Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the opportunity to contribute to this debate. I thank Deputy Bríd Smith for her work on this legislation.

Today marks five years since the historic referendum to repeal the eighth amendment and this Bill provides us with a fitting opportunity to reflect on the legislation passed in December 2018.

Despite the largely positive implementation of the Act, a number of key issues have become apparent and these are laid bare in the review. They include the mandatory three-day waiting period, which has been described by GPs in the HSE inclusion service as problematic, especially for marginalised and vulnerable service users. The World Health Organization, WHO, also specifically recommends against mandatory waiting periods, stating that they serve no benefit. In my view, it is a somewhat paternalistic provision in the current legislation that fails to recognise that the majority of patients seeking an abortion have made their mind up before they visit a doctor. The waiting period can also act as another barrier to those seeking an early medical abortion, with some women timing out of care. The WHO also points out that mandatory waiting periods force some women to disclose their pregnancy so that they can get additional time off work or education or to arrange travel or childcare. This failure to provide a service that ensures privacy and confidentiality in all cases must be addressed.

The wide-ranging issues with the three-day waiting period are further compounded by the limited availability of abortion services in many parts of this country. The review by Marie O’Shea BL found that half of the counties in the Republic have fewer than ten GPs providing services, nine counties have fewer than five GPs providing the services, and six counties have two GPs or fewer providing services. To make matters worse, eight of the country’s 19 maternity units, which are publicly funded units, do not provide termination services.

Research carried out by Dr. Lorraine Grimes and the Abortion Rights Campaign found that 30% of survey respondents who have used the service since 2019 had to travel for four to six hours to access abortion services. This is completely unacceptable. This uneven geographical spread of services must be addressed.

There are also issues with abortion provision in the case of fatal foetal abnormalities. The current 28-day clause is not working in practice and has been described as arbitrary and rigid by the review chair. This section of the 2018 Act is forcing women, often in tragic circumstances, to go abroad to access care that should be available in Ireland. This clause, along with the prospect of criminalisation, is undoubtedly having a chilling effect on doctors providing terminations and is deterring others from engaging in service provision. The recommendation to remove criminal sanctions must be acted upon. Ultimately, our termination services should be guided by international best practice. It is clear from the review, however, that we are out of step with the WHO. Like all healthcare, termination services should be evidence based. To achieve this, our legislation needs to be in line with the WHO guidelines. We must remember that when Covid was raging through this country, the Government and the health authorities regularly told us that we must follow the WHO guidelines and that to do so was good practice. The same should happen here.

While the Oireachtas Joint Committee on Health will certainly play its part in examining the O’Shea report, referral to the committee should not be used as a means to delay the recommended legislative change. This is a Government commissioned review. It is underpinned by extensive research and in my view, it is a very good review. Under no circumstances should we have to wait a further 12 months for the recommended legislation to be produced. The recommendations are clear. It is now up to the Government to act.

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