Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I am sorry I missed most of the discussion and apologise if I am repeating things in my questions. I heard the presentations but not most of the discussion. Returning to the issue of the three days, I note from the presentations that there is nearly full agreement that this should be fundamentally a community-based service, that the vast majority of abortions are likely to be medical, that the abortion pill will be administered in over 70% of cases and that therefore it makes sense for it to be community based. However, if we take my community as an example, there is a very nice, modern health centre in Ballyfermot with several GP practices but it is very difficult to get an appointment. It is a very busy area. The last time I looked for an appointment, I was waiting for over a week to see a doctor even though I did not mind which doctor I saw. That is kind of typical and therefore I think we have a genuine problem in terms of what GPs can provide.

On the whole business of the waiting time, I am very pleased to note all the witnesses agree that it removes power from the woman, is demeaning and can be an obstruction to receiving an abortion. It is also a real problem to have that timing in there given the pressure on GP clinics I have just described. Even the waiting time was counted from the day the woman picks up the phone, it could be still five or seven days before she gets the appointment. I reiterate that it is a big part of it.

This is also linked with a question I have about the definition of "medical practitioner". If anybody has already asked this, I apologise for repeating it. The World Health Organisation safe abortion guidelines say that a medical practitioner is defined as a properly trained healthcare provider, including mid-level non-physician providers. Would the witnesses see that there should be an important role here for midwives, practicing nurses and indeed counsellors in the health service to help provide the service? If we are to go forward from January or whenever we can get this service in - sooner if possible - and if we are to rely totally on GPs when there is a crisis concerning the accessibility of GPs as it is, would it not make more sense for the Medical Council and everybody to recognise that nurses and midwives based in clinics could also provide the service, at least up to the point of providing the pill?

Taking in my second question on conscientious objection, along with the crisis in GP availability is the fact that some doctors may have a conscientious objection, which will add an extra burden onto the provision of the service. There is a real, important role for us to be very clear in the legislation on the question of conscientious objection.

There must be an imperative on doctors to refer onwards if they are going to deny women the abortion service. This must also be policed in order that we can see how conscientious objection is being applied and guarantee that the abortion service is provided. I would like the witnesses to comment on these points.

There has been considerable discussion on the issue of decriminalisation. Does the committee intend to examine it or would it be more appropriately sent on to the justice committee? If a 14-year sentence has a chill factor for medical practitioners, then it is unnecessary and unduly heavy-handed and should be removed. The issue should be examined in more detail by this or the justice committee. Will the Chairman explain how that can be done?