David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I will be supporting most of the amendments, with the exception of one. I just want to make a number of points first, speaking to amendment No. 6, which is a very substantial amendment. I want to welcome the overall proposal, because it is an important measure that will help and support many women. It is important from a family planning perspective. I welcome that it includes the range of contraception products, including long-acting reversible contraceptives. I also welcome the clarification the Minister gave, which is that full cost of contraceptives, including GP consultations and all of the costs that go with it, will be included. It is important for us to acknowledge that. That is a really important step forward in this area under the Minister’s leadership, which I support, as I did on Second Stage.

It is equally important to many who need the pill to help balance hormone fluctuations throughout their cycles. It can help to regulate and regularise their menstrual cycles. It reduces pain and discomfort, relieves symptoms of premenstrual syndrome and it helps to reduce the risk of uterine cancer, ovarian cysts and anaemia and it can be helpful for the management of endometriosis. For all of those reasons, the inclusion of the full range of contraceptive products, including LARCs, is really important.

However, the substantial point I want to make is that I think the Minister would accept that amendment No. 6, in and of itself, merits its own Bill. If the Opposition had tabled an amendment similar to amendment No. 6, it would have been ruled out of order, because it significantly alters the scope of the Bill. I am sure we would have been sent a letter to say that our amendment had been ruled out of order. The merits of the proposals of the amendment, as evidenced by amendment No. 10, show that this is well beyond the scope of the original Bill.

I accept the reasons the Minister is doing this. I accept also that we want to get this done as quickly as possible. Equally, we have to point out that this almost always happens in the approach to the summer recess. We have legislation being rushed through without proper scrutiny. If we had a separate Bill on this issue, we would have had a more fulsome debate on the issue of contraceptives. We would have had a debate on how we get to universal free contraception for all, about what that transition will be and about the Minister's plan to move beyond what is in the scope of this Bill. However, we did not have that chance.

We had Second Stage speeches that had to concentrate on a range of issues, including this issue as well as all of the other elements in this Bill. For that reason, this amendment should have been a stand-alone Bill. It is product of the fact that we do not move the legislation as quickly as we should and then there is this rush towards the summer recess. That happens every year and we have these omnibus Bills that are a mix and match of all sorts of different issues. It is not the best way to progress legislation but there we have it. We are where we are.

There is a significant part of amendment No. 6 with which I do not agree. I am disappointed to see that it has been included. That is subsection (6) of section 67E, proposed to be inserted by amendment No. 6. This prevents the extension of free contraception to people under the age of 17. I understand the rationale to base the eligibility on the age of consent. That is a logical position in some respects but it misses the point in relation to the use of contraceptives, particularly the pill.

As I outlined, the pill is very important to many women for regulating their menstrual cycles and reducing the associated pain and discomfort. There is no reason these products should not be made available free of charge to women aged under 17 who are pubescent for this reason. There are other reasons as well. We can have a discussion about the age of consent but we could also have a grown-up discussion about what unfortunately happens in the real world whether we like it or not. History teaches us that the more we make contraceptives available to everybody, the better it is.

There is just one part of amendment No. 6 with which I cannot agree. I checked and it is not possible to move a Fourth Stage amendment. If I were moving a Fourth Stage amendment, however, it would be to delete that subsection under Standing Order 191. I have been told it is not possible. For that reason, unfortunately, I will have to oppose amendment No. 6 when it comes up and call a vote on it. That is how strongly I feel in relation to it. I do not believe we should be limiting the use to women aged 17 and over. From my perspective, we could have gone further and reduced it to women of a lower age as well. I have given the reasons.

I will make this point because we did not have a chance to make it in what would and should have been a Second Stage debate on the issue of rolling out contraception for women of that age. Given that this is a substantial amendment of the original Bill, as the Minister would accept, it is important that when the Minister gets a chance to respond, he sets out what he sees is the trajectory with regard to universal contraception. What is the next step? This is a very important first step. I do not want to in any way take away from the significant advance this will be. I already commended the Minister on what has been done. Like many areas in relation to healthcare, however, we had previous discussions very recently in the context of free GP care and free primary care, which are all part of Sláintecare. Lots of these promises about universality have been made but it is taking an awful long time to get there. I do not know what the direction of travel is beyond what is in this Bill.

Perhaps the Minister might be able to spell out to us whether he intends to go further than what is in this Bill in the upcoming budget. If it is not in the upcoming budget, has the Minister a timeframe on which he is working to expand free contraception beyond what is permitted in this Bill? It would be important for the Minister to set that out. I make the point again that for the reasons I gave, I cannot support amendment No. 6 because of one element of it. Because I cannot move a Report Stage amendment, however, I have no choice but to oppose the amendment as is.

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