Dáil debates

Tuesday, 10 February 2015

Redress for Women Resident in Certain Institutions Bill 2014: Report Stage

 

6:50 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

It is necessary to recommit the Bill in respect of amendment No. 1 as it creates a charge on the Exchequer.

Bill recommitted in respect of amendment No. 1.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I move amendment No. 1:

In page 3, to delete lines 26 and 27 and substitute the following:"(a) a general practitioner medical and surgical service,".
As I elaborated in detail on Committee Stage, the Government is committed to implementing in full and in good faith the recommendations of Mr. Justice Quirke. The arrangements put in place for the payment of monetary benefits show that we have consistently taken the most generous interpretation of those recommendations. For example, a woman who spent a weekend in an institution will receive a one-off payment of €11,500 and a top-up payment to ensure a weekly State benefit of up to €100 until she turns 66 years of age and then the equivalent of the State contributory pension of €230 per week for the rest of her life. Women who were in the institutions for ten years or longer will each receive a payment of €100,000. More than 70 women fall into this category. As I stated on Committee Stage, more than €18 million has been paid out and payments will continue to be made to the women for the rest of their lives. This is as a result of the Government's decision to do what was appropriate, given the women's suffering in the institutions.

The advocacy group has acknowledged the Department's work in assisting as many women as possible. It is generally agreed by the women concerned and their advocacy group that the Department's dedicated unit has provided the women with a supportive and positive service. I want the same attitude to apply in terms of the health benefits to which the women will be entitled once this legislation has been passed.

All Deputies share the objective of acting in the best interests of the women. A number of amendments have been tabled in good faith but, for technical reasons, have been ruled out of order. I reassure the House that the Quirke recommendations will be implemented in full.

I listened to contributions on Second Stage and addressed them on Committee Stage. A number of concerns were expressed to the effect that we were trying to restrict the choice of general practitioner for the women, but I made it clear that that had never been the intention. I needed to discuss the matter with my colleague, the Minister for Health.

I have decided to remove any doubt by eliminating the explicit link with the medical card GP service. This amendment to section 2(1)(a) will enable the HSE to make available a GP service through a private GP, if that is the woman's wish. Women will also be free to maintain their existing GP if they so wish, where their GP already provides care to medical cardholders. This amendment is making it absolutely clear that there is an unrestricted choice of GP for all the relevant women. The same is available to those who come within the scope of the Health (Amendment) Act 1996. They will also be free to change to a different GP at any particular time.

Mr. Justice Quirke pointed out in his report that the scheme introduced under the Health (Amendment) Act was aimed specifically at women who contracted hepatitis C as a result of contaminated blood transfusions and that some of the benefits that were applicable to women who had hepatitis C would require suitable adaptation in terms of the legislation in this arena for women who were in various institutions. The scheme proposed for the Magdalen women does not have those adaptations because people suffering from hepatitis C required some products outside the normal range of drugs available. That does not apply to the Magdalen women. To ensure that women get the best health care, however, provision is made in the scheme for a number of health services to be provided, by referral, by a medical practitioner or nurse. Obviously, that is not intended to restrict access in any way, as the focus is firmly on the woman's health needs. The referral will ensure that the health care provided will be co-ordinated and will enhance the continuity of care being provided through the GP who is the primary contact with the health service for any individual. In this way, referral will ensure that all care provided will be most appropriate to the needs of each participant.

Mr. Justice Quirke made a clear distinction in his report between what is put in legislation, that is, appendix E of his report, and the broader administration of the scheme. Deputies will be familiar with the fact that there are a range of areas concerning services for the women which are being dealt with outside legislation and on an administrative basis. The Government took that decision and the services are being supplied. I will say a little bit more about that later.

