Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank colleagues for the debate, which has been useful. I acknowledge the contribution from Senator Seery Kearney, which made it all very real and human and reminded us why were are here. I also acknowledge Senators Clifford-Lee, Ardagh and O'Loughlin and others who have pushed hard and worked within the Government and the Opposition to advance progress in fertility. Fertility is obviously for both men and women. There has been a concerted effort and I acknowledge all the Senators who have worked so hard, and continue to work so hard, on this issue.I also recognise that we have some fantastic advocates in the Visitors Gallery, including the formidable Cathy Wheatley, whom I did not mention in my opening address. To those watching who may not know, although most certainly do, Cathy Wheatley has been a tireless advocate, along with many others, in pushing this forward and making it happen. I really acknowledge that.

I also acknowledge the many officials across four different Departments who have been involved in this. It is not just long legislation, but incredibly complex legislation that deals with numerous issues related to ethics, jurisdiction, health, parentage and the rights and protection of children. Senator Craughwell has gone now but all of the concerns he raised are comprehensively addressed in the Bill because of the very long time that was spent on it. My own officials in the Department of Health, along with those in the Department of Justice, the Department of children and the Attorney General's office, have spent a vast amount of time on this. This has been a live topic for a long time. A case came before the Supreme Court 11 years ago. We have been working on the Bill for approximately two years. The first two years of this Government's term were obviously heavily dominated by Covid. Between them, the officials have done what would normally take well in excess of six, seven or eight years in just two years. It really has been a very important effort. When those who have been here for a while hear the phrase "interdepartmental working group", we know that such groups are sometimes where good ideas go to die, or where they are sent to exist in limbo for a very long time. However, this group pulled all of the Departments together and it has worked very well.

I also acknowledge my Government colleagues, the Ministers, Deputies McEntee and O'Gorman. The three of us have been working very closely on this. Both Ministers have been very involved, very supportive and very demanding with regard to timelines, which is only right. It has worked well across the three Government parties.

I acknowledge the frustrations that some Senators have raised regarding the time the Seanad has. I accept that. I would prefer a longer period of time. We had three full days on Committee Stage in the Dáil. We also had lengthy debates on Second Stage and Report Stage in the Dáil. I acknowledge the frustration of Senators. This is being done for one reason, which is to make sure the President has the opportunity to sign this Bill before the recess for political considerations we are all aware of. It would simply not be acceptable to tell all of these boys and girls and mums and dads that we are going to roll the dice on whether they get their parental orders. I accept and acknowledge the frustrations of Senators. We have time this week and next week. Indeed, next week's business may well go into the following week. We will be looking at this in the Seanad for several weeks but I acknowledge those frustrations. There is also a three-year review process. While we hope to have got a lot of this right, with something this complex and new - to the best of my knowledge, Ireland is the first country legislating in this way - it is inevitable that some of it will not play out the way that is intended and so we have included a three-year review clause.

Senators O'Loughlin and Sherlock raised a particular issue regarding access to fertility treatments for children when they are going through particular treatments or have particular progressive disorders that mean that, without intervention, they may not be able to have children in the future. Our amendment was based on clinical advice from the HSE. There has been a disagreement. There are significant differences between the position of the particular healthcare clinician who is briefing parents and Members of the Dáil and the Seanad and the collective view of the HSE on a number of issues. They are technical issues that I am not qualified to speak on but I will be taking the clinical advice of the HSE. On this particular issue, we are going to propose a further amendment.

I want to speak directly to the parents Senator Sherlock has referenced. If those parents have been told that it will now be illegal for their children to undergo such treatment, while I hope that whoever told them that was doing so in good faith, he or she was mistaken. I cannot begin to imagine the worry of those parents having received this information from whoever it may have been. I want to be very clear; the clinical advice we got from the HSE was that, rather than saying it is for progressive disorders, we should say it is related to the specific treatment of the child. In other words, the clinicians involved should be given the freedom to say it is appropriate for a given child. The point the HSE was making was that not all progressive disorders cause these issues and that even some of those that do will affect some children and not others. The HSE wanted to make sure that the clinicians had the full power to say that a given child is at risk and to provide this treatment. The case Senator Sherlock described is actually a perfect example of why the HSE wanted this change because, in that case, it is the treatment the girl is going through that is going to cause the issue. The HSE clinicians have therefore said that they want to be able to intervene on the basis of treatment.

As I do not want any parent to have any concern, in the amending legislation - the September Bill - I will include progressive conditions alongside treatment so that there is no question of anyone being left out. It concerns me that parents are being briefed in that way. It is technically correct but I question the ethics of that kind of briefing if that is indeed what happened. It may have been that the parents misinterpreted what was said. I do not know but I want to assure everybody that no child will be excluded. If the treating doctors say that there is a risk to a child for any reason, whether a progressive condition, a non-progressive condition or a treatment he or she has to go through, that child will be covered. That is the policy position.

For obvious reasons, we spent a lot of time talking about surrogacy. I want to come back to assisted human reproduction for a moment. This Bill is really important as it regulates assisted human reproduction for the first time. During this Government's term, we have rolled out a fertility model of care that is really important for intending mums and dads. There are many pieces to it. We talk a lot about IVF but there are three tiers to the model. First of all, GPs are able to engage and extra training and supports are being provided to them. They are able to help a lot of intending parents who are struggling with fertility. We have also set up six fertility clinics around the country. From memory, those clinics can help another 60% of those who are struggling with fertility, at least among the group who can potentially conceive. They provide various treatments. There is then a third level, referral for IVF or IUI.

Senator Sherlock spoke about privately provided IVF. That is a short-term measure to make sure no couple has to wait the X number of years it will take to bring this in but, as was referenced earlier, we are in the middle of setting up the first HSE IVF clinic. It is in Cork and there is a fantastic team down there. We will be transitioning from private provision to public provision but I did not want any couple to be told that this would take years and that they would have to wait so we are doing private provision now.

The Health (Assisted Human Reproduction) Bill accelerates and regulates all of that work. We tend to focus on IVF. This Bill will allow for the State-funded provision of donor-assisted IVF for same-sex female couples. Male-female couples will also be covered by that. We will now be able to proceed with any donor-assisted IVF.The good news is that IVF treatment is only one part of the fertility model of care now in place. There has been a lot of support in the Seanad for the fertility work, be it AHR, IVF, IUI, surrogacy, free contraception and so forth, which I acknowledge. It has been great to have so much consensus in the Dáil and Seanad. I look forward to coming back to the House next week, I hope, if we now pass Second Stage, to continue the discussion and debate.