Dr. Brendan O'Shea:

It is looking towards a real solution. It is a really important question. The genesis of the issues we are discussing is complex. Because it is a complex problem, the solution is going to be complex. No one size is going to fit everybody and there is no single solution. We actually have been effective in certain parts of public health messaging and we need to do more of it. The work that is being done by the Crisis Pregnancy Agency, for example, has been extremely helpful to us in practice but there needs to be more of it and it must be expressed through different modalities. There is a piece in education that needs to be built up and developed.

We deal with parents of adolescents frequently. Some girls and boys are well able to articulate these issues within their households, we understand, but the impression is that a lot of them - perhaps the majority of them - are not. Our educators could certainly be enfranchised, directed and trained to do more in this area of care so that we would be able to approach a situation where these topics, which are still difficult for many of us to discuss, could become easier. A key set of values and expectations could be built around service provision. A truly multidisciplinary approach could be taken. The practice nurse could be every bit as important and useful as the general practitioner, the community pharmacist and the public health nurse in this area of care. At the moment, bits of it are still hived off and broken up in a way that is not helpful for the public. If we did these things, we might be approaching having a society that is contraceptive-smart.