James Reilly (Dublin North, Fine Gael) | Oireachtas source

Deputy Catherine Byrne asked me to read the first part of my response again. I am happy to do so. Legal advice has been received to the effect that the legal meaning of the term "forthwith" is "immediately". This qualification, like other proposed phrases such as "with appropriate urgency" and "immediately", is unnecessary because this section of the Bill uses terms such as "shall make arrangements" which render such qualifications superfluous for the reasons I have outlined. That is why I have urged the members of the committee not to support these amendments. The word "immediately" has a very clear meaning in law. Other things may need to be done more urgently before this needs to be done. Those things might take just ten, 15, 20 or 35 minutes.

The Minister of State, Deputy White, will speak about the nitty-gritty legality of what these terms mean, and what they might mean in practice. That is the problem. I have no problem with the sentiment behind these amendments. I know they are well intentioned and seek to send a message, but in so doing they could cause serious problems for medical practice. We will all accept that in 99% of cases, medical practice in this country is excellent and is world-leading. This small country produces doctors and nurses who are the best in the world. That is proven by dint of the fact that when they leave this country, they go to the best of the best places and excel there.

Deputy Ó Cuív asked whether we know of a termination of pregnancy that ever took place anywhere, where conscientious objection was used in this regard. I can say I do not know of such a case, but that does not mean it has not happened. I do not profess to have my hand on every situation in this country or elsewhere in the world. Without being in any way disrespectful, it is an unanswerable question. I know what the Deputy is trying to say. The Medical Council guidelines are very clear and they cover this. Clearly, these issues have been raised before. They would not be in the medical guidelines if they had not been raised before.

I will not get into precisely what Deputy Boyd Barrett said or did not say. His statement that these provisions, as explained by the legal meaning of the terms used, "cannot do any harm" is far from the truth. I know he might believe they cannot do any harm. They have a clear meaning in law. I will rephrase what others have said. The purpose of this Bill is to reassure people; most importantly, the women of this country who use our health services, but also the medics who have to provide those services. That reassurance will come through the clarifications we are giving around the law now.

I will restate what I said last night - we are conferring no new rights on anyone and we are not taking any rights away from anyone. We are doing something that I, as a Minister, as a citizen and as a doctor, believe we must do. We must clarify for women what is available to them in this country and, most importantly, how they can access it. We must clarify for the doctors and nurses who provide this care what is legally permissible and what they are obliged to deliver. I think that is at the core of what we are doing. If we keep that to the fore, we will realise that while some people are very uncomfortable with this and other people do not feel it goes far enough, this is what we must do.

I have to make the point that this process was in train before the terrible and tragic event in Galway. Equally, I have to say that stipulating in law that something should be done "immediately" or "with appropriate urgency" would not have changed the outcome. The clarity we are trying to bring to this would have changed the outcome, in the sense that any delays occasioned by a lack of certainty would not have come into play. As we know from the reports we have received, an awful lot more than that was involved in the Galway case. I do not want to make any further comment on it other than to say that the HSE report was comprehensive. At an early stage during the course of the compilation of the report, the chairman, Sir Sabaratnam Arulkumaran, made certain recommendations that were immediately acted upon. Further to that, we were already developing an early warning score system for the maternity services. We had brought in such a system for adult services. We were the first country in the world to do so. We have now done it for maternity services as well. We are working on a system for paediatric services. They are all different because the biology, the parameters, the biochemical markers and the clinical findings are different in all cases.

I would like to confirm what Deputy Ó Cuív said. I believe we have one of the highest standards of maternity care in the world here. I say that on the basis of perinatal mortality and survival rates. I commend the excellent men and women who have delivered that service, which I commend to the women of this country. No matter how good things might be, I would never say they could not be made better or safer. Better systems can be put in place, as has happened in the airline industry, to ensure the wrong thing to do becomes the most difficult thing to do. In some situations in the past, the wrong thing to do was made easier because of the system that existed. I could give examples of that, but I do not think it would be productive for me to do so at this forum. I want to reassure everybody that I fully respect the intent behind these Opposition amendments. The legal situation and the implications for practice are such that I do not believe the amendments should be supported or accepted.