Dr. Janice Walshe:

I thank Deputy Conway for her questions. Having two medical practitioners in medical oncology might be wise because cancer in pregnancy is exceedingly rare. As I stated, we are seeing only 60 to 70 cases in Ireland per year. It is conceivable that there could be a medical oncologist or a haematologist who has never encountered this kind of situation. I would feel personally that, from a safety perspective and in order to ensure we make appropriate decisions, a second medical practitioner in that area should be consulted. In terms of the pathway, once that process had occurred, certification would occur in combination with the obstetrician. I would not envisage this happening often, as indicated through my data. It would be exceedingly rare that this situation would arise. In the context of timelines, we tend not to have extreme medical emergent situations so seven days would be adequate. The Deputy inquired as to whether GPs could be an obstacle. In terms of specialist care such as this, GPs tend to rely very much on the information they receive from us. I would not, therefore, see them as being an obstacle.

Some of Senator van Turnhout's questions overlapped in the context of the pathway and she asked if the legislation would help this situation. It arises so rarely that I am of the view it will be helpful. However, I hardly ever see it arising.

Deputy Regina Doherty asked if we know of patients who have travelled for terminations. I have heard of patients who have travelled in order to have terminations completed. That is more on the basis of foetal abnormalities in the first trimester if they receive treatment. Again, I have no personal knowledge of the ins and outs of that but I have spoken to colleagues about the matter. It would also be exceedingly rare.