Dr. Kevin Walsh:

On Deputy Conway's questions, we usually would provide preconceptual advice in respect of pre-existing conditions. When they are known to the system, they have rapid access to us via nurse specialists and their general practitioners. There is no real problem with that. In terms of a critically ill woman where time would be of the essence, they would usually be very unstable, have blood pressure problems and be in hospital. That would be a pretty unusual event.

I must inform Senator van Turnhout on the prior advice, preconceptual warning, we may advise against it but we would fully support them if they went ahead with the pregnancy. We always make them understand that. We say that we do not think it is a good idea and we try to get their partners involved. However, if they go ahead, they will get full support all the way with it because that is ultimately their choice.

On the two specialists, the problem is that I am the only specialist in adult congenital heart disease. We have been waiting five years for the HSE to appoint another one. At the moment we would probably try to keep it simple and have one specialist. We are always going to be consulting obstetricians - as part of a multidisciplinary team involving all the specialists - in order to make that sort of decision. For us, it would not be a bleeding emergency or something of that nature, we would have a day or two to organise things. The legislation clearly would be very important because it would place matters on a firm footing and would make it happen for women.

Deputy Regina Doherty inquired about women being obliged to travel. I have had two patients in the past number of years who were obliged to travel for terminations. Patients will sometimes delay heart treatment to try to get a pregnancy over but usually they have a reasonable set up in order that they can survive and manage it.