Dr. Clíona Murphy:

With regard to the safety issue, we are not trying to overdo the risks of early medical termination. What we are trying to emphasise is that we would like the service rolled out to be fit for purpose and that there would be no cost-cutting in this area so we would not be trying to do it in another area. We are fully on board with trying to deliver this service. Our members just want the appropriate backup and resourcing so we are able to cope with women who need to go to hospital. My apologies if it was interpreted as us overemphasising certain areas.

We see the 24-hour helpline as a signpost for people. There could be situations where a patient does not want to go to her local hospital or GP. A helpline may provide advice on other appropriate centres. There may be many advantages to such a helpline. We and the other clinical groups felt it might be helpful.

The Deputy's points on the waiting period are well taken. As far as I understand, it will lead to an extra visit and that could be difficult, particularly for someone travelling from one area to another, perhaps to another community practice. It would be a particular difficulty for somebody on the margins of the 12 week limit. If someone at 11 weeks and three days needed to wait three days that would be obstruction, and there is international evidence to state it forms obstruction. I will mention New Zealand, which has a waiting period and a very liberal interpretation of conscientious objection. This has led to weeks of waiting for women and we should try not to go in that direction.

With regard to the change from "risk to health" to "serious harm", the Deputy has highlighted that issues in medicine are not black and white. Certainly we have advocated publicly on the need for the patient's voice to be heard in complex medical decisions regarding her health and pregnancy. Good practice would involve a multidisciplinary team meeting the two practitioners but good practice would also take into account the woman's experience, her social circumstances and her other children. We do not legislate for this but certainly it would be good practice. We already do this in other areas of maternal medicine.

With regard to criminalisation, it is something that has been advocated against worldwide. This year, the Royal College of Obstetricians and Gynaecologists came out strongly against criminalisation of practitioners, particularly those acting in good faith for women. It is an issue that should be addressed.