Dr. Madeleine Ní Dhálaigh:

Conscientious objection in the peripheral hospitals has had an impact on abortion care and has an impact on abortion care being provided by GPs in the community. There is an impact if GPs are unsupported by their local hospital and are expected to provide care in a vacuum. For instance, there is no peripheral hospital providing that care in all of counties Donegal and Sligo. I have colleagues who have very bravely stepped up to the mark and are providing high-quality care, but in terms of accessing follow-up care or in cases where the woman or girl has gone over the ten weeks' gestation period, after which point care cannot be provided in the community, their nearest hospital is Mayo General Hospital. The model of care is that it is provided in the hospital. Conscientious objection is something the HSE needs to address in those peripheral hospitals. One will find that GPs will become providers if that is removed.

With regard to contraception, the main barrier to care for women receiving care and all people who need contraception is the financial barrier. There are very few conscientious objectors now with regard to contraception. Women, girls and people who need contraception have a good choice of who provides it, but they need to be supported. There needs to be a structured programme for women and all people who need contraception. I spoke about the issue earlier.

The Senator mentioned mental health in primary care. Mental health care in primary care is non-existent. GPs are really under pressure to provide the care. Again, this speaks to the subsidies. We should be able to use our subsidies as we see fit, perhaps to employ a psychologist for a session or two a week. What we keep talking about is the need for structured and evidence-based care. We will deliver it, but it needs to be evidence-based and properly resourced or it will not work.