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

Unlike Deputy Murphy O'Mahony I am not concerned that there will be mass resignations because of this. I have great faith in the doctors of this country and their ability to deliver this service, and I want to ask the Minister some questions about the doctors who are publicly and vocally objecting. In the Irish medical profession there is a great tradition of being on the side of women, when it has been allowed. In Ballyfermot in the 1960s, 1970s and 1980s there was a notorious doctor called Paddy Leahy, who has now passed away, who was absolutely brilliant at breaking the law and giving women with 12 or 14 children access to contraception when it was totally illegal. Dr. Andrew Rynne also faced down the law on the question of condoms and the contraceptive pill. Doctors for Choice played an amazing role in delivering the result of the recent referendum. In the 1990s, when it was not popular or profitable to promote abortion services, other doctors really stuck their necks out. I am not worried at all that we are going to lose medical practitioners over this.

I agree that the idea of choice was a key factor in the referendum, and that doctors and nurses should have the choice. The issue arises as to what happens if a medical practitioner says that he or she conscientiously objects and what happens next. That is an important issue because transfer of care could mean that doctors will simply provide the phone number for a 24-7 helpline. It should mean that an employee of the HSE or someone who works on behalf of the HSE who meets a woman in a crisis pregnancy asking for the appropriate help has an obligation, because of the contract the HSE has with that employee, to ensure that the woman seeking help gets the care she needs. Ultimately it is the responsibility of the HSE. The way that is provided for in law really matters.

I want to leave open the possibility of putting in a different kind of amendment at the next Stage on the question of the ultimate responsibility lying with the HSE itself rather than the doctor. However, I can foresee hard cases here, and the law as it is written at the moment may not deal with those cases. Transfer of care might be interpreted as merely providing a freephone 24-7 helpline but will do nothing for a young woman from direct provision or from a marginalised community who only knows about a doctor's clinic. She may be impeded by the use of language, her inability to speak English, or a lack of money to make phone calls. There may be many reasons a young woman could not independently look for help outside a doctor's clinic.

We have to be careful not to create hard cases. Having said that, I am pretty confident that most of our medical practitioners would not be that hard-hearted or so cruel to let somebody walk away in a desperate state. There may be some such practitioners out there, and we should allow for the possibility of that. We have to look at how we frame this provision. We have inserted a clause to say that those doctors must refer the woman on to someone who will treat her. We do not quite use that language, but it is clear that the transfer of care is the duty of the doctors. I want to look at inserting an amendment in the future which will make it the ultimate responsibility of the HSE.

As a corollary to the amendment introduced by Deputy Tóibín which seeks to allow an institution access to conscientious objection, we have submitted amendment No. 162 which would insist that an institution does not have access to conscientious objection by inserting into subsection (1) that, "Nothing in subsection (1) shall be construed as applying to an institution, hospital or a medical facility". We could leave that out, but we believe it would be better in the legislation as an absolute guarantee that there will be no chance that a place like St. Vincent's Hospital can refuse to provide abortion care because it has a Catholic ethos. Some people are terrified that our future national maternity hospital might have that facility. We want it to be written into abortion legislation that it does not. I believe that is a reasonable request. I take the Minister's point that the legislation includes institutions, hospitals and clinics in good faith.

I have heard that many of the approximately 600 doctors kicking up about this legislation are unhappy because it raises a question about the GP scheme and the payment of GPs in general. Dr. Carthy would know about this. GPs lost a lot during austerity; it has been suggested that there were pay cuts of between 26% and 36%. Those payments have not been restored. I can imagine that a cohort of GPs would be annoyed that they are now being asked to take on extra work without proper remuneration. Can the Minister tell us whether that is correct or not? I do not imagine that there are 600 doctors who are saying that they will not give out the abortion pill. It makes more sense that there would be 600 people who are discontented about pay.