The Black List

10 Mar

I recently moved to the UK. As many women before me, I had to get registered with a General Practitioner (GP) in order to get birth control. The joys of having yet another unknown person ask me the most personal questions, giving me unsolicited advice about my personal reproductive choices and even worse, getting acquainted with my vagina are, as also many women will agree, not the joys we daydream about.

The great thing -I was told by the NHS website- is that I could choose my GP as long as it is a practice that is appointed to my postcode. I went into a review for GP practices and was disappointed by the kind of reviews I saw: they all reflected the amount of time they had to wait, whether the secretary was nice, and other banal information.

So here I was, asking myself, how do I choose a vagina friendly GP? And by this I mean, how can I make sure I go to a practice where my choices are met by a respectful, open-minded health operator, that will provide any service I may need in the future without a judgement?

I know what you’re thinking: just say it. Yes, I want to know I go to a GP that will not sabotage me in the future in case I ever need an abortion. No, I’ve never had one and am not planning to ever need one. No, I don’t think I would be terrible if I ever do and actually believe it’s my right.  I do realize abortion is not a right in the UK, this post I believe illustrates greatly some of the issues around abortion in this country.

Maybe it’s not even about knowing I can get one, but making sure I’m not with a GP that in principle believes I shouldn’t get one in any circumstances, or even worse, would on purpose deny me of an abortion, a service I am supposed to be able to get in the UK.

While I was googling away to inform myself on this issue, I  found out that in 2007, nearly a quarter of GPs were refusing to refer women for terminations and a fifth wanted the procedure banned outright. Yesterday, the Independent also raised the issue by reporting that since July 1991, when the abortion pill RU486 was introduced, less than 3,000 women have received it, while more than 60,000 women should have had the option of this non-surgical termination. Less than a half of the NHS hospitals that practice abortions offer the pill. GPs fail to tell their patients they have this option over surgical pregnancy termination.

I’ve been whining about this to friends and they’ve expressed worries from “the other side”. Do I think all GPs should be forced to practice abortions? No, I am a true believer of conscientious objection and think GPs should have a right not to do something against their beliefs. And I believe the NHS system has addressed this and GPs can opt out of providing this service.

But I think: shouldn’t we, women living the UK, have the certainty that we will get a GP that will provide us this service? That’s when the shit hits the wall in some arguments and people suggest I am creating a black list of doctors based on their beliefs, which could create massive discrimination issues. Fair point.

But then, what about us? If we have evidence that GPs are, because of beliefs or any other reason, sabotaging thousand’s of women’s access to a health service, shouldn’t they be accountable for this? After all, once the legal period has passed, that’s it, you’re stuck in a very difficult situation. I briefly thought of the Seinfeld episode “The Pilot”, when Jerry and George write about a show in which a person is convicted with becoming another person’s butler for a while by a judge. Could we then, in such a world, give the baby once it’s born to the GP? Sorry man, you failed to provide me this service, the direct consequence being me having this baby, so here you go: have fun!

As cynical as this may sound, we do have to think about a solution. And I believe the fact that the provision of abortion by NHS personnel is addressed around a GP’s right to opt out, rather than their duty to do so is a critical starting point. If we knew we had GPs that don’t believe in antibiotics and refuse to prescribe them for infections, what would the NHS do? Would they say: don’t worry, you can opt out. Or would they say: the consequence of you not doing this is critical to a person’s health and access to services, so if you won’t do it, you need to tell us now.

I understand that the basic problem is that abortion isn’t a right. And yes, that would fix a lot of problems. But in the meantime…we don’t go around asking if every health service we get is a right in itself, do we? “But doctor, I have a right to chemotherapy when I have cancer”… or “I have a right to painkillers when I’ve hurt myself and am in pain”. Or would we accept a situation in which a person’s died because they didn’t get a blood transfusion in a hospital due to their doctor’s beliefs? We would all be outraged. We consider all these services as part of our right to health and the consequent obligation of this is our State’s obligation to provide us with all it entails. But we are not outraged in this case… not all of us anyway.

So yes, I do think there should be a list. Maybe not a black but a white list. Doctors that are willing to provide this service should enlist and women looking for this service should have a guarantee that the GP they go to will have no problem in giving them what they’re entitled to.

The system still sees this as a favor, an option, something women cannot demand, something for a holy GP to decide in her behalf. That’s the reality, and the consequence of the denial of such a service is as long-term as any can be.

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