Professor Fergal Malone:

We have experience of after-care following patients taking medication to bring on a pregnancy termination as patients present to us in the accident and emergency room of the Rotunda Hospital, for example, with bleeding or an incomplete procedure. There may be some placental tissue, for example, left inside. I assure committee members and patients at large that when patients present in such cases, they will never be judged and will always get absolute top-quality care immediately. There is no question of patients being quizzed as to what their motives were or adding to their difficulty. They will always get appropriate care. Unfortunately, we have significant experience of patients coming to the accident and emergency room having taken medication and perhaps not doing so in the appropriate way. The other problem, as I noted in my position paper, is that when one sources medication like that on the Internet, one would have absolutely no idea what is received. It can be a very challenging issue.

The Deputy asked about the personnel needed should there be legislative change such that pregnancy termination would occur in Ireland. In general, there is no significant difference I foresee in terms of skill set. Medical termination of pregnancy is very similar to what we do now when patients present at 12, 14 or 16 weeks with the unfortunate situation where a baby's heartbeat has stopped.

The same medical process occurs. Surgical pregnancy termination earlier in pregnancy, meaning at less than 14 weeks, is, technically, the same procedure we do at present when patients present with what is called a missed miscarriage. I do not foresee any significant difference in the need for qualifications of personnel. I do, however, foresee a significant increase in resources needed. Last year, 55 women went from the Rotunda to the UK for pregnancy termination for severe complex foetal abnormalities, which is one case a week. I am reasonably confident the Rotunda would be able to absorb that workload into our current situation. If many more patients who terminate for other reasons were to have those procedures performed in Ireland, there would be a significant resource implication for us. By "resources" I mean personnel numbers and a physical environment in which to care for patients such as these in an appropriate manner. The Rotunda is a wonderful place and a wonderful building, but it was built in 1757. We do not have much expansion room to care for those large numbers, so there would be a significant requirement of resources.