More than 2100 abortions went unreported to the Irish Department of Health in 2021, and no one appears to have even noticed this until 30th June 2022.
This is not supposed to happen. Section 20 of the 2018 Termination of Pregnancy Act sets out, quite clearly, the obligations of the abortion provider with respect to notification of each abortion, and the obligations of the Minister for Health in reporting same.
Under Section 20 of the Act, the abortion provider has 28 days to notify each abortion to the Minister. It is an extremely simple report, identifying the abortion provider by registration number, saying which of four sections of the Act the abortion was carried out under, detailing the county of residence of the woman, and the date of the abortion. The Minister then has five months – February to June inclusive – to prepare the report for the previous year’s abortions, after all the notifications for the previous year are in. Five months, to produce a summary of the number of abortions under each heading, the number of monthly abortions, and the county of residence figures.
The abortion provider’s notification looks, at most, a five-minute job, and the Department’s annual report could surely be compiled in a day. Despite these minimal requirements, neither the abortion providers – not all of them, anyway – nor the Minister, discharged their obligations under the Act with respect to the 2021 abortion data.
They did not even come close.
THE ABORTION PROVIDERS
About 2100 of the abortions in 2021, nearly one-third of the abortions paid for by the HSE for 2021, were not notified to the Department at all. Perhaps that should be rephrased, because the Minister is using the cyber-attack of 2021 as a possible excuse: 2100 notifications out of 6700 were not received by the Department of Health for 2021. Of the 4577 notifications that were received, 62 were missing the date, and 204 were missing the county of residence.
These gaps in the data are not peculiar to 2021. The date was missing from 69 notifications in 2019 and from 58 notifications in 2020. The county information was missing from 525 notifications in 2019 and 425 notifications in 2020.
THE MINISTER FOR HEALTH
The Minister was nearly two weeks late putting the 2021 report before the Oireachtas. He had five full months to compile it and publish it. We do not know when he compiled it – it is dated June 30th -but he published it literally the day before the Dáil rose for the summer recess.
That is a full thirteen days after the 30th June statutory deadline – thereby removing even the possibility of questions being asked about it in the Dáil chamber.
If the Minister, or whoever he had delegated for the task, had been monitoring the 2021 abortion data month by month, it would have been patently obvious as early as April or May of 2021 that something was seriously amiss with the notification data. See, for example, the accompanying bar chart. How could anyone miss the huge drop each month in the notifications for 2021?
In fact, there were just 289 notifications for April 2021, 100 for May and 103 for June. In 2019 the corresponding figures for these three months were 538, 580 and 533. In 2020 the figures were 639, 520 and 510. If anyone at all in the Department of Health had taken even a cursory look at the monthly data as it was coming in, these massive discrepancies would have been noticed and corrective measures taken at the time.
HOW COULD THIS HAPPEN?
The Department of Health receives the notifications from the abortion providers, but the HSE makes the actual payments. Logically, the abortion provider should submit the completed notification to the Department, to be forwarded to the HSE for payment after verification that everything is in order.
Bizarrely, what seems to actually happen is that these operations occur, instead, in parallel – the abortion provider claims payment from the HSE separately from notifying Health. The HSE pays out on each application, without first checking that the abortion provider has complied fully with the Act. The abortion provider gets paid, even when the notification form is incomplete or non-existent.
In three and a half years of this system, no one has seen fit to introduce basic logic into its operation.
From the outset, in fact, there has been an evident attitude of contempt towards collection of abortion data in this jurisdiction. A deliberate political decision was made in 2018 to collect as little abortion data as possible – much less than is collected in other countries – and then there was, at best, only a half-hearted effort at collecting the minimal amount of data detailed above.
This is politically convenient, ensuring as far as possible that awkward facts about our new abortion regime are not actually discovered. If one asks why Louth has considerably higher abortion rates than Wicklow, Meath and Kildare, for example, then differences in reporting the county of residence provide a plausible and highly convenient explanation. The real reason might be that GP’s in some counties make a real effort to provide counselling to the woman seeking the abortion, and there are higher change-of-mind rates in consequence. But it is politically easier to hide behind missing data as the explanation.
But it is morally reprehensible. Other countries collect lots of abortion data, because it helps them understand what is happening, and leaves open the possibility of taking corrective action to reduce future abortion numbers. (Not that many of them do, however)
In Ireland, in contrast, the political and medical establishments appear to prefer the Three Monkeys approach. And the mainstream media, and in particular the national broadcaster, appear to have no problem with that.
Did RTÉ even report this latest fiasco with the 2100 missing abortion notifications?
This piece was first published on Gript.
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