Dr. John Monaghan:

Deputy Kelleher asked about referring people to England for a termination. I have never referred anybody to England for a termination. I have sometimes referred people there for medical or diagnostic expertise, but I have not done so for a termination. I know that women are referred there for treatment or delivery in cases of congenital malformations, but such cases are not the subject of this legislation.

The Deputy also asked about the overburdening of the maternity services. Our unit at Portiuncula Hospital delivers approximately 2,200 mothers a year. We might encounter one or two cases of serious maternal illness where the pregnancy has to be ended. I think the figure given for the Dublin hospitals was 30 a year. Such cases do not overburden the maternity service. If a patient has a very serious fulminating pre-eclampsia, for example, she might need to be transferred to a tertiary unit in Galway or Dublin. There may be problems with the transfer if there is overcrowding in the tertiary centre. I do not envisage that this legislation will overburden maternity services significantly unless there is an explosion in the number of terminations of pregnancy under psychiatric or self-destruction grounds.

Deputy Healy asked whether psychiatric services are located alongside maternity services. In the rural system, there might be a maternity or general hospital in one town and a psychiatric hospital in another town. In practice, almost all of the rural maternity units are in close proximity to a psychiatric department. I am afraid I did not understand fully the question about the central location of personnel.

The Deputy also asked about conscientious objection. As Dr. McCaffrey said, if one is prepared to allow a mother to die, one is guilty of very serious professional negligence. There has been no maternal death in my hospital, or death of a woman who was transferred out of the hospital, for 29 years. I am sure that is the norm throughout the country. It is not true that the conscientious refusal by obstetricians to offer necessary treatment which might involve termination of pregnancy is leading to maternal deaths. I am sure it has been pointed out already that this country's maternal mortality rate has always been significantly lower than the rate in the UK, regardless of the figures one uses. Similarly, the maternal mortality rate in Northern Ireland, where the UK Abortion Act does not apply, is lower than the rate in the rest of the UK. I do not think conscientious objection could be considered to endanger women's lives in any way. We do not know where conscientious objection would arise in psychiatric cases. I do not know how an obstetrician would deal with an emergency precipitated by suicide. I cannot imagine that scenario.