There is no reference in the Health (Amendment) Act 1996, or in the draft scheme put forward by Mr. Justice Quirke, to liaison officers or the issue of special cards. They are dealt with under the provisions of the scheme. I went into a lot of detail on Committee Stage about this special card that will be given to the women. It is an administrative issue as regards what the card will be called. It can be called the special card for women who are availing of this scheme, but it is an administrative issue - as it was under the hepatitis C proposals - to work out precisely what the card will look like physically. The services are clearly provided for under the legislation.

We have also included two additional services in this Bill - chiropody and physiotherapy - which were not in the hepatitis C legislation. They were not in the 1996 Act but they are provided to HHA cardholders, so I have put them in to avoid any doubt.

As regards some of the discussions we had on Second and Committee Stages, Mr. Justice Quirke, in paragraph 2.07 of his report, sets out a list of services that should be provided to the women. All these services are being provided under the Bill. I hope Deputies will be able to support the Bill, given that all the services recommended by Mr. Justice Quirke are clearly being provided under its terms.

Mr. Justice Quirke did not comment, one way or another, on complementary therapies. I have examined this issue and, for example, the Minister for Health would have reservations, as others have, about such therapies being provided and funded through the health service and medical card. I am not in a position to provide those services under the Bill. On a personal level, however, I am open to the benefits that could be brought to people through such complementary therapies. I have asked my officials to examine the desirability of providing some limited funding to the women concerned in order that they could avail of such complementary therapies. That would be a separate scheme run on an administrative basis rather than a statutory one. I am not in a position to put that on a statutory basis, but I will examine it in terms of the women's needs. The Department will bring in a scheme that will provide some funding. Funding is provided in the UK to the advocacy group there. It makes various services available to women it works with through funding it has been given. Some of that concerns advocacy for housing and some complementary therapies. Counselling is allowed for in the Bill.

I am in favour of the women having access to advocacy and I intend to implement Mr. Justice Quirke's recommendation on this matter in full. Mr. Justice Quirke makes a clear distinction between what is required for most women and what is required for those lacking full mental capacity. Mr. Justice Quirke recommended that arrangements similar to those provided for in section 21 of the Nursing Homes Support Scheme Act 2009 should be introduced, which allow the court to appoint a care representative to look after the interests of a person lacking full mental capacity, in the context of applications under the nursing homes support scheme.

As regards applications under the nursing homes support scheme, I want to put it on the record of this House that Magdalen women are already covered along with all other applicants, but there is a more general issue. The model recommended by Mr. Justice Quirke was the best available when he published his report in May 2013. However, he Assisted Decision-Making Capacity Bill, which is a better model, was published in July 2013. The range of options covered by this Bill include decision-making assistance, co-decision makers, decision-making representatives and the public guardian measures, which are well suited to look after the interests of the women we are speaking about, who have capacity issues. In light of the Assisted Decision-Making Capacity Bill, which has already passed Second Stage and will be completed in this Dáil term, it would not make sense to introduce a special scheme for women who lack capacity.

I want to make it clear that a medical assessment is sought if there is any indication that an applicant under our scheme has capacity issues. We have identified about 40 women who will need this kind of support and advocacy to help them because of difficulties with decision-making. We want to ensure that the best safeguards are in place for those women.

As we need to have regard to the mental capacity of a number of these women, my amendment to section 2(1) must allow for a situation where a woman does not have the capacity to make decisions about GP services. I am making that point because the other amendment which we will go on to discuss does not take note of that. That is why the wording is different from that of the Health (Amendment) Act 1996. It cannot be the same as in the Act because of those capacity issues. I must allow for that discretion in order that those women are included in this Bill. In some cases, a family member or carer, rather than the women herself, will have to make decisions concerning GP services. We are trying to ensure that all care provided will be most appropriate to the needs of each participant.

As regards women who do not lack capacity, I fully recognise the benefits of them having access to an advocacy service. Such a service already exists for those women who live in the UK because we have given funding to the Irish Women's Survivors Network in London.

