Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I apologise in advance if my voice sounds a little "gappy". I have a chest infection. We should celebrate today because it is historic. It is amazing to be here and to be involved in helping to shape this legislation. I saw both the Minister, Deputy Harris, and Deputy O'Connell, at the March for Choice last Saturday. It was a celebratory event and even months later, winning the referendum felt really good. Tens of thousands of young people attended the march. We should recognising their role in this and celebrate that we have achieved a huge amount.

This time last year, we were sitting on the Oireachtas joint committee hearing the evidence and going through the detail. We had the referendum at the end of the May, and the outcome was decisive. It was not close, with 52% for and 48% against, but decisive. There is no argument about that. However, the process has been held up because there are organisations and individuals who will never stop contesting a woman's right to choose to control her own body. It is important that this legislation does not leave any hostage to fortune in terms of those who might use their wealth and even risk losing their homes by remortgaging them to continue to take High Court and Supreme Court cases, as they did during the summer months, to try to obstruct the outcome of the will of the people.

The tone and language adopted from start to finish in this legislation are important. We have to put women and the choices they make in their lives at the heart of it. I very much agree with Deputy Louise O'Reilly's point that upfront and loaded in the Bill is the question of criminalisation. The Bill states: "It shall be an offence to intentionally end the life of a foetus ...". The use of the words "... to intentionally end the life of a foetus" rather than the word "abortion" smacks of the eighth amendment all over again and the life of a foetus versus the life of the woman, etc. The language used is very important as we will otherwise leave the door open to legal challenge. There is nothing in the legislation providing that it will be a crime to intentionally obstruct a woman seeking to have an abortion. I will return to this issue when I discuss the conscientious objection clause.

This time last year, we were examining the nuts and bolts of the issue and now, a year later, we are legislation for abortion. That is fantastic, but we need to watch out for banana skins. The chill factor that hangs over the medical profession because of the upfront loading of the offences in the Bill has to be dealt with. I know we will have many more chances to do that in the coming weeks.

We need to be careful about including in the Bill provisions that were not part of either the Citizens' Assembly or the deliberations of the Oireachtas joint committee. Whatever about leaving out proposals made by the Citizens' Assembly, we should not insert provisions that did not form part of the deliberations. I refer, for example, to the three-day waiting period when women are to go back and think about their decision. It is important that we do not do that. I believe that was a political decision - the Minister will nod his head - to insert this provision in the Bill because it does not comply with best international practice. While such periods are provided for in some countries, as the Minister told us yesterday, in the Netherlands, where a three-day waiting period applies, the clock starts ticking from the time the pregnant person picks up the phone to her doctor to ask for an appointment on the termination of a pregnancy. If that were to apply here, it would be grand because it will take at least three days to get a general practitioner, GP, appointment in any case. As I have said previously, I wait a week to see my GP, even if I have a chest infection. While GPs do their best to facilitate people, clinics in Ballyfermot and other large urban areas are very busy. We have a ratio of general practitioners to citizens that is far below the European average. We also have many problems in general practice and I am sure Deputy Harty, as a doctor, can speak about the way GPs are paid. Fewer doctors are staying in the profession and many are leaving the country as soon as they qualify.

I am delighted the Minister has appointed Dr. Peter Boylan to oversee this. When it comes to accessing abortion services, particularly medical abortion, we have a major problem with our health service. At the heart of this issue is women's health and our health service is creaking at the edges. Given the problem with the delivery of ordinary GP services, such as prescribing an antibiotic for a chest infection and being able to see people quickly, delivering a proper choice for women will be a real problem. We have to look at that issue very carefully. I am sure many amendments will be tabled on the three-day waiting period, which I believe was inserted for political purposes.

The definitions in the Bill are important, particularly, as Deputy Coppinger stated, the definition of the pregnant person. A pregnant person may not be a woman but could be somebody who is transgender. We need a sentence referring to that somewhere in the Bill to ensure that when we refer to "woman", we refer also to transgender and do not exclude anybody.

The definition of health should be inserted in the Bill also. The World Health Organization recommends that the definition of health include not only physical and mental health but also social health. In this country, that is extremely important because there is a serious social exclusion, specifically in respect of young girls, women in direct provision and women Travellers. That definition should be included.

A medical practitioner is defined as somebody listed on the register. It would help if we changed that because it would assist in dealing with the access question. There are midwives and nurses who have more experience than most doctors in dealing with pregnant people. They should be included in the definition of medical practitioner, particularly for medical abortion. What would be the big deal about seeing a nurse or midwife in the Ballyfermot clinic to procure and take the abortion pill under his or her supervision, instead of having to see one of the doctors?

Last week, a friend of mine had to have the abortion pill. I helped her procure it, but I did not help her through it. She helped herself through it. She told me afterwards that the only reason she was able to get through the experience without serious distress was that she has two children. She understood what was happening to her body and that she was beginning to go into a sort of soft labour, with early contractions, and she expected heavy haemorrhaging. She said she could not imagine what it would be like for a young woman on her own going through that. It is timely, therefore, that we have this legislation before the House. We need to extend the idea of who is and is not a medical practitioner when it comes to giving people access to medical abortions.

On conscientious objection, I have friends who are doctors and they tell me that the Medical Council provides that there is conscientious objection for all sorts of reasons. I have often wrongly attributed a belief to the Mormons - I believe it is another church but I have forgotten its name - by which they often refuse to do blood transfusions. Deputy O'Connell tells me it is the Jehovah's Witnesses. The conscientious objection clause exists but we need a much stronger impetus whereby objecting doctors must refer on. That referral must be immediate and must never be denied. There has to be a criminal sanction for refusing to do so. If we are going to sanction practitioners criminally for helping women to make the choice, we must criminally sanction those who refuse to help them make that choice. I would like to see a body that polices that operation so that if I live in Glenties in Donegal, for example - I have no particular reason for picking it only that I like it - and there is one doctor in the village who conscientiously objects and will not tell me where to go, meaning it will be very difficult for me to get access elsewhere, I would like to think I have a place to go to say I was treated terribly by that doctor. There should be a body that would deal with my complaint immediately, not the Medical Council because that is for doctors but an independent body that has the health and concerns of women at its centre, almost like a feminist body, that would say we are not having that and that would carry out some kind of policing of the way it is done.

There is another thing that is not in the Bill, although I hope there is no need for it because it is widely accepted in this country, as the referendum showed, that we trust women and want them to have a choice. That said, if we had people standing outside hospitals during the referendum with 30 ft high banners that were frightening, humiliating and disgusting, then we may need to have safety zones for women and practitioners. We may need to have a look at that.

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