnelly said TDs were also told by the minister this week he would review the stipulation that the same doctor who certifies an abortion must also be the one to carry it out. Obstetricians said this is impractical.
Around one-third of GPs said during the summer they would definitely provide abortion and this is expected to increase.
Alison Begas, of the Dublin Well Woman Centre, said she expects many women to opt for her clinics and although yet unclear they could be seeing up to five women a day.
A 24-hour phone line will provide counselling and location of participating GPs.
Meanwhile, retired obstetrician Peter Boylan, who is overseeing clinical guidelines, has visited maternity hospitals and units. They will cater for some medical abortions and the more serious surgical terminations.