Brendan Howlin (Wexford, Labour) | Oireachtas source

I thank the Chairman for the opportunity. I thank members for being here. The initiative we are trying to achieve is a single focus issue but a very important one, that is, the extent to which rogue counsellors and rogue agencies are, to put it bluntly, lying to women with crisis pregnancies. Some of these agencies have been operating, on and off, for more than a decade. Undercover journalism has disclosed the extent to which this so-called counselling involves lies, deceit and sometimes grotesque mistruths. Women in crisis pregnancy situations are being told, for example, that abortion increases a woman's risk of breast cancer or that women who have had abortions will later abuse or neglect any children they might subsequently have.

My starting point is that it is no longer tenable to stand over a situation in which health care professionals such as dieticians and opticians must be regulated before they can offer any services to the public but those people who counsel women who are in vulnerable situations face no requirements to register, to be regulated or to be overviewed.

In the belief that new legislation is needed to regulate this area, after some consideration Labour chose the Health and Social Care Professionals Act as the vehicle for this proposed reform. It is the vehicle best suited to deal with the elimination of rogue counselling agencies from the spectrum.

The Act applies to the newer health and social care professions outside the traditional core sectors of medicine and nursing, which as the Chairman knows very well is tightly regulated and always has been. The Act establishes registration boards for those designated newer professions; it protects the use of the titles of those professions and it provides for the resolution of complaints relating to fitness to practice.

We recognised from the outset that there might be practical difficulties in applying this Act to crisis pregnancy counsellors. The Bill was accepted by the Government and by the Dáil on Second Stage. I have discussed it several times with the Minister for Health, Deputy Harris, who has been very helpful and supportive. I thank the Minister and his officials for their support and ongoing engagement. I appreciate his anxiety to co-operate on the Bill and to accommodate what he agrees is a much-needed reform. The Minister for Health and I are at one with regard to the objective and we are trying to work out the best way of achieving that objective.

As we understood from the start, the Health and Social Care Professionals Act applies automatically to certain professions directly named in the legislation itself. These include: chiropodists, occupational therapists, psychotherapists and psychologists. These professions already have what we might call the infrastructure of a recognised and regulated profession, namely, a defined scope of practice, a representative professional body; defined routes of entry and recognised qualifications.

The Act then goes on to enable the Minister by regulation to designate additional health and social care professions. He or she does so by reference to the stipulated factors. In other words, the Minister assesses whether the profession has in place the infrastructure to enable it to be regulated. Normally speaking, the path towards recognition and designation may take months, if not years, involving consultation, assessment, the satisfying of preconditions and so on. That, however, is not the end of the matter. Designation of a profession as suitable to be covered by the Act is just the start of a process that will only lead to full regulation some months later.

For the reasons that will be spelled out later to the committee, the Minister’s approach is to designate counsellors generally, rather than trying to single out pregnancy counsellors and I do not oppose that approach. It might be a better route.

I will leave it to the officials to spell out how much progress they have made to date on this project. The Minister tells me that the Houses may have draft regulations to consider and approve before the summer recess and what work will then remain to be done. I do appreciate that this is inevitably a methodical process. I believe that part of our joint function is to ensure that progress is maintained on this matter, as a priority. I remind the members of section 4(4)(e) of the 2005 Act. It states that, in deciding whether it is appropriate and in the public interest that a particular health or social care profession be designated, regard must be had to "the degree of risk to the health, safety or welfare of the public from incompetent, unethical or impaired practice of the profession". That should be our overriding consideration as the giving of incompetent, unethical or impaired advice or counselling to vulnerable women with crisis pregnancies represents an unacceptable risk to their health and safety. It is for this reason that immediate action is warranted. I am glad that the Minister for Health agrees and that he has engaged so positively on this issue.

The progress achieved to date is not exactly along the lines proposed in the Bill but that is not the material point. What is important is whether and to what extent we are making real progress and whether we can sustain that progress and see this matter through to a resolution.

There is a role for Government and Opposition and for the committee in all of this, as well as for the Department of Health. I do not want to take up more of the committee’s time than is necessary because I believe it could more usefully be spent in listening to a presentation, which is about to come from the Department's officials, as they map out their views and the steps and timelines for achieving a way forward.

There is one other aspect I should mention. It relates to another Act with which I had some involvement when I served as Minister for Health a number of years ago. That is the Regulation of Information (Services Outside the State For Termination of Pregnancies) Act 1995.Committee members will be aware that this Act arose from the 14th amendment to the Constitution, which enshrines in the Constitution that Article 40.3.3° cannot be used to limit the freedom to receive and impart information about services available in another state, subject to such conditions as may be laid down by law. The 1995 Act lays down these specific conditions.

It seeks to balance the constitutional rights and freedoms bearing on the question of abortion information. The legislation seeks to ensure that any doctor or advice agency that provides what is classified as abortion information to pregnant women does so only in the context of full counselling on all of the available options, without any advocacy or promotion of abortion.

Section 5 of the Act applies to anyone who engages in the activity of giving information, advice or counselling to individual members of the public regarding pregnancy. The section states that where such a person is requested by a pregnant woman to give information, advice or counselling on her particular circumstances, it is not lawful for that person to give what is called "Act information" to the woman unless that information, counselling and advice are "truthful and objective". However, it is important to bear in mind - this is something that I want to underscore for the committee - that the scope of the 1995 Act is confined to Act information. This is defined as information likely to be required by women in availing themselves of pregnancy termination services. In other words, Act information relates to that information which helps somebody have an abortion, that is, providing the name, address and telephone number of a foreign abortion service and so on. The 1995 Act does not apply to more general information, such as information about the nature of abortion itself. Therefore, if a rogue agency that seeks to restrict access to abortion provides women with information that is objectively and factually wrong and untruthful, it can do so in my view without breaching the 1995 Act.

I understand that the Department is considering the possibility, in the context of a designated and regulated counselling profession, of amending and perhaps broadening the terms of the 1995 Act. Again, I will leave it to the officials to spell out what options are being considered. I will not take up any more of the committee's time. It may be unusual for the mover of a Bill and somebody who is very anxious to have it enacted to come before a committee and not argue for its urgent and immediate passage, but I know that the committee will want to hear from the Department. If the members are satisfied that real and substantial progress, in accordance with a realistic timeframe, is being maintained towards a practical and workable solution, then it may be that the committee’s best option would be to adjourn consideration of this particular Bill until we see what specific timelines and actions are to be made by the Minister for Health and his Department.

We are looking at a difficult issue and trying to find a solution. In this Bill, I have put forward what I think is a good solution. The Minister for Health has been thinking about this for some time since I have engaged with him. He may have a slightly different solution. To me, the objective is simply to find a solution rather than to have any particular legislation enacted.