Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I thank Senator Hoey for her contributions in the Joint Committee on Health. I enjoyed being on that committee with her. The Minister, Deputy Donnelly, has asked me to deal with this Commencement matter.

I thank the Senator for giving me this opportunity to address the House on the review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018. The Act was signed into law on 20 December 2018 and expanded termination of pregnancy services have been available since 1 January 2019. The Act allows termination to be carried out in cases where there is a risk to the life, or of serious harm to the health, of the pregnant woman where there is a condition present that is likely to lead to the death of the foetus either before or within 28 days of birth and without restriction up to 12 weeks of pregnancy. This is in line with the recommendations of the Oireachtas Joint Committee on the Eighth Amendment of the Constitution, which published its report and recommendations in December 2017. Prior to the May 2018 referendum on the eighth amendment, the general scheme of the Bill to regulate the termination of pregnancy was published. The final legislation enacted is consistent with the published proposals.

In line with statutory and Government commitments, the Minister for Health commenced the review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018 at the end of 2021. The final report of the review was submitted to the Minister at the end of February 2023. The report makes a range of recommendations, most of which are operational in nature with some proposing legislative change. The report was considered by the Cabinet on 25 April 2023. Following the meeting, the Government agreed that the HSE would establish an implementation group to progress the operational recommendations while the proposals recommending legislative changes were referred to the Joint Committee on Health for consideration. In December 2023, the Joint Committee on Health issued its report on the legislative recommendations. The Minister for Health has now asked for further consideration of this issue at the Cabinet committee on health.

The HSE established an implementation group and identified the recommendations that relate to the operation of the service. An action plan for the implementation of these recommendations has been developed and ten workstreams have been identified. The implementation group is chaired by the director of the HSE's national women and infants health programme. The national implementation group includes multidisciplinary representation comprising healthcare professionals across the termination of pregnancy pathway and service users with lived experience of TOP services. The first meeting of the implementation group took place in October 2023. This was followed by five subgroup meetings held in December 2023. Meetings of this group are ongoing.

An overriding message of the review centres on the need to increase access. Substantial strides have been made in this regard. For instance, six additional hospitals came on board in 2023, an increase of 55%. Termination services in early pregnancy, up to 12 weeks, are now provided in 17 of the 19 maternity hospitals, with the remaining two expected to come on board in 2024. There has also been a small but sustained increase in the number of community providers. Approximately 20 additional providers have come on board in the last 12 months alone. Furthermore, the revised model of care introduced in response to the Covid pandemic has now been approved as the enduring model of care. With this blended approach, it is possible for one of the two consultations required for termination in early pregnancy to take place remotely. This will alleviate the time and expense involved in travelling to the doctor's surgery twice and will be of particular benefit to those seeking to access services in remote areas or areas that are poorly served at present.

Safe access legislation is at an advanced stage. It is in progress through the Houses of the Oireachtas. The next Committee Stage session is to take place in this House this evening. It is the Government's priority to have this legislation enacted as soon as possible.It is hoped that the cumulative effect of these measures will substantially reduce the barriers and increase access to services for those who need it.