Ms Alison Spillane:

To add to Ms Ryan's point, sections 13 to 17, inclusive, of the Act outline this review process. It appears that this review process is really not working in practice. There is a requirement under section 18 for the HSE to report annually on the number of reviews sought and carried out under this mechanism. In year one of the provision, 2019, no reviews were sought. In year two, only two reviews were sought, one of which was successful and one of which was not. It appears that this review process is not functioning. I think that speaks to what the Deputy is hearing on the ground that practitioners are actually not aware of these structures and mechanisms.

If I could add one more point in terms of the operation of section 11, there is important research coming out of University College Cork by Professor Keelin O’Donoghue and Dr. Stacey Power Walsh. It would be useful for the committee to hear from foetal medicine specialists who are providing care under this section. What they have done is they conducted qualitative research with foetal medicine specialists throughout the country about the operation of the Act. These practitioners describe the Act as difficult and restrictive and the combination of the language and that definition in section 11 with the criminal provision means that practitioners fear getting a diagnosis wrong due to criminal liability and media scrutiny. There is a great deal of fear around the operation of this section.