Breda O’Brien: GPs are ignoring democracy on abortion issues

Doctors’ group is demanding members fall into line without expressing their concerns

‘GPs are already over-worked, highly stressed and leaving the profession in droves.’ Photograph: Anthony Devlin/PA

‘GPs are already over-worked, highly stressed and leaving the profession in droves.’ Photograph: Anthony Devlin/PA

 

The board of the Irish College of General Practitioners, the professional body for general practice in Ireland, has refused for the second time requests from some of its members to hold an emergency general meeting to debate motions on abortion.  

Why is the ICGP so afraid of democracy? This is only the latest twist in a long-running saga that began when Simon Harris announced in a radio interview that abortion services were to be GP-led.

This was the first that GPs had heard of it. They were already over-worked, highly stressed and leaving the profession in droves. Many were stunned that there had been absolutely no consultation with GPs.

One would have thought that the first thing the ICGP board would do would be to conduct a survey of GPs about how they felt about yet another demand imposed on family doctors. This never happened.

The ICGP board did send out a questionnaire last summer but it only looked for feedback on how best to implement the rollout of abortion provision.

Meanwhile, the Government dealt only with the ICGP and ignored the National Association of General Practitioners (NAGP) which held an emergency general meeting in June 2018 and was willing to represent the views of all, not just some, of its 2,000 members.

In a statement detailing why it was refusing a democratic request for an egm for the second time, the ICGP board stated it had held “an online consultation, six regional meetings, and a dedicated council workshop”.

But what this conceals is that the ICGP never asked the crucial question – is a GP’s surgery the appropriate place to dispense abortion pills in the first place? (In Britain, for example, abortion facilities are usually standalone clinics. Any Irish doctor keen to carry out abortions could still do so in similar facilities here.) 

The board now claims “the fact that over 300 GPs are providing termination of pregnancy services at this time and that over 500 have completed training is an indication that the college’s decision to provide clinical guidelines was appropriate”.

This is tantamount to saying that if a minority of GPs (in this case, 800 of over 4,000 members or one in five GPs) approve of anything the board has done, all other GPs automatically lose the right to be heard.

Refusal to listen

In early October last year, over 200 GPs signed a letter addressed to the ICGP board taking issue with the lack of consultation, and in particular the refusal to listen to, and make known to the Government, some doctors’ concerns about the lack of full freedom of conscience rights in the new abortion legislation.

When it became obvious the ICGP had no intention of listening to its members, in late October more than 600 registered GPs presented a petition demanding an urgent egm to debate and vote on several motions.

Initially, the board refused to convene an egm on the grounds that the signatures were digital rather than handwritten, but in early November, the ICGP board announced that an egm would take place on December 2nd. (The legislation to make abortion services available was due to be enacted in January.)

When the egm agenda was released, all the motions submitted by more than 640 GPs were quashed and replaced with an agenda that consists of nothing more than a series of panel discussions on the rollout of the new abortion law.

Doctors expect nothing better from Minister for Health Simon Harris

Infuriated, many doctors walked out in protest. It is important to note that the signatories were not just anti-abortion. There were also pro-choice doctors who were appalled by the run-around being given to ordinary members.

The process began again. Handwritten signatures were collected this time, over 600 in total and including 490 full members of the ICGP, far above the 350 the ICGP standing orders demand.

Yet this week, the board predictably announced that following “careful deliberation, including taking legal advice”, no egm would be held. This shows blatant disregard of procedures originally designed to allow members to be heard – even when the board wants to ignore them.

Instead, there is to be a debate on abortion at the annual general meeting in May, with motions to be submitted in advance through local ICGP faculties – still more hoops to jump through.

The ICGP agm is scheduled to take place for one hour and 45 minutes at the end of a weekend seminar which costs €240 to attend.

I can only conclude that the ICGP knows the depth of the distress among its members who still adhere to primum non nocere – first, do no harm. It appears to be gambling that if it continues to stonewall its own members, all doctors will eventually meekly fall into line.  

Meanwhile, a GP earns €450 for dispensing abortion pills while an emergency delivery of a baby garners €230.53 – a perfect illustration of this Government’s priorities.

The doctors who the ICGP are ignoring will not go away. There is only so long that any institution can avoid accountability to its own members. Doctors expect nothing better from Minister for Health Simon Harris. They once expected more from the ICGP board.

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