I visited the latter in December and met Sally Mulready, Phyllis Morgan and many of the women who are benefiting from the services being provided. They are receiving very good practical support in the context of accessing housing etc. A number of advocacy groups act on behalf of Magdalen women who are resident in Ireland and, like other Deputies, I have met representatives from them.

In recommendation No. 6, Mr. Justice Quirke suggested the establishment of a dedicated unit which would have a variety of functions, including assisting women in obtaining their entitlements and advocating on their behalf. This does not require any legislative basis. I will be examining how to develop this idea now that the existing dedicated unit in the Department has almost completed its primary task of paying out the cash benefits. I will develop recommendation No. 6 and establish the kind of advocacy support that is suggested by Mr. Justice Quirke.

The various issues to which I refer were discussed on both Second Stage and Committee Stage and I stated that I would bring forward this amendment in response. I hope Deputies understand that it is designed to make it absolutely clear that women will have access to a wide range of services and that they will not be restricted in their choice of GP. What is proposed is exactly the same as the scheme established to deal with women who contracted hepatitis C. I ask Deputies to support the amendment.

7:10 pm

Photo of Niall CollinsNiall Collins (Limerick, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I was late arriving and missed some of the Minister's opening remarks so if she has already dealt with the matter about which I am about to inquire, I apologise. We received correspondence from Justice for Magdalenes Research, JFMR, just prior to the debate's commencement in which a number of pertinent questions are posed with regard to medical cards and the provision of GP services. In the correspondence, JFMR welcomes the Minister's intention that Magdalen women can access the services of any GP, including private practitioners, but indicates that she has not addressed the apparent limitations with regard to dental, ophthalmic and aural services, prescribed drugs and appliances. In addition, JFMR asks whether the dental, ophthalmic and aural services involved be equivalent to those set out in appendix G of Mr. Justice Quirke's report, which relates to the HAA card guide. It also inquires as to whether Magdalen women will be able to obtain access to any and all dental, ophthalmic and aural primary care services, including from private practitioners. JFMR's final question relates to whether, if they are referred for hospital treatment, they will be given appointments within two weeks, which is what they would be entitled to under the terms of the HAA card.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

We are due to conclude our deliberations at 7.30 p.m. Will we be disposing of Report Stage at that point by means of a vote?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Not that I can see. We have to dispose of the various amendments. There is no guillotine. Each Deputy may speak twice and the mover of an amendment can speak on three occasions.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Acting Chairman for his guidance.I am very disappointed by the fact that the Minister did not move to amend the legislation in the appropriate fashion in order to ensure that it is fully consistent with and faithfully reflects the scheme put forward in the Quirke report. We all know that Mr. Justice John Quirke proposed an ex gratiascheme, meaning that the women are asked to waive their rights to pursue the State through the courts in order to obtain a level of compensation that would I believe far outweigh the awards envisaged under the scheme. The trade-off is that in accepting an ex gratiascheme, the women obtain the comfort of prompt action and access to a variety of services. The Quirke scheme contains some extremely modest proposals. Indeed, as a redress scheme, it is not exactly flaithiúlach. It is, therefore, extremely disappointing that what is proposed in the legislation falls very short of what Mr. Justice Quirke envisaged.

On Second Stage I urged the Minister to amend the Bill and stated that if those of us on the Opposition benches attempted to do so, we would fall foul of the rule which states that we cannot bring forward amendments that represent a charge on the Exchequer. That is exactly what happened on Committee Stage and it is happening again now in respect of those amendments that need to be made. The Minister did not, either on Second Stage or Committee Stage, provide a satisfactory reply as to why she decided to go against the approach recommended by Mr. Justice Quirke and set out in appendix E - on pages 77 to 78 - of his report. In his first recommendation, on page 7, Mr. Justice Quirke states that the latter would require "Primary legislation similar to the Health (Amendment) Act 1996 or a statutory amendment to that Act is required in order to implement this recommendation." No reference is made to the Health (Amendment) Act 1996 in the Bill before us and that is what, as the Minister knows, the survivors were expecting.

