Alan Kelly (Tipperary, Labour) | Oireachtas source

It is a very historic day for this House. I am delighted to be here on behalf of the Labour Party to welcome and support this legislation. All of us who were involved in the referendum know that this is legislation which we have to get right. We will work collectively with the Minister to ensure we get it right because we have to get it right. It is a hugely historic occasion for my party, which as a political entity has a long track record on this issue, dating back to 1983, of fighting against this amendment, with the current Uachtarán na hÉireann Michael D. Higgins, leading the campaign, supported by the previous President of Ireland, Mary Robinson, the lady who has just walked into this room, Deputy Joan Burton, Eamon Gilmore, Senator Ivana Bacik, Deputy Jan O'Sullivan and many more. Today is very important for my party, dating back to 1983. I want to remember all of those who have gone before us who fought against this in 1983 on behalf of the Labour Party and may not be around to see this day. I want to remember them.

Over 50% of the population of this country are female. They are entitled to make the right choices about their healthcare in whatever circumstances they find themselves. The Labour Party has always supported them and will continue to do so today in this legislation to remove the barbaric circumstances that were put into the Constitution in 1983, forcing tens of thousands of women to leave these shores and, in recent times, forcing many women to take abortion pills without supervision. The referendum on 25 May will forever live in the history of Ireland, being passed in such large numbers. It is very important today that we remember those who fought so hard. The civic coming together of people on that day represented an outpouring of relief and compassion. People like to say there was celebration but it was certainly an outpouring of emotion. The Minister played a large role in it and I want to thank and congratulate him on that, along with many other people across politics. I look around this room and see people who have been in opposition for many years, people who were previously in government and, dare I say, people who changed their minds. Many across different parties changed their minds. It is often said that the people are sovereign, and they are, but people are entitled to change their minds and should be congratulated on that. I admire those who have come forward and done so.

We have to acknowledge the Together for Yes campaign across the country, a civic movement incorporating people from all politics and none, people who campaigned with me who I have never seen campaigning before and people who will campaign again in the future. I made many new friends. I am thinking in particular of Anita Byrne and Emma Burns in Tipperary. They are two fantastic women who drove on our campaign in Tipperary to deliver a fantastic result for our county. There was a sense that the people of Ireland were ahead of us on this issue. That is what I got from the off. Maybe there is something to be learned inside these walls, when the people can be so far ahead of a certain number of politicians regarding such a sensitive issue as this.

The people knew what they were voting for. There was a critical decision to publish the heads of this Bill, which I will come back to. Nobody in this House can, with any degree of honesty, accept or put forward the argument that people did not know what they were voting on. They clearly knew what they were voting on and made a definitive decision. The Constitution was never the place to make provisions for such a complex issue. It negated the rights of women to make decisions about their own health under the dark forces of 1983 which still have reverberations around this country in some quarters. There have been some stories in recent times but thankfully they are gone. With the provision of the heads of this Bill, it is critically important, now that we are debating the published Bill, that we do so within the structures of what was decided by the publication of the Bill and the decision of the people. There is no earthly way that we should open up this discussion or debate, or allow it to be opened, because some may like it to be opened up again. Let us work within the parameters agreed by the committee, put forward by the Government and voted on by the public.

I have some commentary on the Bill itself. I read the documentation put forward by various organisations about this Bill, some of which I agree with and some of which I do not. This Bill has to be read in great detail. Every single comma is significant and has to be perfect. The National Youth Council of Ireland, NYCI, asked for a Preamble to be given to the Bill to contextualise the Bill, where it has come from, what went before it, what it is changing, the Bill that came before it a couple of years ago about the previous amendment, and so on. I think that is a good idea and ask the Minister to take it on board. When I read it, it hit something that I was looking for. A Preamble would explain the history of this and maybe contextualise the way in which the Bill sits with other legislation. That would be quite useful. The legislation needs to be clear and unambiguous. It needs to give equal assurance to women and to healthcare providers that we will provide accessible services of the highest quality. We need to ensure that healthcare professionals and workers will have no questions about how to interpret this. We need to leave the floor of this House with that being as perfect as can be. We need absolute clarity.

I know people in this House will put forward amendments. That is everyone's right. We will consider them ourselves. We need to be very careful about the manner in which amendments come forward which possibly would have knock-on effects in the Bill. Terminology and consistency of approach are vital. The Minister has a lead role in bringing forward legislation but in this, his guidance to the House with regard to what he is being advised by the Attorney General is at a different level of seriousness.

We do not want to have unintended consequences for people who are doing something for the right reasons, if the Minister can follow my logic.

I believe the Bill honours the commitments given to provide for universal access and free services for the women of Ireland, but a few issues arise with the drafting of the Bill. I agree with what was said in that regard by a previous speaker. In fairness to the Minister, he acknowledged this when we met him yesterday. It is unfortunate that the offences are upfront. I know that it is unintended, but that is the first thing one comes across in reading the Bill.

Section 19 concerning offences seems to be unusually wide in its scope. The Minister might come back to us on it. Healthcare professionals might be concerned in cases where decisions are required to be made in very narrow circumstances. I refer to the 12 week timeframe. They might be worried about litigation. I urge the Minister to examine the wording. I say this to be constructive. Everything I say is to be taken in that vein.

