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29 November 2018
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ICGP Role in Provision of Abortion Services Q&A Document

The Irish College of General Practitioners is holding an Extraordinary General Meeting (EGM) of its members on December 2nd to discuss the concerns of some members regarding the provision of abortion services in the community.

The ICGP's remit is to serve the patient and the general practitioner by encouraging and maintaining the highest standards of general medical practice.

It is the representative professional organisation on education, training and standards in general practice.

In advance of the EGM, this document sets out the facts relating to the provision of the services and the ICGP's role in developing the guidelines while incorporating the concerns of some members.

Please click here to read the Q&A document.


Is general practice the appropriate setting for providing an abortion service?

Some members, including those who have organised an online petition, are opposed to the provision of abortion services by GPs in Ireland.

In May 2018, the Irish people voted overwhelmingly in favour of the repeal of the 8th amendment providing for termination of pregnancy restricted to up to 12 weeks except in the cases of fatal foetal abnormalities and significant risk to the life of the mother. The Government decided that it would be provided in the community.

It is the College's remit to ensure that clinical guidelines, training, education and standards that enable appropriate and safe patient care can be provided for those doctors who wish to offer the service. The guidelines will be available to all GPs.

Countries as diverse as Australia, Canada, the United States and France have termination of pregnancy provided in a general practice/family medicine setting.


Did the College advocate for a GP-led abortion service?

The College never advocated for a GP-led abortion service. The College's remit is to ensure that a safe, quality and patient centred service is available for patients, and that members who wish to provide this service are properly trained and supported.


Will every GP have to provide this service once the legislation is passed?

No. Only those doctors who wish to provide the service will do so. There is no mandatory requirement on GPs to provide the service if they do not wish to. This is an "opt-in" service, i.e. those who wish to and are trained to provide the service can do so.

Based on feedback from members, the ICGP has advocated for an opt-in system at all meetings with external stakeholders, including the Oireachtas Health Committee, HSE, Department of Health, the Institute of Obstetricians and Gynaecologists and RCPI.


How has the College supported those doctors who have a conscientious objection to providing an abortion service?

The College has advocated for a service that ensures that those who do not wish to provide the service are not asked to do so.

It has successfully advocated for a 24-hour helpline as part of an "opt-in" service.

The College supports the rights of all doctors to exercise freedom of conscience in a professional context, in accordance with the Medical Council's Guide to Professional Conduct and Ethics, and has relayed members' concerns in this regard to the Medical Council following the College's consultation process.


How will the "opt-in" system work?

A woman who wishes to access abortion services can contact a 24 hour help line with suitably qualified staff who can direct her to providers who have opted in, as well as provide access to non-directive counselling and provide clinical triage for complications. The helpline will be staffed by clinically qualified personnel, based in Ireland. The woman will be able to choose from three options: access to non-directive counselling; information on how to access services, or clinical triage of complications. The HSE will advertise the number for the helpline via social media, a dedicated website and in a national communications campaign.


Will the College support those doctors who do not wish to offer the service?

The College will give full support to any member who does not wish to provide the service.

The College has strongly advocated for an opt in service and a 24 hour helpline to triage patients.


How will the 24-hour helpline work?

The helpline will be staffed by clinically qualified staff, based in Ireland.

The Help line service will provide access to services, access to non-directive counselling and clinical triage where clinically indicated.

The HSE will advertise the number for the helpline via social media, a dedicated website and in a national communications campaign.


What about the members with genuine concerns about workload and existing pressures on their practices?

Members have expressed concerns that providing this service would put their practices under significant workload pressures and further that the necessary resources may not be provided.

The College in its meetings with the HSE and Department has strongly stressed that the following resources MUST be in place before the service can be provided safely:

  • 24-hour helpline
  • Free and readily accessible ultrasound service
  • Access to secondary care (hospital setting)


Why did the College not put the motions from the October letter of some members to the EGM?

The College received a request for the holding of an EGM on 31st October, but this was invalid as there were no actual signatures provided which is required procedurally. The Board of the College has the key responsibility of ensuring full compliance with company law. Not to do so, would put the future governance of the College at serious risk. Recent media reports that over 600 College members had called for this EGM are incorrect. The original petition was accompanied by a list of names of which 373 were members of the College.

The Board of the College decided to hold this EGM on December 2nd to enable members to voice their concerns, and be accurately informed of the College's role to date.

The College consulted with all members via an online consultation during August and September, and also held six regional meetings to listen to members' concerns.


Will the College provide training for those members who wish to provide the service?

The College will provide initial training in mid-December, and those doctors who wish to offer the service are invited to attend. Educational and training activities will continue throughout 2019. The training relates to understanding of medications, checking for contraindications, knowledge of referral pathways and when to refer.