On Second Stage we referred to the survivors and their advocacy groups many times. The Minister felt at the time that their fears were unfounded and I suggested to her that if that was her view, then perhaps she might meet the women and their advocacy groups. Will she indicate whether she did, in fact, meet them? In any event, I outlined what they were expecting and the fact that it is not included has made them very anxious. It appears to them that the Minister has broken her word and departed from Mr. Justice Quirke's recommendations, which they justifiably anticipated would be implemented in full in return for their ex gratiawaivers. That is a significant point. Section 2(2)(b) makes it quite clear that women who have accepted offers under the scheme are the only ones who can access the benefits established under the legislation before the House. Again, this underscores the nature of the trade-off and the scale of the concession made by the women as opposed to the State.

The explanations the Minister provided on Committee Stage are, quite frankly, not convincing. She claimed then and just now that she is acting in good faith to implement the Quirke recommendations. If that is the case, why is the list of services set out in section 2 so different from and so much more limited than that provided by Mr. Justice Quirke in appendix C of his report and set out in appendix G? Unless it is absolutely necessary to do so, I will not take the liberty of reading appendix G in its entirety into the record of the Dáil. The Minister is aware of what I am referring to. On Second Stage the Minister led the Dáil to believe that survivors would be provided with either HAA cards or RWRCI cards under the terms of this Bill, once it is passed into law. She has again referred to the matter of physical cards as an administrative issue. As she is aware, I tabled a parliament question in the aftermath of the Second Stage debate and she clarified in her reply that there is no concrete commitment in respect of these cards and that a decision on this issue will not be made until the legislation is enacted. I am of the view that this is not good enough, unless the Minister is going to inform us now that she has made a full, final and concrete decision.

The purpose of the legislation is to deliver fully and faithfully the scheme recommended by Mr. Justice Quirke and not the scheme as the Government might wish it to be or some interpretation or version of it. Let us remember that the scheme in question is a very minimalist and modest response to women who suffered the gravest of human rights violations under the watch of the State. I am very disappointed that the legislation does not do what I referred to. I do not believe the Bill as it currently stands is worthy of support.

Most of the amendments have been ruled out of order, as I stated. We will have the opportunity to debate one set of amendments, Nos. 17, 18 and 19. I do not know whether the Minister will be minded to accept any of those. This whole process has been unsatisfactory, underlining the limitations placed on us as Opposition Deputies. Any amendment that represents a charge on the State has been completely taken off the table. Thus, we find ourselves with inadequate legislation and a Minister who will not amend it appropriately to address the inadequacies. Members in the Opposition benches, while they can table amendments, are unable to insist they be debated in the House to try to urge the Minister to accept them. I am very disappointed with the whole process. I know my views reflect the views and anxieties of many of the survivors.

7:20 pm

Photo of Joan CollinsJoan Collins (Dublin South Central, United Left)
Link to this: Individually | In context | Oireachtas source

The Magdalen women, who suffered greatly under the so-called watchful eye of the State, agreed to an ex gratiascheme on the basis that they would have all the benefits accruing to hepatitis C patients, both men and women, with the HAA card. That is exactly what Mr. Justice Quirke said in his report.

The 1996 HAA legislation is quite broad and has no restrictions. It does not state one must be referred by a medical doctor, nurse or otherwise. It simply refers in section 2 to “drugs, medicines and medical and surgical appliances”, “general practitioner medical and surgical services”, “the nursing service specified in section 60 of the Act of 1970”, “dental, ophthalmic and aural treatment and dental, optical and aural appliances”, “counselling services in respect of hepatitis C” and, importantly, "such other services as may be prescribed”. I presume the "other services" are services subsequently covered by the HAA card, including chiropody services provided free of charge. One does not need a referral. One can attend whenever one needs to do so. The hepatitis C liaison officer can provide one with the details of chiropodist in one's area. This is a consequence of section 2(1)(f) of the 1996 Act. Complementary therapies currently covered under the HAA card are reflexology, aromatherapy, massage, acupuncture and hydrotherapy. HAA cardholders need to be referred by their GP or consultant. This is not covered in the Minister's Bill.

