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GPs buried under trusts' workload dump

Concern over extension of nurse abortion role

Plans for greater nurse involvement in abortion looks set to remain a divisive issue in primary care following a select committee recommendation they be allowed to carry out medical abortions and even give authority for a termination.

The Science and Technology Committee report is expected to be extremely influential in this weeks Human Tissues and Embryos Bill where MPs will table amendments to the Abortion Act 1967.

The report sees no scientific evidence to justify supporting a reduction in the 24 week limit on abortion.

But it also recommends scrapping the two doctor rule for consent, and flies in the face of a recent BMA vote which opposed permitting a single nurse or midwife to administer abortions in the first 13 weeks.

Dr Trevor Stammers, a GP in Wimbledon and lecturer in healthcare ethics at the Catholic foundation St Mary's University College, believes that the report represents the Government's increasingly ‘cavalier' attitude to abortion.

He said: ‘The push [for greater nurse involvement] comes from the fact so many younger doctors and those in training are determined to have nothing to do with abortion.

‘If doctors aren't going to do it the nurses are going to be pushed into the role.'

But Dr Fiona Cornish, a pro-choice GP in Cambridge, who is also treasurer of the Medical Women's Federation, said she approved of extending nurses' powers, but only until the seventh week of pregnancy before surgical intervention is required.

‘Nurses should be able to administer medical termination pills in the very early stages but I really don't think they should take part in the surgical procedures which can take place even in the sixth week and are the standard course of action after the seventh,' she said.

The MPs' report also states that one doctor or even a nurse should give be able to give consent for an abortion.

Dr Tony Calland, chair of the BMA ethic committee, said the two doctor rule caused delays which led to otherwise avoid-able surgical procedures. He said: ‘Virtually anyone in the early part of pregnancy automatically qualifies on the basis of risk, so why do we need two doctors signatures when they have been properly informed and can make up their own mind?'

At the ARM this year GPs threw out proposals – sup-ported by the BMA medical ethics committee – which would have allowed midwives and nurses to carry out first trimester abortions.

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