The HSE and Department of Health have reached an agreement with the Irish Medical Organisation (IMO) on a contract for the provision of termination of pregnancy services in community settings.

As part of the contract, no GP will be compelled to provide such services.

According to the Minister for Health, Simon Harris, the majority of terminations up to nine weeks gestation will take place in community settings and this contract will only be offered to medical practitioners who express an interest in providing these services.

"The agreement of this contract is a significant step in the detailed preparations for the introduction of termination of pregnancy services at the beginning of January. It enables the HSE to offer the contract in sufficient time or doctors to consider its terms and, if they wish to take up the contract, to advise the HSE of this," he commented.

The Minister has also approved the fees for these services. The patient's first consultation will be €150, while the combined termination procedure and aftercare will cost €300 - a total of €450.

In line with the provisions in the Health (Regulation of Termination of Pregnancy) Bill 2018, a termination will involve two visits to a medical practitioner. The service will also include a third visit for aftercare, however this will be optional.

At the first visit the medical practitioner will confirm the pregnancy, offer advice and information and certify that the pregnancy has not exceeded twelve weeks gestation.

Following the three-day waiting period, a second visit will be required at which the medical practitioner will obtain consent, provide information on the procedure, possible complications and advice on contraception, administer the first medication and supply the second medication to the patient to be taken at home.

At the third visit, which will be optional, the medical practitioner will confirm that the termination is complete and provide an aftercare consultation.

The HSE plans to write to GPs in the coming days inviting expressions of interest in providing these services. Those interested will be provided with a copy of the contract and if they decide to proceed, they will be expected to return the signed contract to the HSE by early December, so that services can begin in early January.

Commenting on the new contract, the IMO said that it recognises the difficult decision faced by many doctors with regard to this, however any GP ‘who holds a conscientious objection will not be in any way compelled to participate'.

"During these negotiations we sought to protect the rights of all our members in terms of the delivery of the service. It was necessary to conclude the negotiations at this time so as to ensure each GP has the opportunity and time to consider the contractual terms and workload before the proposed implementation date of January 1," said Dr Padraig McGarry, chair of the IMO's GP Committee.