Monday 16 September 2019

Kirsten Fuller: 'GPs must be allowed to use their conscience on abortion'

Health Minister Simon Harris should abandon megaphone diplomacy over the provision of abortions, writes Dr Kirsten Fuller

Health Minister Simon Harris. Photo: Steve Humphreys
Health Minister Simon Harris. Photo: Steve Humphreys

Kirsten Fuller

Health Minister Simon Harris broke the news to GPs on radio that abortion services in Ireland would be GP-led. It seems Minister Harris likes to engage in megaphone diplomacy rather than sitting down and talking to people.

From January 1, he insists that GPs must provide abortions in their surgeries or else facilitate the abortions taking place somewhere else. Just as strange is the tone from the minister. It often seems to me that doctors who have concerns or objections are cast in the role of the awkward squad - uncaring, unkind people who will be made to put up with the plans.

That is a travesty of the truth and an increasing number of doctors, with different points of view about abortion, are deciding that they will not put up with it.

That's why over the past fortnight, 640 GPs have signed a petition raising serious concerns about the Government's plan to press ahead with a GP-led abortion service without ever discussing the issue with GPs on the ground. Some of these doctors are pro-life. Others wouldn't describe themselves as such but are in sympathy with doctors who don't regard this as healthcare and don't want to be part of the machinery.

At a time when there is a considerable pressure on the health service, doctors are being placed under a legal obligation to either carry out or refer women for abortions. If they can't do this, they face being struck off the medical register.

Some might say that objecting doctors should simply refer those seeking an abortion on to more willing providers. Here's the problem. The minister's new law defines abortion as "a procedure intended to end the life" of an unborn child. Doctors who hold that this is not genuine healthcare are not prepared to surrender their conscience or their clinical judgment, or both, no matter what the law says.

It is deeply irresponsible and unjust for the Minister to put hard-working conscientious doctors into this nerve-racking position. To do it without any consultation is even worse. And to do it in the full knowledge that hundreds of GPs feel utterly disrespected and bullied is no way to run a health service.

When GPs began to voice genuine concerns about having a GP-led abortion service, it would have been much more satisfactory for all concerned had the minister met with concerned GPs or taken their concerns onboard instead of chiding them in public.

For many doctors, Minister Harris has become Minister Harass.

The impasse has been brought about entirely by his refusal to acknowledge the depth of feeling among GPs and his decision to impose a GP-led service without any consultation. But there are now 640 GPs who demand answers and won't be given the runaround.

Many GPs don't believe General Practice is the appropriate setting in which to deliver abortion because of lack of capacity in an already overstretched environment, lack of training and availability of ultrasound, and delivering on genuine freedom of conscience protections for doctors who don't want to be involved in overseeing abortions taking place.

These views have not been articulated by the Irish College of General Practitioners board to the Oireachtas. In fact, the ICGP board has turned down the opportunity to seek the views of its members on numerous occasions, which is primarily what prompted the petition from the 640 GPs.

It was Minister Harris himself who chose to enter talks with the ICGP board and exclude other GP representative bodies from any discussions. It's implausible that he's not fully aware of the multiple approaches in recent months by hundreds of GPs to the ICGP board seeking proper representation at talks with the Department of Health regarding the rollout of abortion services.

The decision of the ICGP to defer the EGM sought by its members until after the amendment stage is concluded in the Dail ensures that the voice of mainstream General Practice will not be heard by legislators. This is unacceptable.

I fully acknowledge the outcome of the referendum in May - that the public voted to repeal the Eighth Amendment. They did not, however, vote to make abortion services GP-led.

There is now a serious crisis emerging as the rollout is less than two months' away. GPs have completely lost faith in the process and in Minister Harris's ability to find a resolution.

Instead of storing up problems for later, the Taoiseach should intervene to present a compromise before the legislation is passed. And at a press conference last week, a group of GPs called on Micheal Martin to meet with them in the coming days.

General Practice is facing many challenges at present in addition to this one. It's vital that the Government recognises the need for a fair solution. Just as importantly, GPs must stay united to ensure the Government doesn't bully some of their colleagues.

If this problem is not solved, then from January, doctors who refuse to be involved in abortions run the risk of being hounded out of their jobs by the present government. If that happens, it won't be the end either. It will give rise to a political movement for freedom of conscience and become a major election issue.

Dr Kirsten Fuller is a GP based in Co Tipperary.

Sunday Independent

Today's news headlines, directly to your inbox every morning.

Don't Miss