Lynn Ruane (Independent) | Oireachtas source

I move amendment No. 2:

In page 7, line 27, to delete “physical or mental health” and substitute the following:“a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity”.

I thank the Minister for Health, Deputy Harris, for being in the Seanad today. We are looking forward to a constructive Committee Stage debate and, hopefully, we can progress through the Bill quickly. I tabled this amendment on foot of my own thoughts on how we view a woman's health throughout this Bill and regarding our needs as they apply to the termination of pregnancy. This issue arose on Committee Stage in the Dáil but I did not feel the importance of an amendment like this was properly aired. That is why I have tabled it here again today.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The constitution of the World Health Organization, WHO, states:

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political belief, economic or social condition. The health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States. The achievement of any State in the promotion and protection of health is of value to all.

The constitution of the WHO goes on to state:

The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health. Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people. Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.

What is important for me is that we acknowledge the social and environmental elements of our well-being. Every time we give an account of lives that may be impacted by this legislation, we point to the vulnerability of people within their lives and circumstances. Whether it is poverty, disability or race, time and time again we state we want to protect them. Make health and services accessible to all women. Poverty and poor health cannot be separated and social well-being cannot be omitted from the definition of health. They are all intrinsically linked.

The primary cause of poor health for thousands of people in this country is inseparable from social and economic injustices.During the debates by the Committee on the Eighth Amendment of the Constitution I tabled an amendment to our report that would have allowed social indicators to be included in an assessment of a woman's health. At no point in this legislation do we acknowledge the role of social and financial capital on a person's well-being and-or ability to access healthcare. One way to ensure that we adequately address this matter would be to amend the definition of health in the Bill. The most vulnerable in society are the least likely to receive healthcare and we must take positive steps to address health inequity now. This amendment would amend the definition of health in the Bill from solely meaning physical or mental health to a broader holistic view of health that is used by the World Health Organization. The definition would incorporate the many factors that need to be considered when making an assessment of someone's health and frames it positively around well-being, not just a state of not being sick. My amendment proposes a better definition that I hope the Minister will accept. If we cannot add my definition, I ask that it form part of the discussions when the Bill is reviewed in three years.

There are many elements to acknowledging the role of social circumstances in a person's health outcomes. There is also a relationship between people with lower socio-economic status and the barriers they face in accessing responsive care. These include poor quality of interactions, difficult living conditions and the complexity of the healthcare system. Amending the legislation to include the definition of health approved by the World Health Organization would be a positive step towards acknowledging the health inequity that exists in this country and allow people's circumstances, living conditions, income, poverty, health outcomes and all of that complexity to be part of the framing of this legislation.