HAA cardholders can avail of counselling not only for themselves but also for their immediate families. This is ruled out or is not contained in the Minister's legislation. If the Minister is to introduce legislation and says certain required measures will be covered elsewhere, she should bring the whole package to the Magdalen women. She should state the provisions may be introduced in bits and pieces but at the same time lay out the whole package. The legislation under discussion does not include the whole package. It is not what the hepatitis C patients have access to in any shape or form, and it does not give assurance in this regard.

Our amendments have not been ruled out of order for technical reasons but because they would impose a cost on the State. What is in the Minister's Bill that restricts the cost to the State and what is it in the amendments that costs the State extra? We need an answer to this question. Counselling for Magdalen women and their families, similar to that provided to those in the HAA card scheme, would involve an extra cost for the State but this is supposed to be based on the accessibility provisions in the HAA card scheme. The Minister refers to an administrative task not referred to in the legislation. I accept that; it is not a problem but the vital point concerns the services to which one is entitled as a cardholder. It is on this that clarity is needed.

I am very reluctant to support this Bill because it is not what the survivors want. I ask the Minister for clarification on the next Stage and to arrange a special meeting with the Magdalen survivors and the Opposition to explain the whole package and exactly what the women will be entitled to by way of counselling and other services. This Bill is absolutely different from the 1996 HAA Act.

Section 2(1)(e) refers to “dental, ophthalmic and aural treatment and dental, optical and aural appliances”. There are no restrictions in this regard and no referral is required by a doctor. The section also refers to “counselling services in respect of hepatitis C, and “such other services as may be prescribed”. The Minister needs to be more robust and convince people that her Bill covers these services. I do not believe it does.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I am very unclear about what the words “general practitioner medical and surgical services” actually mean. There was considerable clarity in Mr. Justice Quirke's recommendation. Everybody knew what the HAA card meant and there was a full list of services. Other Deputies have said there seems to be approximately six discrepancies between the HAA card and that laid out in this Bill.

A few general points need to be made first. It is absolutely galling that we come in here to have a serious debate about one of the most serious social issues that has arisen in this country, namely the mistreatment of the women in the Magdalen laundries and the need to secure restorative justice for them, and practically all the amendments we have tabled have been ruled out of order on the spurious grounds that they involve an additional financial cost to the State. How could there not be a financial cost to the State when we are trying to get for the women the financial health benefits they were promised by the Government? If the Government backtracks significantly on a promise it made and the Opposition says the Government should honour its promise, the latter can be ruled out of order. This is an absolute sham.

We have just had a debate on fatal foetal abnormalities, which can only happen to women. The legislation thereon has been voted down by what is very much a male-dominated older Parliament. Certainly, it poorly represents public opinion and, in fact, it is in inverse proportion to it. Everybody saw the tears the Taoiseach, Deputy Enda Kenny, shed two years ago in 2013 when he promised the women he would deal with this issue. However, one must really draw the conclusion they were crocodile tears if he is now backtracking. I realise the Government does not take too much note of anything the Opposition says but the National Women's Council of Ireland, which the Minister used to chair, has condemned the Government's backtracking on the pension and health issues. Practically all the advocacy groups for the Magdalen women have done so also. Why is this happening? How much money are we really talking about? What is occurring is just penny-pinching for no particularly apparent reason. There are not that many Magdalen women.

