As the introduction of widespread abortion looms ever closer, the journey towards becoming this brave new Ireland suddenly appears to be fraught with difficulties.
Before the referendum in May, Government politicians and pro-choice activists went to great lengths to accentuate the perils of our constitutional ban on abortion.
Ireland was unsafe for women, they said, and doctors were playing medical roulette with their patients’ lives, (It never seemed to matter that Ireland’s maternal mortality rates without abortion were among the lowest in the developed world, as even a Journal.ie Fact Check acknowledged).
Voters were repeatedly told that we were exporting the problem of abortion. Never did our leaders mention that by introducing abortion, we could end up importing serious problems which other countries had experienced.
None of that mattered amidst the euphoria in Dublin Castle on May 26th. Our political class had won, and they savoured their victory.
But with the referendum over, and the reality of legal abortion becoming ever clearer, it is clear that these same politicians never gave much thought to how they saw our health service coping with this new ‘service.’
Doctors hit out at lack of preparation:
The ongoing unrest among GPs about the Government’s decision to make abortion a GP-led service without consulting them has received much coverage.
This strange decision never received enough scrutiny from the media pre-referendum.
Abortion has long been legal across much of the developed world, but a GP-led abortion service is virtually unique. Why trial such a system here?
This decision likely stemmed from the Government’s need to insulate itself from charges that abortion clinics would become part of the Irish medical landscape should such procedures be made legal.
This was no small issue. In May, the Tánaiste Simon Coveney promised that post-Repeal there would be “no abortion clinics in Ireland.”
That was always a curious commitment. Abortions were fine, but clinics in which to carry them out were inherently problematic. Is there something wrong with clinics, Tánaiste?
Of course, he had his reasons.
Most of the 200,000 terminations performed in the UK annually take place in Marie Stopes and BPAS clinics.
These organisations have well-earned reputations for incompetence and malice. Recent scandals have included widespread botched abortions, staff bonuses to encourage women to choose abortion and limited training of their medical personnel.
Throw in the occasional death of a patient or emergency hospitalisation of many others, and you can see why those who demanded abortion in Ireland said so little about what abortion services here would look like.
Other than that they would not take place in abortion clinics, which are bad, for some reason.
Training and guidelines lacking:
Of course, it made sense for them to do so. But having achieved their referendum victory, Minister Harris and the rest of Government had a responsibility to make clear how the new legislation would impact upon doctors and nurses and how the system would operate more generally.
This has not been done however, and medical professionals are up in arms.
A petition addressed to the chair of the Institute of Obstetricians and Gynaecologists has received enough signatures to require an emergency general meeting.
The motion which will be discussed there reads: “Because of risks to patient safety due to inadequate preparation, the implementation of forthcoming legislation in relation to termination of pregnancy cannot commence on January 1, 2019 and should not take place until these risks are addressed.”
Abortion supporters have frequently accused the pro-life minority here of deliberately erecting barriers to their cherished legislation. But what is especially noticeable is how leading pro-choice doctors have taken such a critical line in public.
The former master of the Coombe Professor Chris Fitzpatrick took aim at the “inadequate planning and insufficient resources” when writing in The Irish Times on December 7th.
“We are on the verge of introducing a new termination of pregnancy service, which, if rushed into operation on January 1st as scheduled, will pose a serious threat to the health and wellbeing of women,” he wrote.
Dr. Fitzpatrick does not object to abortion, and will provide it when he feels it is safe to do so. That time has not yet come though, and he cites a number of glaring problems which exist at present: the lack of agreed models of care, the absence of clinical guidelines or Medical Council guidelines, the lack of engagement in relation to life-limiting conditions, the failure to respond to concerns which are being expressed within the profession, the fact that doctors have received little or no training for this work, etc.
He predicts that this shocking lack of preparation will lead to major failures.
“At this very late stage, it appears that the alarm bells are not yet ringing in the Department of Health or the HSE. If history is anything to go by, they may yet toll along the corridors of Hiqa and the State Claims Agency,” he said.
Dr. Keelin O’Donoghue, an obstetrician at Cork University Maternity Hospital, struck a similar note in The Sunday Business Post some days later.
Dr. O’Donoghue campaigned for Repeal, and wants to see abortion becoming part of our health system.
“But the reality is that we will not be able to introduce a safe high-quality or accessible service in January 2019. Why? Because there has been a fundamental failure to recognise the complexities involved,” she wrote.
Many other medical professionals appear bewildered as to what is happening, and how little legislators appear to care.
A case-in-point. To facilitate the training of doctors in abortion provision, a one-day training course is to take place just days before they are expected to provide these procedures.
In what other area of medicine would that be considered acceptable?
Introducing abortion was always going to require increased financial resources, not to mention large-scale training of doctors and nurses who have no prior experience in this area.
Indeed, it represents a fundamental re-imagining of any health service which was previously concerned with saving lives, rather than deliberately ending some as well.
Politicians looked for easy answers, and they won:
Remarkably, none of this seems to have registered with the Government, and in particular, Simon Harris.
The man who has spent so much of his time since May glibly tweeting about the prospect of abortions taking place in Ireland appears to have devoted no time to considering how the health service would actually be affected by this.
It is not just the Health Minister who took the opportunity of a landslide referendum victory to bask in reflected glory. His colleagues in the Dáil have spent the last weeks and months engaging in similar activity.
Pro-choice politicians have taken every opportunity to launch verbal onslaughts against those few elected representatives who continue to speak on behalf of the unborn.
All pro-life amendments to the Government’s bill have been voted down, even those which would command strong support amongst the general public: pain relief for unborn children, a ban on abortions based on disability, and a stipulation that discarded babies be given dignified burials, rather than being disposed of as hospital waste.
The attitude of the Government and the pro-choice majority was summed up very neatly by Fine Gael’s Deputy Kate O’Connell.
“We won. Ye lost…It must be hurting.”
In the coming months and years, we will find out very quickly who their victory will hurt the most.