Dr. Caitriona Henchion:

The Senator asked for clarification on the meaning of home self-management. The situation is the same as it was prior to the referendum to repeal the eighth amendment. In certain circumstances, there are people who still have to travel. That can be very difficult for them. Even if it means travelling to Dublin rather than to the UK, the women concerned are still having to travel, which means, for example, that they are not going to be there to collect their kids from school and that they must tell somebody else because they have to make arrangements in that regard.

Telemedicine is an advantage because only one attendance is required and women only need to make contingency arrangements once rather than twice. It is, however, difficult for women who are coming from a distant location for many reasons. Such women do not feel that the option is open to drop back into that provider if there is a problem. They may be faced with a choice to attend a local maternity unit where they know there are no services being provided and where they might potentially face stigma. That is another part of the issue.

On the non-documented issue, Ms Ryan is right that there is a barrier there in terms of language difficulty. The simple black-and-white fact is that there is no way for a doctor to be reimbursed for providing that service if the patient has no personal public service, PPS, number. Many doctors will simply not be able to provide the service because it is not sustainable to provide lengthy consultations for free. Those women are being excluded unless they have money which in almost all cases, they do not. It is not all about women who are in direct provision or that sort of setting. There are students who have been in this country for a year but who do not have PPS numbers. When this kind of situation arises, they have no way to access services. It is not only one demographic that is affected. People should be clear that there are several areas in which this happens. There needs to be a pathway for the provision of this care if we want women who are resident here to be entitled to it, regardless of their circumstances.