Simon Harris (Wicklow, Fine Gael) | Oireachtas source

It is on the way.

The third and final part of the Bill includes provisions covering consent, conscientious objection, offences and provisions for providing universal access to services for persons ordinarily resident in the State.

Section 21 deals with consent, and I want to be very clear on this because we had a long discussion on this is in the Dáil last night. The issue of consent here is exactly the same as for other medical procedures. It is set out in Medical Council guidelines and medical practitioners know how to go about obtaining consent on a daily basis so the law is no different here on consent and nor do I believe it should be because this service will be part of the public health service.

Section 22 of the Bill covers conscientious objection. It states that where he or she has a conscientious objection, a medical practitioner, nurse or midwife shall not be obliged to carry out, or to participate in carrying out, a termination of pregnancy. This is in line with both the Medical Council's guide to professional conduct and ethics for registered medical practitioners and with the Nursing and Midwifery Board of Ireland’s code of professional conduct. I tabled amendments to this section in the Dáil to ensure that conscientious objection extends to all those who may be asked to participate in the service, including students, which was important.

I want to be clear that the law on abortion is changing in this country but the law on conscientious objection is not. As the Minister for Health, I will always respect conscientious objection and I believe a significant majority in these Houses of the Oireachtas would do likewise, but I will not respect conscientious obstruction. This law is coming in and it will be passed in accordance with the wishes of the people. People who conscientiously object do not need to play a role in that but there cannot be a situation where they would obstruct a woman accessing a legal health service or where a woman seeking help, often in a crisis situation, perhaps having been raped, would be shown the door or given the cold shoulder. We need to have a situation where conscientious objection is absolutely respected but not obstruction and they are different issues.

Section 23 sets out the substantive offences under the Bill and it provides that it shall be an offence for a person, by any means whatsoever, to intentionally end the life of a foetus otherwise than in accordance with the provisions of the Bill. Section 24 of the Bill provides for the offence by a body corporate.

Section 25 prohibits receiving financial or other benefits in kind in cases where referrals are made to services providing terminations of pregnancy. I have met the Irish Family Planning Association and the Dublin Well Woman Centre on this and the aim of this is not to interfere with their work in any way but to protect a woman's interest and to ensure that she receives objective advice and information, uncoloured by any financial or other considerations. It would prevent anybody from receiving a commission for referring a woman for a termination of pregnancy either in Ireland or abroad.

Sections 26 and 27, respectively, amend provisions of the Health Act 1970 and of the Nursing Home Support Scheme Act 2009 so that both make reference to this Bill. Section 28 amends sections 20 and 23 of the Health (Pricing and Supply of Medical Goods) Act 2013, to include references to the amended Health Act 1970. The provision of services on a universal basis will not prevent women from accessing the service on a private basis, should they wish to do so. Section 29 of the Bill amends the Schedule to the Bail Act 1997 to include an offence under the Bill.

I would now like to turn to what the service would look like, should the Bill become law and this is important because there will be women, medics and healthcare professionals watching this debate and to see what we are about to pass the law. I want to assure them that in parallel to the work that we are doing as legislators, a huge amount of work is ongoing to be ready for the service delivery. This includes the drawing up of clinical guidelines by the medical colleges and the preparation for the roll-out of this service within the HSE.

I pay tribute to Dr. Peter Boylan, in particular, the former chairman of the Institute of Obstetricians and Gynaecologists and former master of our National Maternity Hospital, for taking up my invitation and that of the HSE to act as a clinical adviser on this service. It is my absolute intention that termination of pregnancy services should be provided as part of the continuum of women’s health services. This would mean that in the future, women would be able to choose to have this service from their own GP - a person with whom they are comfortable and familiar as the family doctor. However, where a woman so chooses, she would also be able to seek the service from another general practitioner, or from another provider such as a clinic as part of the integrated health service.

I am pleased to announce that in the middle of November we reached agreement with the Irish Medical Organisation on a contract for the provision of termination of pregnancy services in community settings. I look forward to a high rate of participation among general practitioners, so that women can access the service at the stage in pregnancy when it is safest to do so. I am sure this will come up in the debate so I also point out that I intend to legislate for safe access zones. I have received a Government decision to do so. I refer to them as safe access zones but they are also known as exclusion zones but they are zones where doctors and women can access the health service in a safe manner and not have their access impeded. After engaging with colleagues, I decided to do that in separate, stand alone legislation. It will be health legislation and I will bring it forward and sponsor it in Cabinet and I intend to introduce it in early 2019. It is very important that people can go about their work and access our health services without being obstructed in any way.

I have directed the HSE to make arrangements to put in place a 24-7 telephone service as well. It is really important that women know how to access this service, that they can be signposted as to where to go, especially when conscientious objection is taken into account, and that there is a helpline for people in crisis that can provide non-directive information and give all the legal options available to a woman in this country. Experience from other jurisdictions has shown that this is an important component of service provision to ensure the safety of services for women and to act as an appropriate back up to the delivery of front-line services as well.

There is a comprehensive plan in place for communicating with the general public and with stakeholder groups. This includes www.sexualwellbeing.iewhich will have its information expanded when this law is enacted. A variety of advertising in terms of public health messaging will take place as well. Obviously, the HSE cannot begin that advertising until the law of the land has actually changed as well.

I commend Senator Noone for her work in chairing the committee on the eighth amendment and the committee's ancillary recommendations asked that we look at what we need to do as a country to reduce the number of crisis pregnancies. I heard some crude language in the other House last night about Deputies being in favour of abortion. No woman ever wants to find herself in that situation so there is a duty on us as a society to help reduce the number of crisis pregnancies and the number of women who find themselves in crisis. That can be done through a variety of means and the committee's report is very instructive on that.

It can be done through better sex education in our schools and through better availability of contraception. Senator Norris has a long record in this area but from 2019, I intend to significantly increase access to barrier contraception such as condoms and to bring forward legislative proposals. I have asked the Chief Medical Officer to advise me on that so that we can expand eligibility for free contraception for more women in this country.

I ask the Seanad to work together, as we have for quite a period of time, on this very difficult and sensitive issue which the country has debated at great length, to pass this legislation in advance of Christmas so that this service can come into place at the start of January.

I heard it in the other House and I am sure I will hear it here, so I am conscious of and I respect the fact that, as legislators, we have the right to scrutinise this legislation and there is no disputing that. We also have to balance that right with the responsibility that we have in the knowledge that nine women will be in the airport today leaving our country for Britain to access an abortion and at least three women in our country will illegally use the abortion pill today without any medical supervision.

We have our rights and they have their rights so we need to make sure that we pass this legislation in as swift a manner as possible so that we can move forward to a future where any woman facing a crisis pregnancy can be assured that she will be treated with compassion, in a non-judgmental way and will be able to access all of the care that she and perhaps her family need in this country, supported by those who love them.

I ask for a respectful debate, that we be respectful of each others many different views on this issue and be respectful of the decision made by the people in telling us to pass legislation on this. Our debates earlier this year on the Thirty-sixth Amendment of the Constitution Bill 2018 showed that, by and large, a constructive debate is possible and I hope we can continue to debate this legislation in that vein.