Séamus Healy (Tipperary, Workers and Unemployed Action Group) | Oireachtas source

I welcome the opportunity to speak to the Health (Regulation of Termination of Pregnancy) Bill 2018 which I welcome. As one of those who opposed the introduction of the eighth amendment in 1983, I welcomed the outcome of the referendum held on 25 May. It was particularly welcome that the proposal to repeal the eighth amendment had been carried by such a significant majority. I thank all those who worked and voted for the repeal of the amendment, especially the members of the Tipperary Together for Yes campaign who worked throughout County Tipperary. As a result of their work, over 60% of those who voted in the county voted in favour of repeal. As someone who opposed the eighth amendment in 1983, I could see that things were very different on this occasion. In 1983 it was very difficult for those who opposed the eighth amendment to make their views known. On this occasion, there was significant support for the proposal that the eighth amendment be repealed and many people were prepared to canvass and work for repeal. People from a broad cross-section of life supported repeal of the eighth amendment. While I have no intention of rehashing the debate that took place during the referendum campaign and in the past 30 years or more, it is appropriate to recall that the proposal to repeal the eighth amendment was carried by a significant and clear majority on 25 May. A well informed decision was made after a process involving full and transparent public consultation. The heads of the legislation were made available as part of that process. Now that the people have voted heavily in favour of repeal, it is important to pass and implement the Bill before the House as soon as possible.

The Bill follows on from the Thirty-sixth Amendment of the Constitution Act 2018 which was signed into law by the President on 18 September following the referendum held on 25 May when the people voted to delete Article 40.3.3° of the Constitution and replace it with wording which confirms that the Oireachtas may make laws "for the regulation of termination of pregnancy". The Bill seeks to give effect to the decision of the people to permit the Oireachtas to make such laws.

The main purpose of the Bill is to set out the law governing access to termination of pregnancy. The explanatory memorandum reads, "The legislation permits termination to be carried out in cases where there is a risk to the life, or of serious harm to the health, of the pregnant woman, where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth, and without restriction up to 12 weeks of pregnancy." It is important to ensure that the Bill provides for a situation in which there are free, safe, legal and local termination services.

I do not intend to rehash the debate, which has gone on for years, but I will draw attention to two elements of the Bill, the first being the waiting period. A mandatory waiting period of three days is stipulated for a termination to proceed within the first 12 weeks of pregnancy. According to the World Health Organization, WHO, mandatory waiting periods that are not medically necessary constitute a barrier to safe abortion access and can result in care being delayed. The imposition of mandatory waiting periods also undermines a woman as a competent decision maker in her own right. Since such unwarranted waiting periods can cause delay in accessing services, it is clear that they are inordinately onerous and can result in unnecessary restrictions. It is also unclear from the Bill whether the three-day waiting period is included within the 12-week limit. For these reasons, the mandatory period should be removed from the Bill.

The second element is conscientious objection. Doctors, nurses, support staff and health professionals must of course be entitled to object on a conscientious basis. For the conscientious objection clause to be workable and not hinder a patient's right to termination services, though, there must be an obligation to make an appropriate referral so as to ensure refusal of care does not create an obstacle to accessing services. It must be clear that conscientious objection can refer only to an individual and not to an institution. In rural areas where access to services and options is limited due to, for example, geographical restrictions, services must be made available locally. The UN Committee on Economic, Social and Cultural Rights has specifically recommended that states should ensure that an "adequate number of health-care providers willing and able to provide such services should be available at all times in both public and private facilities and within reasonable geographical reach." Clarification is needed as to the oversight process for medical practitioners opting to use conscientious objection and the question of how a guarantee of access to abortion care will be provided not just in theory, but in fact, right across the country.

These two elements must be considered. The waiting period should be removed while ensuring that, while the conscientious objections of individuals are honoured fully, referrals are made available and services are provided locally.

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