I understand the need to provide for the offence of aiding, abetting or forcing someone to have an abortion against her will, as well as for the references to abusive partners, pop-up clinics and rogue doctors, among other issues, and the reason the measures have been framed in the way they are. However, I am concerned specifically about the wording "procure a pregnant woman". Is there a better way to word it? Let us call a spade a spade. I know that it deals with coercion and merely pose the question.

Data provision is vital. We need to know when women are having terminations, where geographically, gestation periods and other matters. The records of clinicians who carry out terminations must be tightly managed. The protection of clinicians is also important. Medical data collection is very important in that regard.

Section 24 concerns preventing medical professionals from making a profit or commission from referring women to abortion services. I understand this also, but, again, I wonder if the wording could be tightened a little.

Reference was made to the three-day period following the signing off on the request by a certifying doctor. The issue arose in the course of the committee's discussions. Many of us have different views, but we are where we are and I understand why we have to go about it in this way. However, we must ensure the legislation is clear and that no conflict will arise with the three-day period in the context of the 12 week barrier. From discussions with the Minister yesterday, I understand the three-day period includes the day on which a woman is certified or meets a practitioner.

The term "medical practitioner" is used throughout the Bill and there is only one exemption. Do we need to include a provision to give the Minister for Health or a future Minister the ability to change it without having to amend the legislation in order to include other healthcare providers such as nurses, obstetricians or other practitioners? We now have multi-disciplinary teams I think it is necessary to do so and merely ask the Minister to examine the issue.

I previously raised with the Minister the need to provide for safety zones around hospitals and primary care centres to protect women and practitioners.

In the time remaining to me I wish to deal with the issues of conscientious objection and meeting the timeline for the provision of services. Conscientious objection is not new, but it is very specific in this case. It is incredibly important that while we have processes in place in which to do this, no medical practitioner can cite a conscientious objection which could have a detrimental impact on a woman's health. The issue is that serious. This is very important. Institutions cannot have a conscientious objection. I have a concern about institutions using subtle methods to try to get their clinicians to act in a certain way. We must have strong procedures in place to ensure that cannot happen. We must also ensure such institutions could not try to force women to take the private healthcare route, given the fact that the service is to be universally available publicly. We must consider how and where we manage the lists of those who provide services and those who do not.

Following meetings of the health committee, I have a concern about meeting the 1 January deadline. I have raised the issue with the Minister previously. There must be a 24-hour helpline, a referral system, geographical coverage across the country and within an acceptable timescale in order that women will not have to wait for longer periods than is necessary just because they are based in one part of rural Ireland as opposed to another.

We must consider what will happen to a doctor who refuses to refer and where there are consequences for the health of a woman as a result. I do not just mean from the point of view of the Medical Council. The intention is that the 24-hour service is to provide for referrals, but it must also provide all other supports such as counselling. Midwives and nurses should potentially provide the 24-hour service, but they require training and 1 January is fast approaching. The protocols on referrals must be agreed to, as well as on how the work is to be done. How will that happen? A 24-hour number is to be provided, but how will we ensure the people who take an alternative view do not spend the day blocking the number while women who are in distress cannot access it?

We must protect healthcare providers when it comes to those who conscientiously wish to provide services. There has been a lot of discussion about conscientious objection to providing services. but what about protecting those who conscientiously want to provide them? Respect for self-determination at work works both ways. Respect for the professional integrity and decisions of those who wish to provide services is also paramount. We must ensure there will be processes in place to protect them.

We all know that the GP contract is coming up for renewal. I welcome the update provided by the Minister on the issue at the health committee yesterday. GPs are not set up to provide the services. What extra resources will be provided to ensure they will be adequately resourced?

I have a concern about the phrase "as soon as may be" in section 23(3). The reference is to "shall, as soon as may be, make such arrangements for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the termination of pregnancy concerned". To one GP that could mean one thing, but it could mean something else to another.

We must include a reference to contraception in the context of GPs and medical practitioners dealing with pregnancies and terminations. I urge the Minister to deal with that issue.

I am also concerned about the provision of resources in the context of the lack of trained ultrasonographers, obstetricians, in particular those dealing with issues between nine and 12 weeks, midwives and other health professionals.

I congratulate the Minister on appointing Dr. Peter Boylan. He is the right person to liaise with the HSE and the medical colleges on the implementation of this

programme.

We must ensure not alone that the guidelines for these services are put in place through him working with the Minister, but that there is also a plan to ensure that in the coming years we have free services such that pregnant women can rely on the public health system. As I stated, contraception is being dealt with. We need more crisis service provision. We know that many women accessed abortion services abroad. It would not be right to kick that can down the road. We must implement the maternity plan and strategy of which I am very supportive, as the Minister is aware. It is one of the best healthcare provision strategies ever written in Ireland and we must ensure it is implemented.

I wish to conclude by acknowledging on this historic day that in November 2016, having received a letter signed by Deputy Billy Kelleher and me, the Minister met me and Amanda Mellet. On a day such as today it would be remiss of me not to mention Amanda and the women who came after her, such as Siobhán Whelan, who led the fight and ensured that this issue was brought to international attention. I thank her and Siobhán-----

See this speech in context