Tommy Broughan (Dublin Bay North, Independent) | Oireachtas source

I thank the Ceann Comhairle for the opportunity to speak on the Thirty-sixth Amendment of the Constitution Bill 2018 before us. I thank Ms Justice Mary Laffoy and everyone involved in the Citizens' Assembly, the members of the Oireachtas joint committee and all those who gave their testimonies to both processes. It has not been an easy task, and I have the utmost admiration for all our colleagues involved who went into these processes open-minded and listened to the medical and legal evidence and personal stories of people affected by the eighth amendment. When the former Taoiseach, Deputy Enda Kenny, announced that there would be a Citizens' Assembly to examine the eighth amendment and then an Oireachtas committee to review the proposals of the assembly, many of us believed it was can-kicking exercise. However, the process has in fact turned out to be very informative and helpful for many citizens, including Deputies and Senators. Prior to the general election of 2016, I pledged to support repeal of the eighth amendment, Article 40.3.3°, and I will support the Bill.

Article 40.3.3° was inserted into Bunreacht na hÉireann in 1983. At the time I was opposed to the insertion of such an amendment into our Constitution because I believed it was wrong to tie the hands of Oireachtas Members on vital areas of public health policy involving women's health and pregnancy. Like many other citizens, I was profoundly disappointed that the former Taoiseach, Garret FitzGerald, one of my former teachers, did not stand up to the intense lobbying to change our Constitution during that period. Charles Haughey, who served as Taoiseach both before and after Mr. FitzGerald, was equally supine despite commitments he often made on Irish health care. It is also very revealing now to reread the prescient advice given to the FitzGerald Government by the Attorney General, the late Peter Sutherland, which that Government published in February 1983. Mr. Sutherland advised that the wording of the eighth amendment "will lead inevitably to confusion and uncertainty, not merely amongst the medical profession, to whom it has of course particular relevance, but also amongst lawyers and more specifically the judges who will have to interpret it".

Unfortunately, those who voted "No" in 1983, fearing that legislators would be placed in a straitjacket in respect of women's health issues, were proven right by the litany of tragedies and legal quagmires which have enveloped us since. Sheila Hodgers's cancer treatment, for example, was stopped by a hospital because she was pregnant. She lost her life in 1983 and was also denied pain relief. The X case, in which a 14 year old girl became pregnant after being raped, led to a referendum in 1992, and a subsequent referendum on the right to travel for terminations was passed. In 1997, Ms C, a 13 year old girl, was raped and became pregnant. She was taken into care and there was a court battle regarding her entitlement to travel to access an abortion. In 2007, Miss D, a 17 year old girl who was in State care, received a diagnosis of an anencephalic pregnancy and took the HSE to the High Court to allow her to travel for a termination. In 2010, Michelle Harte had cancer and became pregnant. She was not well enough to travel for an abortion, Cork University Hospital refused to perform a termination and in 2011 she died from cancer. In October 2012, Savita Halappanavar died tragically in University Hospital Galway after being denied a termination while she was miscarrying because of the presence of a foetal heartbeat. Ms Halappanavar's needless death led to the passage of the Protection of Life During Pregnancy Act in 2013. The Act has seen an average of 25 terminations taking place in Ireland each year since its commencement in 2014.

I have carefully studied the transcripts of committee proceedings, as well as the reports by the Oireachtas joint committee and the Citizens' Assembly and I have considered deeply the stream of emails, letters and calls from my constituents, as I think we all have. I have also met delegations representing both sides of this debate and am grateful for the respectful and informative discussions I have had. The Oireachtas joint committee comprised a cross-party mix of Senators and Deputies and heard from a variety of legal, medical and human rights professionals from Ireland and abroad. The committee heard personal testimonies from two groups representing families that had received the heartbreaking diagnosis of fatal foetal abnormality. Some of the committee contributions which I found particularly compelling were those of the consultant obstetricians and gynaecologists, Dr. Rhona Mahony, Dr. Peter Boylan, Dr. Maeve Eogan and Professor Fergal Malone; law lecturer Mr. Tom O'Malley; Ms Noeline Blackwell, chief executive officer of the Dublin Rape Crisis Centre; and the chief investigator into the death of Savita Halappanavar, Professor Sabaratnam Arulkumaran. These witnesses from the fields of academia, law, human rights and health have done a great service to the Government and the people of Ireland, and we must consider their expert opinions based on lived experience and international best practice. All have said that the eighth amendment endangers women and precludes doctors from being able to give the best medical care to women with unintended pregnancies or crisis pregnancies or both.

