Sharon Keogan (Independent) | Oireachtas source

I thank the Minister of State for being here today. I would have like to have seen the Minister, Deputy Donnelly, here to discuss this very important matter and answer the questions I put down.

I raised the issue in March in this House about the state of telemedicine provisions for abortion in Ireland and the risk surrounding its operation. Telemedicine abortion was introduced in March 2020 as a temporary Covid-19 emergency measure. While virtually all emergency measures have been pulled back, telemedicine abortion remains in place, with no signs of the Minister for Health seriously committing to pulling it back. This is regrettable as there are serious acknowledged risks associated with telemedicine that must urgently be addressed. I raised some of these in my contribution on 1 March.

I am aware the Minister for Health ordered a review of the revised model of care for termination of pregnancy in quarter 4 of 2021, which took a largely positive view of telemedicine abortion and valued its convenience for women having an abortion.However, I must stress that there are considerations more important than convenience and ease of access, such as the physical and mental safety of women and girls in this country. As such, how can the Government stand over the acknowledgement from the HSE, in reply to a parliamentary question, that meeting the woman in person increases the likelihood of the provider identifying any coercion or domestic abuse, yet it continues to operate a policy that facilitates the abuse of vulnerable women? I understand the Minister is considering a blended approach for telemedicine, which would allow operational in-person consultations. Under this proposal, the most vulnerable women would inevitably fall through the cracks. Women suffering from domestic abuse, coercion and those trapped in human trafficking would not benefit from a blended approach. It cannot be seriously argued that abusers would permit their victims to opt for an in-person consultation over a remote, impersonal phone call. Moreover, a phone call is an inadequate substitute for an in-person consultation and examination. There is no way to guarantee a woman's privacy in a phone call scenario.

Recent findings from a BBC Four poll reveal that 15% of women between the ages of 18 and 44 in the UK have experienced pressure to go through with an abortion they did not want to have. Allowing telemedicine at-home abortions to continue without the requirement of a face-to-face consultation for such an important decision leaves open an extremely likely probability of women being coerced into having abortions by the malign influence of a partner or third party. How does the Minister for Health intend to address this alarming probability? Clearly his "whatever you are having yourself" attitude to a blended approach fails to adequately redress this alarming issue.

I fail to see how telemedicine abortion, including even a blended approach, could accurately verify a woman's gestational stage. If a pregnant woman were beyond nine weeks and six days and had inaccurately self-assessed her last menstrual period, she could receive and self-administer abortion pills, which could impose immense health risks. Moreover, there is no way to guarantee a woman would take the pills at home as soon as they are received. Situations like these could lead to complications like haemorrhaging, infection, incomplete abortions and ongoing pregnancy. I cannot see how telemedicine, either in full or in a blended approach, would adequately address these risks. I am calling on the Minister for Health to acknowledge the realities of the situation. People's lives are in danger here. Women in abusive situations are being utterly failed by telemedicine abortion. The Minister cannot continue to live in a bubble where the only issues around abortion relate to how easy and convenient it is to have one. The argument that this measure is a temporary Covid response is increasingly losing its relevance. The Minister needs to address these very serious matters and ensure a full return to mandatory in-person consultations for women seeking abortions.