A GROUP OF GPs and nurses who are calling for a No vote in the upcoming abortion referendum have taken issue with a statement by Tánaiste Simon Coveney regarding the provision of abortion services.
Writing in the Ireland Edition of The Times today, Coveney said that the new laws the government is proposing would be “based on the principle of ‘informed consent’ and would require a medical professional to enter into an honest and caring process with a woman who is requesting an abortion in which alternatives and optional counselling supports are discussed”.
He also asserted that “there will be no abortion clinics in Ireland”.
Asked about Coveney’s stance at a press event hosted by the anti-repeal Save the 8th group this morning, GP Neil Maguire said there would “have to be” abortion clinics if the government wants to proceed with its plans for new legislation, which were outlined earlier this year.
Maguire said that on an average day he dealt with 40 patients, wrote 20 prescriptions, dealt with 15 phone calls and made one house call.
“I don’t have an hour of time to counsel a patient,” Maguire said. “So what will happen is you will have to concentrate this work.”
Most local GPs or healthcare centres could not afford equipment like ultrasound machines, Maguire said. Ultrasound equipment, he explained, was essential to effectively gauge gestational age. He added that giving a woman an abortion pill without that certainty could be highly dangerous to the woman.
“It’s not just about going out and paying 10 or 15 or 20 thousand euros for an ultrasound scanner – you have to be trained to do that, you have to maintain your skills, you have to be certified and recertified.
So that kind of specialised activity in medicine has to be concentrated and it’s only going to be concentrated where it’s being done on a daily basis.
Ann Flynn, a Dublin-based nurse who also spoke at today’s event, said that the health system would be presented with an organisational nightmare in the event of the legislation being passed as planned.
She raised the scenario of four nurses on shift at an operating theatre being asked to assist in an abortion and said that if all four of them conscientiously objected to doing so, they may feel pressured into performing the procedure.
Flynn said:
More and more staff are going to be put in that position because more and more staff will want to help the woman, but they are caught in a bind because they feel that the procedure and what they’re being asked to do is wrong.
Health Minister Simon Harris has said that conscientious objection will be provided for, and the issue is dealt with in Head 15 of the proposed legislation which was published in March.
It has been acknowledged by the government that, if its proposals for abortion are made a reality, additional resources will be required to provide such services. The government has said that it will engage with heath bodies and providers as the government prepares legislation in the event of a Yes vote.
Together for Yes today confirmed that 1,300 doctors have so far declared their support for a Yes vote.
Abortion services
Although the General Scheme of the Bill to Regulate the Termination of Pregnancy has already been published, any final legislation would first have to go through all the usual stages of the Oireachtas.
Harris was recently asked a number of questions on the issue of abortion services by Fianna Fáil TD Éamon Ó Cuív - including questions related to “the cost and staffing implications” of such services and “if these will take place in registered maternity hospitals or in specially provided facilities”.
In his response, the minister said that such issues would be addressed if the referendum was passed.
“In the event that the proposed referendum on Article 40.3.3 is passed by the people, the government would seek to give effect to legislation regulating the termination of pregnancy in Ireland,” Harris said.
In such circumstances, the Department of Health would, in considering any such legislation, consult with representative bodies of all relevant medical practitioners on the details of the legislative proposals and possible service implications, as is usually the case in developing legislation.
The question of who would provide abortion services in Ireland was also discussed at the Oireachtas Committee on the Eighth Amendment.
Dr Meabh Ni Bhuinneain and Dr Peter Boylan of the Institute of Obstetricians and Gynaecologists said that obstetricians and gynaecologists already have the skills required to carry out a termination.
They stated that little or no additional training would be required but that additional resources would be.
Boylan stated:
The skill levels required in termination of pregnancy, every trained obstetrician possesses, so we are more into resources and so on. It is well-known that the Irish maternity services are under-resourced – that is no secret. In a broad sense, yes, we would require more investment, more personnel and so on.
The skill sets are there already. Early terminations with tablets can be done through GPs’ surgeries and clinics, and by nurses who are certified to prescribe.
It is proposed in the planned legislation that abortion would be made available without restriction as to reason up to 12 weeks of pregnancy, and it is envisaged that this would take place in most cases in a GP setting.
Boylan highlighted that abortion pills are now commonly used in medical terminations up to 12 weeks of pregnancy.
Speaking to TheJournal.ie in an interview last week, the new head of the National Association of General Practitioners (NAGP), Ireland’s GP union, stressed that the group was taking a neutral stance on the 25 May vote.
But regarding the suggestion that any abortion service will be GP-led, he said he didn’t believe that would be possible.
“We’re not in a position to provide a GP-led abortion service. I don’t believe we can do it. No other country in the world does it, to the best of my knowledge,” he said.
We haven’t got the resources, like ultrasound machines even.
The bottom line is we don’t have the resources, and nowhere else expects its GPs to do this. I don’t think that GPs can provide it, and I don’t think a GP surgery is the place for it.
A Doctors for Yes event was also held over the weekend. The Together for Yes campaign said 1,000 doctors had signed a public declaration of their support for repeal of the Eighth Amendment.
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