No qualified surgeons on panel to advise Scottish Government
The Herald has now seen emails which reveal that Scotland's only two fully qualified surgeons in providing abortions up to the 24-week legal limit have been excluded from the Task and Finish group, despite their keenness to be involved.
The women's health minister has since told The Herald NHS chief executives nominated "local representatives from relevant services" to become members of the group.
The group was established this year to agree on the best way to implement a service for patients seeking an abortion between 20-24 weeks in Scotland and its first meeting took place yesterday.
In an email chain between abortion providers north and south of the border this month seen by The Herald, one 24-week provider from Scotland stated: 'Unfortunately neither xx [a 24 week provider] and I have been invited.'
They told a senior consultant in touch with the group: 'I hope you can convince them that having at least one of us there might be helpful for informing decisions.'
The group was set up following concerns from campaigners and reports in this paper that later stage abortions in Scotland are almost non-existent and are only carried out under exceptional circumstances.
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Ed Dorman has been an abortion provider throughout his 40 plus career in the NHS in England and has helped train the two Scottish surgeons excluded from the group.
He is urging the group to reconsider as he pointed out these two Scottish surgeons would be the people best-placed to set up a later stage abortion facility in Scotland.
The surgeon told The Herald: 'It would make an awful lot of sense for one or both of these highly skilled and highly dedicated clinicians to be involved in these discussions because they are the people who are best-placed to be involved in setting up a service for Scotland.
'It's mystifying to me as to why they have not been brought into this group.
"I hope they will think again and get the expertise on board.'
Latest figures reveal a woman is forced to travel from Scotland to England every four days to receive later abortion care.
Health boards in Scotland do not provide the care up to legal limit unless in specific cases such as foetal abnormality or a threat to the woman's life.
The cut-off for most cases currently stands at 20 weeks.
The lack of two surgeons, both qualified in providing surgical care, may also lead to the group pushing up the limit of medical abortion provisions in Scottish hospitals, Dr Dorman worries.
In 2014, the proportion of all abortions in Scotland that were surgical was 22%, however, this has now dropped to 1.9% in 2024.
Dr Dorman said this is likely due to pioneering tele-medical abortions (pills at home) during the Covid lockdown.
However, he said there is a concern that because there is no later stage abortion provider sitting on this group, the government and health boards could decide to only provide medical (i.e pill-induced) later abortion.
He said this would limit the choice for women seeking the care who may prefer surgical care.
Dr Dorman told The Herald: 'It limits the choice for women to something that is really quite traumatic and unpalatable for many of them.
'Having a later medical abortion up to 24 weeks is really quite traumatic. That's why, given the choice, the majority of people who sadly end up needing to have an abortion that late, tend to choose a surgical abortion.'
Dr Dornan added that there are circumstances where surgical abortion is "definitely safer" than medical ones at a later gestation, namely for people have had previous uterine surgery or, most commonly, Caesarean sections.
The Scottish Government's 2021 Women's Health Plan had an aim that 'all women will have a choice about how and where they access abortion care'.
During their conference in 2022, the SNP committed to ensuring abortion services are available up to the legal limit of 24 weeks for all patients.
However, this is still not the case.
Earlier this month, the women's health minister Jenni Minto told The Herald she had written to the chair of the group urging them to report back within six months and provide 'an expert view' on establishing a later stage abortion service in Scotland.
Since then, the Scottish Government has committed to pay for training for any clinician who wishes to provide later stage abortions.
Scottish Government has previously said they are working with the Scottish Abortion Care Providers network, the Faculty of Sexual and Reproductive Health and the Royal College of Obstetricians and Gynaecologists to improve access for clinicians to surgical abortion training at all gestations.
Ministers have said they will "present" information gathered from Health Boards to Chief Executives to help inform discussions about where surgical abortion provision could be increased.
Public Health Minister Jenni Minto said: 'I want NHS Boards in Scotland to deliver later stage abortions, to all women that need them, as soon as is viable.
"The Scottish Government is providing individual clinicians who wish to receive training to deliver later stage abortions with funding to do so. That is why there are ongoing conversations with clinicians interested in training, and more staff are undergoing training - in addition to previously trained staff.
'A Task and Finish Group has been established to ensure equitable access to abortion services up to the legal gestational limit within Scotland, as soon as possible. NHS Board Chief Executives have nominated local representatives from relevant services, who will engage with a range of service providers and staff within their regions.
'I have asked the Group to report back within six months and provide an expert view on establishing the later stage abortion service in Scotland. The Scottish Government will work closely with Health Boards to implement the service as soon as possible.'
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