Dr. Rhona Mahony:

On Senator Bacik's point, we have already covered the lack of intensive care. I will come to Dr. Crown's comments presently. I passionately believe that the maternity hospitals should be co-located and that they require a great deal of further resources to carry out their day-to-day work.

I appreciate the comments on psychiatrists. The additional resources needed in psychiatry comprise a question best posed to the psychiatrists.

I am interested in the Senator's comments on head 19. She is absolutely correct. If a doctor has made an error in judgment or has not acted according to the law, I do not believe a woman could then be at risk of finding herself in breach of the law. If it were the case, it would not be wise law, I would argue.

The question of time limits is more related to Dr. Boylan. I agree, however, that we must be very careful that the appeal time not be too long. The appeal time must be appropriate to the urgency of the medical condition that is unfolding.

With regard to head 3, on the termination of pregnancy in private institutions, the concern must, of course, be addressed. I refer to the idea that one could set up a clinic and perform terminations of pregnancies. I think we can assume that Government-approved hospitals would get around that so it would not be possible to set up a clinic. That is not what we are suggesting here. Practically, it is very unlikely that a Marie Stopes or termination-of-pregnancy clinic would be dealing with very sick women at risk of dying. That is simply very unlikely. Most of the women would be in hospital because they would be very ill.

With regard to head 6, it seems to be a matter for the psychiatrist. There is a hint and a suggestion that we should be locking women up. I would always not concur with that, but that is a matter for the psychiatrists.

With regard to the effect, I have no doubt that the termination of pregnancy can be really harmful for a woman's health, and the circumstances surrounding it can be really harmful. I also believe that, on very rare occasions, it could save a life. That is my only comment on that. Psychiatry is not my area of expertise. With regard to delivery at the threshold of viability, I practice in foetal and maternal medicine and believe that there is no doubt that where we deliver babies at a very early gestations, there is a risk of cerebral palsy.

To give an example, the survival we expect now in Ireland at approximately 24 weeks is approximately 50%, and of those survivors we might anticipate that up to 50% of those babies will have cerebral palsy. These are enormous considerations and we spend much time, if we have time, talking to parents, counselling them and making them aware of this. However, what we are talking about here is saving women's lives and we are making the assumption that if we do not carry out this termination or interruption of pregnancy, even if it is at 24 weeks and with all the risk of cerebral palsy, the woman will die and her baby dies too. It should be noted that medical obstetrics is extremely complex, as are these decisions. That reflects the complexity of what we do.

In response to Senator Crown, I am glad to have the opportunity again to talk about figures, because I missed that opportunity in the last round. I note the presence of Paul Cullen in the Press Gallery. He wrote a very nice article two weeks ago in which he looked at comparisons between here and the UK. He said Scotland has 121%, England 81% and Wales 63% more obstetricians than Ireland. I might be misquoting the figures, but it was clear there is a big disparity in the number of obstetricians here. Dr. Boylan says we have about eight obstetricians. It is actually fewer than that when talking in whole-time equivalents. The majority of consultants in our hospitals work between two areas, so when we look at the numbers ratios, we must look at whole-time equivalents. Dr. Boylan is correct that it is about eight whole-time equivalents. There are approximately 15 consultants on the staff but it is about eight whole-time equivalents. The same applies to neonatologists. We have just under four whole-time equivalent neonatologists looking after more than 9,000 babies.

There are huge resource issues that must be addressed, and addressed urgently in obstetrics. However, that is not a matter for this Bill. We must be very careful. The resource issues need to be addressed, but we drafting this legislation in the context of women who might die, so we must not let resource issues influence this important legislation which will last into the future.

What can we say about the rarity of suicide? It is extremely rare. I agree it is unlikely we will see it. We just do not see it because it is a rare condition which is best dealt with by psychiatrists. This Bill is not about legislating for suicide intent in pregnancy; it is not about suicide. It is about the risk of a woman dying, whether that is for mental or physical reasons. This Bill will largely cater for women who might die either because of direct complications of pregnancy or because of a medical disorder such as cardiac disease. We might never see a woman presenting through this process with suicide intent. She will likely go to England.