Dr. Caitriona Henchion:

I will mention two things on telemedicine, the first of which is to point out that it is not restricted to abortion care. Telemedicine has been widely used since the pandemic particularly. I would like to say it was really good to see that the HSE very proactively came out at the beginning of the pandemic to make sure that even though there is a restriction in the law saying the woman must be examined, it felt that in the emergency, we could actually still use telemedicine in these situations and still make an estimation of gestation in good faith or refer for a scan without physically having to see every person since it was not going to be safe to do so. The really clear message was that abortion is the same as all other healthcare and that the abortion providers could act in the same way when providing this service as every other service. That was really good.

The other thing, to be clear for people, is that I would not like anybody to get the impression that telemedicine is somehow a reducing of a service to women. It is actually a huge extra amount of work for the provider to make sure that all of the information is being transmitted during the consultation because we so often rely on body language when looking at someone to see whether they look confused and get everything we say. Much more effort goes into those consultations. We put a lot of extra resources into making sure we had little links put into text messages, which we could send in order that people could click and read extra information. We had little video clips showing them what to expect in their packs. We would have already had information sheets and one pagers for people on how to take their medication at home, advice on what to expect and emergency contact numbers. We made sure all of those went either by email or text.

A proper package has to be put together in order to have good telemedicine. That is when we will get really good results. We have to also be open for business. We have to actually realise that it is not going to suit everybody. Some people have no privacy at home and need to get out of it to actually be able to have a confidential conversation. Some will just physically feel uncomfortable. People could be deaf. People will not always be able to do telemedicine. We need to be very flexible about and also say, yes, we had this conversation over the phone but our door is open. If a person has this or that issue, we want that person to come in and feel that they are welcome to do so. We do not actually provide it in a vacuum where people feel they do not know where the service is and where they can go.