Seanad debates

Tuesday, 11 December 2018

Health (Regulation of Termination of Pregnancy) Bill 2018: Committee Stage (Resumed)

 

10:30 am

Photo of Rónán MullenRónán Mullen (Independent) | Oireachtas source

-----and continuity in healthcare data.

Supporters of the Bill will be familiar with the Guttmacher Institute, a think tank that is bankrolled by an organisation called Planned Parenthood, which is the largest and most profitable abortion business in the UK. Planned Parenthood made $100 million last year and its CEO is paid just shy of $1 million. Last year, representatives and affiliates of the Guttmacher Institute were invited to give evidence to the Oireachtas Joint Committee on the Eighth Amendment of the Constitution, as so-called independent and impartial witnesses. Even the institute accepts that it is hard to assess the impact of abortion laws on safety and so forth where data collection is inadequate.

As everybody will accept if he or she is being honest, the ultimate intention at some point in the near future is that abortion services in Ireland will be provided by private clinics operating for profit. That is my belief. It is the logical extension of the reality that the public system will struggle badly to cope with the sudden introduction of this service from next month. Dr. Boylan and others have more or less admitted this. This is another key reason data collection needs to be of a high standard from the outset and the law must be prescriptive with respect to the data that are required to be recorded. We cannot allow for the development of a situation where self-regulation or self-assessment of this kind of information is permitted in the case of private clinics or abortion providers which may have a service level agreement with the State.

We know from analyses conducted elsewhere by groups, including the Guttmacher Institute, that this may lead to circumstances in which reports on the level and type of abortion that result are disparate and inaccurate. The Guttmacher Institute has stressed the need to obtain baseline and follow-up estimates of a range of indicators that help to assess the impact of an abortion law. These vary from abortion incidents, related morbidity and its severity, mortality due to unsafe procedures, the circumstances under which women terminate pregnancies, and the characteristics of women using legal services. These are exactly the kinds of information that this amendment requires. If that is good enough for the Guttmacher Institute, whose representatives were invited to Leinster House last year, why is it not good enough for the supporters of this Bill?

The amendment also represents best international practice beyond the UK. Since 1969, the Centers for Disease Control and Prevention have published annual reports on the incidence of abortion in the United States. We know that 46 US states require hospitals, facilities and physicians providing abortions to submit regular and confidential reports to the state. I repeat that 46 states in the US require the collection of similar data. The requirement extends far beyond the deep south, as it was referred to pejoratively in the other House. We must have robust, statutorily protected data measures. If, at some future point, it can be proven that these measures are onerous or overly prescriptive, the legislation can be amended to reflect that position. We cannot simply airbrush the difficult or challenging statistics that confront us with the practical day-to-day reality of what abortion involves. Those who support the Bill do not want women to be shamed or abortions to be hidden away or covered up. In that case, why do they not want the fullest information to be gathered on the practice in Ireland and presented in a completely anonymised fashion? By setting the recording requirements at an absolute minimum, that is exactly what will be done. What we will also do is send a message that the manner and circumstances in which the lives of unborn children end is of real consequence and deserve to be of some statistical consequence at least.

In an attempt to deflect from this amendment, or a similar amendment, and in search of reasons to oppose it, the Opposition focused on the reference to ethnicity, one of the issues that would be required to be reported. Again, ethnicity is included because it is the standard followed by the national health service, NHS, in the UK, which adapted it from the set of 16 ethnic categories developed for the population census by the UK Office for National Statistics, in conjunction with the UK Equality and Human Rights Commission. From that point on, it has been a required part of the data recording with respect to abortions carried out in England and Wales.

Reference to ethnicity was also considered important because the UK Equality and Human Rights Commission felt it was appropriate that those people accessing abortion should have the right to self-identify with a particular ethnic group. Opponents of this amendment surely cannot claim that the UK Equality and Human Rights Commission is subtly encouraging ethnic profiling or racism. Such information was considered vital to addressing inequalities and improvements in public health in commissioning functions. It has long been acknowledged that in Ireland those from certain ethnic backgrounds and members of the Traveller community, for example, have poorer health outcomes in society as a whole. Surely we should gather these data on abortion. Otherwise we will have no way of knowing if there are disparities of care within and between different ethnic groups, we will have no knowledge of facts that will be relevant to providing for the welfare of citizens, and we will have no access to knowledge that could identify problems in particular subgroups in society and so on.

It would be a perverse irony if this Bill was about importing everything from the UK except the requirement to keep statistics. Good policy and health planning systems depend on people being able to know what is happening. Medical and statistical experts crunch information and policy decisions flow from the good and accurate collation of information.

The amendment extends the requirement of information to be notified. It does not in any way interfere with a service that is being legalised. Instead, it would provide important information on which future policy decisions could be made.Surely it is not the Government's intention to keep people in the dark on how abortion services operate in Ireland, or perhaps it is. I hope not and that the amendment will be accepted.

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