I believe the vast majority of Irish people understand the nuances of very difficult decisions on reproductive rights and know that such decisions to terminate a pregnancy are never taken lightly. I also believe the Irish people are compassionate and caring and want our pregnant women to be able to access health care in this land, at home. I believe they trust women and our skilled medical professionals to make correct private decisions on their personal and family lives. One can be anti-abortion but still support another person's right to make a decision as to whether to continue with an unintended pregnancy. Then there are the tragic and heartbreaking cases of much-wanted pregnancies that become crisis pregnancies when the parents receive a devastating diagnosis of fatal foetal abnormality. Any of us who has ever heard members of Terminations for Medical Reasons, TFMR, speak cannot help but be moved by their stories and admire their strength in speaking out. It does not bear thinking about what these families have had to go through in trying to access the health care they need when their heads are spinning and their hearts are breaking and their medical professionals cannot even provide them with the care they need.

According to the available statistics, more than 170,000 Irish women have had to travel to the UK or further afield to access reproductive health care since the 1980s. According to today's estimates, approximately nine to 12 women travel each day to access health care in another jurisdiction and approximately three more take safe but illegal abortion pills at home, which they have bought on the Internet, risking 14 years in prison. I have heard colleagues talk about these citizens having to try to access their health care in lonely bedrooms around the country. The eighth amendment affects all pregnancies: those which are much wanted and those which are unintended. A woman who is pregnant is not entitled to consent during pregnancy care and labour and a woman who has made the difficult decision to end a pregnancy is forced to get the funds together and make arrangements to travel to another jurisdiction, usually England, to access reproductive health care. The Citizens' Assembly and Oireachtas joint committee both came to the conclusion that abortion is a reality for many women and families in Ireland and that we should care for our women in every possible way at home and not add the trauma of travelling abroad to the situations of these often very vulnerable fellow citizens at that stage in their lives.

I have learnt some notable things that were surprising to me in my discussions and research. I heard a colleague refer to some of these statistics recently. The majority of people accessing reproductive health care are already parents and in long-term relationships. The age demographics of pregnant people also show that a majority of people travelling are in their late 20s and early 30s. We also know that pregnant women travelling from Ireland access abortion care slightly later than their UK counterparts because of the added issue of arranging travel and so on. Among many incisive comments to the committee, Dr. Rhona Mahony said that the current constitutional provision "facilitates a real possibility that clinical decision-making may be delayed or distorted as clinicians ponder the law rather than medicine". The eighth amendment has put clinicians in this situation of having to ponder the law rather than rely on their own professional expertise. Dr. Mahony also drew attention to the fact that "we have the lowest number of obstetricians in the OECD, comprising some 140 to 150 whole-time equivalent posts" and concluded that by "any reasonable international standard, that number should be at least twice if not three times as large". We have drawn the Minister's attention again and again at the Committee on Budgetary Oversight and across the floor of this House to the fact that his budget is at least €1 billion short, even for 2018. He has lost some battles in this regard and will have to start winning them. Among the most valuable of the joint committee's work was its ancillary recommendations, as referred to by my colleague, Deputy Maureen O'Sullivan, a few minutes ago, aimed at greatly improving services for pregnant women and seeking more effective ways to avoid crisis pregnancies. These recommendations included major improvements in sexual health and relationships education; decriminalisation, including repeal of section 22 of the 2013 Act; addressing the costs of contraception, on which I heard the Minister's comments earlier, which are welcome; and the provision of an easily accessible and uniform standard of obstetric care across the State. The Oireachtas and the Departments of Finance and Health must immediately begin providing the necessary additional funding to implement these recommendations after the referendum.

We have had a discussion about the paper the Minister published today. Gestational limits of 12 weeks are by far the norm across Europe, adopted by a plethora of countries. I think the exceptions might be Portugal, Slovenia and perhaps one other, which have ten-week or eight-week provisions. Most other European countries have adopted a 12-week provision.

Ireland has, after Malta, the most restrictive reproductive health system in Europe, with only Malta having an outright ban. Many of the OECD countries highlighted our strict regime as a cause for concern during Ireland's second universal periodic review. I have the list of countries that raised a concern about women's health and pregnancy.

A key issue, which has been raised by colleagues who have already spoken, is trusting the House and our colleagues in the Seanad in the future. A fundamental reason I was opposed to the insertion of the amendment in 1983 was I believed it was the task of a parliament to legislate in these areas. We may have wide differences in economic areas, but at the end of the day, we are the people's representatives and it is right that we should take responsibility for these matters. It may not be too long before a future Dáil is much more gender equal. It is right to trust the House and all of our colleagues to address these matters after the referendum.

I will support the Bill and I welcome the opportunity for the electorate to have its say, at last, on the matter. No one under the age of 53 has had a substantial say in the matter before us, and we have a whole generation of people who have never before had a vote on something that directly affects them so profoundly. It is imperative that the referendum be held by 25 May in order that the thousands of students travelling for the summer months are given an opportunity to cast their votes. I believe the majority of people want a kinder, better Ireland, where the eighth amendment has been removed from our Constitution so that we can look after our women in their own country, safely, caringly and compassionately.

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