Patients not covered by medical cards who receive abortion services will have to pay for the cost of pain relief drugs and antibiotics under draft proposals for a new model of care.
The draft document, dated December 14th, says that while termination of pregnancy services will be provided universally free of charge, those without medical cards will have to pay for drug costs and those with the card will be subject to a prescription charge.
Separately, doctors and nurses who want to opt out of the provision of abortion services will have to do so in a timely manner, under a new draft policy document. The proposals, drawn up by the HSE after consultations with trade unions, say that conscientious objection provisions may only be invoked by the employee where the specific duties of staff include carrying out or participating in carrying out a termination of pregnancy.
The draft also says that “in order to facilitate service planning and scheduling of rosters and to ensure that patients will have access to the termination of pregnancy procedure within the hospital in a timely manner, employees who wish to opt out of carrying out or participating in carrying out termination of pregnancy procedures, or in accordance with the provisions of their professional codes of practice, due to a conscientious objection should inform an appropriate manager as soon as practicable”.
It says an employee may disclose their conscientious objection verbally or in writing. “This information will be used solely for the purpose of identifying which doctors/nurses/midwives are available to be assigned to rosters for termination of pregnancy procedures. The manager is required to treat this information in confidence and with due respect for the employee’s right to disclose his/her conscientious objection.”
The draft says employers should identify and inform employees of an appropriate manager with whom they can discuss any concerns and to whom they can disclose a conscientious objection.
“Each employer should ensure that appropriate arrangements are in place for the maintenance of a confidential record of notification of conscientious objection from employees in relation to carrying out or participating in carrying out termination of pregnancy procedures.”
The draft proposals also say that employees who wish to exercise their right to conscientious objection in appropriate circumstances must not be subject to adverse treatment.
Meanwhile, the majority of the maternity units which are due to provide abortion services around the country have said they are working with the HSE to try to ensure the services are provided by the planned introduction date of January 1st.
The Rotunda Hospital has indicated will be in a position to provide abortion services, provided it is given the necessary resources by the Government.
“The Rotunda Hospital will be complying with enacted legislation providing the appropriate model of care, resources and funding is in place to enable a safe service provision to women,” a spokesman said.
The South South West Hospital Group said it would be clarified in the coming days whether their hospitals could provide the services from January 1st.
"The HSE, in consultation with the Department of Health, is working collaboratively on an implementation plan for the delivery of the termination of pregnancy service by 1st January 2019. The service will be provided by general practitioners and maternity hospitals and will be clarified in the coming days."
The group includes Cork University Maternity Hospital, Kerry General Hospital, South Tipperary General Hospital and University Hospital Waterford.
A spokesman for five maternity units – including University Hospital Galway, Letterkenny University Hospital, Mayo University Hospital, Portiuncula University Hospital and Sligo University Hospital – said the hospitals were working with the HSE.