Ministers have been warned that GPs may use Government promises to introduce abortion services by next year as a negotiating ploy to seek “significant” fees for carrying out terminations.
The Irish Medical Organisation (IMO) has in the past used deadlines to introduce new services by a specific date to seek much higher fees from the State, the Cabinet has been told.
Minister for Health Simon Harris told the Cabinet last week that if agreement cannot be reached with the IMO, the State could unilaterally set its own fees and see how many GPs take up its offer.
The warnings come against the backdrop of an ongoing pay dispute between the State and GPs.
Taoiseach Leo Varadkar and Mr Harris have said services allowing for abortion in the first 12 weeks of pregnancy will be in place by January.
The proposed new laws allowing for abortion are not expected to be introduced into the Oireachtas until a number of court challenges to the referendum to repeal the Eighth Amendment to the Constitution have been dealt with, which is expected to be autumn at the earliest.
Memorandum
A memorandum sent to the Cabinet this week said if a fee for abortion services cannot be negotiated with GPs in time, the Government will invoke public service pay legislation.
This would allow Ministers to set specific fees which would be then offered to GPs prepared to provide abortion services for the amount set by the Government, and not at the level of fees sought by groups such as the IMO.
The document also said that although Mr Harris’s preference is to have abortion “delivered primarily by GPs”, he also envisages services being provided by other service providers such as family planning clinics.
"It is possible that this will complicate the process of reaching agreement on a contract for the provision of abortion services," the document from the Department of Health says. "In the past, when the State has attempted to introduce new services by a specific date, the Irish Medical Organisation has negotiated significant fees in return and it is possible that it could adopt such an approach in the current situation."
If no agreement can be reached on a fee structure with GPs, the Public Service Pay and Pensions Act – which would allow the State to set fees – would then be invoked. There would still be a “formal, appropriate, 30-day consultation on fees”, it adds.
Discussions
“This would not prevent discussions with GP representatives and others interested in providing a service, but it would allow the State to reach a conclusion on an appropriate fee in a timely manner and to issue contracts to interested parties well in advance of introduction of the service.”
The document also provides other details on the abortion regime envisaged by the Government, and says that while Mr Harris’s preference is to have abortions in early pregnancy delivered by GPs, “he also envisages services being provided by other service providers such as family planning clinics”.
“This approach will help to ensure the availability of services and will also allow women to have a choice of provider where they so wish.”
The document also deals with the potential numbers of abortions that will take place when the new system is in place.
While it says the exact levels cannot be predicted, it adds: “It is expected that, as in other jurisdictions, an increase in the expected numbers could be anticipated in the early years.”