There is a big difference between alternative therapies and complementary therapies. "Alternative" suggests something that has not been backed up by medical science, or something that is a bit spurious. I believe angel healing was mentioned in this regard in the previous debate. We are not talking about therapies such as that but about therapies that have well-founded benefits for people, including massage and acupuncture. I am not clear on whether these are in the Minister's promised package. It does not sound like "general practitioner medical and surgical services" would include those services.

The Minister cannot come in here and say she will bring in something separately. We must vote on what we see in front of us. That is what we are here to do.

On the general point of the amendments being ruled out until they mean nothing, how can that be stood over? If the Government back-tracks on something, how are we meant to restore it?

7:30 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

By way of explanation, I have a detailed note on each amendment that is ruled out of order and I will read out that note when we get to that stage. There is an explanation given, which is the standard explanation in relation to amendments in all parliamentary practice.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I know it is.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

There is nothing particular about it. It is the way it always has been. I would prefer to wait to get to that amendment before we discuss it.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

May I continue or is the Acting Chairman going to say something else? I am talking about the general debate into which we are entering here and the fact-----

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Yes, but it is not-----

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

Is the Acting Chairman going to keep interfering?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Just a second, Deputy Coppinger.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

The fact that a lot of amendments are ruled out is very relevant.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Just a second, this is not a Second Stage debate. It is a debate on a amendment, brought forward by the Minister, that was agreed on Committee Stage and therefore we do not go back over the whole debate again. I have given latitude but that is as much as I can give.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

The Acting Chairman has spoken for quite a long time now. I am speaking on the Minister's proposal, which is the substitution of "a general practitioner medical and surgical service". All of my party's amendments dealt with that whole issue and it is on that I am speaking.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

When we get to those amendments, we will debate them. Whoever is sitting in the Chair at that time-----

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

We cannot debate them because it has been ruled out of order.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----will dispose of the amendments and that is all that has to be done. I am sorry but we cannot allow a long Second Stage debate on something that was already agreed on Committee Stage. Deputy Coppinger should proceed.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

Is the Acting Chairman finished?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Pardon?

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

This is unbelievable. I am allowed speak on what the Minister has put forward. I am allowed make the point that we are allowed talk about all of my party's amendments which dealt with the health benefits and the Acting Chairman is unjustly interfering in my contribution. I will finish now.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have bad news for Deputy Coppinger, I am not.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

The Acting Chairman, Deputy Durkan, is interfering. He usually does it from the Government benches and now he is doing it from the Chair.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The rules of the House are already agreed and Deputy Coppinger knows what they are as well as everybody else. I pointed out already that whenever we reach those amendments, we will deal with them in seriatim - as the occur. It is not in order to have a Second Stage-----

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

We cannot deal with amendments that are no longer on the agenda. That is the point.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Deputy Coppinger is out of order. She is trying to widen the debate, and that is not in order. The Deputy should proceed, if she would, in relation to-----

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I am asking the Acting Chairman to stop interrupting my contribution. We cannot deal with each amendment because they have been ruled out of order. I am making my points here.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I will deal with that when we get to it. One cannot make a Second Stage speech at this Stage because we are at a different time in the Bill.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

How long can I speak for on the Minister's amendment?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

On this Stage, we allow a certain amount of tolerance.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

Exactly, there is not a limit.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Under the standard procedure, there is a certain amount of tolerance and a certain amount of latitude.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

Will the Acting Chairman stop interrupting me now and let me finish?

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The next time the Deputy speaks she will have two minutes.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I know that so let me finish, and stop interrupting unnecessarily.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Just in case there is any dispute about it, that is not the way one addresses the Chair. I am aware Deputy Coppinger is not very long a Member of the House and all Deputies have to learn, but one cannot proceed to talk on a subsequent amendment when one is dealing with another amendment, unless they have been taken together.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I am dealing with the Minister's amendment to substitute "a general practitioner medical and surgical service" and merely making the point that it is not clear what services would be included in that regard. I am also making the point about all of my party's amendments which were on this same topic that have been ruled out of order. Unfortunately, the Acting Chairman took the time to interfere unnecessarily. I will sit down now because it is so obvious that we will not be able to-----

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I ask Deputy Coppinger to resume her seat for a moment. The Chair does not interfere.

