Hildegarde Naughton (Galway West, Fine Gael) | Oireachtas source

I thank Senator Mullen. I am taking this matter on behalf of the Minister for Health, Deputy Stephen Donnelly. He welcomes this opportunity to update the House on this important matter. I would like to thank Senator Mullen for raising the issue. The model of care for the termination of pregnancy service became operational in January 2019 following the enactment and commencement of the Health (Regulation of Termination of Pregnancy) Act 2018.Termination up to nine weeks' gestation is carried out in the community by GPs or doctors working in family planning and women's health clinics, providing clinical supervision and supporting women's self-management. Women with a pregnancy between nine and 12 weeks' gestation are referred for hospital-based care. The arrival of Covid-19 in 2020 required a substantial shift in how care was provided across the health service, including the adoption of measures to facilitate social distancing and reduce personal contacts and footfall in medical facilities as appropriate. As part of the Government's ongoing efforts to protect public health and limit the spread of Covid-19, the Department of Health and the HSE worked together in 2020 to agree a revised model of care which put in place arrangements to allow termination-of-pregnancy services in early pregnancy to be provided remotely. For the duration of the Covid-19 public health emergency the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners were paramount. It became possible for a woman to access a termination under section 12 of the Health (Regulation of the Termination of Pregnancy) Act 2018 before 12 weeks from her medical practitioner by telephone or via conference consultation. Engagement is ongoing between the Department of Health and the HSE to monitor service provision, to facilitate the smooth running of the termination-of-pregnancy service and to resolve any issues that may arise. However, as restrictions began to ease, it became timely to revisit the model of care, to review its operation and to consider whether remote consultation, as part of a blended approach to termination-of-pregnancy care, should be continued after the Covid-19 public health emergency period. At the request of the Department, the HSE conducted a review of the revised model of care of termination of pregnancy, taking into consideration the experiences of healthcare providers, service-users and international best practice. The review found that the majority of providers in primary care feel that a blend of remote and in-person care is optimal. In-person consultations allow provision of personalised care and allow potential problems to be identified and mitigated, while remote provision improves access for many women and addresses geographical and logistical barriers. It also alleviates some of the difficulties associated with the mandatory three-day waiting period. The review also found that the provision of a remote consultation as part of the termination-of-pregnancy services was safe, effective and acceptable to both service-users and providers.