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Simon Harris tells HSE poor coverage of abortion services in west and north west 'is a real concern'

In May, Harris spoke to representatives of the HSE about why abortion services are available in just half of maternity hospitals and units.

Image: RollingNews.ie

MINISTER FOR HEALTH Simon Harris has said that the current provision of abortion services in the north and north west is “a very real concern” and is “not acceptable”.

The minister made the comments during a meeting with the HSE in May about the progress in rolling out abortion services at all of Ireland’s maternity hospitals and units.

Abortion services, as legislated for in the Health (Regulation of Termination of Pregnancy) Act 2018, were in place in nine maternity hospitals and units across the country from the 1 January this year.

A number of healthcare professionals, including former Master of the National Maternity Hospital Dr Rhona Mahony, said that there was a concern about that implementation deadline, as the detail in the legislation was only provided in the winter months.

It had been planned to rollout abortion services gradually from the 1 January, but as it stands, just one more maternity hospital – the Coombe – has also introduced the service, bringing the total to 10 out of 19 maternity hospitals and units.

Documents released under a Freedom of Information request show that the Department of Health General Secretary Jim Breslin wrote to the HSE in April to say that it wasn’t acceptable that nine maternity hospitals or units hadn’t yet implemented the full abortion service, as legislated for last year. Breslin then requested a meeting between the HSE and the Health Minister.

The Minister’s speaking notes for that meeting with the HSE, held on 2 May, he praises the work done to date “within a very challenging timeframe”, and thanks the health services for their efforts.

He then goes on to say that he’s “very disappointed that there are still only 10 hospitals providing early termination of pregnancy services”.

As things stand we have poor geographic coverage in the west and north west, and this is a very real concern, and, to be frank, this situation is not acceptable to me. I would like to understand what the barriers are to providing the type and extent of the service that I, and the government, have mandated. 

In previous updates sent to the department and seen by TheJournal.ie, the HSE states that conscientious objection, staffing issues, and other operational challenges are preventing the provision of abortion services in nine maternity hospitals and units.

In the case of South Tipperary General Hospital, the HSE said in previous correspondence with the Department that abortion services would require “a minimum of two clinics and at least one theatre slot a week” which “would not represent optimal use of scarce resources given the proximity of STGH to other hospitals providing the service”.

The Midlands Regional Hospital Portlaoise, is using “a networked approach” to provide abortion services, with the procedures being carried out in the Coombe”.

In his speaking notes for the meeting with the HSE, Harris responds to these suggestions and says: “This confuses me as, from the outset, I have been very clear that government policy is to normalise termination of pregnancy service provision within our maternity hospitals and that services should be provided in all 19 maternity hospitals (sic).

“In that context, I cannot understand why the HSE should seek to defer the rollout of services in line with government policy.”

FOI document Source: FOI/Department of Health

Harris continues to say that €7 million in funding has been provided to the acute sector (meaning hospitals and clinics) and that he wishes to see a timeline of when the full rollout of services will take place.

In previous documentation, the Department of Health expresses concern about conscientious objections preventing the rollout of abortion services at Letterkenny University Hospital and Sligo University Hospital, meaning that there are no acute abortion services for less than 12 weeks “north of Castlebar from January”.

The documentation shows that Department of Health has requested that abortion services will be available in all maternity hospitals and units by 1 September.

Statement from the HSE

As it stands, all 19 hospitals provide some level of abortion service: all hospitals will provide terminations in emergency situations. In cases of fatal foetal abnormalities, the service will be available in tertiary hospitals (eg, University Hospital Galway, University Maternity Hospital Limerick, Cork University Hospital, and the three Dublin maternity hospitals).

Thirteen hospitals will provide both medical and surgical terminations up to 12 weeks. One hospital, University Hospital Waterford, will provide medical terminations only.

In line with the Health (Regulation of Termination of Pregnancy) Act 2018, a primarily community-led service is being delivered by GPs in primary care settings and women’s health service providers with appropriate access and care pathways to acute hospital services as required. No capacity issues have been raised, and service demand remains within the predicted limits.

In a statement to TheJournal.ie, the HSE said that there are 335 GPs signed up to provide abortion services so far, and all maternity hospitals are providing the following termination of pregnancy related services:

  • Managing complications arising from termination
  • Providing appropriate care and supervision for women following a diagnosis of fatal foetal abnormality, and referral to the appropriate tertiary unit
  • Providing appropriate care and supervision in cases where maternal health/life is at risk, and referral to the appropriate tertiary hospital, as appropriate.

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