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

The Acting Chairman is interfering.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Chair does not interfere; the Chair intervenes. I intervened correctly. Has Deputy Coppinger concluded?

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

Yes.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I repeat - I am disappointed Deputies opposite have not pointed out this - that what we are bringing in fully implements Mr. Justice Quirke's recommendations. That is the reality of the situation.

I do not accept the points made, that the Government is back-tracking or that this in some way undermines the Taoiseach's genuine expression of sympathy. Quite the opposite is the case. I suggest Deputies look at the facts as opposed to making comments that do not reflect the reality of what we are doing here because some of the comments that have been made are misleading.

On what Mr. Justice Quirke recommended, I would refer the Deputies who have made these points to page 35 of the report. The services Mr. Justice Quirke outlined there are: GP services; prescribed drugs, medicines and appliances; dental services; ophthalmic services; aural services; home support; home nursing; counselling services; and a range of other services, to include chiropody-podiatry and physiotherapy. I refer the Deputies to section 2 of the Bill in which are outlined all of the services that were recommended by Mr. Justice Quirke. We are implementing Mr. Justice Quirke's recommendations in full. That is the reality of what is being done here. It is misleading of Deputies to say that we are not. We are implementing the recommendations that were made by Mr. Justice Quirke in relation to all of these services.

In terms of the amendment I am bringing in this evening, Deputy Collins asked some questions which I will answer. Other Deputies did not comment on the fact that what we are doing, by the amendment tonight, ensures that women have the choice of a greater range of GPs. That was always the intention but I am making it even clearer by putting in this amendment tonight.

All of the services listed by Mr. Justice Quirke are set out in detail in section 2 of the Bill. That is the reality. The women are entitled to all of those services - to a GP of their choice, to change GP, to have a private GP or a GP who is in the public service. That is what is being provided in this legislation, and it is in line with what Mr. Justice Quirke recommended.

Obviously, the scheme itself was agreed by Government. The women have been accessing that service and €18 million has been paid out in relation to it.

Not everything needs a legislative base. I spoke clearly in this regard on Committee Stage, which none of the Deputies attended, and went into a lot of detail of the approach I would take to both the advocacy and the complementary therapies. I stated that the Department would move forward on those two issues.

The only area, in terms of the HAA card, where there is a difference - Mr. Justice Quirke did not recommend it and we are fully implementing his recommendations - is on complementary therapies. I already explained that the Department of Health does not cover complementary therapies on the medical card and I am not in a position to do that in this Bill. That is where it is different.

The other point is that the Bill provides that there is referral for a very small number of the services, the chiropody and physiotherapy, from a GP, and it is reasonable to include that.

All of the key medical services that the women would seek are covered. Everything that Mr. Justice Quirke recommends, in terms of medical services, is covered in the Bill. I have brought in an amendment to make it even clearer that there is that choice in relation to GPs.

I refer the Deputies to section 2. It includes: the general practitioner medical and surgical service; drugs, medicines and medical and surgical appliances; nursing services; home help services; dental, ophthalmic and aural services; counselling services; chiropody services; and physiotherapy services. That is the range of medical services that the women are entitled to access under the Bill. Those are the services that Mr. Justice Quirke recommended. In terms of meeting the recommendations for health services on a legislative basis, they are all being covered.

I have already discussed and gone through the other areas and suggested an approach to some services that could be helpful to the women. I have acknowledged those services could be helpful and I have suggested a way of ensuring that the women have access to those services as well, but not on a statutory basis.

Deputies should look again at page 35 of Judge Quirke's recommendations and look at the list of services in section 2 where they will see that the recommendations are covered. The answer to Deputy Niall Collins's first question is "Yes".

Debate adjourned.