Annie Hoey (Labour) | Oireachtas source

I thank all the representatives for their hard work on this issue in the run-up to the referendum, in the subsequent monitoring of abortion provision in Ireland, in ensuring that we have such provision, and providing the critical advocacy we needed in this area over the past three years. I have to agree that we have had three years of understanding how it can operate. Many of the flaws the representatives highlighted were potentially picked up on three years ago. We kind of knew this was going to happen. I hope, therefore, we do not waste this opportunity to fix these issues because that means we will have gone through two rounds where we will not have put in place best practice in the first instance or, in this case, tried to amend the situation.

I am astonished that so many maternity hospitals are not providing care. For an entire institution not to be providing care seems to go far beyond what was envisaged regarding conscientious objection, with individuals not being forced into doing something they do not want to do. To have full-blown maternity hospitals not offering care is not in keeping with what was envisaged. I ask for some comments on that.

One of the witnesses referred to the provision of care. The people not providing it are not just conscientious objectors. This has come up in recent months with some GPs I have spoken to, both in public debates and privately, whereby they have said they do not have the capacity to do it. I ask the witnesses to tease that out. Dr. Henchion mentioned that not every GP offers every service. From some of the people I have spoken to, my understanding is that they were not providing it because they did not have the capacity to do it. This does not apply to all. Some GP practices are pointing patients to other GPs offering the service, which puts enormous pressure on a small number of GPs, in particular those in remote areas who have to deal with it all. I know that not all GPs offer all services, but it would be incredible if it was 90% of GPs. If it was mix of conscientious objection and just not being able to do it, I cannot think of any other service that would have 90% saying they could not do it for whatever reason.

We know that the three-day wait forces a medically unnecessary delay. I already know the answer to this. As far as I am aware, for no other procedure is a person required to wait three days. People may get a major diagnosis and need to take time to consider their care options. Am I correct in stating that there is nowhere in medicine where there is a required mandatory, legally bound three-day wait for any care? We all know the answer to that. I just want to confirm it.

I do not work in this area, but the 28-day mortality clause seems highly complex and difficult to work out. We would all agree that it is not right or fair to force families to face that. It puts the doctor in the situation of saying that it could be 29 days and therefore the pregnancy must proceed. As an outsider looking in, it seems impossible for a doctor to make a call on the matter. I ask the witnesses to elaborate on that.

Many people have found that telemedicine works very well. It has been a very positive development. From the witnesses' perspective, how has telemedicine been working? I do not want to pose a leading question, but we all know where I stand on the value and necessity of telemedicine. We were at the launch of the UNFPA. There is a local conversation on telemedicine, but particularly here in Ireland regarding this.

The WHO recommends an abortion-on-request model as best medical practice. I ask the witnesses to explain for the sake of the people listening in why that is the best model. If this is the best practice, why are we not doing it?